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Food allergies are skyrocketing in North America and around the world.

Rates in children and teens have gone up 50 percent in the past 15 years, to 1 in 20, one new report says. And today’s numbers could be even higher: A recent survey of 38,000 parents found that 1 in 13 kids have had mild to life-threatening reactions to everyday foods including milk, eggs, nuts, wheat and shellfish. And 30 percent of food-allergic kids have reactions to more than one food.

Scientists are racing to pin down the causes of this puzzling outbreak. Leading the list are the usual suspects: emulsifiers and additives used in processed foods, such as peanut butters that are made with more than just peanuts, lunch meats, margarine, mayonnaise, sauces, candy and bakery products. Interesting fact: Emulsifiers seem to make a protein – like peanuts – appear foreign, so the immune system attacks it. In China, where peanuts are boiled and peanut butter is made only with peanuts, the allergy is rare; when the nuts are fried or cooked in non-peanut oils and emulsifiers are added for quick spreading, the allergy pops up.

Another possible trigger is our too-clean environment; it makes our immune system overeager for work, so it turns on us and creates autoimmune diseases and allergies.

Here are five smart ways to prevent and deal with food allergies.

1. Keep up with the latest info about allergy-causing foods: You can ban eggs, nuts, shellfish, wheat and soy from your home, but these foods are lurking in restaurant foods. Watch out for emulsifiers in mass-produced salad dressings and sauces, and for sulfites in seemingly safe packaged foods like trail mix or dried fruit. Get the inside info by connecting with groups including Food Allergy Research & Education at www.foodallergy.org. You can sign up for email alerts.

2. Turn off “allergy genes”: Cutting-edge thinking says something in the environment is switching genes on and off in ways that set the stage for allergies. Early evidence points to tobacco smoke, polluted air and fast food. The gene changes may even be passed down through several generations. Meanwhile, pregnant moms can help fortify their newborns against allergies by eating a healthy diet, and after birth, by breast-feeding their baby as long as possible.

3. Take kids with food reactions to an allergist: Fewer than 25 percent of kids who end up in hospital emergency rooms are told to see an allergist, but that should be your next move. This specialist can determine which foods likely caused the allergic response and make sure you’re equipped with emergency medication that stops life-threatening reactions.

4. Outfit kids (and yourself) with TWO EpiPens: Experts suggest that kids with food allergies carry two EpiPens, self-injectable epinephrine that stops severe reactions. One in eight kids who go to the ER with a bad reaction need a second shot, yet many leave the ER without a prescription. Talk with your doctor about getting the doses you need, and about when to replace EpiPens. Not all states allow or require schools to stock these life-saving devices – though more are considering this smart move. So make sure your kid’s classroom and school nurse have a supply of several pens. Check their expiration dates.

5. Talk with your pediatrician about introducing allergenic foods: Until recently, conventional wisdom said delaying “trouble foods,” such as peanuts, protected babies from developing allergies. But in 2013, an American Academy of Allergy, Asthma & Immunology committee suggested that early exposure actually might train a young immune system to react properly. Some experts even suspect that lowered exposure to common food allergens like peanuts and wheat could help explain the rise in food allergies.

WARNING: This advice is not for babies and young children who have already reacted negatively to a food, have a related allergic condition like eczema or atopic dermatitis or a sibling with a food allergy. Remember to talk this over with your doctor before trying.

Dr. Mehmet Oz is host of “The Dr. Oz Show” and Dr. Mike Roizen is chairman of the Wellness Institute at Cleveland Clinic.