For millions of people, food allergies are real and potentially deadly.
But estimates of how widespread this condition really is may be exaggerated.
A new report published by the National Academies of Sciences, Engineering, and Medicine offers recommendations for how health officials can develop a clearer picture of the prevalence of food allergy in the United States.
This includes adults and children.
The authors say this would help food allergies gain the attention they deserve.
“For too long, food allergies have been minimized, little understood, and stigmatized,” Dr. James R. Baker, chief executive officer and chief medical officer at Food Allergy Research & Education (FARE), said in a press release.
Baker was not part of the committee that released the report, but FARE is the lead sponsor of the project.
What exactly is a food allergy?
Part of the problem with knowing how many people have a food allergy is that this term has become a catchall for a variety of symptoms that may or may not be caused by an allergic reaction to food.
Gluten sensitivity and lactose intolerance are commonly misperceived as food allergies.
Food allergies, though, can be harder to diagnose and more severe, even leading to a life-threatening allergic reaction known as anaphylaxis.
The authors of the report cite several studies that found confusion about food allergy and its symptoms among not just parents, but also doctors, school nurses, child care providers, and others.
Some patient education and advocacy groups agree that more work is needed in this area.
“Great confusion still exists regarding food intolerances versus food allergies among healthcare providers and the general public,” Tonya Winders, president and chief executive officer of the nonprofit Allergy & Asthma Network, told Healthline. “We need to continue to raise awareness and educate people on the differences between the two.”
The authors of the report call for improved education across the board — medical professionals, the food industry, and the general public — about food allergies.
Scratching the surface
According to the report, food allergies cost almost $25 billion per year in the United States. This includes direct medical expenses and costs incurred by the family.
But food allergies can also take an emotional toll, especially on parents whose children have the condition.
Every time a child goes to school, to a friend’s house, or gets on an airplane, parents may be worried that a single peanut could land their child in the emergency room.
This constant vigilance, and the need to always have injectable epinephrine on hand, can also create anxiety for the child.
In spite of the stress involved with having a food allergy, many people needlessly avoid foods without a proper medical diagnosis.
According to the report, one study found that 12 to 13 percent of adults and children diagnosed themselves as having a food allergy. Medical testing, though, showed that only 3 percent actually did.
This brings up another challenge — there is no simple, accurate diagnostic test for food allergy.
Most people are familiar with the skin prick test, in which a small amount of an allergen is placed on or just under the skin. In this way, doctors can identify substances to which people may be allergic. A blood test is also available.
These tests can suggest that a person may react to a certain food, but the results are not definite.
In some cases, an oral food challenge may be needed to confirm a food allergy. In this test, a person eats gradually increasing amounts of possible allergens — under medical supervision — and is monitored for allergic reactions.
The report recommends that physicians rely on these evidence-based methods to diagnose food allergies and avoid nonstandardized and unproven procedures, such as applied kinesiology and electrodermal testing.
So how many Americans actually have food allergies?
Some studies estimate that the number is around 15 million.
“We need better diagnostic and reporting tools to better understand the true prevalence of food allergies,” said Winders. “We certainly know that the prevalence is on the rise and, yet, we do not truly understand why.”
In spite of the uncertainty about food allergy prevalence, enough people have food allergies that the authors of the report say there is a need for better approaches to preventing and treating them.
This includes improving the quality of life for people with food allergies through research into safe and effective treatments.
It also means educating the public about the realities of food allergies and dispelling many of the myths.
“We strongly believe that severe food allergies must be top-of-mind not only for the millions of families working to manage them, but for all who may know, treat, serve, and interact with a child or adult suffering from severe food allergy,” said Baker.