When Sharon Wong’s son was 4 months old, his skin developed itchy red patches and he developed a wheezing cough that persisted for weeks. Her first pediatrician dismissed the symptoms as a recurring cold. Then one night, as a child, Wong’s son ate a spoonful of Thai-inspired peanut soup, which caused him to gag and scratch his stomach. Panicked, Wong called her new pediatrician, who recognized the signs of anaphylaxis.
“Our second doctor was very clear about the seriousness of the situation and what I needed to do: get Benadryl, an allergist and an EpiPen,” Wong recalls of the incident 19 years ago. “It probably saved my son’s life.”
Today, 6 million American children live with food allergies, and young Asian Americans, like Wong’s son, now a college student, are 40 percent more likely to develop one than the general population. general. Scientists have struggled to explain this disparity since it was first documented in a study. historical study from 2011.
Now a recent study from Stanford University of nearly half a million California pediatric records is one of the first to examine subgroups of Asians under the age of 18 in the United States to try to understand why Asian Americans are so at risk. The study finds that Filipinos, Vietnamese, Native Hawaiians and Pacific Islanders are particularly vulnerable. “Existing allergy research often overlooks Asian Americans or treats them as a monolith,” said Dr. Charles Feng, the study’s lead author.
For immigrant communities, where language and culture often divide generations, food represents a connection, Feng added. “That’s why it seems so urgent to solve this mystery, which is ultimately a problem of health inequity.” »
Why might Asian American, Pacific Islander and Hawaiian children be vulnerable to food allergies?
Wong and her husband, who live in California, have no known allergies, but their two sons are allergic to a daunting list of foods: peanuts, tree nuts, eggs, shellfish, sesame, tomatoes and some fruits. Their family reflects a broader, disconcerting trend: Between 2007 and 2021, the prevalence of food allergies among American children jumped 50%.
The place of Asian American children in this trend remains unclear. Little longitudinal studies include them, an oversight that Dr. Ruchi Gupta, a pediatrician and allergist at Northwestern University, calls a missed opportunity. As the fastest-growing racial group in the United States, Asian Americans provide a unique window into national trends in food allergies, she said.
Genetics alone cannot explain the dramatic increase or disproportionate impact on Asian American children. The time frame – just a few decades – is too short to allow for significant genetic changes. Additionally, Gupta’s research in countries like India doesn’t identified the same allergy patterns seen in American children of similar ancestry. “Studying Asian Americans may uncover the missing link in rising allergy rates among all children,” Gupta said.
Most likely, a child’s genes interact with environmental and dietary changes, said Dr. Latha Palaniappan, a Stanford University physician who studies health disparities. For example, adopting a Westernized diet can alter children’s gut microbiomes, which play a key role in immune responses.
To test these gene-environment hypotheses, granular data on rates of food allergies within Asian American subgroups is essential. Recent research, including the new Stanford study co-authored by Palaniappan, offers a promising direction. The study showed that rates of food allergies vary widely, from 2.9% among Native American children to 8.2% among Filipino children. (The price for all American children represent 5.8%.) These findings highlight the importance of studying how country-of-origin and culture-specific practices, such as common cooking methods, might influence allergy patterns.
Yet much of the puzzle remains unanswered, forcing families to adapt to the immediate challenges posed by food allergies. “I’m seeing an increasing number of Asian patients with various allergic conditions,” Feng said. “It’s harder to provide evidence-based care because we simply don’t have the data we need. »
The cultural tensions of food allergies
Food allergies can cause a seemingly healthy child to go unconscious within minutes. For children without a formal diagnosis and without an EpiPen to remove in an emergency, the risks are even greater.
This danger is pronounced for Asian American children, who are 30% less likely to be diagnosed with food allergies despite their increased vulnerability. Doctors may overlook symptoms, or parents – especially those from communities where allergies are rarely discussed – may fail to recognize warning signs. “Families may not associate the reaction with a specific food or recognize it as anaphylaxis until it becomes severe,” explained Dr. Anna Chen Arroyo, an allergist at Stanford University. Language barriers, limited knowledge of specialist services and cultural reluctance to see a doctor can also prevent access allergy care.
Even with a diagnosis, managing food allergies often involves overcoming cultural barriers. Asian American families experience a greater decline in quality of life food allergies than other racial groups. Arroyo hypothesizes that this is due in part to the role of food in many Asian cultures, where shared meals are the cornerstone of community and tradition.
Wong has experienced this tension. She pored over food labels and called manufacturers of Asian cooking ingredients, a daunting task when terms like “antihistamine” and “anaphylaxis” don’t translate easily into Cantonese. She created allergen-free versions of beloved childhood dishes, like nian gao cake and lo han jai vegetable stew.
But cultural celebrations have proven particularly difficult. During Chinese New Year, peanut desserts and sesame-covered snacks symbolize prosperity, but they put Wong’s son’s life in danger. “He couldn’t even be in the same room as the nuts, but our loved ones didn’t want to take away these happy ingredients,” Wong said. They started skipping family gatherings altogether.
How families advocate for change
Advocating for a child with food allergies starts close to home. In some Asian American families, older parents may be unfamiliar with dietary accommodations, especially if they come from countries where allergies common in the West, such as peanut allergies, are common. less common or underdiagnosed. Wong began hosting family potlucks herself, using the opportunity to teach her skeptical relatives about food safety. She shares her experiences and allergen-free Asian recipes on her blog, Wok without nutsand successfully lobbied for legislation to improve EpiPen access in schools.
Other parents, like Ina K. Chung, oppose stereotypes. After her daughter was diagnosed with peanut, dairy and egg allergies at 6 months old, Chung joined Facebook groups for parents with allergies, where she found both support and guidance. Widespread misinformation about Asian cuisine. Some parents, including other Asian Americans, issued blanket warnings against Asian restaurants, writing that they “couldn’t trust the food.”
“Why can’t you trust what restaurant employees say about how the food was prepared? » Chung wondered, particularly troubled by the way some Asian American parents were distancing themselves from their own cooking. “The assumption that all Asian foods are dangerous reflects a lack of understanding and unfair stereotypes.” Thanks to his Instagram page, @theasianallergymomit contradicts these misconceptions. Her posts feature classic dishes from her childhood, like Korean chicken kimchi soup, that are naturally free of common allergens. “I want people to know that Asian cuisine is not monolithic, just like Asians are not,” Chung said. She also wrote a children’s book to help parents teach their children about food allergies and self-advocacy.
Chung saw this empowerment reflected in his family. When her daughter was 5, she attended a friend’s birthday party and asked the host’s mother, “Is this cake safe for me?” What did you use to make it?
“You could see the pride radiating through me,” Chung said. “These small victories are my North Star when it comes to allergy advocacy.”
New treatments and hope
In Gupta’s office, a comic the tape hangs on the wall. One panel shows an adult telling a child, “When I was your age, there were no food allergies.” » In the next, the now-adult child says to another child: “When I was your age, there was were food allergies.
Barely ten years ago, treatments for food allergies did not exist. Today, oral immunotherapy and skin patches can desensitize children to allergens, thereby reducing the risk of serious reactions. Yet, Gupta said, many Asian American families she sees are unaware of these options, emphasizing the importance of early diagnosis and education.
In 2014, Wong’s son completed a clinical trial that increased his allergen tolerance from 1 mg to 1,440 mg of peanut protein, or about six peanuts. Although the family still avoids peanuts and carries epinephrine, he no longer reacts to traces in the air.
Wong shares this story to encourage other families to seek out tests, treatments and tools like EpiPens – to take control rather than living in isolated anxiety. Today, she cooks alongside her son, recreating the dishes she once watched her parents prepare. Together, they found a way to reclaim tradition and enjoy a new beginning.
