For food allergies, even after prick and blood testing it may be difficult to confirm whether a person has an allergy or has outgrown it. To help confirm the diagnosis, medical practitioners may perform an ''oral food challenge''. 

Food allergy

Food allergy affects approximately 2.5% of the general population but the spread of prevalence data is wide, ranging from 1% to 10%1.

The most common foods that cause allergic reactions, whether eaten separately or as an ingredient, even in trace amounts (also known as hidden foods), are milk, egg, fish, shellfish, tree nuts, peanut, wheat, and soybean2. There is no cure for food allergy and avoidance of the food allergen is the only way to protect against an allergic reaction3

Food allergy symptoms are most common in babies and children but can appear at any age. People can develop an allergy to foods they have eaten for years without any allergic reaction3. Food allergy reactions include a variety of clinical conditions affecting the gastrointestinal tract, skin and lungs, as well as sometimes fatal anaphylaxis4.

It is believed that lifestyle factors, dietary habits and maternal–neonatal interactions play a pivotal role in triggering the onset of food allergies, including qualitative and quantitative composition of the microbiota. These factors seem to have the greatest influence early in life4.

The economic burden of food allergies worldwide varies across countries with mean annual costs estimated at $806 (household level) to $2081 (individual level) for the medical system and up to $4881 for household costs5.

Symptoms 

The most common food allergy signs and symptoms include6

  • Vomiting and/or stomach cramps 
  • Hives. 
  • Shortness of breath. 
  • Wheezing. 
  • Repetitive cough. 
  • Shock or circulatory collapse. 
  • Tight, hoarse throat; trouble swallowing. 
  • Swelling of the tongue, affecting the ability to talk or breathe. 
  • Weak pulse. 
  • Pale or blue coloring of skin. 
  • Dizziness or feeling faint. 
  • Anaphylaxis a potentially life-threatening reaction that can impair breathing and send the body into shock.  

 

1. Bartha I, Almulhem N, Santos AF. Feast for thought: A comprehensive review of food allergy 2021-2023. J Allergy Clin Immunol 2024;153:576-94
2. FDA. Food allergies. Online: https://www.fda.gov/food/food-labeling-nutrition/food-allergies. Last assessed February 2024  
3. ACAAI. Food allergy. Online: https://acaai.org/allergies/allergic-conditions/food/. Last assessed February 2024
4. Nature Review, Disease Primers. Food allergies. Harald Renz et al. Online: https://www.immunetolerance.org/sites/default/files/Renz_Nat%20Rev%20Dis%20Primers_2018.pdf. Last assessed February 2024
5. Bilaver et al. 2019 Economic burden of food allergy - A systematic review Ann Allergy Asthma Immunol 122 (2019) 373e380
6. ACAAI. Food allergies – Overview. Online: https://acaai.org/allergies/allergic-conditions/food/. Last assessed February 2024
 
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