Food allergies are more common than you might think. This is especially true if you’re unaware of the new data, as the rates of these conditions are on the rise. According to the CDC, the prevalence of food allergies among children increased from 3.4% in 1997–1999 to 5.1% in 2009–2011. It’s now estimated that 8% of children are affected. And, while some reactions will wane or even vanish over time, it’s also possible for new food allergies to emerge even in adulthood.
However, identifying the causes of allergic reactions and preventing exposure may be easier than ever. “In kids, greater than 95% of food allergies are going to be a result of one of nine allergens,” said Carah Santos, MD, an allergist and immunologist at National Jewish Health.
For this reason, we’ve compiled a simple guide to help you understand these common food allergens, along with the steps you can take to limit your risk.
Top Nine Allergens
Dairy products are abundant in grocery stores and restaurants, making an allergy to milk inconvenient. Fortunately, due to increased public awareness around allergies, there are also numerous dairy-free alternatives to common items, many of them derived from soy and almonds.
Eggs are another common food allergen, with people developing a sensitivity to the protein found in either the egg yolk or egg white. Fortunately, there are also egg substitutes available, and most people will outgrow their egg allergy by age 16.
As an allergen, wheat is one of the sneakier usual suspects, as it’s found in foods you may have never considered: ice cream, soy sauce and hot dogs, for instance. This is why diligent label reading is so important.
Because of its use in infant formulas, soy can pose a unique problem for young children with an allergy. Additionally, like wheat, soy is another food item that makes its way into processed foods like candy and meat products.
Some people with peanut allergies can experience particularly severe reactions, including anaphylaxis. This is why you’ll find schools that are “peanut-free.” In addition to being used in many candies and baked goods, peanuts are often used in cooking, which is why it’s a good idea to consult with the restaurant if you’re prone to severe reactions.
6. Tree Nuts
Not to be confused with peanuts, which are legumes, the six tree nuts most commonly discussed when dealing with allergies are walnuts, almond, hazelnut, pecan, cashew and pistachio. Many people with an allergy to one tree nut will often have an allergy to another.
An allergy to fish is among those that can develop later in life. Due to the biological differences between finned fish and shellfish, someone who’s allergic to tuna will not necessarily be allergic to lobster.
Shellfish allergies commonly develop in adulthood. Additionally, someone with a shellfish allergy may not have an equal allergic reaction to all shellfish. Lobster, shrimp and crab might need to be avoided, while oysters, clams and scallops can be eaten, for instance.
Because of the growing number of allergy cases, sesame was recently added to the list of top food allergens. The 2021 The Food Allergy Safety, Treatment, Education and Research Act requires that all sesame be labeled on packaged foods beginning in 2023.
What are some ways to avoid food allergens?
“What we recommend for patients with food allergies and/or their parents is very diligent label reading,” stressed Dr. Santos, explaining that the FDA requires companies to place clear labels on food items that contain one of the eight allergens above (with sesame to be added starting in 2023).
“The label has to say, ‘Contains peanuts’ or ‘Contains tree nuts,’ or it clearly spells out the name of these allergens in parentheses. It’s very clear language. So it’s really important that we be mindful of label reading. This way, it’s possible to ensure safety if you’re buying something at the store,” said Dr. Santos.
Naturally, there are situations where labeling safeguards don’t come into play. Social gatherings and restaurant outings, for example, might call for detective work. According to Dr. Santos, it’s important to pry. Ask the chef or organizer about allergens and make sure they understand the gravity of your condition.
“That’s not always going to be the most convenient thing for, say, Fourth of July or large birthday parties,” added Dr. Santos. “And so, in some of those situations, parents may feel more comfortable packing safe foods for their child that are devoid of their food allergens.”
Due to allergy awareness campaigns, most restaurants now understand the need to identify allergens in their offerings. According to Dr. Santos, the majority of restaurant staff are willing to investigate further if their product could contain a food allergen—all the more reason not to feel self-conscious about advocating for yourself or your child.
How should you prepare in case of exposure?
If you or your child have been diagnosed with an allergy, it’s essential to carry epinephrine auto-injectors in case of severe reactions due to accidental exposure. “As diligent as we try to be in avoiding our food allergens,” said Dr. Santos, “unfortunately, despite people’s best intentions, there still might be a way that a specific food can sneak up on you.”
If symptoms are mild (typically rashes, redness or itching of the skin), an oral anti-histamine is usually enough. However, for more severe reactions, such as difficulty breathing or throat swelling, an epinephrine auto-injector can be a lifesaving tool.
“We know that a lot of bad outcomes from food allergies, including mortality, can be due to the lack of access to epinephrine or delayed administration of it,” explained Dr. Santos. “So, while I really hope that our patients never have to use their epinephrine, we still always want to make sure that that’s easily accessible wherever they go.”
How can you learn even more?
Perhaps you’ve never been diagnosed with a food allergy before, but you find that fruits and vegetables are causing your mouth to become itchy and dry. If that’s the case, you might find our discussion of oral allergy syndrome symptoms helpful.
This information has been reviewed and approved by Carah B. Santos, MD (May 2022).