Nearly Half of the People Who Think They Have a Food Allergy Actually Don’t

updated May 30, 2019
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(Image credit: Leela Cyd)

For those of us with food-based allergies, mealtimes can be a minefield, especially when eating food not prepared yourself. There are an astonishing 170 different types of foods that can cause allergies, including milk, fish, eggs, and wheat — all extremely common items in American food.

According to research organization Food Allergy Research & Education (FARE), approximately 15 million people in the United States have food allergies, including more than 5.9 million children. Every year approximately 200,000 people require emergency or medical care for allergic reactions to food, so for those with allergies, innocent mistakes can turn into life-or-death situations.

But recent research, however, seems to indicate that a big chunk of the people who think they have food allergies might not have them at all.

On January 4, a study published in the medical journal JAMA Network Open found that about half of adults in the United States who think they have a food allergy actually don’t. In a population-based survey an estimated 10.8 percent were food allergic at the time of the survey, whereas nearly 19 percent of the people surveyed self-reported an allergy that turned out to be something else completely: food intolerance, a less-severe form of food-based sensitivity.

The study was written by physicians from several hospitals and medical schools, led by Ruchi S. Gupta, MD, attending physician at Children’s Hospital of Chicago, and Professor of Pediatrics and Medicine at Northwestern Medical School. Gupta and her team found that while one in 10 adults have a food allergy, “nearly twice as many adults think that they are allergic to foods, while their symptoms may suggest food intolerance or other food-related conditions,” says Gupta in the study.

The Difference Between Food Allergies and Food Intolerance

A true food allergy causes an immune system reaction that affects numerous organs in the body. According to the Mayo Clinic, it can cause a range of symptoms, in some cases an allergic food reaction can be severe or life-threatening. “In contrast, food intolerance symptoms are generally less serious and often limited to digestive problems,” says Dr. James Li, chair of the Division of Allergic Diseases in the Department of Internal Medicine for Mayo Clinic. Just think of how many people claim that they’re allergic to gluten these days. With no confirmation from their doctors, what that person may be experiencing (if anything medically worse than poor judgment), may be food intolerance.

“If you have a food intolerance, you may be able to eat small amounts of the offending food without trouble. You may also be able to prevent a reaction. For example, if you have lactose intolerance, you may be able to drink lactose-free milk or take lactase enzyme pills (Lactaid) to aid digestion.”

Other causes of food intolerance include the absence of an enzyme needed to fully digest a certain type of food, like lactose intolerance, irritable bowel syndrome, celiac disease (which believe it or not isn’t actually a food allergy, but a digestive condition), and sensitivity to food additives like sulfites (the chemical that preserves dry fruit, wine, and other foods) which causes asthma attacks in certain types of people.

If You Think You Have a Food Allergy, Get Tested

“It is important to see a physician for appropriate testing and diagnosis before completely eliminating foods from the diet,” Gupta explains. “If food allergy is confirmed, understanding the management is also critical, including recognizing symptoms of anaphylaxis and how and when to use epinephrine.”

Having a food intolerance can be very uncomfortable, but it’s not the same thing as an allergy. Ultimately, if you think you have an actual allergy, you should get tested and become familiar with warning signs and potentially life-saving measures.