Food for Thought: A Current Look at Children’s Food Allergies

David Jeong, MD

Pediatric allergist David Jeong, MD, works with Benaroya Research Institute to explore the basic science of food allergies in children.

Whether or not we have a personal connection to food allergies, most of us are familiar with their impact. From peanut restrictions in schools to the prolific advertising of emergency auto-injectors, there’s a wider awareness of how severe food allergies can disrupt and even threaten lives.

It’s not our imagination that food allergies have spiked in recent years. According to a 2013 study by the Centers for Disease Control and Prevention, allergy rates in children increased approximately 50 percent between 1997 and 2011. What accounts for such a steep increase?

“First we must get away from the notion that just one thing causes food allergies,” says pediatric allergist David Jeong, MD. “The hygiene hypothesis, which points to excessive cleanliness skewing immune system development, may have some validity, but there’s a bigger picture. We see differences in food allergy rates by regions and cultural factors, such as the way food is prepared. For example, in the U.S. peanuts are often roasted which impacts how allergenic they are. Another difference among diverse populations is when foods are first given to children.”

Dr. Jeong notes that prior to 2008, the American Academy of Pediatrics recommended potentially allergenic foods – such as peanuts – not be given to children before three years of age. Yet studies of cultures that introduced peanuts earlier showed fewer food allergies than their peanut-delaying counterparts. Current guidelines now recommend delaying any solid food until four to six months of age, but there are no suggested delays for giving allergenic foods beyond six months.

Because food allergies can come on in infancy, Dr. Jeong recommends introducing one new food at a time in the first six to 12 months. That way a trigger food will be easier to identify. Even if it seems clear a certain food causes a reaction, it’s important to visit a pediatrician or allergist to have a test confirming the allergy.

As food allergies have no cure, avoidance of the trigger food remains the best defense, with antihistamines or epinephrine injectors on hand in case of accidental exposure. But promising new treatments are on the horizon, says Dr. Jeong, with some of the most advanced research and clinical trials happening right here in Seattle.

The Seattle Food Allergy Consortium (SeaFAC) is a collaboration of six institutions committed to world class food allergy treatment and research, and includes Virginia Mason, Benaroya Research Institute at Virginia Mason, Northwest Allergy and Asthma Center, UW Medicine, Seattle Children’s and  ASTHMA Inc Clinical Research Center.

“SeaFAC clinical trials are underway to discover if patients can be safely desensitized to food allergens, a type of immunotherapy,” says Dr. Jeong. “Immunotherapy has been around for many years in the form of allergy shots for environmental and bee venom allergies. In the future we may learn that controlled exposure to food allergens over time can reduce the severity or eliminate allergic reactions from foods.”

Dr. Jeong acknowledges some medical practices may be administering immunotherapy for food allergies “off-label,” but he cautions the treatment is still experimental and patients must understand the risks. Dr. Jeong suggests interested parents of children with a confirmed diagnosis of peanut, tree nut, milk, and/or egg allergy contact Benaroya Research Institute at Virginia Mason to learn about eligibility for clinical trials. Email allergy@benaroayresearch.org, or call
(877) 202-5200. To explore more food allergy research, education and local community resources provided by SeaFAC, visit seafac.org

 

Comments

  1. It is interesting that childhood allergies increase by 50% in just 14 years. It sounds like waiting too long to introduce new foods can increase the chance of an allergic reaction. Introducing one new food at a time in the first year sounds like good advice. Just be sure to visit an allergist if you notice a reaction. http://www.drdianeozog.com

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