FeaturesOct/Nov 2013 Issue

Food Allergies and Teenagers

Out and About

Every March, CHOP’s Center for Celiac Disease hosts an education day, with breakout sessions where teens talk about subjects like adjusting to the gluten-free diet and how to order gluten-free food in restaurants.

“We gear a lot of the discussion toward adolescents,” Verma says. “I will usually ask them, ‘Where do you hang out with your friends when you’re in the mall? Where do you eat? Where do you shop? What do you do and how do you do it?’ Then I talk to them and try to navigate for them what they can do in the mall and where they can eat.”

Teens with food allergies face the same social pressure as teens with celiac disease but they have the added danger of a potential life-threatening allergic reaction. When food-allergic teens take risks, they are literally gambling with their lives. Studies show that teenagers and young adults are the highest risk group for fatalities from food allergy.

Teens are more likely to be impulsive, eating a food without making sure it’s safe. They are also less likely to carry their medications and less likely to promptly treat a reaction, says Scott H. Sicherer, MD, professor of pediatrics and a researcher at the Jaffe Food Allergy Institute at Mount Sinai in New York and author of Food Allergies: A Complete Guide to Eating When Your Life Depends on It.

“Teenagers may feel that they don’t always have to carry their epinephrine auto-injector if they perceive that they are unlikely to need it or if it’s inconvenient. They may not speak up at restaurants with friends or at parties, either because they think they can control the situation or they feel uncomfortable or embarrassed,” Sicherer says.

According to his 2006 study of risk-taking in adolescents with food allergy, only 61 percent of teens and young adults reported that they “always” carry an epinephrine auto-injector and 54 percent indicated purposefully ingesting a potentially unsafe food.

Many teens are apt to leave behind their life-saving epinephrine auto-injectors or asthma inhalers when going to a sporting event or school dance or while wearing tight-fitting clothes. This is why younger children should get in the habit of always carrying their medications, Sicherer says. Families also should continue yearly visits to the allergist, so the doctor can talk to the teen about peer pressure, bullying, dating and when and how to administer epinephrine.

Kissing is a popular topic, says Sicherer, who researched peanut’s presence in saliva after an individual eats peanut butter. With peanuts, he found that brushing teeth and chewing gum help reduce residual allergen but they don’t completely remove it from the mouth. But if a teen’s partner does not ingest the allergen for four hours and then eats a meal that does not contain the allergen, they’ve likely removed any trace of the allergen from their mouth.

“I’m not worried about a kiss on the cheek—but whatever the person has been eating is in their mouth,” he says. “Teens with food allergies should avoid spontaneous, unplanned passionate kissing. Fortunately, if you’re in a relationship with someone, the chances are pretty high that they’re going to be happy to avoid the food that you’re avoiding.”

In 2010, Sicherer conducted a quality-of-life study which revealed that most teens are concerned about food allergies placing limitations on their social activities, not being able to eat what others are eating and being a burden to others because of their food allergies. Surprisingly, they were much less troubled by their parents being “overbearing” about their food allergies.

“When we asked teenagers what one thing we could do to make living with food allergy easier, they wanted their peers to be educated about food allergy—but they didn’t necessarily want to do the education themselves,” Sicherer says.

Friends can help reduce social stress and add a layer of security, says John Lehr, CEO of Food Allergy Research and Education (FARE).

“Having supportive friends who understand how serious food allergies and anaphylaxis are is important,” Lehr says. “Many teach their friends how to use an epinephrine auto-injector so that they know what to do if there’s an emergency. Carrying two epinephrine auto-injectors at all times is critical to being prepared for an anaphylactic reaction. Educating your close friends about what it is, why you need it and how to use it can help remove worries about feeling awkward.”

Next: Food and Mood

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