Allergy food ranking

Milk, eggs, peanuts, tree nuts, wheat, soybeans, fish, and crustacean aquatic animals. Allergic reactions caused by these eight types of foods account for more than 90% of all food allergy cases. However, the ranking of allergenic foods will be very obvious among people of different ages, regions, and genetic backgrounds. There is no so-called "absolute list that is common to the entire population."

A while ago, I accompanied a friend to the pediatric allergy department to get the child's allergen report. I met a 3-year-old baby in the waiting area. Her grandma secretly fed her a mouthful of steamed eggs. Within two minutes, her lips were swollen like sausages, and a red rash appeared around her eyes. The nurse on duty's first reaction was to ask, "Did he touch milk or eggs?" ”These two are indeed the absolute top two on the list of allergies among infants and young children under 1 year old. Data show that the rate of milk allergy in domestic infants and young children is about 2%-3%, and egg allergy is even higher by one percentage point. These two are the first pitfalls that many parents fall into when adding complementary foods to their babies.

Don't think that this ranking is one-size-fits-all. In the adult group, the situation is completely different. Among the adult patients with allergies that I have followed before, the top two are nuts and crustacean seafood. Many people ate shrimps and crabs when they were young, but nothing happened. In their twenties, they suddenly get wheezes all over their body after just one bite, and they even can't breathe. To put it bluntly, the "temper" of the immune system also changes with age. Peanuts are known to be highly allergenic. There was news last year that someone took a bite of a mooncake mixed with trace amounts of peanuts and suffered anaphylactic shock and was admitted to the ICU. Even a few milligrams of residue may trigger a reaction. It is not an exaggeration to call it an "invisible bomb."

Many people may ask, why are mango, peach, and kiwi fruits, which are commonly heard of allergic foods, not in the top eight? Here we have to talk about the difference in statistical caliber. The allergy rates of fruits such as mangoes and peaches can indeed be ranked among the top 10 in East and Southeast Asia, especially peaches with downy texture. Many people’s mouths are numb when they touch them. According to statistics from European and American countries, the proportion of such allergies is less than 1%, and they are not ranked at all. In Japan's allergy list, buckwheat has even a higher priority than wheat. This is also because the consumption rate of local buckwheat noodles is too high and there are many accumulated cases. The statistical results in different regions are naturally biased.

I have to add here that the “allergy” that many people talk about is not really a food allergy at all. Last time I met a girl who said she was allergic to milk and had diarrhea when she drank it. I asked her to check her serum specific IgE. It turned out that nothing was wrong. She was lactose intolerance - to put it bluntly, it is a lack of enzymes that break down lactose in the body. It is completely different from an allergy in which the immune system treats food proteins as invaders and attacks them wildly. There are also many people who say that they are allergic to seafood. It is most likely caused by histamine poisoning caused by eating stale seafood. If they are really allergic, even eating a bite of freshly caught shrimp will cause trouble.

Regarding the prevention and control of highly allergenic foods, there has actually been considerable debate in the academic community. Guidelines from more than a decade ago also said that infants and young children under 1 year old should completely avoid highly allergenic foods such as peanuts and tree nuts. Now the new U.S. FDA guidelines recommend that when adding complementary foods at 4-6 months, they can be exposed to low-risk peanut products such as peanut butter in small amounts, which can actually reduce the probability of subsequent allergies. Both views are now supported by research data. The specific operation should be judged based on the child's family allergy history. There is no absolute right or wrong.

An old director of the allergy department I know who has been in the allergy department for more than 20 years would never directly prescribe dietary taboos to patients using universal rankings. He often said, "Rankings are dead, people are alive." There was a patient who had previously tested negative for common allergens, but his mouth swelled when he ate dragon fruit. After a food provocation test, it was confirmed that he was allergic to a rare protein in dragon fruit. This one-in-10,000 probability situation is not even visible in the general rankings, but for this patient, dragon fruit is more dangerous than peanuts.

After all, the biggest role of this ranking is actually to serve as a reference for food supervision and popular science. Prepackaged foods are now compulsorily labeled with these eight types of allergens to help the vast majority of people avoid risks. When it comes to your own taboo list, instead of guessing at the ranking, it is better to record your reaction after each meal and do a professional test if necessary. After all, the "number one allergenic food" for you will always be the thing that causes trouble as soon as you eat it.