The number of people diagnosed with food allergies in England has more than doubled in a decade and a third of those with life-threatening reactions do not carry adrenaline pens, research has revealed.
Experts at Imperial College in London GP records for 7 million people analyzed. The number of new food allergy cases increased from 76 per 100,000 people in 2008 to 160 per 100,000 people in 2018, they found. Total incidence grew from 0.4% to 1.1% over the 10-year period.
The highest food allergy prevalence was seen in children under the age of five, of whom 4% were affected. The figure was 2.4% for children aged five to nine, 2% for 10-14 year olds, 1.7% for 15-19 year olds and 0.7% for adults aged 20 or over in 2018, showed the data.
The rise in cases in England was likely mirrored in the UK, the researchers said. They also found that one in three patients who had previously experienced anaphylaxis – a life-threatening allergic reaction – did not have their own adrenaline auto-injectors (AAIs).
The findings has been published in the Lancet Public Health journal.
Lead researcher Dr Paul Turner, a professor of pediatric allergy at Imperial’s National Heart and Lung Institute, said the results showed there was an “urgent need” to “better support GPs and primary care staff” to help patients with food allergies to take care of.
“Food allergy can have a huge impact on people’s lives, and in some tragic cases it can shorten lives,” he said.
Food allergies occur when the immune system overreacts to certain foods, such as cow’s milk, peanuts, eggs or shellfish. In severe cases, this can lead to anaphylaxis, which can cause swelling of the airways, breathing problems and cardiac arrest.
The study did not examine why cases increased, but experts said there are likely many different factors behind the increase. For example, increased awareness of food allergies is likely to have led to more people seeking help from the NHS.
Parents who follow outdated advice about not giving their baby certain foods until they’re older are probably also to blame, experts said. If a child has been prevented from eating peanuts, exposure through dust, contact with furniture or ice cream containing peanut oil can cause a reaction in their immune system.
Increased use of cleansers, creams and body lotions may also play a role because they can break down the skin barrier, experts said. This allows food to enter the immune system through the skin, rather than through the gut, which increases the risk of food allergies.
Poor diets, genetics, vitamin D deficiency, pollution and environmental factors have also previously been proposed as possible explanations for the rising number of cases.
Imperial said that while more doctors diagnosed food allergies in the decade studied, the incidence of new cases may be slowing. It was unclear why newly diagnosed cases of food allergy might be leveling off, they said.
One possibility was changes in infant feeding guidelines that no longer recommend delaying the introduction of foods such as peanuts into a child’s diet, Imperial said. In children at higher risk of food allergies, earlier introduction of eggs and peanuts are now standard recommendations.
Turner said the study paints an important, if mixed, picture of food allergy in the UK.
He added: “The good news is that although the incidence of food allergy has increased, the number of new cases occurring each year appears to have plateaued. However, more than one-third of patients at risk of severe reactions do not potentially carry life-saving adrenaline auto-injectors, such as EpiPens.”
Prescriptions for AAIs — devices given to those at risk of anaphylaxis — were also less common for people living in more deprived areas of the country, researchers found. Only 55% of adults and 64% of children who had previously experienced anaphylaxis had AAI prescriptions.
Nadim Ednan-Laperouse, the co-founder of the Natasha Allergy Research Foundation, said: “It is shocking and worrying to discover that more than a third of people who experienced anaphylaxis – the most serious allergic reaction – were not prescribed an adrenaline not. auto-injector, and the poorest in society are less likely to have prescriptions for these life-saving medicines.
“This is totally unacceptable and will inevitably put lives at risk. Anyone with a severe food allergy should carry two AAIs with them at all times.”
