At this point, the vast majority of us know someone who’s avoiding a specific food—or many foods—for one reason or another. Maybe they've suddenly gone gluten-free, abandoned alcohol for Dry January, or opted out of a whole slew of foods for a miserable month of Whole 30. But for the ones who say it's out of necessity due to food allergies, we're inclined to take them seriously; after all, food allergies can be deadly.
But, according to research published on Friday on JAMA Network Open, plenty of people who think they have serious food allergies might be fooling themselves (and ostensibly, others). The survey found that "real" food allergies are extremely common; at least one in ten American adults has one or more. But while that may sound high, as much as twice that many people believe they have food allergies when many of them do not.
While one in five adults is convinced that they're allergic to certain foods, only an estimated one in 20 has had those food allergies diagnosed by a physician. These findings come from a survey of over 40,000 adults in the United States that was conducted by a group of doctors and researchers affiliated with the Northwestern University Feinberg School of Medicine.
Per this new report, lots of Americans seem to be confusing food intolerances with food allergies. If they’re avoiding foods unnecessarily, their quality of life could be suffering as they bend over backwards to avoid common ingredients. With the most common food allergens being shellfish, milk, peanuts, and tree nuts, according to the report, think, for instance, of how much more difficult going out to eat is for those with a serious food allergy—checking ingredient lists, asking about cross-contact, and learning an entirely new process for ordering.
Overall, the research reinforces previous findings that people are increasingly avoiding foods without a legit scientific basis. A 2015 study found that if you don’t have celiac disease, gluten-free alternatives don’t really have any health benefits, but people who tolerate gluten just fine continue to buy those products anyway.
To differentiate between adults with "convincing" food allergies and those without, researchers relied on "stringent symptoms" in responses to those foods. Those reactions included hives, swelling, difficulty swallowing, trouble breathing, chest tightening, chest pain, vomiting, and a few others. In order for a food allergy to be classified as "convincing," the participant would have had to have experienced at least one of those things in response to a given food.
Participants could report from a wider range of symptoms including itching, hoarse voice, cough, and a feeling of impending doom (gotta love it!), but those alone would not classify a "convincing" food allergy, though they might qualify as an intolerance. (And while researchers mentioned that identifying the difference between allergies and intolerances might improve quality of life, there is, of course, the consideration that even if a food doesn't result in trouble breathing or vomiting, you might not want to eat something that makes you, say, hoarse and itchy.)
It's that confusion between food preferences, intolerances, and serious allergies that has led to a lot of confusion and scorn, especially in the restaurant world. Some chefs have denounced diners with "fake food allergies," for example. But while this all might be a headache for people involved in food preparation, it could have damning results for people with real allergies. Sure, maybe half of milk-avoiders are faking it, but the other half might spend the rest of the night on the toilet—or in the hospital—if they're accidentally served something that causes a reaction.
At the end of the day, per the report, people should seek medical testing if they suspect that they might have a real food allergy. This gluten-free guessing game isn't helping anyone.