The number of fatal food allergies among children is increasing. The cause is not what you might think | Devi Sridhar

IIn February 2023, 13-year-old Hannah Jacobs died from a severe allergic reaction after drinking hot chocolate from Costa Coffee. Hannah suffered from allergies to dairy, fish and eggs, and her mother had asked for soy milkbut the hot chocolate included cow’s 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 but not listed on the ingredients label.

These types of fatal events associated with food allergies appear to be becoming more common. They appear in the headlines and have stimulated a movement to make planes, schools and other restricted environments ‘nut-free’. But are food allergies really increasing, or is our reporting about them only increasing?

A recent study in the journal Lancet Public Health provides answers. Under the leadership of Paul Turner of Imperial College London, it was discovered that there were food allergies doubled between 2008 and 2018. Most of these affect children. Looking at data from GP practices in England, researchers found that food allergies had increased from 0.4% to 1.1% of the population across all age groups.

Since 2014 the increase has been less noticeable, which may be due to advice from the NHS and medical staff to introduce potential food allergens into children’s diets 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 can’t see what happened more recently: the Lancet Public Health analysis couldn’t go beyond 2020 because the Covid pandemic affected GP visits and data.

This rise in allergies is not unique to England. They are increasing all over the world. What explains this? 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, swollen face, eyes or lips, difficulty breathing and even cardiac arrest. In short, food substances ensure that the immune system does not function properly. As medical anthropologist Theresa MacPhail put it, “If your immune response is triggered by the wrong things, it will kill you by trying to protect you.”

One possible explanation is the rise of the “Western” diet, which is rich in ultra-processed foods. A 2022 study of nearly 3,000 children and 4,256 adults in the US suggested that consuming ultra-processed foods was associated with allergic symptoms in children and adolescents. Perhaps the full harmful effects of ultra-processed foods are only now emerging be recognisedwhile data is collected and analyzed. There are close links between the gut microbiome and the immune system; Similar concerns have been raised about the possible link with cancer of the digestive tract in young people.

Another theory is that those who develop allergies are deficiency of vitamin Dthe vitamin that our body produces when exposed to sunlight. Research has shown that children are spending more and more time indoors on screens instead of playing outside. This isn’t just a post-pandemic trend: it has been going on for more than a decade, alongside the increasing use of tablets, gaming consoles and phones.

Other explanations include the widespread use of antibiotics in young children (for ear infections or other conditions), 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 people with severe allergies by raising awareness in the food and drink industry to ensure correct labeling and stop cross-contamination; by moving towards “allergen-free” environments, including on airplanes and in schools; and by ensuring people have wide access to EpiPens and other treatments to prevent life-threatening incidents. Turner led another analysis which showed that many patients are not prescribed these pens even after experiencing a severe allergic reaction.

We are only now beginning to understand the rise of food allergies. It’s a topic ripe for more research because it could literally be a matter of life and death.