Things aren’t always what they seem with life, love, and food allergies.
Food allergies aren’t as clear cut as, say, explosive diarrhea. Very few people think that they have explosive diarrhea when they don’t. The reverse is true as well. You tend to know when you have explosive diarrhea, so being oblivious to the “explosions” may be a bit unusual. By contrast, as a study just published in JAMA Network Open showed, food allergies remain very misunderstood and potentially “misunderestimated” and “misoverestimated” at the same time.
For the study, a team from Northwestern University (Ruchi S. Gupta, MD, MPH, Bridget M. Smith, PhD, Jialing Jiang, BA, Jesse A. Blumenstock, BS, Matthew M. Davis, MD, MAPP, Robert P. Schleimer, PhD), the University of Southern California (Christopher M. Warren, BA), and Stanford University (Kari C. Nadeau, MD, PhD) analyzed responses from 40,443 adults in the U.S. to Internet and telephone surveys conducted from October 9, 2015, to September 18, 2016. Survey questions asked respondents about what food allergies they had, their symptoms, and what testing and medical attention they had received. The team then classified the identified food allergies as “convincing” or “non-convincing”, based on the responses.
They found that 10.8% of the respondents currently had one or more “convincing” food allergies, well below the 19.0% total who reported having food allergies whether they were “convincing” or “non-convincing.” In other words, only about half of the people claiming food allergies seemed to provide enough backing evidence. Of course, the researchers did not follow around and test each of the 40,443 adults, which would have been really, really time consuming. Therefore, they had to base their assessments purely on the survey responses.
Do these results convince you that many “food allergies” may not be real food allergies? Before you become a doubting Thomas, or Tammie or Tilapia or whatever your name may be, about all food allergies, look at the flip side of this situation. The study also found that many people with real food allergies hadn’t gotten official physician diagnoses. Less than half (47.5%) of the convincing crowd had actually been diagnosed by physicians as having food allergies. This makes you wonder how many people have food allergies without knowing it. After all, unlike explosive diarrhea, you may not realize that you have a food allergy until you get a more severe obvious reaction. Maybe that funny feeling that you thought were nerves is actually a food allergy. Or how about those unexplained gastrointestinal symptoms for which you’ve been chugging antacids? That difficulty breathing that you thought was love? Perhaps, it is just all that peanut butter that he or she smears on his or her face. Then, there are those weird skin rashes that you simply tried to cover up with make up or clothing.
Thus, there seems to be major mismatches regarding food allergies in general. It may be that not enough people are seeing their doctors and using real medical science to address potential allergies. There are a lot of food allergy claims, theories, and treatments floating around the Internet. A Google search reveals a number of chiropractic clinics offering advice and services regarding food allergies A research letter published in BMC Allergy, Asthma & Clinical Immunology by Timothy Caulfield, LLM, LLB, and Christen Rachul, PhD, from the University of Alberta found that 42-45% of the websites for naturopathic clinics in Alberta and British Columbia, Canada, offered “allergy testing” and 47%-60% offered “allergy treatments.” The question is how many of these claims and treatments are actually based on scientific evidence.
At the same time, there may not be enough real medical doctors addressing or considering food allergies. When is the last time that your doctor discussed food allergies in depth with you in between staring at the computer screen and trying to squeeze everything else into a 15-minute window? Plus, some people may not even have access to or be able to afford a doctor who can adequately cover food allergies. In fact, the study found that those who had annual incomes of less than $25,000 were significantly less likely to have a physician-diagnosed food allergy.
Moreover, much remains unknown about food allergies. They can be very serious and even life-threatening, as the study revealed that a little over half (51.1%) of those with “convincing food allergies” had experienced at least one severe allergic reaction. They can really hinder and alter your daily life. In the study, the 5 most common culprits for “convincing” food allergies were shellfish (reported by 2.9% of the adults), peanuts (1.8%), milk (1.9%), tree nuts (1.2%), and fin fish (0.9%). You may think that “not being shellfish” may be easy, but avoiding peanuts, milk, and tree nuts can be quite a challenge. Think about how many packages have the warning “made in a facility where there were nuts.”
Additionally, many aspects of food allergies need better explanations. For example, why did the study find racial and ethnic minorities to be more likely to have “convincing” food allergies, with Asian-Americans 28% more likely and Black Americans and Hispanic Americans both 20% more likely than White Americans? Then, there were the gender differences, with women being 67% more likely than men.
With our food supply becoming more complicated and more chemicals and other additives in our food and our environment in general, expect the food allergy issue to just grow more and more complex. As a National Academies of Medicine report indicated, evidence suggests that food allergies have been on the rise for the past two decades, but experts still don’t know why. Some of it may be growing awareness of food allergies. But that probably doesn’t explain all of it. More studies and science are needed. And if you have unexplained symptoms or are concerned about having a food allergy, see a doctor to get tested for allergies, a real doctor and not someone who is allergic to science.