FAMILIES managing food allergies often exclude allergens from their homes, a practice linked to greater psychosocial stress. Food allergy affects approximately 10% of children worldwide, posing significant challenges for families. Allergies to common foods such as peanuts, tree nuts, and sesame frequently result in anxiety about accidental exposure and emergency management. Many families adopt allergen exclusion practices in the home to mitigate these risks, but the psychosocial impacts of this approach have been less explored. Recent research examined the prevalence of allergen exclusion and its association with psychosocial functioning in families of children with food allergies.
A cross-sectional survey was conducted between April 2022 and November 2023, involving 919 parents of children diagnosed with food allergies. The participants, predominantly mothers (96.6%), represented diverse regions of the United States and Canada. Logistic regression analyses compared food exclusion practices by allergy type and assessed associated psychosocial outcomes. Among households, 63.8% excluded at least one allergen. Allergies to peanuts, tree nuts, and sesame were most commonly associated with exclusion, with 62.4%, 54.7%, and 51.3% of affected families respectively removing these allergens. In contrast, only 24.3% of families with egg allergies excluded eggs.
Parents who practised allergen exclusion reported higher mean scores for worry (2.6 vs 1.7), anxiety (34.3 vs 16.9), and lower self-efficacy (79.7 vs 84.8) compared to those who did not exclude allergens (all p < 0.001). Children in allergen-exclusion households were also more likely to have elevated anxiety scores, particularly among those aged 8 to 17 years (30.4% vs 15.6%, p = 0.03). These results suggest that allergen exclusion practices may exacerbate stress and anxiety in both parents and children.
While allergen exclusion may offer a sense of safety, this study highlights the unintended psychosocial burden it may impose. Clinicians are encouraged to ask families about their allergen management practices and provide guidance on reducing anxiety. Future research should explore strategies to improve psychosocial well-being in families managing food allergies, particularly those involving prevalent allergens such as peanuts and tree nuts. Addressing these concerns in clinical practice could enhance the quality of life for both children and their families.
Abigail Craig, EMJ
Reference
Ruran HB et al. Household food allergen exclusion practices and food allergy-related psychosocial functioning. JAMA Netw Open. 2024;7(12):e2452646.