UK Government Institute Warns Against Alternative Tests for Children’s Food Allergies

The use of these alternative tests is on the increase because of a lack of allergy services on the NHS and difficulties with diagnosing the condition in primary care.

2/24/2011 --- UK children are being placed on restrictive and potentially dangerous diets as parents look to the internet and the high street for alternative tests to diagnose food allergy, the National Institute for Clinical Excellence (NICE) has warned.

NICE has issued the first ever national guideline on food allergy in children which advises against the use of alternative tests, such as Vega testing, hair analysis and kinesiology.

The use of these alternative tests is on the increase because of a lack of allergy services on the NHS and difficulties with diagnosing the condition in primary care.

But there is very little evidence to support the use of these tests, some of which can retail for £60 or more.

It is estimated that of those children who report an allergy, 20 per cent wrongly self-report diagnoses of various food allergies and do not eat certain foods because they think they are allergic to them.

NICE recommends that GPs, practice nurses and health visitors diagnose and assess a suspected food allergy, commonly an allergy to cow's milk, fish and shellfish or peanuts, using either skin prick testing or by taking a blood test for IgE antibodies.

This decision should be based on the results of the allergy-focused clinical history and whether the test is suitable, safe and acceptable to the child.

Dr Adam Fox, Consultant in Paediatric Allergy at Guys and St Thomas' Hospital in London who was involved in the development of the NICE guideline, said: “These are the only two scientifically proven tests that should be carried out to diagnose food allergy, and they should be validated alongside a full clinical history.

“It is very frustrating when you see a patient who has had a bad deal. Parents often think that these alternative tests offer a quick fix but many children often end up on restrictive diets.

“I have had parents who have come to see me holding a printout based on a completely unvalidated test that they have bought from some shiny website.”

Dr Fox added that IGG testing, often confused by parents with the scientifically proven IgE blood test, is readily available on the internet but does not have a role to play in food allergy testing.

Mandy East, from the National Allergy Strategy Group and Anaphylaxis Campaign, said: “We have heard of parents who are cutting out whole food groups from their children's diets because they have used alternative tests.”

Dr Joanne Walsh, a GP who was also involved in the development of the guideline, said: “Parents want to do the best for their children so many will take up these alternative tests.

“This guideline will help to empower GPs to recognise the symptoms of food allergy, to take a really good history, and offer the most appropriate tests.

The guideline comes as the number of food allergies rises across the UK, with a 500 per cent increase in hospital admissions seen since 1990.

One in every 20 children will develop a food allergy, which means that every primary school year group is likely to have a child with an allergy.

“Many of us in primary care are seeing an increase in numbers. Just last week I saw 1 or 2 cases of food allergy in one surgery,” said Dr Walsh.

“The bulk of what I see in my clinic is now food allergy,” added Dr Fox.

“In the past we tended to see the immediate type of reaction, such as a reaction to nuts, but now we are seeing much more in the way of serious delayed reactions like colic or diarrhoea. We don't know why there has been such an increase.”

The hygiene hypothesis - where a lack of exposure in early childhood to infections increase susceptibility to allergies - has been suggested but this theory has holes in it, he said.

The UK Food Standards Agency has welcomed new guidelines on the diagnosis and assessment of food allergy in children and young people.

Sue Hattersley, Head of Food Allergy at the FSA, said: ‘These guidelines are an important step forward in improving the consistency and quality of care provided by health professionals. Food allergy is a serious health problem, which appears to be increasing, so it’s important that these people have effective clinical support. The FSA is continuing to carry out research into food allergies and we are working with the food industry and enforcement officers to minimise the risks for those with food allergy, and to provide them with the most up-to-date information.’

It is hoped that these guidelines will lead to better diagnosis of allergies in children. For those who have been diagnosed with a food allergy, the Agency issues Allergy Alerts by email and SMS text messages to warn people about foods that are being recalled because they have been incorrectly labelled.

The FSA also has an ongoing programme of research investigating food allergy and it has also funded the UK arm of a much larger EU study called EuroPrevall, which is gathering information on the types and prevalence of individual food allergies in infants, children and adults across Europe (including the UK). This is the first study to provide robust data on the prevalence of different food allergies across Europe. It is expected that results from this study will be available later this year.