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Food for Thought

Millions of Americans are allergic to certain foods. Here's what you need to know.

If you worry that you, or your child, could be allergic to a certain food, there are a few things you need to know right away.

  1. The only sure way to prevent a reaction to a food you’re allergic to— whether it’s milk, peanuts or pistachios—is to ban that food completely from your diet.
  2. Mild reaction today may be followed by a severe reaction tomorrow. You never know for sure what to expect.
  3. Chances are you or your child is not allergic at all. Or, that the things you’re doing to prevent a reaction are completely missing the mark.

These are all terrific reasons to ease your mind by going to see an allergy specialist.

“The main point of coming to us is to define if there is an honest food allergy, and if so, to what food or foods,” says Scott Commins, M.D., Ph.D., an allergist at UVA Health System.

From there, Commins adds, you can learn the most sensible ways to rearrange your life to avoid the offending food.

Misconceptions Prevail

About 12 million Americans have food allergies, including anywhere from 4 percent to 8 percent of children, according to the Centers for Disease Control and Prevention.

Symptoms can be as mild as a faint tingling sensation around the mouth, or as severe as a multi-systemic reaction known as anaphylaxis that can leave a person struggling to breathe.

The symptoms are not one size fits all. Some people can develop an itchy rash after eating or even touching peanut butter; for others, all it takes is a whiff to make their throat swell up. Still others react strongly to drinking milk, for example, but have no reaction from munching on a cookie baked with milk.

It’s no surprise, then, that fears and misconceptions about food allergies prevail. And yes, it’s important to take any symptoms seriously. But you shouldn’t let anxiety rule your life. To ease your mind about food allergies, learn how to gain control over them for you and your child.

Will My Child Outgrow Allergies?

The good news is that young children rarely have life-threatening episodes, according to UVA pediatric allergist Amy Stallings, M.D. They also tend to outgrow allergies to certain foods before reaching adulthood.

The most common allergies among both children and adults are to milk, egg, soy, peanut, wheat, fish and shellfish.

“Almost all children outgrow milk, egg and soy allergies, while allergies to peanuts, tree nuts, fish and shellfish tend to persist. Only one in five outgrow a peanut allergy,” notes Stallings.
Often, the first sign of a food allergy in a child is a skin reaction, she explains. There might be an itchy rash, hives or swelling of the lips, tongue or throat; or less commonly, vomiting or diarrhea.

“We often have to counsel patients on what isn’t a food allergy,” she adds. For example, lactose intolerance can cause gastrointestinal problems but it doesn’t involve the immune system, usually doesn’t cause skin reactions, and isn’t life threatening.

“One reason parents should come in and see an allergist is they don’t want to start avoiding things in their diet that they don’t necessarily need to. The testing can tell us whether it’s peanut, or egg or milk. Our goal is to have the least restricted diet possible, especially in childhood.”

Risk Rises with Age

Puberty is when many young people start going off with friends and making their own choices about what they eat, so this is an important time for a doctor to go over their allergies with them and make sure they know what to do.

Importantly, when a food allergy persists into the teens and beyond, there’s an increased chance of a serious reaction.

Compared to children, adults tend to experience less vomiting, but seem to have more hives and anaphylaxis from food allergies. Just in case, patients are advised to keep on hand the self-injectable drug epinephrine, which can help control a severe reaction.

Easing Anxiety

“It’s important for a patient to see a specialist who is up to date in ongoing research, because what we know about food allergy is changing all the time,” says Stallings.

“At UVA, we have a lot of experience in a wide range of food allergies,” she says. “If there’s any question whether you or your child has a food allergy, you should definitely see a specialist to have the testing done.

“Education about the cause, and learning how to avoid these foods, is the key to reducing the scare.”

Your doctor may also ask you to keep a one- to two-week record of everything you or your child eats, along with any signs or symptoms.

This food diary works, insists UVA pediatric allergist Amy Stallings, MD. “If you are allergic, you can plan to see immediate improvement once the food is identified and you take action to avoid it.”

Is It a True Food Allergy?

The best way to find out is through a diagnostic test done by an allergy specialist. We offer the full array of tests including:

A skin-scratch test, to reveal which food, if any, you or your child may be allergic to.
A blood test, which may be performed if the skin-scratch test does not provide clear results.
Food challenge test, which introduces patients to specific foods in the safety of the clinical setting to establish if a suspected allergy is indeed a true one.