Does Anyone Really Know What’s Up With Food Allergies?

He doesn't look so bad.
He doesn’t look so bad. Photo: Planters

Did you know a 2007 study of New York–area restaurant managers, servers, and chefs found that a lot of them don’t really know how to deal with allergens in food? Troubling news for food-allergy sufferers. Especially troubling given the fact that there are a lot more sufferers than there used to be! This week’s New Yorker has a terrific story (subscription required) about the recent rise in incidence of food allergies. In fact, Dr. Hugh Sampson, the director of the Jaffe Food Allergy Institute at Mount Sinai, estimates that “three of five percent of the population is now allergic to milk, eggs, peanuts, tree nuts, or seafood.” So what’s causing the spike? Sounds like nobody is really sure.

A decade ago, the thinking was that children should avoid foods that contain potential allergens, in order to give their immune systems more time to develop: ” … if we wait until their immune system matures after a few years they could do better when later exposed to the food,” Sampson tells the magazine. And in 2000, the American Academy of Pediatrics issued guidelines based on this line of thinking. But wait!

Dr. Gideon Lack, a pediatric allergist at St. Mary’s Hosptial in London, noticed a rise in peanut allergies in the U.K. But when he gave a lecture in Tel Aviv in 2003 and asked how many in the audience — filled with pediatricians and allergists — had seen a similar rise in Israel, practically no hands went up. It turns out, kids in Israel eat peanut products almost from birth. Specifically, they eat a packaged snack food called Bamba (“a peanut concoction that looks like a Cheez Doodle,” according to the story) that we’ve personally never had, but which sounds pretty good. In the same year, Lack reported, among other findings, there was “no correlation between women who had eaten peanuts while pregnant and the development of peanut allergies in their children.”

Hold up! So does that mean mothers who limited their babies’ diets so many years ago are actually the reasons why we can’t so much as open a bag of peanuts on an airplane anymore for fear of killing any nut-allergy-having fellow fliers? Or, taken to the next level, does it mean that early exposure to potential allergens might even lead to greater tolerance later in life? Maybe! In 2008, the AAP released new guidelines that focused far less on restricted diets as means of preventing food allergies. Dr. Susan Baker, a professor at SUNY Buffalo who chaired the committee that released the 2000 guidelines, offers this insightful quote: “We in medicine are making a lot of decisions and recommendations based on not a lot of solid evidence.” Dr. Lack says, “I try to emphasize with my patients not to feel guilty that they did or did not do something that would have resulted in their child having a food allergy.” Comforting!

In summation for all you expectant mothers out there concerned about your kids developing food allergies: Just order the pad Thai next time you’re at a restaurant — while you’re at it, ask if the kitchen will garnish it with milk and a little lobster — and see what happens!

The Peanut Puzzle [NYer]

Does Anyone Really Know What’s Up With Food Allergies?