FOOD allergies (FAs) are an escalating public health concern, with studies documenting a troubling rise in cases worldwide. Although estimates suggest that FAs affect roughly 2% of the population, self-reported cases often suggest higher prevalence rates. For example, in Saudi Arabia, 13% of adults reported FAs, yet physician-confirmed cases stood at only 6.5%. Similarly, a Canadian survey found 12.1% of participants claimed FAs, compared to 9.3% indicated by national data. This discrepancy highlights the challenges in accurately diagnosing FAs, as reliance on self-reports and specific antibody tests may not fully reflect true allergic responses.
Children are particularly susceptible, with some reactions linked to food additives, affecting 1.2% of young individuals. Common allergens include milk, eggs, peanuts, tree nuts, fish, and shellfish, often influenced by genetic predispositions and early feeding practices. The development of FAs involves both IgE-mediated and non-IgE-mediated immune responses, with genetic and environmental factors playing significant roles. Emerging research has revealed the importance of the gut microbiome in FAs. Dysbiosis, or microbial imbalance, can predispose individuals to allergies, while a balanced gut microbiome fosters immune tolerance. Studies have shown that early microbial exposure, such as through rural living or probiotic use, can protect against FAs.
Environmental factors such as urbanisation, pollution, and dietary habits also significantly contribute to FA risk. For instance, exposure to peanut dust in households increases sensitisation risk in infants, particularly those with eczema or genetic mutations like FLG. Moreover, cooking methods, which can alter protein structures, may affect allergenicity, influencing immune responses.
Addressing the FA epidemic requires improved diagnostic tools, public education, and targeted therapies. Strategies such as early allergen exposure, microbiome modulation, and personalised dietary recommendations hold promise for preventing and managing FAs. Further research into genetic-environmental interactions and immune mechanisms is critical for developing effective interventions and reducing the societal burden of FAs. By prioritising accurate diagnoses and evidence-based treatments, we can enhance the quality of life for those affected and mitigate this growing challenge.
Reference
Unar A et al. The role of bacterial toxins and environmental factors in the development of food allergies. Allergies. 2024; 4(4):192-217.
