Xinhuanet, Beijing, May 6 (Wu Qilong) In recent years, the incidence of food allergies has continued to rise, gradually becoming a new challenge that threatens public health. Li Hong, chief physician of the Pervert (Allergic) Reaction Department of Peking Union Medical College Hospital, said in an exclusive interview with Xinhuanet that there are significant age and geographical differences in food allergies in my country, and the public's cognitive misunderstandings about the allergic mechanism frequently occur - from mistakenly classifying food intolerance as allergies to ignoring the fatal risk of special types of allergies.

"Data shows that the rate of self-exposed allergic in children aged 0-5 is about 4.8%, but the actual diagnosis rate is much lower than this; severe allergic reactions caused by wheat allergies are particularly prominent in the northern regions, and may even cause fatal risks due to exercise." She said that food allergies need to be based on scientific diagnosis and combined with individualized management, and early intervention in infants and young children may change the allergic process.

Professor Li Hong, chief physician of the Department of Perversion (Allergic) Reactions at Peking Union Medical College Hospital

The incidence of food allergies increases, and the causes of allergies vary from age to region

Globally, the incidence of food allergies is on the rise, and our country is no exception. Li Hong introduced that due to the different research properties and design plans, there are differences in the incidence data of food allergies in my country. A study jointly published by my country's Center for Disease Control and Prevention and the Health Commission in 2024 showed that the prevalence of food allergies in children aged 0-5 is about 4.8%. However, this data has not been tested and identified by professional tests and identification, and the prevalence of self-exposed disease is often higher than the actual number of allergies.

The high incidence of food allergies varies from age to age. Li Hong said that among infants and young children, milk, eggs and wheat are common allergens. After infants and young children eat these allergic foods, they often experience symptoms such as itching, rash, vomiting, and diarrhea.

"As we get older, our intestinal and general immunity increases, and most children will gradually tolerate milk and eggs." She said that we observed more than 100 patients with milk allergies (IgE antibody positive) and found that about 80% of people are no longer allergic at the age of 6.

Food allergies in adolescents and adults are more complicated. According to Li Hong, in my country, about 20-40% of pollen allergies have food allergies, which is particularly obvious in some provinces in Northwest, North China, Northeast China and central areas.

"Cashmere nuts, pistachios, walnuts, Brazilian fruits, hazelnuts, almonds and other nuts are also common allergens, among which nuts are a common category that triggers severe food allergic reactions abroad." She said that in adults, seafood allergies are more common.

Li Hong further explained that in the cases in the Allergic Department of Peking Union Medical College Hospital, wheat is a prominent allergen that triggers severe allergic reactions, and the symptoms are diverse, which may also lead to severe allergic reactions related to food dependence on exercise. In addition, due to different climates and pollen distributions in the north and south, allergies also vary. Patients with pollen allergies in the north are more likely to have related food allergies.

Food allergies ≠ food intolerance, scientific cognition and accurate diagnosis are required

Many people tend to confuse food allergies and food intolerance. Li Hong explained that food allergies are an abnormal reaction of the immune system to specific food ingredients, while food intolerance is caused by non-immune mechanisms. The symptoms of the two may be similar, but their essence is completely different. For example, abdominal distension and diarrhea after eating milk may be caused by food intolerance or food allergies, which requires professional examinations and identification.

"Many information will simply attribute symptoms such as bloating and diarrhea after eating to food allergies, but may actually involve other factors such as lactose intolerance or food toxins." She said that differential diagnosis is crucial at this time. Professional medical institutions need to make comprehensive judgments through various means such as medical history collection, skin tests, serum-specific IgE detection and oral excitation tests.

She added that food allergies are diverse, the most common is immunoglobulin IgE mediated, which is mostly a rapid reaction. It usually occurs within two hours of eating, which can affect multiple organ systems such as the skin, digestive tract, and respiratory tract. In addition, there are two special IgE-mediated types: oral allergy syndrome (also called pollen food allergy syndrome) and food-dependent exercise-related allergies.

"Patients with birch pollen allergies are prone to apple allergies, and patients with artemisia pollen allergies in my country are often associated with peaches and other food allergies." Li Hong gave an example and said that food-dependent exercise-related allergies need to be paid more attention. If people with fitness groups experience suspicious allergies such as rashes after exercise, they should seek medical treatment and check in time.

According to reports, the gold standard for confirming food allergy is the oral food excitation test, which is divided into single-blind open and double-blind placebo controlled excitation test. "Open food oral stimulation tests can be used as a diagnostic basis. When the results are uncertain, double-blind placebo-controlled stimulation tests can be further carried out." She said that routine diagnosis can be based on medical history, allergen skin tests, serum-specific IgE testing, etc. In response to special situations such as wheat allergy, exercise and food combined exercise are also required.

Combined with graded treatment and early intervention, allergies should be managed scientifically

For patients with different degrees of food allergies, the treatment methods are different. Li Hong said that for patients with mild allergies who only have mild symptoms such as local rash and oral itching, most people can relieve themselves within a few hours by avoiding continuing to intake allergens, taking oral anti-allergic drugs, resting, etc., but if there is a recurrence, you need to seek medical examination.

For patients with moderate allergic allergies who have vomiting, diarrhea, and large-area rash, if oral anti-allergic drugs are ineffective or if respiratory symptoms appear, they should go to the hospital for diagnosis and treatment in time; severe allergic reactions can threaten the respiratory and circulatory system. If symptoms such as laryngeal edema, dyspnea, decreased blood pressure, confusion, etc., they need to seek medical treatment as soon as possible. The first choice is to intramuscular adrenaline injection and call the emergency number.

"Severe allergic reactions have their own development process, and early detection, medication and rest are crucial. Patients should sit down immediately after symptoms to avoid falling, and use first aid drugs in time." She added that timely use of adrenaline can significantly reduce mortality.

It is worth noting that children are a special group of food allergies. Infants and young children who have confirmed food allergies need to avoid malnutrition when avoiding allergens. "Take children with milk allergies as an example, infants and young children can eat deep hydrolyzed milk powder and amino acid formula milk powder instead. The specific plan needs to be formulated by pediatricians; as they get older, most children can gradually try low-allergic processed foods such as roasted milk, but oral excitation tests must be done first." Li Hong reminded that allergic symptoms may not disappear after avoiding food, and scientific steps must be followed to avoid causing serious allergic reactions.

Early addition of complementary food is an important part of intervening in children's allergies. Li Hong introduced that existing studies show that the rational introduction of allergic foods such as eggs and peanuts during the 4-6 month period will help reduce the occurrence of food allergies in children. "Parents should be wary of the "overdiagnosis" trap. It is not recommended to postpone the introduction of allergenic foods such as eggs and milk when there is no definite evidence. If you have any doubts, the diagnosis should be clarified under the guidance of a specialist and the advice of children's health doctors and nutritionists should be listened to to ensure that the child is nutritious and develops healthily." She said.

Although food allergies are complicated, they are preventable and controllable. Li Hong admitted that the public should establish a "three early" awareness: early identification (distinguishing allergies and intolerance), early diagnosis (relying on professional medical testing), and early intervention (grasping the golden period of allergy management in children); for children, it is necessary to comprehensively evaluate allergic risks and nutritional needs to avoid "one-size-fits-all" avoidance; and with the advancement of medicine, the precise diagnosis and treatment system for food allergies is becoming increasingly perfect, and scientific response is the key to protecting health.

[Editor in charge: Wang Yuqi]