Food Allergy Quick Guide

FACTs & Statistics (from FAAN)

  • Food allergy is a growing public health concern.
  • As many as 15 million people have food allergies.
    • An estimated 9 million, or 4%, of adults have food allergies.
    • Nearly 6 million or 8% of children have food allergies with young children affected most.
  • Boys appear to develop food allergies more than girls.
  • Food allergies may be a trigger for or associated with other allergic conditions, such as atopic dermatitis and eosinophilic gastrointestinal diseases.
  • Although childhood allergies to milk, egg, wheat and soy generally resolve in childhood, they appear to be resolving more slowly than in previous decades, with many children still allergic beyond age 5 years. Allergies to peanuts, tree nuts, fish, or shellfish are generally lifelong allergies. 

Food Allergies are on the Rise

  • The prevalence of food allergies and associated anaphylaxis appears to be on the rise.
    • According to a study released in 2008 by the Centers for Disease Control and Prevention about an 18% increase in food allergy was seen between 1997 and 2007.
    • The prevalence of peanut allergy among children appears to have tripled between 1997 and 2008.

Top Food Allergens

  • Eight foods account for 90% of all food-allergic reactions: milk, eggs, peanuts, tree nuts (e.g., walnuts, almonds, cashews, pistachios, pecans), wheat, soy, fish, and shellfish. Estimated prevalence, some based on self-report, among the U.S. population:
    • Peanut: 0.6-1.3%
    • Tree nuts: 0.4-0.6%
    • Fish: 0.4%
    • Crustacean shellfish (crab, crayfish, lobster, shrimp): 1.2%
    • All seafood: 0.6% in children and 2.8% in adults
    • Milk and egg: based on data within and obtained outside the United States, this rate is likely to be 1-2% for young children and 0.2-0.4% in the general population.

Food Allergy Reactions and Anaphylaxis

  • The CDC reported that food allergies result in more than 300,000 ambulatory-care visits a year among children under the age of 18.
    • From 2004 to 2006, there were approximately 9,500 hospital discharges per year with a diagnosis related to food allergy among children under age 18 years.
  • Even small amounts of a food allergen can cause a reaction.
  • Most allergic reactions to foods occurred to foods that were thought to be safe. Allergic reactions can be attributed to a form of mislabeling or cross-contact during food preparation.
  • Food allergy is the leading cause of anaphylaxis outside the hospital setting.
    • Every 3 minutes a food allergy reaction sends someone to the emergency department– that is about 200,000 emergency department visits per year, and every 6 minutes the reaction is one of anaphylaxis.
  • Teenagers and young adults with food allergies are at the highest risk of fatal food-induced anaphylaxis.
  • Symptoms of anaphylaxis may recur after initially subsisting and experts recommend an observation period of about 4 hours to monitor that the reaction has been resolved.
  • Individuals with food allergies who also have asthma may be at increased risk for severe/fatal food allergy reactions.
  • Children with food allergy are 2-4 times more likely to have other related conditions such as asthma and other allergies, compared with children without food allergies.
  • It is possible to have anaphylaxis without any skin symptoms (no rash, hives).
  • Failure to promptly (i.e., within minutes) treat food anaphylaxis with epinephrine is a risk factor for fatalities.

Food Allergy Treatment

  • There is no cure for food allergies. Strict avoidance of food allergens and early recognition and management of allergic reactions to food are important measures to prevent serious health consequences.
  • Prompt administration (e.g., within minutes of symptoms of anaphylaxis) of epinephrine (adrenaline) is crucial to successfully treating anaphylactic reactions. Epinephrine is available by prescription in a self-injectable device (EpiPen® or Twinject® or Adrenaclick®, depending on local availability).
  • There are a number of promising food allergy therapies under study, although none are yet proven for general use.

Food Allergies in School

  • Approximately 20-25% of epinephrine administrations in schools involve individuals whose allergy was unknown at the time of the reaction.
  • More than 15% of school aged children with food allergies have had a reaction in school. Food allergy reactions happen in multiple locations throughout the school, and are not limited to the cafeteria. Care must be exercised regarding bake sales, classroom parties, and snacks outside of the cafeteria.