Peanuts in shells arranged over a blue background

When it comes to food allergies, lack of savvy matters—reactions send people to the emergency room every three minutes.

Here’s the 411 on food allergies, courtesy of Gabriela Gardner RDN-AP, LD, CNSC, clinical dietitian at Memorial Hermann–Texas Medical Center’s Ertan Digestive Disease Center.

Q. What are the top food allergies?

A. Nine of 10 food allergies can be blamed on eight foods:

  • Soybeans
  • Peanuts
  • Milk
  • Wheat
  • Eggs
  • Fish (bass, flounder and cod)
  • Shellfish (crab, crayfish, lobster and shrimp)
  • Tree nuts (almonds, walnuts and pecans)

Q. Are some food allergies more deadly than others?

A. Any food can cause a severe reaction. However, peanuts, tree nuts and cow’s milk tend to cause the most life-threatening reaction, anaphylaxis.

Anaphylaxis is an acute reaction in which the throat and airways close and blood pressure plummets as the body releases an antibody intended to eject the unwelcome invader.

The FDA estimates such extreme allergic reactions lead to 30,000 emergency room visits, 2,000 hospitalizations and 150 deaths every year.

An allergist can check you for both food and airborne allergies.

Q. What are signs you’re having a food allergy reaction?

A. Signs may include rash, itching, tingling, wheezing and swelling of the throat, tongue, lips and face. Stomach cramps also are possible.

Q. Which food allergies tend to occur in childhood? Later in life?

A. Any allergy can appear in childhood, but most common are cow’s milk, wheat, eggs and soy.

A child may outgrow an allergy, particularly cow’s milk, Gardner says. “But generally, if they’re still reacting to a food at age 5, they’re less likely to outgrow it.”

Other top allergies may arise in adulthood. “The response is very individual, and we have no way to predict when an allergy may occur,” Gardner says. “Generally, allergies to peanuts, tree nuts, fish or shellfish are lifelong.”

Q. Do certain food allergies accompany other allergies?

A. Yes. People who are sensitive to certain airborne allergens may develop some food allergies, “This is known as oral allergy syndrome.”

Thus, if you’re susceptible to ragweed pollen, during seasons where ragweed pollen is high the person may experience a reaction with the ingestion of one of the following: cantaloupe, honeydew, watermelon and bananas.

Foods associated with birch tree pollen allergy include: apples, apricots, cherries, peaches, pears, plums, kiwi, carrots, celery, parsley, almonds and hazelnuts.

Q. How can you treat a food allergy reaction?

A. If you think you’re having an allergic reaction, you should first ask for help. If you’ve previously experienced a food reaction, you may have been prescribed an Epipen, an auto-injecting device containing epinephrine—this will help open your airway and raise your blood pressure. Epipen use can save lives in those with anaphlaxis.

A medical bracelet can alert others to an allergy should the person lose consciousness and some people may need CPR.

If symptoms are mild, over-the-counter antihistamines (such as Benadryl) may control rash, itching and swelling.

Q. What does getting tested for food allergies involve?

A. You can be checked for both food and airborne allergies. An allergist can pinpoint the precise culprit and the severity of your response. Usually, the doctor administers a skin prick test, in which serums with specific allergens are injected just below the skin surface in arms or back and they observe if there are any reactions and the severity.

Your blood also could be tested for IgE antibodies, but this test is less accurate compared to the skin prick test.

“Either test should be done under supervision of a doctor because if the person develops anaphylaxis during testing, they’ll need immediate care.”

Q. How many people have food allergies?

A. Up to 15 million Americans have food allergies, including 5.9 million children under age 18, reports the U.S. Centers for Disease Control and Prevention’s latest data.

That’s one in 13 children, or roughly two in each classroom. And about 30% of children with food allergies are allergic to more than one food—and they also are more likely to suffer asthma or skin irritation known as eczema.

Q. Are food allergies becoming more common?

A. We’re seeing more food allergies, but researchers have yet to find the reason, Gardner says.

The CDC reports prevalence of food allergies in kids rose 50% between 1997 and 2011. Peanut or tree nut allergies tripled in children during that time frame. Childhood hospitalizations also have tripled.

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