Go out for dinner these days and you can guarantee at least half the people sitting at your table will either be asking for ‘the burger, without cheese’, substituting the pasta for some sort of vegetable, or dosing themselves up with antihistamines before picking at their salad. Or possibly doing all three.
If you’re sitting on the other half of the table, doing none of these things, it’s easy to dismiss the claims of allergies as a modern fad.
It’s just as easy to say that those ‘suffering’ have probably half-read something about a celebrity’s diet and are now meekly following in their very misguided footsteps.
But you’d be wrong. And during Allergy Awareness Week, we look at why.
A very real problem
“The rise in prevalence of allergies is real, particularly in the UK and developed world,” says Professor Edward Kaminski, consultant immunologist at Nuffield Health Plymouth Hospital.
Certainly, figures from allergy support charity Allergy UK confirm this. They reveal that an estimated 21 million adults in the UK suffer from at least one allergy, and that an estimated 10 million adults suffer from more than one. Food allergies alone have lead to a 500% increase of hospital admissions since 1990.
West is not best
A BBC Two documentary, Horizon - Allergies: Modern Life and Me, explored the issue further, and most of the blame will, perhaps predictably, fall on our sanitised Western lifestyles.
“[The rise in allergies] is happening because of our higher standard of living,” agrees Kaminski. “Our immune system has developed over millennia to deal with microorganisms.
“However, our improved standard of living has led to decreased exposure to certain microorganisms and parasitic worms, which in turn has led to a dysregulation of the immune system, causing allergy.
“Factors in our environment that reduce the overall microbial burden and increase allergy are antibiotics, immunisations, hygiene and reduced exposure to microbe-rich dirt.”
When is an allergy not an allergy?
Clearly, the rise in allergies is genuine. But surely there are still some of us ignorantly jumping on the bandwagon?
“Although many people do correctly self-diagnose allergies, some incorrectly diagnose conditions which are not allergies as being allergies,” Kaminski admits.
“This is mainly due to incorrect information being available about allergies in the public domain and also to alternative practitioners using unscientific tests to make such diagnoses.”
Many people also mistake an intolerance for an allergy – intolerances are also uncomfortable, but not as dangerous as allergies.
“An allergy is a reaction mediated by the immune system to harmless environmental substances such as pollens, animal hair, house dust mite and foods,” explains Kaminski.
“Allergies cause typical symptoms such as a rash, facial swelling or anaphylaxis.”
“Most allergies are triggered by an antibody called IgE which can be tested for by a blood or skin prick test.”
An intolerance, however, is ‘an idiosyncratic reaction to food’. Tyramine-rich foods – generally fermented foods like aged cheeses, smoked fish and cured meats - can often trigger migraines, for example.
“And wheat and milk can cause abdominal bloating. Such reactions are not mediated by the immune system though and therefore there are no reliable tests to diagnose them.
“Intolerances are the most common condition misdiagnosed as an allergy by lay people.”
For those genuinely affected though, is there any hope?
“As a society there’s little we can do to reduce allergies, because of our higher standard of living (and fewer life-threatening infectious diseases),” Kaminski says.
“Much research is going into trying to understand this, for example there are ongoing trials in which patients with allergies are being given helminths [worms].
“In the future it may be possible to alter the immune system (with a vaccine, for example) to prevent allergies occurring in later life, but this will almost certainly have to be done in early childhood - the first six months - as this seems to be the crucial period in life for developing an allergic tendency.”