Last week, the National Academies of Sciences put out a report outlining the gaps in global food allergy management. Titled, “Finding a Path to Safety in Food Allergy Assessment of the Global Burden, Causes, Prevention, Management, and Public Policy,” the authors made recommendations that would lead to significant change in the quality of life of patients and families living with food allergies.
This was an important and informative report which helps prioritize ways in which we may see adjustments to food allergy diagnosis, information and policy in the future. I listened to the live presentation while furiously taking notes, but you can read the report for yourself at:
In case you missed it, here are the highlights and some reflections:
Prevalence of Food Allergies:
The committee noted that although no formal studies have been able to corroborate the information, doctors across the country have confidently noted the increased prevalence of food allergies. Studies of this sort are difficult to conduct and expensive, Dr. Hugh Sampson of the Icahn School of Medicine at Mount Sinai in New York noted. However, the true prevalence of food allergies would help lawmakers and other health-related institutions prioritize food allergies as the “major health problem” it is in this country. It is currently estimated that between 12 and 15 millions American are living with food allergies.
Recommendation: The CDC or other organization conduct a food allergy prevalence test that will help inform us of current food allergy levels and serve as a baseline for future assessments.
This is no one, standard way to diagnose food allergies. Some doctors use skin tests (otherwise known as “scratch tests”) and some use IgE blood tests. Still others consider the use of IgG testing to detect food intolerances. Each test varies in conclusiveness and none can accurately predict the reaction a person will have to an allergen. Only an oral challenge can determine the type and severity of an allergic reaction.
[More on this testing in a separate post.]
Recommendation: Doctors follow a standardized set of tests and protocols to inform them of a patient’s allergy and future medical action.
While there has been much in the news about best strategies to prevent food allergies from developing, advice on the ground from doctors and within parenting circles is lagging.
Recommendation: Clear, concise and solid advice about the early introduction of food and its benefits would greatly help parents and patients alike.
Education and Training
Misconceptions still abound. Some dangerous. Timely, proper management of food allergies saves lives.
Recommendation: The launch of an educational campaign to align doctors, patients and general public regarding the diagnosis, prevention and management of food allergies. This is especially important in organizations that provide emergency services as well as in medical schools and other healthcare institutions.
Policies and Practices
The list of major allergens identified in each country has not been updated since they were established in 1999. And, labeling laws (particularly those known as Precautionary Allergen Labels, PALs – “may contain” and “made on equipment with” are two examples) aren’t currently effective at helping consumers assess risk.
Recommendation: Reassess the priority list of major allergens to better identify regional allergens. Develop a new, risk-based system for labeling – specifically to address issues related to PALs – and outline guidelines for the labeling of prepackaged food such as those distributed at schools, on airlines, and in other public venues. Additionally, the committee recommended that federal agencies re-imagine and standardize food allergy and anaphylaxis response training for employees who work at public venues (schools, airlines, etc).
I was encouraged to listen to the guidance from the committee in each area. There is certainly a long way to go in getting federal and state-level attention for the growing epidemic that is food allergies. But by identifying current gaps and taking action to improve communication of standardized, evidence-based information and advice, I am confident we can help improve the lives of those living with food allergies in the near future.