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March 05, 2010

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John Talbott

This just in:
Food allergies may be less common than believed.
On its front page, the New York Times (5/12, A1, Kolata) reports that approximately "30 percent of the population believe they have food allergies," but a new report, "commissioned by the federal government," indicates that many of those people are wrong. "While there is no doubt that people can be allergic to certain foods, with reproducible responses ranging from a rash to a severe life-threatening reaction, the true incidence of food allergies is only about eight percent for children and less than five percent for adults."

Before reaching those conclusions, "researchers at Stanford University, Rand Corp., and the Veterans Affairs Palo Alto Healthcare System searched databases, analyzed reviews, assessed controlled trials, and compared sample sizes," the Los Angeles Times (5/11, Dennis) "Booster Shots" blog reported. "Their conclusion largely seems to be: What a mess." In other words, there is "voluminous literature related to food allergy, but high-quality studies are few." Yet, the confusion begins with terminology, according to the Wall Street Journal (5/11, Hobson) "Health Blog."

It "turns out that the term 'food allergy' has no universally accepted definition, nor are there well-accepted criteria for diagnosis," CNN (5/11, Landau) pointed out. Indeed, a "common method of diagnosing food allergies is the skin prick test," and a number of physicians "also recommend blood tests called 'serum-food specific IgE,'" while others turn to the "atopy patch test." But, "none of these methods...says anything about the severity of symptoms that a person will experience if he or she ingests the substance -- for some, there may be no reaction at all." In short, "there is no one test that's better than the other, either, researchers said."

Investigators also "looked at 25 studies of seven food allergy management strategies: elimination, immunotherapy, food substitutions, diets in breastfeeding women, medical or pharmacologic therapies, probiotics, and education," MedPage Today (5/11, Fiore) reported. Regarding elimination diets, the "lone study that assessed their effects reported improvement in atopic dermatitis," and "immunotherapy is promising...but data are insufficient to recommend use." In terms of prevention, "the researchers found that delayed introduction of solids was tied to decreased food intolerance, but the quality of these studies was limited," as well.

According to Medscape (5/11, Larson), this led the investigators to conclude that the "sweeping lack of key information has led to an overdiagnosis of food allergies -- a dangerous situation." But, on the other hand, the team wrote in their Journal of the American Medical Association paper, the "overdiagnosis or misdiagnosis of food allergy by medical practitioners obscures the substantial morbidity caused in patients truly affected by immune-mediated food allergy and serves to perpetuate some public misperceptions that food allergy is a trivial medical condition." HealthDay (5/11, Preidt) also covered the study.


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