The impact of food allergy from infancy through adulthood

Food allergies are immune responses that lead to adverse reactions upon exposure to specific foods. These responses can cause a range of symptoms, from acute allergic reactions and anaphylaxis to chronic inflammatory disorders like eosinophilic esophagitis and atopic dermatitis. The manifestation, triggers, and natural course of food allergies vary significantly with age, influencing diagnosis, prognosis, and management strategies.
In infants and young children, common triggers include milk, eggs, and peanuts. Allergies to these foods often resolve with age, but they can sometimes persist into adulthood. For instance, while milk and egg allergies frequently resolve, peanut and tree nut allergies tend to persist. Emerging food allergies in adults, such as shellfish, tree nuts, and fin fish, highlight the evolving nature of these conditions. Nearly half of U.S. adults with food allergies report that their allergies began in adulthood.
Diagnosis of food allergies relies on identifying specific IgE antibodies through skin prick tests, serum tests, and oral food challenges. Epidemiological studies indicate a prevalence of 7.6% for childhood food allergies and 10.8% for adult food allergies in the U.S. The prevalence and triggers vary globally, with higher rates observed in Western countries.
Management of food allergies involves strict avoidance of known allergens, prompt recognition of symptoms, and readiness to treat reactions with medications such as epinephrine. Age-specific management strategies are essential, as responsibilities for managing allergies transition from caregivers to children and adolescents, and finally to self-management in adulthood. Effective management requires continuous education and adaptation to life stage changes.