Self-reported food allergy, particularly to seafood, is higher in African Americans
Published: November 17, 2022
Up to 10% of the U.S. population reports an allergy to one or more foods. Despite this high frequency, differences in food allergy between U.S. population groups is less well known. Nationwide surveys have suggested that food allergies are higher among African Americans when compared with white Americans, and these observations are consistent with the higher rates of other allergic conditions, including asthma, in the former group. In a recent publication in The Journal of Allergy and Clinical Immunology: In Practice, Xiao and colleagues provide additional evidence that food allergies differ between population groups. They studied a large and diverse cohort of individuals with and without asthma from southeast Michigan and the Detroit metropolitan area.
The study called SAPPHIRE included 7,627 individuals: 4,558 African American individuals, 2,391 white individuals, 6,253 individuals with asthma, and 1,374 individuals without asthma. Common food allergies, such as to peanut, egg, and fruits (but not tree nuts), were more common in African Americans. However, the most striking difference observed was for seafood, including shrimp, other shellfish, and fin fish. African American individuals were approximately three times as likely to report an allergy to seafood when compared with white individuals, and the former group was three to five times as likely to report symptoms consistent with seafood-associated anaphylaxis (extreme and potentially life-threatening food-induced allergy symptoms) when compare with the latter. These between group differences were still observed when the investigators limited their analysis to individuals who did and did not have a history of asthma. Interestingly, the between group difference could not be explained by genetic differences attributable to African or European ancestry. Study senior author, L. Keoki Williams, MD, MPH, FAAAAI, noted, “While genetics likely play a critical role in determining one’s susceptibility to developing a food allergy, the differences that we observed between population groups likely has an important environmental component.” He also noted that important studies, such as the Learning Early about Peanut Allergy (LEAP) trial, showed that early introduction of peanuts into the diet of high-risk children during infancy reduced the likelihood of developing peanut allergy. According to Dr. Williams, “It is too early to know whether the findings of LEAP will extend to other food allergens, such as seafood, but this is an important and pivotal moment for food allergy research. The next decade is likely to bring big breakthroughs in our understanding of the genetic and non-genetic causes of food allergy, as well as how to prevent food allergy from developing.”
The Journal of Allergy and Clinical Immunology: In Practice is an official journal of the AAAAI, focusing on practical information for the practicing clinician.