The 8 Most Common Food Allergens in the United States
Whether it's a subtle reaction to a specific food, like a scratchy throat or something much more serious like anaphylactic shock, food allergies are very common. In fact, Melanie Carver, chief mission officer of the Asthma and Allergy Foundation of America says about 32 million people have food allergies in the United States—roughly 26 million adults and 5.6 million children.
"A person can develop food allergies at any age," she says. "About half of adults developed their food allergies during childhood and the other half became allergic to a food after they became an adult," she explains.
Symptoms range in severity and a person can display one or several symptoms, including redness, itching, swelling, dizziness, stomach pain, vomiting, and shortness of breath. "The immune system releases defenders to attack the food it sees as harmful, but in doing so, it causes symptoms seen in an allergic reaction," Carver explains.
Immunoglobulin (IgE), the first type of food allergy, causes symptoms that result from the body's immune system making antibodies called IgE antibodies, which react quickly when they encounter the proteins of the food allergen. "The resulting symptoms can be severe and potentially life-threatening and can include hives, low blood pressure, difficulty breathing, swelling and more," Carver says. She adds that having this type of allergy to one food may mean your body reacts the same way to similar foods. "For example, if you are allergic to cow's milk, you are likely to be allergic to goat's and sheep's milk."
On the contrary, non-IgE mediated food allergies involve the digestive tract. In these types of reactions, allergy symptoms can develop up to three days after eating the food allergen. "When an allergic reaction occurs with this type of allergy, epinephrine is usually not needed," Carver explains. "In general, the best way to treat these allergies is to stay away from the food that causes the reaction."
Despite how widespread food allergies are, just eight food allergens cause 90 percent of most reactions, according to Carver. Here, we outline what those foods are.
The most common food allergy among infants and young children is milk, but Carver says it's often outgrown during childhood. According to Food Allergy and Research Education (FARE), 70 percent of children with a milk allergy can tolerate baked milk, which has been extensively heated, disrupting the structure of the proteins that cause the allergy.
Another allergy that's common among children but is typically outgrown by age six is eggs. When someone with an egg allergy is exposed to the food, the proteins in the egg bind to IgE antibodies and trigger the person's immune defenses causing an allergic reaction.
Unlike milk and egg allergies, peanuts are typically a lifelong allergy with only about 20 percent of children outgrowing it over time. Peanut is the only food allergy that the United States Food and Drug Administration has approved treatment for. According to the FDA, the treatment, called Palforzia, may be used in individuals aged four through 17 with a confirmed diagnosis of a peanut allergy.
Tree nut allergies which include almonds, walnuts, pecans, cashews, and pistachios, are one of the most common allergies among both children and adults. According to Carver, most people do not outgrow this type of allergy. Additionally, 50 percent of children with an allergy to one type of tree nut have any allergy to other types as well.
Most often reported in young children, Carver says wheat allergies are often outgrown during childhood. Different from celiac disease, a wheat allergy results from an adverse immunologic reaction to proteins in wheat.
A member of the legume family, soybeans are a common allergy among infants and young children. According to FARE, people with a soy allergy are more likely to also have an allergy or be sensitive to other major allergens, including peanuts, tree nuts, egg, milk, and sesame than to non-peanut legumes like beans, peas, and lentils.
About one percent of the U.S. population is allergic to finned fish—think bass, flounder, salmon, tuna, and cod—making it one of the major food allergens in the country.
The most common food allergy among adults, shellfish allergy impacts about two percent of people across the country. While there are two categories of shellfish—crustaceans (shrimp, prawn, lobster, and crab) and mollusks (oysters, clams, octopus, muscles)—crustaceans are the most common allergy to shellfish, with shrimp dominating as the most common shellfish allergen.
While this isn't among the top eight foods outlined by Carver, she notes that sesame is a "rising food allergy in the United States and was recently declared a major allergen in the United States." Although it affects less than one percent of the population, FARE states that on January 1, 2023, sesame will become the ninth major allergen that must be labeled on packaged food across the country.