According to Food Allergy Research and Education (FARE), a nonprofit organization, an estimated 33 million Americans–including one in every 13 children–suffer from food allergies. And roughly 90% of potentially deadly reactions are caused by just a handful of specific ingredients.
In this article, we’ll explore the 9 major food allergies that affect most sufferers, with insights from the Cleveland Clinic’s allergist and Associate Director of Food Allergy Center, Dr. Jaclyn Bjelac.
Major food allergies Identified by the FDA
1. Shellfish
Shellfish contain the #1 food allergen in the U.S., affecting approximately 8.4 million people. This allergy often starts in adulthood, with 60% of cases emerging around age 28.
It causes a high incidence of severe and immediate reactions, including anaphylaxis or anaphylactic shock. Typically lifelong, this allergy can be triggered by:
- Crustaceans (shrimp, crab)
- Mollusks (clams, oysters)
The primary allergens in shellfish are proteins called:
- Tropomyosin
- Arginine kinase
- Parvalbumin
Even being exposed to shellfish fumes during cooking can trigger a reaction if you’re highly allergic. So you’ll need to steer clear of any place they’re being prepared, as well as avoiding consumption.
2. Fish
Fish allergies impact about 6.6 million people or 2.3% of the U.S. population–predominantly female adults. Occurrences are higher in areas like Scandinavia and Asia, where seafood is a dietary staple.
Studies suggest if you’re allergic to one type of fish, such as salmon or tuna, you’re likely allergic to others due to the presence of parvalbumin, a protein in all finfish.
Fish and shellfish are biologically different, so an allergy to one doesn’t necessarily indicate an allergy to the other.
3. Peanuts
Peanuts are the third most common food allergen in the U.S., affecting around 1-2% of the population–over 6 million Americans. Despite its prevalence and severity, research suggests about 22% of sufferers outgrow their peanut allergy by age 20.
The chance of outgrowing a peanut allergy depends on the initial level of sensitivity. Those with lower levels of a type of antibody called peanut-specific IgE are more likely to enter remission. People with only skin-related symptoms (i.e. rash) are also more likely to outgrow it.
A family history of peanut allergies can increase your risk. However, research suggests introducing a child to peanuts early in life could potentially reduce it.
4. Tree nuts
Unlike peanuts–which are legumes–tree nuts are true nuts that grow on trees. Common examples include:
- Walnuts
- Almonds
- Hazelnuts
- Pecans
- Cashews
- Pistachios
Roughly 1.1% of the U.S. population suffers from a tree nut allergy, and these numbers have been rising over recent decades.
Tree nut allergies are a leading cause of food-allergy-related emergency room visits–and are usually lifelong. Only approximately 10% of those affected outgrow this allergy.
Some research indicates 50% of children who are allergic to one tree nut also suffer reactions to others. However, one study found many people can tolerate certain nuts while being allergic to others.
If you suffer from this allergy, check labels carefully. Be on the lookout for tree nuts in items you might not suspect, such as:
- Baked goods
- Candies
- Pesto
- Barbeque sauce
5. Milk
Another of the 9 major food allergens is milk, which triggers symptoms in about 4.7% of the U.S. population. This is the most common food allergy among infants and young children, affecting between 1.8% and 7.5%.
Most children develop this allergy before age one. And while experts previously thought most would outgrow it before school age, recent studies suggest fewer than 20% do by age 4. However, approximately 80% outgrow their milk allergy by age 16.
For others, this allergy can be lifelong–or may not develop until adulthood. It may require you to avoid all dairy products, including:
- Butter
- Cheese
- Yogurt
However, research shows some people (75% of children) can tolerate baked goods containing milk. This is because the baking process denatures milk’s proteins, reducing allergenic properties.
If you’ve been diagnosed with a milk allergy, consult your doctor to determine whether you need to avoid dairy entirely.
Difference between milk allergy and lactose intolerance
It’s important to note that a milk allergy is very different from lactose intolerance–and the former can be far more severe.
Lactose intolerance is a digestive issue resulting from a lack of enzymes that process milk sugar, leading to symptoms like nausea and diarrhea. It isn’t life-threatening.
A milk allergy, on the other hand, triggers a serious immune response that can range from rashes to life-threatening airway swelling, Dr. Bjelac says.
6. Eggs
0.9% of all U.S. children and 1.3% of those under five suffer from this major food allergy. Interestingly, African American children–who constitute 13.2% of the U.S. pediatric population–represent 23.4% of those with an egg allergy.
About 70% of affected children outgrow egg allergies by age 16. This allergy is less common in adults, affecting only 0.6%.
Some people are only allergic to either egg whites or yolks because they contain different proteins. Among sufferers, egg white allergies are more common.
If you’re allergic, eggs can be challenging to avoid, as they’re often hidden in foods like:
- Breads
- Cakes
- Pasta
- Breaded, fried foods
- Condiments including mayonnaise
- Even some drinks, such as protein shakes
However, you may not need to avoid the above foods as long as they’ve been cooked. One study found that nearly two-thirds of children with an egg allergy could tolerate baked eggs (as in bread or cakes), as there may be a decrease in allergenicity due to the cooking process.
Consult an allergist to determine whether you can safely introduce foods containing cooked eggs into your diet.
7. Wheat
Wheat allergies are more common in younger populations than adults, affecting up to 1% of U.S. children. Most kids outgrow this allergy by age 12–although, for some, it’s lifelong.
Wheat allergies involve an immune system reaction to any of the four proteins found in wheat, which include:
- Albumin
- Globulin
- Gliadin
- Gluten
This sets it apart from celiac disease and non-celiac gluten sensitivity (NCGS).
Wheat allergy vs. celiac disease vs NCGS
Celiac disease is an autoimmune disorder in which only the protein, gluten, triggers damage to the small intestine. NCGS is less well-understood, but research shows it causes similar symptoms to celiac disease without harming the intestines.
Unlike those with celiac disease or NCGS, people with a wheat allergy may only need to avoid wheat, not all gluten-containing grains. But this depends on your specific allergies.
Avoiding wheat can be a challenge, since it’s found in many prepared foods, including:
- Baked goods
- Breakfast cereals
- Beer
- Even condiments like soy sauce
However, in recent years, there’s been a rise in wheat-related health concerns, making alternative types of bread, pasta, and even beer available at thousands of grocery stores, worldwide. Look for products made with grains like:
- Amaranth
- Rice
- Quinoa
- Oats
- Sorghum
8. Soybean
While less common than other food allergies, soy allergies are still prevalent. They affect approximately 0.4% of children and 0.3% of adults.
Most children outgrow this allergy before age 10. And most also react to peanuts, as both soy and peanuts are legumes.
Avoiding soy can be challenging due to its widespread use in processed foods. However, Dr. Bjelac says many people with a soy allergy can tolerate processed soy-based products like soy flour and soy milk, which contain less allergens.
Consult an allergist to determine which soy-containing products you can safely enjoy.
9. Sesame
The final major food allergen is sesame, which has spawned a rising risk of severe reactions like anaphylaxis in recent years. Approximately 0.2% of both children and adults in the U.S. are allergic to this seed–a number that’s comparable to soy and pistachio allergies.
Avoiding sesame isn’t as simple as staying away from sesame seed buns, either. This seed is a common component in numerous prepared foods, including hummus.
If you’re allergic to sesame, check labels carefully. And consult your doctor to determine which packaged foods are safe for you.
Symptoms of a food allergy
Symptoms of food allergies vary widely from person to person, but they might include:
- Itchy skin or hives
- Swelling of the lips, cheeks, or eyes
- Coughing, wheezing, or breathlessness
- Hoarse voice or noisy breathing
- Nasal itching or congestion
- Sneezing
- Nausea, vomiting, or abdominal pain
- Diarrhea
- Dizziness
In severe cases, anaphylaxis can occur–which may be life-threatening. Its symptoms include:
- Difficulty breathing
- Swelling in the throat
- Rapid heart rate
- Sudden low blood pressure
- Fainting
These symptoms can arise within minutes or be delayed for several hours. If you notice any of these signs, seek medical attention immediately.
Natural treatment for food allergies
Typically, treatment for food allergy is strictly avoiding the offending food or ingredient. However, recent research supports the use of oral immunotherapy (OIT). OIT involves gradually exposing the immune system (via ingestion) to increasing doses of the allergen to desensitize the body over time.
Consult with your doctor to determine whether allergen avoidance or immunotherapy is the best strategy for managing your allergies.
Recognizing the top 9 food allergens can help you take control of your health–especially if you’re experiencing symptoms. If you’re allergic to any of these foods, work with your healthcare provider to determine the best strategy and eating plan.
You can still enjoy a diverse diet filled with delicious and nutritious options while remaining healthy and reaction-free.
References:
Facts and Statistics – FoodAllergy.org
The US population-level burden of cow’s milk allergy – PMC
Milk Allergy – an overview | ScienceDirect Topics
Milk Allergy | Causes, Symptoms & Treatment | ACAAI Public Website
Modulation of Milk Allergenicity by Baking Milk in Foods: A Proteomic Investigation – PMC
Lactose Intolerance – StatPearls – NCBI Bookshelf
Food allergy: immune mechanisms, diagnosis and immunotherapy – PMC
Egg Allergy in US Children – PMC
Egg Allergy: Diagnosis and Immunotherapy – PMC
The natural history of egg allergy
Adult onset egg allergy: a case report
Recent advances in the management of nut allergy – ScienceDirect
New onset egg allergy in an adult
Peanut-Induced Anaphylaxis in Children: A Literature Review – PMC.
Peanut Allergy: New Advances and Ongoing Controversies
The global burden of illness of peanut allergy: A comprehensive literature review – PMC
The natural history of peanut allergy
Accidental Reactions to Foods: Frequency, Causes, and Severity – PMC
Shellfish Allergy – StatPearls – NCBI Bookshelf
Seafood allergy: A comprehensive review of fish and shellfish allergens
Prevalence and Characteristics of Shellfish Allergy in the Pediatric Population of the United States
Allergens and molecular diagnostics of shellfish allergy – PMC
Adult seafood allergy in the Texas Medical Center: A 13-year experience – PMC
Allergens and molecular diagnostics of shellfish allergy – PMC
What Do We Know Now about IgE-Mediated Wheat Allergy in Children? – PMC
Wheat Allergy in Children: A Comprehensive Update – PMC
Recent advances in understanding non-celiac gluten sensitivity – PMC
A Meta-Analysis of the Prevalence of Wheat Allergy Worldwide – PMC
Allergen immunotherapy for food allergy: Evidence and outlook – PMC
Food Allergy from Infancy through Adulthood – PMC
The natural history of soy allergy
Prevalence and Severity of Sesame Allergy in the United States – PMC
Allergic to Sesame? Food Labels Now Must List Sesame as an Allergen | FDA
Oral immunotherapy for food allergy: Translation from studies to clinical practice? – PMC
Oral Immunotherapy for Food-Allergic Children: A Pro-Con Debate – PMC
Food Allergy and Intolerance: A Narrative Review on Nutritional Concerns – PMC
Parvalbumin: A Major Fish Allergen and a Forensically Relevant Marker – PMC.
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