No, your kid is not allergic (probably)

Pax Arcana

In every classroom in every elementary school across the entire nation, your children sit in mortal danger of spiraling into a terrible, violent death. The cause for alarm? Peanuts. And wheat. And milk. And cherries. And glucose. And shellfish. And anything else that can accurately be described as “food.”

Don’t get me wrong. Food allergies exist, and can be very dangerous. Even deadly.

But they are also incredibly rare. And there is no way in hell they affect as many people as it appears.

peanut_sandwichFor long time, I thought parents were simply overreacting to a perception epidemic — that they were claiming food allergies simply to guard against the worst-case scenario. Or they were simply gaming the system to ensure that little Schuyler didn’t ingest anything in school that mommy wouldn’t approve of.

But still, I’ve met more than my share of young parents whose children have legitimately tested positive for certain types of allergies. What is to explain this?

The answer may be partly environmental or biological. But also, according to this, it appears some food allergy tests may be total bullshit:

The culprit appears to be the widespread use of simple blood tests for antibodies that could signal a reaction to food. The tests have emerged as a quick, convenient alternative to uncomfortable skin testing and time-consuming “food challenge” tests, which measure a child’s reaction to eating certain foods under a doctor’s supervision.

While the blood tests can help doctors identify potentially risky foods, they aren’t always reliable. A 2007 issue of The Annals of Asthma, Allergy & Immunology reported on research at Johns Hopkins Children’s Center, finding that blood allergy tests could both under- and overestimate the body’s immune response. A 2003 report in Pediatrics said a positive result on a blood allergy test correlated with a real-world food allergy in fewer than half the cases.

In one case mentioned in the article, a young boy was given a feeding tube (!!!) because blood tests indicated he was allergic to just about everything. Doctors gave the kid the old taste test and found at least 20 types of food he could eat.

And then there’s the common doctor’s warning against giving your kid peanuts and other common allergenic foods. A 2008 study of 10,000 British babies found that exposure to peanuts lowered the incidence of allergies.

Some doctors even advise against giving your kids food allergy blood tests, because they are more likely to return false positives than actually spot a problem.

If only there was some foolproof way to know whether you or your kid is actually allergic to food.

“The only true test of whether you’re allergic to a food or not is whether you can eat it and not react to it,” said Dr. David Fleischer, an assistant professor of pediatrics at National Jewish Health.

Well okay then, Dr. Smarty Pants.

Telling Food Allergies From False Alarms [NYT]

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