What are the top food allergens

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The Big-8

A group of the eight major allergenic foods is often referred to as the Big-81 and comprises milk, eggs, fish, crustacean shellfish, tree nuts, peanuts, wheat and soybean. These foods account for about 90% of all food allergies in the United States and must be declared on any processed food according to the USA food allergen labeling act (FALCPA)1. In addition labeling of the Big-8 is mandatory according to EU, Canadian, Japanese and Australian / New Zealand regulations, all of which follow Codex Alimentarius recommendations.

Allergic consumers may accidentally encounter problem foods as several of the Big-8 (e.g. eggs, milk, wheat, and soybean) are often used in processed products and can be "hidden".

For a detailed description of the individual members of this group please follow the links.

Milk
Eggs
Fish
Crustacean Shellfish
Tree Nuts
Peanuts
Wheat
Soybean

Common food allergies include milk, eggs, peanuts, tree nuts, sesame, soy, fish, shellfish, and wheat. 

Food allergies are very common and occur when the immune system mistakenly identifies proteins in certain foods as a threat, releasing chemicals that trigger an allergic reaction. Most food allergies develop in childhood but can also develop in adulthood in rare cases. 

Here are 20 of the top food allergies.

20 of the top food allergies

1. Milk: Milk allergy is the most common food allergy in infants and young children under age 3. About 2.5% of this age group are allergic to cow's milk.
2. Eggs: Egg allergy is mostly found in children under 16 and is less common in older children and adults. About 70% of children allergic to eggs can tolerate baked eggs because the heat disrupts the protein structure responsible for egg allergy. Regular ingestion of baked foods containing eggs can contribute to tolerance or resolution of egg allergy over time.
3. Peanuts: Peanut allergy is common in children under 18 and is the second-most common food allergy in adults. The allergy is usually lifelong, although about 20% of children outgrow it over time. Symptoms may include difficulty breathing, swelling, or rash upon peanut consumption.
4. Tree nuts: The six tree nut allergies are walnut, almond, hazelnut, pecan, cashew, and pistachio. Approximately 50% of children who are allergic to one tree nut are allergic to another tree nut. Difficulty breathing, swelling, and rashes are some common reactions to the allergen. 
5. Sesame: Allergic reactions to seeds can be severe. Although some seed oils are highly refined where allergy-causing proteins are removed from the oil, individuals with a seed allergy should be careful when eating foods prepared with seed oils. Sesame allergies in particular are common, and reactions range from mild cramps and skin hives to anaphylaxis.
6. Soy: Soy allergy is more common in infants and babies. In children, the proteins in soy may cause symptoms such as a runny nose, itchiness, rash, and asthma symptoms. Some babies who are allergic to cow’s milk are also allergic to soy products.
7. Fish: Fish allergy can cause symptoms such as skin and gastrointestinal irritation. Occasionally, severe systemic reactions or anaphylactic shock may occur. The fish protein parvalbumin is responsible for causing most allergic reactions. Individuals with an allergy to one fish species tend to be sensitive to others as well.
8. Shellfish: About 60% of people allergic to shellfish tend to have their first allergic reaction as adults. There are two types of shellfish: crustaceans (shrimp, prawns, crab, and lobster) and mollusks (clams, mussels, oysters, scallops, octopus, squid, abalone, and snail). Allergy to crustaceans is more common, with shrimp allergy being the most common. Individuals may experience swelling, redness, stomach pain, and vomiting.
9. Wheat: Wheat allergy results from an adverse immunologic (IgE-mediated) reaction to proteins in wheat that cause symptoms involving the skin, gastrointestinal tract, and respiratory system in some individuals. Those with a wheat allergy are often intolerant to gluten, which is a protein found in wheat and can cause digestive distress, vomiting, rashes, or swelling.
10. Triticale: Triticale is considered one of the top food allergens that cause most allergic reactions. Triticale is a hybrid grain created by crossing wheat and rye. Though not typically commercially available, people allergic to wheat should avoid triticale as well.
11. Celery: Celery consumed as a raw vegetable can cause allergic reactions ranging from mild local reactions in the oral cavity to severe systemic responses.
12. Carrot: Though carrots are nutritious and loaded with beta-carotene, they can cause severe allergic reactions if the person has oral allergy syndrome or an allergy to pollen in certain raw fruits and vegetables. Individuals may experience an itchy throat, mouth, or ears.
13. Avocado: Avocado allergy may be associated with tree pollen allergy or with latex allergy. Symptoms may develop immediately or up to an hour after eating fresh avocado and may include local reactions in the mouth and throat with itching and inflammation.
14. Bell pepper: Bell pepper allergy often presents with respiratory symptoms and headaches accompanied by allergic rhinitis, which is a rare symptom of food allergy.
15. Potato: Potato allergy may cause a reaction from touching, peeling, or eating potatoes. Symptoms vary and can include rhinitis, itchy eyes, a runny nose, and sneezing with red, itchy skin.
16. Pumpkin: Allergy to pumpkin can be caused either by the ingestion of pumpkin or pumpkin seeds or in rare cases, simply touching pumpkin flesh or seeds. 
17. Mushroom: Allergy to mushrooms can occur at any age even if a person has consumed them for an extended period of time. Symptoms may vary ranging from mild to severe reactions, which can be experienced within minutes to hours after exposure.
18. Onion: People who are sensitive to onions are often allergic to other alliums as well, although having a true onion allergy is relatively rare.
19. Mustard: Symptoms of mustard allergies are often serious and similar to other food allergies. They include hives, nausea, dizziness, swelling in the throat, difficulty breathing, and loss of consciousness.
20. Spices: Allergies to spices, such as coriander and garlic, are rare and are usually mild, although a few severe reactions have been reported. Individuals who are sensitive to these environmental allergens have a higher chance of developing a spice allergy.

Medically Reviewed on 2/17/2022

References

Image Source: iStock Images Cleveland Clinic. Food Allergies. https://my.clevelandclinic.org/health/diseases/9196-food-allergies Seth D, Poowutikul P, Pansare M, Kamat D. Food Allergy: A Review. Pediatr Ann. 2020 Jan 1;49(1):e50-e58. https://pubmed.ncbi.nlm.nih.gov/31930423/ Lopez CM, Yarrarapu SNS, Mendez MD. Food Allergies. [Updated 2021 Oct 1]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2022. https://www.ncbi.nlm.nih.gov/books/NBK482187/

Kids Health. Food Allergies. https://kidshealth.org/en/parents/food-allergies.html