The Impact of Migration and Diet on Food Allergy Development

Food allergy is a potentially life-threatening immunologic reaction to food protein upon consumption of food. It affects 8% of children in the United States, while almost 40% of children with food allergy experience a severe reaction.1 Common symptoms include hives, vomiting, dizziness, shortness of breath, and wheezing. Past studies demonstrate that food allergy prevalence is on the rise,2 yet factors contributing to food allergy development are still not well understood.

Major hypotheses for food allergy development include, but are not limited to, birth via caesarian section, the hygiene hypothesis, and infant eczema. Previous literature suggests that environmental changes upon migration to a new country may contribute to peanut allergy development among immigrant populations. When observing a group of Australian infants, peanut prevalence among infants with both parents born in East Asia was 7.7%, 6.7% for infants with one parent born in East Asia, and 2.3% for infants with both parents born in Australia.3

There is a burgeoning prevalence of food allergic disorders in individuals of Asian origin residing in the USA. Review of the scarce literature published on this topic4 reveals the possibility that Asians have higher odds of food allergy compared with Caucasian children, but significantly lower odds of formal diagnosis.

In addition to environment, distinctive cultural practices and dietary cuisine may contribute to food allergies. South Asian diets are often different from Western diets. A study on food allergy among Indian adults in Karnataka, South India suggested that cow’s milk and apple were among common food allergens.5 Other sources also suggest that eggplant, melon, and legumes like chickpea are commonly reported food allergens for Indian adults. A pilot study exploring food allergies among individuals in Kansas City, Missouri of Asian Indian descent revealed that Indian Americans have ‘different’ food allergens  (such as chickpea flour, capsicum, eggplant and Indian lentils) in addition to the classic “Top 8” allergens reported in the USA (milk, egg, wheat, soy, peanut, tree nuts, fish, shellfish).6

To study the potential impact of environment and diet on food allergy development, a team of researchers from Northwestern Feinberg School of Medicine, Ann & Robert H. Lurie Children’s Hospital of Chicago, and Stanford University School of Medicine are conducting a survey exploring food allergies in adults and children of Asian Indian descent in the United States. Information from this voluntary and anonymous survey will be used to advance knowledge regarding allergies among individuals of Asian Indian origin. For more information and to access the survey, please visit:

Or visit:

Ruchi S. Gupta, MD, MPH, is an Associate Professor of Pediatrics and Medicine, Northwestern Feinberg School of Medicine, and is the Director, Science and Outcomes of Allergy & Asthma Research, Northwestern Feinberg School of Medicine (SOAAR); Mary Ann & J Milburn Smith Senior Scientist in Smith Child Health Research Outreach and Advocacy Center

Stanley Manne Research Institute, Ann & Robert H. Lurie Children’s Hospital of Chicago

Clinical Attending, Ann & Robert H. Lurie Children’s Hospital of Chicago.

Dr. Ruchi Gupta MD, MPH has more than 15 years of experience as a board-certified pediatrician and health researcher. She is nationally recognized for her groundbreaking research in the area of food allergy and asthma epidemiology; especially for her research on childhood food allergy prevalence.

Dr. Gupta has also significantly contributed to academic research surrounding economic costs, pediatric management of food allergy and asthma, ED visits and hospitalizations, quality of life, and community interventions in schools. In addition to being the author of The Food Allergy Experience, Dr. Gupta has written and co-authored over 70 original peer-reviewed research articles and has had her work featured in major TV networks and print media. She continues to make meaningful improvements in population health outcomes and the lives of children and their families.


  1. Gupta RS, Springston EE, Warrier MR, et al. The Prevalence, Severity, and Distribution of Childhood Food Allergy in the United States. Pediatrics. 2011.

  1.        Prescott SL, Pawankar R, Allen KJ, et al. A global survey of changing patterns of food allergy burden in children. World Allergy Organization Journal. 2013;6(1):21.
  2. Koplin JJ, Peters RL, Ponsonby AL, et al. Increased risk of peanut allergy in infants of Asian-born parents compared to those of Australian-born parents. Allergy. 2014;69(12):1639-1647.

  1. Arakali SR, Green TD, Dinakar C. Prevalence of food allergies in South Asia. Annals of Allergy, Asthma & Immunology. 2017;118(1):16-20.
  2. Mahesh PA, Wong GW, Ogorodova L, et al. Prevalence of food sensitization and probable food allergy among adults in India: the EuroPrevall INCO study. Allergy. 2016;71(7):1010-1019.

  1.        Motiani R, Dinakar C.  A survey to explore the types of food causing food allergic reactions among adults and children of Asian Indian Origin.  Journal of Investigative Medicine.  Feb 2013; 61(2): abstract 320.

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