Food Allergy Statistics Can be Confusing

by contributing writer, Carol Depke of Gateway FEAST

The exciting news of peanut-safe sections popping up all over is coming with some debate as we raise awareness. In an article that was referenced in the Boston Globe written two years ago, one might wonder if this is all necessary. Are peanut allergies really on the rise? One could construe this piece to imply that there is not an issue.

In my opinion, statistics can always be argued. There is no “fact” in statistics. I feel however, they can show trends. Even the argument that there aren’t that many deaths caused by anaphylaxis is flawed as apparently there is a problem with how a coroner labels the cause of death since asthma attacks and anaphylaxis look similar in the end.

However, here is our group medical advisor’s, a board certified allergist’s response to this confusing piece:

“I am not surprised that there is controversy over the concern. There probably always will be. The statements that Dr. Sanghavi makes are factual, but can certainly leave one confused.

Making a diagnosis of the basis of prick skin tests food-specific IgE levels or subjective assessment all do overestimate the incidence of true food allergy. Realize that there are a lot of people who equate food allergy with an upset stomach after eating onions.

But true food allergy does truly exist and is made on the basis of a clinical history and objective testing, such as skin or blood tests and an oral challenge.

Dr. Hugh Sampson has published data that demonstrates absolute levels of specific IgE are helpful for certain foods such as peanut. For example, if a peanut specific IgE is greater than 14, there is virtually a 100% chance that someone will have a positive challenge. (Recognize that this study was done in children who had symptoms supportive of food allergy--not a random group of healthy kids off the street.)

His statement about IgE levels is unfortunately misleading. We never measure total IgE levels in the evaluation of food allergy (or cat or dog or pollen allergy for that matter). Total IgE levels correlate very poorly with allergy; yet specific IgE levels do correlate with allergy to those specific allergens. It is not a perfect correlation; rather, when combined with a clinical history, it is good.

I think that ultimately this physician is on our side. His last paragraph does reinforce the importance of being prepared for the worst, and having injectable epinephrine.

Once again, allergies are of little concern to those who do not have them.”