Washington, DC, April 17, 2012 --  

While food allergies are rare, Americans with food issues are all too common.

Overflowing boxes of shelled peanuts greet customers to the Five Guys burger joint in the heart of this city's business district. Crisp, salty, and delicious, customers munch on the nuts as they wait for their takeout burgers and fries. But signs attest that taking the peanuts out of the restaurant is a big no-no:

"Due to possible severe allergic reaction, please DO NOT remove peanuts or peanut shells outside of Five Guys."

Given the restaurant's location in the lawyer-filled lobbying district a block from K Street, you could forgive the management for fears of the wrath of overly litigious Washingtonians. But it isn't just the downtown location of the restaurant that has the signs -- they can be found in locations everywhere. The widespread fear about food allergies has been growing for years.

Statistics on how many people believe they have food allergies and intolerances are hard to come by. Doctors and researchers widely claim that 30 percent of Americans now claim a food allergy¹, and academic studies from two decades ago found between 14 and 16 percent of Americans then reported the same.²

Most of these people were wrong about their supposed problems, because real food allergies are quite rare. A broad study published last year in the Journal of the American Medical Association found that the actual number of affected Americans is less than 10 percent and perhaps not much more than one to two percent.²

You certainly wouldn't know that from talking to yuppie Americans in coastal cities who claim a dizzying variety of allergies, intolerances and other earnest dietary limitations. Many of these restrictions, like vegetarianism, pescatarianism, no-carb and gluten-free diets are acknowledged matters of choice. Some bleed into matters conscience (think ethical vegans and vegetarians, Halal and Kosher-keepers, and Hindus who don't eat beef.)

Throughout a religious holiday season that introduced a Passover prohibitions on eating leavened bread among Jews (and a whole host of things that Catholics may have given up for Lent), sharing a table with a large group of friends became nearly impossible. This is amazing, given that in coastal America, religious observance has been waning for decades.

Perhaps urbanites with a mild religious affiliation are merely trying to keep up with their whiny friends in the vegetarian and gluten-free crowd -- not to mention the huge number of people who claim an allergy one or more obscure food items. But a more pleasurable strategy to dealing with these people would be to just shut up and eat.

Just what is wrong with Americans, anyway?

Yes, food allergies are real, and must be taken seriously in the rare cases where people actually have them. Food intolerances (like the common intolerance to milk protein) are less serious, but can cause discomfort if people who have them eat something disagreeable. But given that 95 percent of Americans probably don't have any food issues that threaten their health, why on earth do so many people take one of the most pleasurable parts of life and a source of social bonding and turn it into a minefield of communal friction?

Part of the answer clearly lies in a culture of affluence, where primal fears of not getting enough food simply have no remaining outlet. And some of the explanation may come from over-diagnosis. For years, an IgE blood test has been offered by doctors' offices for testing for food allergies, despite ample evidence of a huge false-positive rate that makes it counterproductive.⁴ These tests were commonly used during the first wave of peanut allergy fears in the 1990s, and led to a public perception that such allergies were becoming more common -- when in reality much of the rise was due to an increase in testing and resulting false positives. But this false perception likely fueled even more people to believe they had similar conditions, too.

Another factor is Americans' obsession with celebrities and their wacko eating habits (think Madonna's "air diet" or Fergie's "vinegar diet") ⁵. Between celebrity food nonsense, false allergy diagnoses, and the echo chamber of Americans listing to their friends complain about conceived food issues, you get a recipe for a really screwed up national food culture.

Fortunately, subcultures can also exist and even thrive in America. For those of us who still know how to enjoy food, it's time to tune out our annoying friends, and get down to the business of eating.

Notes:

1. UCLA Health System, Think You Have A Food Alergy? Maybe Not, June 23, 2010

2. Environmental Toxicology and Pharmacology, Public Perception of Food Allergy, November 1997

3. Journal of the American Medical Association, Diagnosing and Managing Common Food Allergies, A Systematic Review, May 12, 2010

4. Phys.org, Is Your Child's Food Allergy Real? Tests Trigger False Alarms, February 22, 2010

5. U.S. News, 7 Wacky Celebrity Diets and Weight-Loss Tricks, March 5, 2012