What You Need to Know about Food Allergies

A collage of different types of food.Aug 29, 2023
  • For clear answers to your peanut allergy questions, visit NPB’s new website www.peanutallergyfacts.org. You’ll get tips for managing peanut allergies plus expert videos on topics ranging from proper introduction of potentially allergenic foods to young children to managing peanut allergies at school.
  • About 4% of teens and adults and 5% of children suffer from allergies, with less than 1% of Americans allergic to peanuts.
  • Fortunately, more than 99 % of people can enjoy nutritious and delicious peanuts and peanut products, while being part of the solution to keep those with allergies safe.

Facts and Figures

More than 160 different foods have been reported to cause a reaction. However eight foods are responsible for 90 percent of reactions in the U.S.: milk, eggs, peanuts, tree nuts, crustacean shellfish, fish, soy, and wheat (FDA, 2012).

According to the NIAID Guidelines for the Diagnosis and Management of Food Allergies in the U.S. (NIAID, 2010):

  • Approximately four percent of teens and adults and five percent of children suffer from allergies;
  • Among children, the most common allergens tend to be milk and eggs, while shellfish allergy is the most common allergen in adults;
  • Prevalence of peanut allergy and tree nut allergy in the U.S. are comparable at 0.6 percent and 0.4-0.5 percent, respectively.

More than 99 percent of people can enjoy peanuts without any issue.

Any food has the potential to cause a serious, even life-threatening reaction, so all food allergies should be taken seriously. Reactions are unpredictable from person to person and between reactions.

Diagnosis and Management

Diagnosing food allergies can be tricky, even for clinicians who work with food allergies all of the time. To make it more complicated, the symptoms can be confused with other conditions and can occur at any age (Skypala, 2011).

Fortunately, the National Institutes of Allergy and Infectious Disease convened a panel of experts from the U.S. and internationally to develop a consensus document to help. These guidelines provide more than 40 recommendations for the diagnosis and management of food allergies. The document was also published with a companion for families and caregivers called Summary for Patients, Families, and Caregivers. A few key highlights from the Guidelines include:

  • Diagnosis should be performed by a Board Certified Allergist.
  • The diagnosis process should include a detailed history, skin and/or blood tests, but each of these is insufficient for diagnosis alone.
  • Placebo controlled double blind oral food challenge is the gold standard, but an open challenge may be more reasonable.
  • The only current preventive treatment for managing food allergy is total avoidance. Food allergy reactions should be promptly treated and anaphylaxis should be treated with epinephrine.

It’s important for people to understand the difference between intolerances, sensitivities and allergies, since they are very different. For more information about food allergies, consult an allergist.

What’s Next

Research on food allergy is ongoing to answer many common questions such as:

  • What causes food allergies?
  • Can we prevent food allergies from developing? If so, how?
  • Why do adults sometimes develop food allergies?
  • How do breastfeeding and infant feeding affect the development of food allergy?
  • Can we reverse food allergy?

In the area of treatment, research is underway using oral or sublingual immunotherapy, as well as Chinese herbal therapy to elicit tolerance among those with food allergy. Each of these novel approaches is sure to provide additional pieces of the puzzle that is food allergy.

Handouts and Additional Resources


  1. U.S. Food and Drug Administration (FDA). Food Allergies: What you need to know. Available at https://www.fda.gov/food/buy-store-serve-safe-food/food-allergies-what-you-need-know.
  2. National Institute of Allergy and Infectious Diseases. Food Allergy: Guidelines for the Diagnosis and Management of Food Allergy in the United States. Available at https://www.niaid.nih.gov/diseases-conditions/guidelines-clinicians-and-patients-food-allergy.
  3. Skypala I. (2011). Adverse food reactions--an emerging issue for adults. Journal of the American Dietetic Association, 111(12), 1877–1891. https://doi.org/10.1016/j.jada.2011.09.001

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