A recent study conducted by researchers at Imperial College London has revealed a troubling trend: the incidence of food allergies among children in England has more than doubled from 2008 to 2018. The study, published in The Lancet Public Health, indicates that food allergies are most prevalent among preschool children, with 4% of this group having a “probable” allergy.
The study also highlighted a significant issue with managing severe allergies: approximately one-third of individuals at risk of anaphylaxis—an acute, potentially life-threatening allergic reaction—do not carry adrenaline autoinjectors such as EpiPens. The study found that people living in deprived areas are less likely to have been prescribed these critical devices.
Estimating the true prevalence of food allergies has proven challenging due to variations in measurement methods. Estimates of food allergy prevalence range widely from under 1% to over 9% of children. These figures are derived from different sources, including prescription data for adrenaline pens, self-reported symptoms, and blood tests for specific antibodies.
Self-reported data is often unreliable, as many individuals confuse food intolerance with actual allergies. According to a recent report by the UK’s Food Standards Agency, of the more than 30% of adults who reported adverse food reactions, only 6% were confirmed to have a genuine food allergy. To address these discrepancies, the Imperial College study utilized extensive population healthcare data from over 7.5 million people in England, combined with clinical criteria to refine allergy estimates.
The study categorized individuals as having a food allergy based on medical records indicating a possible or probable allergy, or if they had been prescribed an adrenaline pen. This broader approach revealed that the prevalence of food allergies doubled over the past decade, although rates have stabilized since 2018. Currently, the prevalence is about 4% among preschool children, 2.4% in school-aged children, and under 1% in adults.
The study acknowledges that not all cases were confirmed through additional tests such as antibody detection or food-challenge tests, which might have led to missed cases, including less common conditions like pollen food allergy syndrome. This syndrome can cause mild symptoms, such as mouth itching, in individuals with specific pollen allergies when consuming raw fruits.
The increasing rates of food allergies in developed countries have long puzzled scientists. The “old friend’s hypothesis” offers one potential explanation, suggesting that changes in the microbiome, infections, and environmental factors may be contributing to this rise. Evidence supports this theory, showing a link between early antibiotic use and a higher risk of allergies later in life. Additionally, exposure to pollution may exacerbate allergy risks.
Dietary factors in early life also play a crucial role. Previous UK guidelines recommended avoiding early exposure to peanuts and eggs, which may have inadvertently contributed to the increase in allergies to these foods. More recent studies, however, indicate that early introduction of peanuts and eggs may reduce the risk of developing allergies. The UK revised its dietary advice in 2009, but the supporting trials demonstrating the benefits of early exposure were not published until 2015 and 2016. The recent plateau in allergy rates could be linked to these changes in dietary recommendations.
Effective management of food allergies is essential. For infants diagnosed with food allergies, gradual reintroduction of the allergenic food under medical supervision has shown promise in helping them overcome their allergies. However, proper management requires expert support, which may be lacking in general practice settings.
The study underscores the need for improved support and resources for individuals with food allergies in the UK. Enhanced guidance from specialists, such as dietitians, and better access to necessary medications are crucial for effective allergy management.
