Food Challenged: A look back

Joshua about to eat his first plate of eggs

The following is the final post in series on food allergies and their treatment at Children’s Hospital Boston. Written by Joshua Feblowitz, a research assistant at Brigham & Women’s Hospital and a freelance writer for Children’s.

After last week’s successful food challenge, it was finally time to head to my favorite diner for my first plate of eggs. As I pulled into the diner’s parking lot, a few questions were running through my mind: will I have a reaction? What should I order? What if the anticipation is better than the food? Admittedly, most of my thoughts were preoccupied with the upcoming meal, but I also couldn’t help but think about how much things have changed since I was first diagnosed with severe food allergies two decades ago.

There’s no question that the landscape surrounding pediatric food allergies has shifted dramatically. Around the country, all kinds of food allergies are on the rise. Current research indicates that as many as 4 out of every 100 kids in the US now have food allergies, a dramatic increase over the numbers a decade ago. Hospital admissions for food allergies have risen more than 500% since I was diagnosed in the late 1980s.

There are a number of different theories about the cause of this trend. One is that our diets are to blame, that processed foods or a lack of certain nutrients may increase the risk of food allergies. Another is the hygiene hypothesis, the idea that less exposure to dirt and germs has made our immune systems more sensitive and potentially hyperactive, causing them to attack otherwise harmless food enzymes as if they were toxins. Others believe it is the timing of when a child first begins eating particular types of foods, where too early or too late of an introduction could spell disaster. While each one has compelling aspects, none of these theories is an entirely satisfactory explanation for the growing food allergy phenomenon.

On the positive side, however, there have also been changes for the better. Today there is a far greater increase in awareness of food allergies, a widening array of food alternatives available and better resources and support for kids suffering from food allergies.

People tend to know more about food allergies these days. When I was a kid, most assumed by MedicAlert bracelet was for diabetes. When I would explain it was for my food allergies, people would say things like, “So, you’re really, really lactose intolerant, huh?” While their misconceptions weren’t too far off— a food allergy is like an intolerance but specifically involves a person’s immune system instead of just their digestive system— it underscored how alien the idea of food allergies were to some people back then.  Today, understanding is far more commonplace. Many more people know a friend or relative with food allergies and most restaurant staffs understand allergies better than ever. The result is a safer world for everyone with severe food allergies.

When Joshua (left) was first diagnosed with food allergies, much less was known about their treatment than today.

There are also more resources available to kids with food allergies and their parents. Allergen statements (e.g. Contains: Soy, Milk) are mandatory on food labels now. Many restaurants publish food allergy guidelines or offer allergen-safe version of their menu. Food alternatives are also far more common; from sunflower seed “peanut butter” to coconut milk ice cream, there are a great deal more options available for the allergy conscious food consumer. (Though, much to my dismay, no one yet seems capable of making a really good non-dairy cheese).

But the most exciting advancement in the realm of food allergy is the new research in oral immunotherapy taking place, both at Children’s and around the world. The idea behind it is simple: feed allergic kids tiny amounts of an allergen (with or without medication) and increase the amount gradually over time so their body naturally builds up a tolerance to that food. The strategy is being applied to treat milk allergies here at Children’s as well as peanut and egg allergies. This represents a dramatic shift in attitude and a new willingness to tackle food allergies head-on.

It gives me comfort knowing our scientific understanding of food allergies has advanced so far since I first was admitted for a severe food allergy reaction. Each day new research continues to take promising steps towards a cure. Yet at the same time, I’m also deeply concerned that we cannot seem to find an explanation for the current food allergy epidemic or slow its expansion.

For now, however, I’m just happy to breathe a little easier knowing there’s one less allergen potentially lurking in my meals. It’s a wonderful feeling, one that I hope that every child with food allergies will eventually experience.

I’m incredibly thankful for all Dr. Schneider and Children’s Hospital Boston’s Allergy Program have done for me over the years, and I have faith that the incredible researchers devoting their time and efforts will find a cure in the not-so-distant future.

Oh, and, in case you were wondering, the scrambled eggs were quite delicious. 🙂