Marcia Frellick

November 01, 2017

BOSTON — Peanut allergies in children have risen 21% since 2010, according to data from a national survey of 53,000 families, presented here at the American College of Allergy, Asthma & Immunology 2017 Annual Scientific Meeting.

This brings the prevalence of children with peanut allergy — the most common food allergy in children in the United States — to 2.5%. The data also suggest that the risk for peanut allergy in black children might be twice that in white children (odds ratio, 2.0; P < .05).

"This is really important because, for a long time, we thought food allergy didn't affect minorities as much," said Ruchi Gupta, MD, associate professor of pediatrics and medicine at Northwestern Medicine in Chicago.

"That was always curious to me because, with asthma and eczema, we do see higher rates in minority populations," she told Medscape Medical News.

The survey of 53,575 American households was conducted from October 2015 to September 2016, and captured self-reported allergies, not diagnoses.

Nearly Half of Adults Developed Allergies in Adulthood

The data show that 45% of adult respondents reported developing at least one allergy after age 17, which was a surprise because allergies are commonly thought of as something you develop in childhood.

Anecdotally, Dr Gupta explained, allergists hear that adults used to be able to eat seafood, for instance, but no longer can.

In fact, the survey data show that allergy to tree nuts increased 18% and allergy to shellfish increased 7%.

Table. Prevalence of Adult-Onset Allergies by Food Type

Food type Adults Who Developed a Food Allergy, %
Any shellfish 43.3
Fin fish 35.6
Any tree nut 35.6
Sesame 24.7
Peanut 17.4

 

Allergies in adults varied greatly by race, as they did in children. Asian adults were 2.1 times more likely to report shellfish allergy than white adults, and Hispanic adults were 2.3 times more likely to report peanut allergy than white adults.

The numbers reinforce the need for primary care physicians to ask adults if they have had adverse reactions to food, said Dr Gupta. Patients often avoid foods they react to rather than coming in for testing or treatment.

"I've heard my own patients say, 'I didn't tell you about the food allergy because there's nothing you can do'," she reported. The message needs to get out that there are treatments — whether patients are truly allergic or just intolerant, she added.

Physicians should ask patients specifically about any adverse effects of food, especially if a child has asthma or atopic dermatitis, she advised. When the allergy question is asked, it is often asked only about medications.

This study highlights the continued climb in peanut allergy, which is not surprising, "considering that only in the past 2 years have we found a way of reversing this trend by introducing peanuts early to high-risk infants," said Bryce Hoffman, MD, a fellow in allergy/immunology at National Jewish Health in New York City.

I want to be out of a job. I want the risk to be gone.

The good news is that the introduction of peanut products in the first year of life can prevent peanut allergy, as reported by Medscape Medical News, and reflected in guidelines released in January (Ann Allergy Asthma Immunol. 2017;118:166-173.e7),

Educating families and providers about the new guidelines is crucial, "and doubly important for black children who are at increased risk," said Dr Hoffman.

"While we continue to look for treatments for peanut and other food allergies, prevention is where we can currently have the biggest impact," Dr Hoffman told Medscape Medical News.

Both Dr Gupta and Dr Hoffman said they hope that, with the change in guidelines on the early introduction of peanut, allergy prevalence will come down.

"I want to be out of a job. I want the risk to be gone," Dr Gupta said.

Dr Gupta reports relationships with Before Brands, Kaleo, Mylan, Thermo Fisher Scientific, Aimmune Therapeutic, the Stanford Sean N. Parker Center for Allergy Research, and the Denise and Dave Bunning and Sunshine Charitable Foundation. Dr Hoffman has disclosed no relevant financial relationships.

American College of Allergy, Asthma & Immunology (ACAAI) 2017 Annual Scientific Meeting. Presented October 30, 2017.

Follow Medscape on Twitter @Medscape and Marcia Frellick @mfrellick

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