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Below are answers to some frequently asked questions about food allergy.  This FAQ has been developed by The National Peanut Board (NPB) with guidance from its Scientific Advisory Council, which includes some of the world’s leading food allergy researchers as well as with input from the Food Allergy & Anaphylaxis Network (FAAN).

What is a food allergy?
Food allergy is a specific reaction of the body’s immune system to a food or food proteins.

What are the most common food allergens?
In Western Hemisphere countries, experts attribute 90 percent of all food-allergic reactions to eight foods: cow’s milk, egg, soy, wheat, peanut, tree nut (e.g., almonds, walnuts, and pecans), fish and crustacean shellfish. Sesame seed also seems to be an increasingly important cause of food allergy in some parts of the world.  Experts do not know why some foods cause more allergy than others. Very frequently, patients with pollen allergies have mild cross-reactions to fresh fruits, such as apples, peaches, cherries and to raw vegetables, such as carrots and celery.

How many people have a food allergy?
Studies show that a true food allergy affects about 4 percent of the U.S. adult population and about 4 to 6 percent of children. Many young children outgrow their food allergies overtime. Reduced levels of serum IgE over time may indicate reduced levels of reaction or an outgrowing of peanut allergy.  Experts do not k now why the prevalence of food allergy differs in different parts of the world.  Additionally, experts do not know why peanut and some other food allergies are on the rise. 

What are common allergic reactions to food?
The most common manifestations of allergic reactions to foods may involve the skin (causing rash, hives, itching or swelling), respiratory tract (wheezing, cough, chest tightness, shortness of breath, sneezing, runny nose), cardiovascular system (dizziness, lightheadedness, loss of consciousness, chest pain) and gastro-intestinal tract (including stomach cramps, nausea, vomiting, and diarrhea).  Experts do not know why some people have mild reactions and others have life threatening reactions.

What are the most serious allergic reactions to food?
The most serious allergic reactions to food are those that involve the respiratory or cardiovascular systems.

What is Anaphylaxis?
Anaphylaxis is the systemic manifestation of allergy – when an allergic reaction affects the body as a whole and not just locally.  In other words, some patients have hives just in the area of contact with the food allergen, such as the lips and mouth, while other patients have hives over their entire body, regardless of the route of exposure.  It is this latter systemic total body reaction that is termed anaphylaxis.  The severity of anaphylaxis can be graded mild, moderate, or severe. Anaphylaxis is a potentially life threatening allergic reaction.

Is there a way to prevent a food allergy reaction?  
Currently, the only way to prevent a food allergy reaction is by strict avoidance of the food.

Who is at risk for developing severe food allergy reactions?
Individuals with peanut or tree nut allergy and those with asthma appear to be at highest risk for severe food allergy reactions.

How do I know if I have a food allergy?
Experts recommend individuals visiting a board certified allergist for proper diagnosis of food allergy, and that at all times they carry a written food allergy management plan from their doctor and any prescribed medications for handling an allergic reaction. For information about finding an allergist in your area, visit the American Academy of Allergy, Asthma and Immunology (AAAAI) website at www.aaaai.org or the American College of Asthma, Allergy and Immunology website at www.acaai.org.  It is not correct that it is easy to tell if someone has a food allergy just by looking at them.

What may cause other reactions to food?
Other reactions to foods may be due to food tolerance (e.g., lactose intolerance) rather than food allergy. These reactions do not involve the immune system.

Can a tiny amount of food cause a severe allergic reaction? 
 Tiny amounts of a food can cause severe allergic reactions.  Additionally, experts have not yet defined the smallest amount of food allergen that can be safely consumed by an allergic individual, and it is not correct that just “one little bite” of an allergy-causing food will not hurt you. 

Do you have to eat the food to have an allergic reaction? 
Some people do not have to eat the food to have an allergic reaction; breathing or touching the food to which they are allergic can cause a reaction.

Is it true that if you administer a shot of epinephrine during a food allergic reaction, you can forgo further treatment?
It is not correct that if you administer a shot of epinephrine during a food allergic reaction, you can forgo further treatment.  It is also not correct that you should try to “tough out” a reaction.

Who is at risk for developing a food allergy?
Anyone can acquire a food allergy at any time in life.  If there is a family history of any allergy, asthma, or atopic dermatitis a child is more likely to develop food allergy. If an immediate family member has a peanut allergy, the child is at an increased risk for developing peanut allergy.  However, experts do not know why certain individuals develop food allergies while others do not.

Can you outgrow a food allergy?
Eighty-five percent of children diagnosed with milk, soy, wheat, and/or egg allergy lose their sensitivity to the food between three to five years of age.  Up to 20 percent of children will outgrow their peanut allergy (particularly those who had mild reactions early in life); however, experts do not know why certain individuals outgrow food allergies while others do not. 

Is there a link between consuming certain allergenic foods during pregnancy and the onset of food allergy in the child?
Experts do not know whether there is a link between consumption of certain allergenic foods during pregnancy and the onset of food allergy in the child.  Substances from the foods such as peanut are passed from the breastfeeding mother’s diet into her breast milk; the effect on the breastfeeding infant is still unknown. 

How many people have a peanut allergy?
Recent population based studies in the United States, UK, and Canada estimate that approximately 0.6 – 1.5% of the U.S. population has a peanut allergy.

Why are peanut allergies on the rise?
The rise in peanut allergies most likely parallels the rise in all allergic diseases in children.  There are numerous theories to explain the increase; however, the theory that seems to have the most support from laboratory and clinical studies is the “Hygiene Hypothesis.” 

What is the Hygiene Hypothesis?
The Hygiene Hypothesis states that the more hygienic a society is, the more allergic they are as well.  Studies suggest that the immune system in early infancy is primed to recognize and fight infections.  In the absence of infections, the immune system begins to target innocuous items in the child’s diet and environment.

Do 150 people die of peanut allergic reactions ever year?
It is not true that 150 people die of peanut allergic reactions every year.  Approximately, 150 people die of all food allergic reactions every year.

Does peanut oil elicit an allergic reaction?
If refined peanut oil is used properly and is not reused after cooking peanuts, it seems to be safe for most people with peanut allergy; crude oil, however, represents a risk. Cold pressed, expelled or extruded peanut oil is NOT safe for peanut allergic individuals.

Where can I learn more about food allergy?
Education is the key to preventing and managing food allergies. For more information visit the Food Allergy & Anaphylaxis Network (FAAN) Website at www.foodallergy.org.

Still Have Questions?
If you have specific questions regarding food allergy or would like us to facilitate a meeting with one of the Scientific Advisory Council Members, please contact the National Peanut Board at 678-424-5750.

References
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