Food allergies' broad impact on quality of life demands greater awareness

By Priyanjana Pramanik, MSc.Mar 28 2024Reviewed by Susha Cheriyedath, M.Sc.

In a recent review article published in the journal Frontiers in Nutrition, researchers summarized the current state of knowledge regarding the impacts of food allergies (FA) on people experiencing them on their economic, psychological, and social quality of life (QoL).

Their findings have implications for raising awareness about FA-related issues, which can improve the QoL of people living with these conditions.

Study: Food allergy issues among consumers: a comprehensive review. Image Credit: Kaspars Grinvalds / Shutterstock

FA has widespread consequences

FA impacts more than 10% of adults and approximately 8% of children, with some common allergens being milk, shellfish, tree nuts, peanuts, eggs, soy, wheat, sesame, and finfish. Atopic comorbidities such as allergic rhinitis, eosinophilic esophagitis, atopic dermatitis, and asthma are common in children who have food allergies.

Living with FA, which has no cure, has widespread consequences, including psychosocial burdens related to managing emergencies, fear of reactions, and potential bullying. Past reactions and having multiple allergies are correlated with a higher impact on QoL.

Daily management increases stress and leads to avoidance and sometimes social isolation. The impact spans school, social, family, financial, and daily activities such as dining out and shopping.

The Food Allergy Independent Measure (FAIM) is an index that researchers use to assess the perceived risk of being accidentally exposed to an allergen, with a higher score indicating a more significant QoL impact.

School- and work-related consequences

Schools are meant to be safe settings for children as they develop socially and academically. Young children often have not learned to advocate for themselves when it comes to FA, which requires that childcare settings have the appropriate systems and resources to respond to FA-related emergencies.

However, early childcare professionals often lack the preparedness to address allergic emergencies. Many report that they are not familiar with allergy-friendly food labels and Emergency Action Plans (EAP), which lay out protocols for situations when a child is experiencing an allergic reaction.

The frequency of allergic reactions in school without effective management strategies contributes to higher potential rates of bullying and stress for affected children. Studies also suggest that adolescents and young adults with FA may show more risk-taking behaviors as they lack support systems.

Young adults continue to face challenges during the transition to college. They are concerned with food safety and social interactions, which affect academic performance and mental health. Education and policy implementation are crucial for fostering inclusive environments and ensuring the safety and well-being of students with FA.

While there is limited research on the management of FA in workplaces, firsthand accounts reveal challenges such as bullying, anxiety, and discomfort despite the Americans with Disabilities Act of 1990, which provides legal protections against discrimination for people with FA.

 Adults with FA often face stress and isolation due to concerns about cross-contamination while not wanting to be a burden. Advocacy and education, including initiatives to promote non-food events and raise awareness through the sharing of educational resources, may improve workplace inclusivity.

Relationships and social interactions

FA can significantly affect relationships and social interactions as food plays central roles in many cultures.

Families with allergic children may restrict travel, social activities, and dining out to reduce their children's exposure to allergens, which can strain marriages while limiting children's social interactions and participation in events.

Extroverted adults with FA face other challenges in situations, including anxiety and unkindness from others. Support systems are crucial to managing and living with FA, which can otherwise become overwhelming.

Economic effects and inequities

People with FA rely on food labels to limit their exposure to allergens, but navigating labels, especially precautionary allergen labeling (PAL) poses challenges due to limited regulations.

While the Food Allergen Labeling and Consumer Protection Act (FALFPA) requires that packaged foods be labeled with major allergens, PAL statements like 'may contain' lack consistency.

Studies suggest that more than half of shoppers who must vigilantly check labels for changes find labeling practices disruptive. Concerningly, approximately 27% of people in one study reported that they had an adverse reaction after consuming PAL-labeled food products, indicating the need for clear policies to ensure consistent PALS and FA consumer safety.

The financial impact of food allergies is substantial, totaling $24.8 billion, with direct medical costs at $4.8 billion and family costs at $20.5 billion. Hospitalizations, special diets, missed work, and job loss are everyday expenses. Socioeconomic disparities exacerbate the burden, highlighting the need for accessible specialty care and support systems.

Conclusions

Managing FA involves addressing the complexities impacting individuals and their support systems, with implications for all aspects of life and going beyond simply avoiding allergens.

People living with FA face skepticism about the severity of their condition and struggle to ensure their safety; this is particularly true for children who cannot advocate for themselves.

Awareness of FA's QoL impacts is crucial for fostering inclusive and supportive communities and reducing the burden on people with FA.