Managing Food Allergies: 5 Surprising New Approaches to Prevention, Diagnosis and Treatment
Nearly 15 million Americans – 8 percent of them kids – have food allergies. What you need to know. (Photo: Getty Images)
Food allergies now affect nearly 15 million Americans, including 8 percent of kids, according to the Centers for Disease Control and Prevention, but those numbers are continuing to rise. Researchers have been racing to understand why there’s been a 20 percent jump in children’s food allergies over the past decade in order to help reverse the trend. One thing they’ve determined: Having at-risk children avoid allergenic foods such as eggs, nuts and fish until preschool – which was common practice a decade ago – likely has contributed to the increase in food allergies.
These recent research findings will probably lead to new feeding advice for babies who are prone to food allergies, experts say.
Scientists are also experimenting with ways to treat food allergies by desensitizing the immune system to minute amounts of the allergen – similar to the allergy shots given to treat seasonal allergies for decades.
If you’re dealing with food allergies yourself or raising children with them, here are five things you need to know when it comes to treatment and prevention.
1. Babies with early signs of food allergies don’t necessarily need to avoid allergenic foods. That’s according to a recent landmark clinical trial published in the New England Journal of Medicine. It found that introducing peanut-containing foods into the diets of babies under age 1 who are prone to allergies is a safe practice and drastically reduces their risk of developing peanut allergies later on. The trial included babies who already had mild peanut allergies, based on skin prick tests, and those who had other food allergies or severe eczema, a skin condition that’s often related to allergies to foods and other substances.
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“Current guidelines from the American Academy of Pediatrics don’t restrict when certain types of foods are introduced even in those with food allergies in the family,” says Scott Sicherer, a professor of pediatrics at the Jaffe Food Allergy Institute at Mount Sinai in New York and author of “Food Allergies: A Complete Guide to Eating When Your Life Depends on It.”
2. Consult with an allergy specialist for diet advice if you suspect your child has food allergies.While the peanut allergy clinical trial provides good reasons for feeding allergy-prone babies a wide array of foods, parents of such babies should still consult with an allergist specialist for advice, Sicherer recommends. Babies in the study with mild peanut allergies and other food allergies were closely monitored for allergic reactions by the researchers, and babies in the real world should be too.
Typically, allergists would conduct a food challenge, giving increasing amounts of a particular food to a child who tests positive for an allergy to see when symptoms develop. But such tests aren’t usually conducted in children under age 2 because it’s difficult for babies to communicate their symptoms, says Wayne Shreffler, chief of pediatric allergy and immunology and director of the Food Allergy Center at Massachusetts General Hospital for Children in Boston.
Parents also need to be aware that the peanut allergy trial excluded babies with severe peanut allergies based on their skin tests.
3. Food allergy tests can be unreliable. The American Academy of Pediatrics has advised its pediatrician members to avoid overtesting for food allergies because tests can often indicate an allergy where none actually exists. Sicherer points to studies that have shown that 9 percent of kids will test positive for peanut allergies but only about 1 percent actually develop full-blown allergic reactions when they eat peanuts.
Pediatric allergists should be selective about food allergy tests they order for this reason, according to the AAP. If your child develops hives after eating a peanut butter cookie, testing for peanut allergies might be warranted but not for wheat allergy if that child has already eaten wheat without any problems.
4. Consider asking for newer, more specific food allergy tests. A growing number of allergists are using more accurate allergy tests that look for immune reactions to several proteins specific to particular foods. These component tests will differentiate, for example, between those with pollen allergies and those with peanut allergies – which traditional allergy tests did not because they only tested for allergic reactions to proteins found in both. “These tests are better at defining whether a person has a specific food allergy,” says Sicherer. “They’re not perfect, but they’re a step up.”
Related: Why You Need To Stop Lying About Having Food Allergies
Many allergists are holding off on using these tests because they still consider them to be experimental and often are not covered by insurance.
5. Hold off on food allergy treatments or “cures,” unless part of a clinical trial. Over the past several years, research conducted by Shreffler and others has demonstrated that some older children and young adults can be “cured” of their peanut, milk or egg allergies, at least temporarily, through a complex and somewhat risky process called desensitization; this uses increasing doses of food or an experimental skin patch swabbed with the food allergen to teach the immune system to recognize the allergen as friend, not foe.
While some food allergists are trying the procedure called immunotherapy in their own practices, both Sicherer and Shreffler caution against doing it outside of a clinical trial because of risks of severe allergic reactions. They’re both conducting new studies to see whether adding certain immune system modulating medications or Chinese herbal remedies to the therapy can help improve long-term success rates and reduce the risk of allergic reactions.
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By Deborah Kotz
