The Rising Prevalence of Food Allergies Facts and Figures

Allergens are present in the food we eat, in everyday items that we use or wear and in the environment around us. Food allergies are thought to affect between 1% and 2% of the UK adult population. 

More data needs to be collected about allergies, in particular in Asia and parts of the developing world; however, it is widely accepted that the prevalence of food allergies is increasing globally. This includes both diagnosed allergies and people self-reporting to be allergic to food items.

Being allergic to foods can impact a person’s lifestyle and, in severe cases, allergies can actually threaten a person’s life. Increased education and advocacy about allergen awareness in the UK, including food law on allergen labelling, is improving outcomes for people living with allergies or food hypersensitivities. However, in some parts of the world, it remains an emerging area of research that requires better knowledge and funding. 

Prevalence of Food Allergies

Allergies are on the rise across the globe. Scientists and other experts are unsure exactly why this is happening; however, research into the phenomenon is ongoing.

Hospitalisations due to severe allergic reactions are rising, although related deaths are falling.

The way people experience allergies in different parts of the world is thought to be connected, for the most part, to:

• Dietary differences
• Differences in our exposure to pollen
• Available healthcare services / health-seeking behaviour

In the UK, around 2 million people are thought to have a diagnosed food allergy. In the US, 33 million people are thought to have allergies. Australia has some of the highest rates of allergies in the world with food allergies seen in 10% of infants, 4-8% of children and 2% of adults.

The impacts of food allergies are being increasingly considered a worldwide public health burden. The World Health Organization (WHO) estimates that food allergies affect more than 10% of the general population worldwide. 

The rising instances of food allergies is possibly due to changes in our modern lifestyles, such as unhealthy eating and city living, rather than family history/genetics. 

Age and Food Allergies

Current estimates suggest that more children than adults have allergies in most of the countries in the world that we have available data for. In the UK in particular, whilst allergies affect 1% to 2% of the adult population, it is thought that between 5% and 8% of children are living with allergies. With many allergies going undiagnosed, these numbers are likely much higher in reality. 

Up to 80% of children will grow out of their allergies to common allergens such as milk, eggs or soya by the age of five. However, allergies to seafood, peanuts and tree nuts are rarely outgrown.

A study funded by the Food Standards Agency and Medical Research Council found that young adults are the group most at risk from severe and fatal allergic reactions to foods. It also found that although almost half of all deaths from anaphylaxis were related to peanuts or tree nuts, in children, the most common cause was a fatal reaction to cow’s milk.

Due to increased awareness about food allergies, people may be becoming more likely to seek a medical diagnosis if they have experienced allergic symptoms after consuming food, particularly for their children. 

After an allergic reaction, it is not always immediately obvious what specific food caused it, as it could be an ingredient within an item, including one that there are only trace amounts of.

If you are worried that you or your child have an allergy you can speak to your GP. If they think it is necessary, they may refer you for allergy testing. 

Allergy testing usually involves one or a combination of the following:

• Skin prick or patch tests – this is where small amounts of allergens are put onto the skin to see if a reaction occurs
• Blood tests – blood samples are taken to check for allergens
• A special diet – avoiding or reducing certain foods to see if symptoms improve and the problematic food can be isolated

Common Allergens 

When some people consume a trigger food that contains an allergen, their body produces an immune response which leads to chemicals, including histamine, being released. 

Allergic responses to foods vary from mild discomfort to severe anaphylaxis, an acute allergic reaction which can be fatal. Anaphylaxis is a very serious allergic reaction and requires hospital treatment.  

Certain foods will trigger painful, uncomfortable and potentially dangerous symptoms in people who are allergic or intolerant to them.

Food hypersensitivity is an area of ongoing research. This research looks at both allergies and coeliac disease. Coeliac disease is an autoimmune disease triggered as a response to eating gluten. Research suggests 1 in 100 people in the UK may currently suffer from coeliac disease.

According to current NHS data, the most common allergenic foods include: 

• Cow’s milk
• Eggs
• Peanuts
• Tree nuts (walnuts, hazelnuts, pecans etc.)
• Fish and shellfish (prawns, crab, lobster etc.)
• Wheat
• Soy
• Sesame

However, the UK government has outlined a list of 14 specific allergens that they consider the most common allergenic items. The law requires that food businesses must declare if these allergens are present in food; this is often done by printing them clearly on menus, highlighting them on packaging, having signs clearly displayed or having an allergy sheet available that contains all of the relevant data.

The common 14 allergens set out in law are:

• Celery
• Cereals that contain gluten (including wheat, barley and oats)
• Crustaceans (including prawns and crabs)
• Eggs
• Fish
• Lupin
• Milk
• Molluscs (including mussels and oysters)
• Mustard
• Peanuts
• Sesame
• Soy
• Sulphur dioxide / sulphites (if they are at a higher concentration than 10 parts per million)
• Tree nuts (including hazelnuts, pistachios, cashews and walnuts)

These allergens apply to not only the finished product but also any ingredients, manufacturing or processing methods used. People can be allergic to both basic foods or food ingredients as well as to food additives, such as food colouring, sulphites or E-numbers. 

In addition to food allergies, people in the UK experience other types of allergies, such as:

Insect bites or stings (especially bee stings)

• Animals/pets
• Tree and grass pollen (hay fever)
• Latex
• Dust allergies
• Chemicals
• Cosmetics (including shampoos, soaps, make-up and perfume)
• Medicine

Key legislation that relates to food allergies in the UK includes:

• The Food Safety Act 1990
• The Food Labelling (Declaration of Allergens) (England) Regulations 2008
• The Food Information Regulations 2014
• Natasha’s Law

When preparing food, it is important to understand good allergen management, such as correct labelling as well as cross-contact (where an allergen is accidentally introduced, for example via toast crumbs entering butter from a knife).  

Contributing Factors 

Although anyone can develop a food allergy, some common risk factors include:

• Eczema
• Genetics/family history
• Asthma
• Changes to microbiome (microscopic bacteria, fungi and other organisms that live in and around our bodies)

Both eczema and food allergies have been on the rise for the past few decades. This has given researchers the idea that the two may be linked. Children with moderate to severe eczema are more likely to develop food allergies than children who have mild eczema or no eczema at all.  

Some scientists are currently exploring whether children with eczema may actually absorb allergens through their damaged skin in early life, rather than ingesting them, causing their immune system to be triggered as the body thinks the allergen is a threat. 

Some non-UK-based studies have found a potential link between environmental factors (in particular a shift towards more urban living) and food allergies. In addition, a paper published in 2018 suggested a vitamin D deficiency in early life may contribute to the risks of a child developing an allergy. 

The Impact of Food Allergies 

Having an allergy can impact a person’s life significantly, especially if the allergic reaction is severe. Allergies can make normal activities more challenging and riskier. Allergies can affect people at home, when they go out and when they go to work. 

Having an allergy means that you have to be extra vigilant and aware when undertaking activities that people who have no food hypersensitivity may take for granted, such as:

• Eating out at restaurants or cafes
• Attending children’s birthday parties
• Buying takeaway items
• Having a school meal
• Shopping at the supermarket
• Going to a dinner party
• Buying food from the staff canteen

The impact of having a food allergy may include: 

• Reduced choice
• Stress
• Isolation / feeling or being left out
• Being mislabelled as ‘difficult’ or ‘fussy’

The negative health effects from symptoms of allergic reactions cannot be emphasised enough. Although they vary in severity, people with allergies often suffer uncomfortable, irritating and painful symptoms. According to government statistics, anaphylaxis, the most serious type of reaction, is thought to cause 20-30 deaths per year (actual numbers may be even higher). 

Symptoms of an allergic reaction can include:

• Sneezing or a runny nose
• Itchy raised rash (hives)
• Skin redness, swelling or tenderness (often on the face, ears, hands or feet)
• Nausea or sickness
• Upset stomach
• Swollen eyes, lips or throat
• Tightness in the throat or chest
• Problems breathing

Treating food allergies also has an economic impact on the health service. 

Panic and misunderstandings about food allergies, especially in countries where access to education and healthcare is limited, or there is food insecurity, can pose a risk of increased rates of malnutrition when the avoided food is considered ‘essential’. In such instances, it is crucial to increase awareness, improve education and ensure suitable alternatives are widely accessible.  

Research and Future Outlook

There is currently no cure for food allergies. Healthcare providers will usually advise patients with allergies to:

• Avoid the allergen as far as possible
• Manage symptoms using medicine when an allergic reaction occurs

Allergic reactions are often treated with antihistamines or steroids. Severe anaphylaxis is treated with adrenaline. People known to suffer anaphylaxis are usually prescribed an adrenaline auto-injector (EpiPen) to keep with them at all times. 

In severe cases, immunotherapy may be used. This involves tiny amounts of an allergen being gradually introduced over time to begin to desensitise the body to the trigger. Immunotherapy/desensitisation must only be done under the guidance of a medical professional. 

Historically, those with allergies had reduced choice when it came to food and the cost of buying alternatives, or ‘free-from’ products, was often higher than traditional products. The rising prevalence of food allergies is changing the landscape of allergen-friendly shopping. Many supermarkets offer their own ranges of free-from items and the pricing of lots of allergen-friendly products is making them more affordable.

Dining out or attending parties is also becoming easier for allergy sufferers to navigate. Most menus indicate allergens now and food service staff must have undertaken basic allergen training. The quality of allergen-friendly items (such as gluten-free cakes, dairy-free ice cream etc.) is also improving with it sometimes being difficult to tell the difference between the allergen-friendly version and the traditional version of a product.

Improved legislation around food labelling is also making it easier to spot allergens in foods across the board.

Research into diagnostics and treatment of allergies is ongoing, as well as research into disorders relating to food allergies, such as oral allergy syndrome and eosinophilic esophagitis. Research can provide insight into:

• New treatments
• Prevention options
• Risk management
• The relationship between food allergies and other related issues (such as eczema, asthma or oral allergy syndrome)

Collaborative research into allergies and their prevalence can also help to inform new legislation or guidance about allergens.

Data on changes in the prevalence of allergies in the developing world is limited and this is an area that requires further study in order to better understand global trends on the subject.

Conclusion

Having food allergies can seriously affect the way we eat, socialise and shop. Anxieties about severe allergic reactions can lead to stress and isolation and allergic reactions can lead to discomfort, upset and occasionally even death. 

Allergies are on the rise worldwide; however, so is increased awareness about them. Better legislation around allergen labelling means improved outcomes for people living with food hypersensitivities. In turn, this is reducing instances of severe allergic reactions which lowers the burden on healthcare services. 

If you would like to try your hand at cooking some delicious, allergen-free recipes, you may enjoy our blog post which is packed full of allergen-friendly cooking ideas here.