Adult food allergies affect millions of Americans

According to the American College of Allergy, Asthma and Immunology, more than 50 million Americans suffer from food allergies, which occur when a person’s immune system overreacts to something in a food. Photo by AngelHM/Wikimedia Commons

You bite into an apple and suddenly your mouth starts to tingle. Or you eat shrimp for dinner and get hives.

You’re not a kid and you’ve been able to eat these foods all your life, so what’s going on?

A number of conditions could cause this, but one of them is adult food allergies. It becomes allergic – sometimes seriously – after reaching adulthood.

Researchers aren’t sure why some people become allergic to certain foods after adulthood, but there are several theories about triggers as well as possible cures.

“There are so many dietary conditions, and it’s so important to really understand what you have because you want to know how to manage it, and some of them actually have treatments,” said Dr Ruchi Gupta, director of the Center for Food Allergy and Asthma, which is part of the Institute of Public Health and Medicine at Northwestern University Feinberg School of Medicine in Chicago.

According to the American College of Allergy, Asthma and Immunology (ACAAI), more than 50 million Americans suffer from food allergies, which occur when a person’s immune system overreacts to something in a food.

That includes about 10% of adults, according to Gupta’s own research. Some allergies date back to childhood, but almost half of them started in adulthood. About 38% in the 2019 study of 40,000 people said they had a severe reaction to the food that sent them to the emergency room.

Although you can be allergic to anything, nine substances cause 90% of food allergies: peanuts, tree nuts, milk, egg, shellfish, fish, soy, wheat and sesame.

In adults, shellfish allergy is the most common, affecting nearly 3%, Gupta said.

life changing trigger

Although allergies tend to run in families, among the many reasons researchers have identified for new allergies in adulthood is a change in environment. Maybe you have moved and are exposed to different allergens, which trigger your immune system.

A viral or bacterial infection could also flip this switch.

Hormones can also be a catalyst, especially in women. It is not uncommon to develop food allergies during puberty, pregnancy or menopause.

“Allergies are a bit higher in adulthood in women, and we don’t quite understand the mechanism yet, but it may be related to changes in our hormones,” said Dr Tania Elliott, door – ACAAI spokesperson and NYU faculty member. Langone Health in New York.

Some women may experience worsening allergic systems during different phases of their menstrual cycles, she said.

Another possible cause: Certain medications or alcohol can alter gut acidity, so the body stops breaking down certain foods the way it once did, Elliott said.

This triggers what’s called an IgE-mediated immune response, which Elliott described as “a fancy term for our body reacting abnormally to something naturally occurring in the environment.”

This natural reaction prompts the body to release chemicals, including histamine, that can cause itching, redness, swelling and dilation of blood vessels, Elliott said.

Allergies can affect multiple organ systems with skin reactions, vomiting, difficulty breathing, and dilation of blood vessels. Anaphylaxis is a serious, life-threatening allergic reaction. Your doctor may want you to carry epinephrine so you can treat this dangerous reaction quickly.

An allergist can help with the diagnosis

Food intolerance is different. Symptoms may include bloating, fatigue, or other discomfort, which may appear days later instead of minutes or hours. If you experience these symptoms, Elliott suggests keeping a food diary for about two weeks and then having a doctor analyze it. This may lead to an elimination diet to identify the culprit.

That tingling in the mouth that some people get after biting into a fresh apple may be a condition called oral allergy syndrome.

When you are allergic to pollen from a tree, for example, you can react by eating the fruit of that tree. In addition to a tingling sensation, you may have a rash or hives on your mouth. It’s unlikely to cause anaphylaxis and, Gupta said, you may be able to continue eating food.

“It’s important to talk to your allergist and make sure you know what’s going on,” she said, because sometimes cooking food can reduce the reaction.

This is not true, however, for those who experience a severe allergic reaction.

“These are the ones where you have to completely avoid this allergen,” said Gupta, who added that getting a formal diagnosis was important.

While 10% of adults have food allergies, about 20% of people in Gupta’s study suspected they did. Many may simply have had an intolerance to a certain food – for example, the lactose in milk. About 1 in 20 in Gupta’s study said they had sought a diagnosis.

A small Canadian study of 14 patients found that “adult food allergy – particularly with resulting anaphylaxis – is an important phenomenon to recognize, even when patients have previously tolerated the food in question” .

If you have a suspected allergic reaction to a food and it’s not something serious enough to send you to the emergency room, photograph your reaction to the food, including the spices used in the dish, and share the photos with your doctor, Elliott suggested.

That’s because spice allergies are on the rise. Your doctor can perform targeted tests, she said, on the specific ingredients of the suspected dish.

Don’t despair if you love crab or nuts and can’t eat them anymore. Treatments are ongoing, Gupta said.

There is already an oral immunotherapy approved by the United States Food and Drug Administration for peanut allergies in children. Although it’s not yet approved for adults, Gupta predicts it will be eventually.

Ongoing clinical trials are also evaluating biologic drugs that alter part of the immune pathway that causes a reaction.

“I just want everyone to know that there is hope right now, in the next five to 10 years, we will have treatments for food allergies,” Gupta said.

More information

The United States Food and Drug Administration has more on food allergies.

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