These common myths about food allergies can have serious consequences
Today, it’s common to see menus with labels indicating which dishes contain nuts, milk, eggs, or other common food allergens. Many grocery stores have a wide range of allergen-free food options.
While there is increased awareness about food allergies, there are also a number of harmful myths that plague the allergy community. Here are some of the biggest misconceptions about food allergies, according to experts.
A food intolerance or allergy is the same as a food allergy
“A food allergy is a reaction of our immune system, which produces antibodies that identify foods as harmful, and results in the release of other chemicals that cause an allergic reaction,” Dr. Adela Taylor, an allergist and immunologist at the Mayo Clinic, tells TODAY. .com. Taylor adds that food sensitivities or intolerances do not involve the immune system and are not life threatening.
Symptoms of an allergic reaction often include hives, swelling of the face or lips, wheezing, throat tightness or vomiting, Dr. Scott Sicherer, pediatric allergist, immunologist, and professor at the Icahn School of Medicine at Mount Sinai, tells the website. TODAY.com. He adds that a life-threatening allergic reaction (anaphylaxis) can cause a drop in blood pressure or a loss of consciousness. “It all usually happens very quickly,” says Sicherer—it can take just minutes.
“Usually intolerance has to do with metabolism,” says Sicherer. A person often lacks a chemical or enzyme that is necessary to digest a particular food, according to the Mayo Clinic. Lactose intolerance, for example, occurs when someone has problems digesting the sugar in milk (lactose), which can lead to gas, bloating, upset stomach, or diarrhea. Food intolerance symptoms can begin hours or even days after eating.
Food allergy tests are always accurate
“One of the misconceptions is that allergy testing by itself tells people whether or not they have an allergy,” says Sicherer, adding that diagnosing a food allergy involves a full evaluation by an allergist.
There are two classic tests for food allergy. During a skin test, a drop of food extract is placed on the skin and scratched off. Then the doctor will look for signs of a reaction, usually a red bump. The blood test measures the amount of a protein the immune system makes in response to an allergen, called IgE antibodies.
But these tests can yield false positives because “it’s not a yes-or-no test, it’s more of a statistical test,” says Sicherer. “The larger the bump on your arm or the bigger your blood test results, the more likely you are to have an allergy.” He adds that a key part of diagnosing a food allergy is looking at the patient’s history and past reactions.
Doctors can also diagnose food allergy using an “oral food intake challenge,” in which they give patients small amounts of food under medical supervision and measure their reaction, says Taylor.
Experts caution against home allergy tests or self-diagnosis. “If you think you may be allergic to something, you should see an allergist,” says Sicherer.
Exposure to air can cause a severe allergic reaction
Another legend? “Just smelling food is very dangerous or there is a real risk of exposure to the air,” Dr. Robert Wood, director of pediatric allergy and immunology at Johns Hopkins Children’s Center, tells TODAY.com.
“It’s a myth that affects people’s lives,” says Wood. “I see patients who would never get on a plane because they were afraid there might be peanuts on the plane.”
According to Taylor, studies have shown that the amount of peanut allergen particles trapped in an airplane filter is too small to cause an allergic reaction.
Wood says it’s possible for allergens to be carried into the air — for example, if someone is in the immediate vicinity of food that’s being cooked, especially at a high temperature. “If a child with a severe egg allergy is in their mother’s arms while she is frying an egg, that child may develop a reaction,” says Wood. But these airborne reactions are rare and usually not severe.
“In the places where airborne reactions are feared the most, airplanes and school cafeterias, there is a lot of anxiety without any real justification,” says Wood.
Some people develop a reaction when a food they’re allergic to touches their skin, but it’s usually just a rash or hives. “It won’t cause a life-threatening allergic reaction. You have to swallow it,” Taylor says.
Each reaction will be worse than the last
“Allergic reactions to food are very unpredictable, and there are a lot of variables that go into how severe a food reaction is,” says Taylor. Symptoms can vary each time.
There is no general rule or pattern of severity that allergic reactions follow, says Sicherer, adding, “You shouldn’t assume things, because if you’re wrong, it can be consequential.”
People with food allergies should always be prepared for a severe reaction, Taylor says, which might include carrying antihistamines or epinephrine, which is the first line of treatment for anaphylaxis.
Peanuts are the most dangerous type of allergy
“There is no single food that is more dangerous in terms of a food allergy,” says Taylor. Although peanuts are one of the top foods that cause the most food allergies, Taylor says, any food can cause an allergic reaction, and any reaction can be severe.
“It’s very common for people, whether it’s a teacher or a restaurant worker, to think that a peanut allergy should be taken seriously, but a milk allergy doesn’t have serious risks,” says Wood.
He adds that one possible reason is that there is more misdiagnosis of milk allergy in people with lactose intolerance, which does not lead to serious outcomes.
“Peanut allergy has also gotten a lot of publicity,” Wood says, adding that there are more children with severe reactions to foods that do not contain peanuts than children with severe peanut allergy.
You only get a food allergy during childhood
“The majority of food allergies occur in infants and children, but you can develop a food allergy at any time in life,” says Taylor. Experts note that adults may suddenly develop an allergy to a food they’ve been able to eat their whole life.
However, some allergies are more prevalent in children than in teens and adults. “Obviously, milk and egg allergies are more common in the first five years of life….then peanut allergy is most common in school-aged children and adolescents, and shellfish allergy is the most common allergy in adults,” says Wood.
It’s rare to develop a new peanut allergy in adulthood, but it’s possible, says Wood. “No one should assume that an adult who thinks they have a new food allergy cannot have a new food allergy,” says Wood.
In addition, food allergies diagnosed during childhood do not always last forever. “Most children outgrow allergies to milk, eggs, and soy. … 20% of young children outgrow a peanut allergy, and 10% of young children outgrow a nut allergy,” says Sicherer.
Children should not be given major food allergens
“The previous thought was to completely avoid foods that could cause severe allergic reactions (milk, eggs, nuts), and I think this may be one of the biggest reasons why we suffer from food allergies as we do today,” Dr. Sandra Hong, MD, chief of allergy and immunology at the Cleveland Clinic, told TODAY.com.
The old recommendation was that for children at risk of developing a food allergy (those with eczema or a parent with a food allergy) they should wait to introduce milk until age 1, eggs until age 2, or nuts until age 3, Hong says. – But that’s outdated.
“Recommendations at present are not to delay the introduction of these common allergens, and to give them in child-safe forms as you would any other food,” says Sicherer.
There is mounting evidence from clinical trials that early introduction of foods like peanuts, for example, can reduce peanut allergy among high-risk children, Hong says. “We’ve treated children who show evidence of allergy and have amazing results. They are able to eat and tolerate food,” Hong says.
Hong adds that the research on food allergy treatment is promising. “It could change lives.”
This article was originally published on TODAY.com