| by Dr. Joon H. Park |
In recent years, we have observed an increased prevalence of food allergy. Based on recent reviews obtained from various published studies, food allergy is estimated to affect more than 1% to 2% and less than 10% of the population, and this reflects a growing public awareness and concern for food allergy. Some of the more common food allergens responsible for a relatively high proportion of food allergy are cow’s milk, hen’s egg, soy, wheat, peanut, tree nuts, fish, and shellfish. As these foods are all very commonly found and contained in our diet, there exists a significant challenge for food allergic individuals as they try to maintain an appropriate diet free of relevant food allergens.
Another challenge that is frequently encountered in dealing with food allergy is the issue of food sensitivity. Food sensitivity merely indicates the presence of IgE antibodies (“allergic antibody”) to a food, often in the absence of adverse symptoms or “reactions.” When patients with food sensitivity demonstrate an adverse response upon ingestion of a food to which they are sensitized, they can be more accurately categorized as having food allergy. Given an increased awareness of food allergy in recent years, patients undergo food allergy testing more commonly now than ever before for various medical reasons, and it is not uncommon that food sensitivity is discovered in asymptomatic patients. An important question then arises: should they start avoiding certain foods based on positive test results alone? What are the risks involved in continuing to ingest those foods in question? Should they carry epinephrine? What should they do when they dine out or travel internationally? For children, how should this be addressed in their school? The list goes on and on.
There are many intricacies involved in the accurate diagnosis and management of food allergy, and it is also important to distinguish food allergy from food sensitivity. Diagnosis of food allergy affects patients’ lives in myriad ways, from altering their dietary habits to being prepared to appropriately deal with allergic reactions to educating family members, to name a few. In children especially, food allergy can also have negative psychosocial effects, including bullying. On the other hand, a subset of patients with food sensitivity can still tolerate the food in question; however, this determination should be made only after a proper evaluation and consultation with an expert in food allergy. This is an important decision to make, however, as it can have a tremendous implication on a patient’s quality of life, including avoiding unnecessary dietary elimination. With growing public awareness for food allergy, it is likely that we will discover more patients who will be left with positive test results for foods. The answer is not always an avoidance, especially if it represents a mere sensitization without clinically significant food allergy. Board-certified allergists can help these patients find the right answer so that they can receive proper treatment plans tailored to their specific clinical scenario. As we further our knowledge about food allergy with ongoing, active research studies, now is the time to face the challenges of food allergy with more confidence!
Dr. Joon H. Park is a board-certified allergist/immunologist at ENTA and Allergy Associates in Tarrytown who has an extensive experience in diagnosing and treating food allergy. During his fellowship training at Mount Sinai Medical Center, he has also participated in food allergy research under the mentorship of world-renowned food allergists.