HEALTH LINE: Food Allergies in Adults: Risky and On the Rise

CINCINNATI—While food allergies are more common among children, the population of adults with moderate to severe food allergies is also growing, though clinicians aren’t sure why.

The American College of Allergy, Asthma & Immunology estimates that up to four percent of adults have food allergies. These cases may reflect continued childhood allergies, or new sensitivities that have developed in adulthood. 

"We’re seeing disturbing evidence that points to an increasing incidence in peanut allergy in children in more developed nations like the U.S.,” says UC Health otolaryngologist and allergy expert Alfred Sassler, DO. "There also seems to be increasing numbers of ER visits for adults with these types of reactions that may represent food allergy as well. But it’s not clear if this represents a greater incidence of these allergies or increased reporting of them.”

Allergies to shellfish, fish, peanuts and tree nuts are most common among adults.

If an adult has one of these allergies, they can experience a sudden onset of symptoms after eating, including a swelling of the mouth, tightness in the throat or chest, wheezing and shortness of breath, itching, and hives.

"This type of reaction is called anaphylaxis and is potentially life-threatening,” says Sassler, who also serves as associate professor of otolaryngology–head and neck surgery at the University of Cincinnati College of Medicine. "After the emergency treatment is done to reverse this overwhelming reaction (usually in the emergency room), a diagnostic evaluation needs to be done by an allergy specialist to determine if it was the food or some other factor that caused the reaction.”

Even if you’re not sure if you’ve had a reaction, Sassler says ignoring the symptoms isn’t worth the risk, as mild symptoms don’t preclude more serious reactions in the future.

"There is also a phenomenon of food sensitivity that can appear through a wide range of symptoms such as bloating, fatigue, headache, voice change, throat clearing, joint pain and nausea,” he says. "These symptoms are more difficult to link to a typical allergic response and may represent another type of response that involves the immune system or digestive tract.”

Even with blood and skin testing, he says, the most important diagnostic tool is still a thorough review of a patient’s allergy history, including a "food diary” and review of current medications, vitamins, soaps, lotions and other agents used in day-to-day activities at home and work. A family history of allergy is also key, especially if biologically direct relatives like parents, siblings and children have allergies.

Ultimately, Sassler says, the only approved treatment for foods that cause life-threatening reactions is avoidance. The other less-severe but still significantly life-impacting symptoms, like those from food sensitivity, can be potentially de-sensitized with special diets.

At this time, Sassler says there are no broadly approved immunotherapy treatments for food allergy, though research on oral drops for food sensitivity is underway in some practices: "Some allergy practices are utilizing these techniques already, due to some anecdotal reports of success with a high level of safety. However, dosing schedules and success rates have not yet been standardized by rigorous study so the jury is still out.”