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Australia has often been called the ““.

An estimated Australian children develop a food allergy in their first 12 months of life. Research has previously suggested food allergies are more common in infants in than infants living in Europe, the United States or Asia.

So why are food allergies so common in Australia? We don’t know exactly – but local researchers are making progress in understanding childhood allergies all the time.

What causes food allergies?

There are many different types of reactions to foods. When we refer to food allergies in this article, we’re talking about something called . This type of allergy is caused by an immune response to a particular food.

Reactions can occur within minutes of eating the food and may include swelling of the face, lips or eyes, “hives” or welts on the skin, and vomiting. of a severe allergic reaction (anaphylaxis) include difficulty breathing, swelling of the tongue, swelling in the throat, wheeze or persistent cough, difficulty talking or a hoarse voice, and persistent dizziness or collapse.

Recent results from Australia’s large, long-running food allergy study, , show one in ten one-year-olds have a food allergy, while around six in 100 children have a food allergy .

In Australia, the most common include eggs, peanuts, cow’s milk, shellfish (for example, prawn and lobster), fish, tree nuts (for example, walnuts and cashews), soybeans and wheat.

Allergies to foods like eggs, peanuts and cow’s milk often present for the first time in infancy, while allergies to fish and shellfish may be more common . While most children will outgrow their allergies to eggs and milk, allergy to peanuts is more likely to be lifelong.

Findings from showed around three in ten children grew out of their peanut allergy by age six, compared to nine in ten children with an allergy to egg.

Are food allergies becoming more common?

Food allergies seem to have become more common in many countries around the world over . The exact timing of this increase is not clear, because in most countries food allergies were not well measured 40 or 50 years ago.

We don’t know exactly why food allergies are so common in Australia, or why we’re seeing a rise around the world, despite extensive research.

But possible reasons for rising allergies around the world include changes in the and increasing , leading to fewer infections as well as less exposure to “good” bacteria. In Australia, factors such as increasing and high levels of migration to the country could play a role.

In several Australian studies, children born in Australia to parents who were born in Asia have higher rates of compared to non-Asian children. On the other hand, children who were born in Asia and later migrated to Australia appear to have a lower risk of .

Meanwhile, studies have shown that having and as a young child may reduce the risk of food allergies. This might be because having pet dogs and siblings increases contact with a range of bacteria and other organisms.

This evidence suggests that both genetics and environment play a role in the development of food allergies.

We also know that infants with eczema are more likely to develop a food allergy, and are underway to see whether this link can be broken.

Can I do anything to prevent food allergies in my kids?

One of the questions we are asked most often by parents is “can we do anything to prevent food allergies?”.

We now know introducing peanuts and eggs makes it less likely that an infant will develop an allergy to these foods. The Australasian Society of Clinical Immunology and Allergy introduced guidelines recommending giving common allergy-causing foods including peanut and egg in the first year of life .

Our research has shown this advice had and may have slowed the rise in food allergies in Australia. There was no increase in peanut allergies between .

Introducing other common allergy-causing foods in the first year of life may also be helpful, although the for this is not as strong compared with peanuts and eggs.

What next?

Unfortunately, some infants will develop food allergies even when the relevant foods are introduced in the first year of life. Managing food allergies can be a significant burden for children and families.

Several Australian trials are currently underway testing new strategies to prevent food allergies. A large trial, soon to be completed, is testing whether in infants reduce the risk of food allergies.

Another trial is testing whether the amount of eggs and peanuts a mother eats during has an influence on whether or not her baby will develop food allergies.

For most people with food allergies, avoidance of their known allergens remains the standard of care. , which involves gradually increasing amounts of food allergen given under medical supervision, is beginning to be offered in some facilities around Australia. However, current oral immunotherapy methods have potential side effects (including allergic reactions), can involve high time commitment and cost, and .

There is hope on the horizon for new food allergy treatments. Multiple are underway around Australia aiming to develop safer and more effective treatments for people with food allergies.

Jennifer Koplin receives funding from the ³Ô¹ÏÍøÕ¾ Health and Medical Research Council of Australia. She is a member of the Executive Committee for the ³Ô¹ÏÍøÕ¾ Allergy Centre of Excellence (NACE), which is supported by funding from the Australian government.

Desalegn Markos Shifti is supported by the ³Ô¹ÏÍøÕ¾ Health and Medical Research Council (NHMRC)-funded Centre for Food and Allergy Research (CFAR) Postdoctoral Funding.