In February 2023, 13-year-old Hannah Jacobs died of a severe allergic reaction after drinking a hot chocolate from Costa Coffee. Hannah suffered from allergies to dairy, fish and eggs, and her mother asked for soy milkbut the contains hot chocolate cows’ milk. In July 2016, 15-year-old Natasha Ednan-Laperouse died on a flight after eating a Pret a Manger baguette she bought at Heathrow. She had a severe allergic reaction to sesame, which was baked into the bread was not listed on the ingredients label.
These types of fatal events linked to food allergies seem to be occurring more frequently. They make headlines and have fueled a movement to make airplanes, schools and other confined environments “nut-free.” But are food allergies really on the rise, or is our coverage of them simply increasing?
A recent study in the Lancet Public Health journal provides answers. Led by Paul Turner of Imperial College London, it found that food allergies had doubled between 2008 and 2018. Most of these affect children. Reviewing data from GP surgeries in England, the researchers found that food allergies had increased across all age groups from 0.4% to 1.1% of the population.
Since 2014, the rise has been less significant, which may be due to advice from NHS and medical staff to introduce potential food allergens into the diets of children before the age of 12 months. Early introduction appears to significantly reduce the risk of developing allergies to foods such as peanuts and eggs. But we cannot see what happened more recently: the Lancet Public Health analysis could not go beyond 2020 because the Covid pandemic affected GP visits and data.
This rise in allergies is not unique to England. They are increasing around the world. What does this explain? Experts have put forward a number of hypotheses, all of which need to be tested. A food allergy is caused by the immune system overreacting to certain foods, releasing chemicals that cause symptoms such as itchy skin and hives, a swollen face, eyes or lips, breathing problems and even cardiac arrest. In short, food substances cause the immune system to malfunction. As the medical anthropologist Theresa MacPhail put it: “If your immune response is triggered by the wrong things, it will kill you trying to protect you.”
One possible explanation is the rise of the “western” diet, which is high in ultra-processed foods. A 2022 study of nearly 3,000 children and 4,256 adults in the US suggested that consumption of ultra-processed foods is associated with allergic symptoms in children and adolescents. Perhaps the full adverse impact of ultra-processed foods is just now be recognizedas data is collected and analyzed. There are close connections between the gut microbiome and the immune system; similar concerns have been raised about their possible link gastrointestinal tract cancer in young people.
Another theory is that those who developed allergies a deficiency of vitamin Dthe vitamin that our body produces when exposed to sunlight. Surveys have shown that children a increasing amount of time indoors on screens instead of playing outside. This isn’t just a post-pandemic trend: it’s been happening for over a decade, along with the growing use of tablets, game consoles and phones.
Other explanations included the widespread use of antibiotics in young children (for ear infections or other ailments), affecting the digestive tract, rising air pollution and early exposure to skin infections. The health community will continue to look to scientists like Turner, who is also a pediatric allergy consultant, to test the various hypotheses about why these allergies develop and what can be done to prevent them in children.
We need to support those with severe allergies by raising awareness in the food and drink business to ensure proper labeling and stop cross-contamination; by moving to “allergen-free” environments, including on airplanes and in schools; and by ensuring that people have broad access to EpiPens and other treatments to prevent life-threatening incidents. Turner led another analysis who found that many patients were not prescribed these pens even after suffering a severe allergic reaction.
We are only beginning to understand the rise of food allergies. It’s a topic that’s ripe for more research, because it can literally be a matter of life and death.
