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The Rise in Childhood Food Allergies
The facts about the increase of allergic disease in childrenCourtesy of Health Behavior News Service;
reprinted with permission. Copyright © 2007.
Widespread and Growing
The International Study of Asthma and Allergies in Childhood surveyed more than 700,000 children in 56 countries since 1991. The latest numbers from ISAAC show a significant worldwide increase in allergy symptoms, particularly among younger children.1
"I think it is a pretty global increase, as we have seen the rise in various types of allergies food, pollen, animal dander, hay fever and food allergies," says Scott Sicherer, M.D., a pediatric allergy specialist at Mount Sinai School of Medicine in New York.
Familiar headlines: Another classroom becomes a peanut-free zone, another innercity child rushes to the emergency room in the throes of a severe asthma attack. News coverage of childhood allergies is on the rise, but the trend reflects a true increase in the prevalence of allergy and asthma in the past decade.
Why Now?The startling trend has researchers scrambling to find a cause that can explain both the speed and the scope of the rise in childhood allergy. One of the most popular explanations is the "hygiene hypothesis," which suggests the cleanliness of Western lifestyles has banished many of the infectious agents that train a child's immune system, making it prone to allergic overreaction.2 Other possible culprits include pollen increases from global warming3, environmental toxins4, common medications5 and changes in diet.6
A 2000 review of asthma trends worldwide concluded that asthma is more common in Western countries and that asthma prevalence increases in countries as they become more urban and westernized.7
Asthma prevalence among children in the United States rose from 3.6 percent in 1980 to 6.2 percent in 1996.8
A 2003 national telephone survey suggests the prevalence of children's peanut allergies doubled between 1997 and 2002.9
Cockroach and mouse allergens at levels high enough to contribute to asthma were found throughout a nationally representative sample of U.S. households, according to two recent studies.10, 11
In a study of nearly 14,000 7-year-old children in the United Kingdom, grass pollen and dust mites were the most common allergy triggers.12
Some evidence links obesity to a higher risk of developing asthma, but the underlying mechanism is not clear, finds a recent review.13
Firstborns may have a greater risk of developing asthma, allergy and eczema than later-born siblings, according to some studies.14, 15
A child's risk of developing a food allergy is greater when the child is fed solid foods before six months of age, according to a 2006 review.16
Intestinal parasites do not offer protection against the development of asthma, according to a 2006 systematic review.17
Soy formula does not prevent food allergy among infants at risk for such allergies, while hydrolyzed milk formula (milk proteins broken into tiny digestible pieces) may prevent wheezing in infants with a family history of asthma, according to two systematic reviews.18, 19
In a recent survey, 34 percent of parents who have children with food allergies said this has affected their child's school attendance.20
In another survey, 54 percent of teenagers with a food allergy said they sometimes purposely ate their "trigger" food.21
Allergy Side Effects: Stress and Isolation
For some children with food allergies, birthday parties, soccer games and school field trips are dreaded ordeals. Rather than face an unknown and uncontrolled food situation, families opt out. In a recent survey of 87 families, pediatric allergy specialist Mary Bollinger, D.O., and colleagues at the University of Maryland found that half had made significant changes to their social activities to accommodate their childs food allergy.20
Food allergies also affect home life, especially meal preparation. But Bollinger says allergies seem to have a greater impact on outside activities, "perhaps because there is a feeling of less control." Dr. Scott Sicherer, a food allergy specialist, said that many families shy away from events with food, at least at first."Sometimes it takes a lot of preparation to participate safely and so there could be reluctance. So many social activities are food-centric," he said.
Parents may be more anxious at the thought of sleepover camp or an after-school snack than the children themselves. In Bollinger's study, 41 percent of the parents surveyed said their child's allergy had a "significant impact" on their own stress levels. When Sicherer and colleagues asked a small group of teenagers and their parents about the worst part of having a food allergy, "the main parental answer was fear and anxiety about death in the event of a reaction. For the teens, the main problem was social issues," he said.
"You can imagine a teen's wish to fit in rubs against some aspects of food allergy management such as eating at a fast food restaurant," Sicherer said.
Sicherer's work "showed that the main thing teens wanted was for people around them to understand the allergy." Peer education "is an area of food allergy management that is sometimes overlooked," he added.
So far, there are very few studies about how stress and avoiding activities might affect the psychological and social development of children with allergies, Bollinger said. Her team is working on further studies to find out how food allergies might affect the relationship between parent and child.
The allergy itself can have potentially serious health consequences that should not be taken lightly, according to Bollinger: "If the child is going to be cared for by someone out of the home, it is important for them to understand the dietary restrictions and how to treat an allergic reaction," she said.
Sicherer, who has written a book for parents of children with food allergies22, said, "A balance can be obtained with a healthy amount of worry to be safe but not so much fear that social activities become problematic." He said parents should know as much as they can about their child's allergies and how to deal with emergencies so that social situations will seem less overwhelming.
"People with a food allergy should do and can do everything that a person without food allergies does, except for eating the food to which they are allergic," Sicherer said.
Copyright © 2007; Health Behavior News Service, reprinted with permission.
For the full text of this article, please visit:
This article first appeared in the Spring 2007 issue of Support Net™.