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Navigating Food Allergies and the College Admissions Process

I am not alone. I am one of the millions of Americans living with a food allergy. It affects everything from grocery shopping, to food prep, to travel. I used to be embarrassed to speak up and tell others because I didn't want to be viewed as demanding or difficult. But after a few scares over the years, I am now direct and unapologetic.

As awareness becomes a hot button topic, I have a significant number of families reaching out to me about how colleges handle dietary restrictions and food allergies, not only when the student arrives on campus but through the admissions process. In fact, I read a growing number of college essays on food allergies every year.

So if you live with a food allergy or have a child who does, here are some tips on what to share, who to share it with, and how colleges will view it.

1. If the student plans to write about their food allergy for their college essay, take a step back.

There are a lot of students writing about this topic in 2019. It can be done. But when you choose a popular topic like this, you have to do something really novel with it. I read an essay last year from a young man who put an unexpected twist on his personal experience living with a severe food allergy. He ended up getting admitted to his Early Decision choice!

FREE DOWNLOAD: The Ultimate Guide to Picking the Perfect College Essay Topic

2. If the student chooses to write about this topic, they have to be comfortable being known as the "student with the food allergy."

Admissions officers are guilty of nicknaming students unfairly based on the topic of their main essay. It's a personal choice on whether to share this in the admissions process. But if you don't want to be defined by this in your application, I would recommend considering a different topic for your essay .

3. Check out the college's website to learn about its dining options.

More colleges than ever before have all of their dining information on their websites. They will have specific information about special dining halls for students with food allergies and individuals on campus to help students navigate their college experience. For instance, Boston University's options and philosophy are front and center on its dining services website.

4. Do your research BEFORE visiting.

Families should review the offerings before planning a college visit or attending an open house . You can request specific meals or arrange special dining options while you are there. How the college responds to your requests speaks volumes about what the student will experience on campus.

Want insider tips on the colleges on your list?

Join application nation - class of 2020 for the scoop and to get 24/7 access to sara, 5. if you are worried about this backfiring or being used against you in the admissions process, don't disclose your food allergies until after getting admitted..

And, yes, discrimination of ALL kinds still happens in college admissions.

Several years ago when I was working in a college admissions office, a family visiting for an open house was upset about how we handled their request for a gluten-free meal. The student suffered from celiac disease and the "gluten-free" meal given to her for lunch had gluten all over it. I was ashamed and mortified that this happened. A few of my colleagues were complaining about how the family was overreacting. I understood the family's concerns personally, though.

Awareness brings understanding, to improve how colleges handle students with food allergies—and for the families who face this every day. I never want anything to get in the way of a student's opportunities—not a food allergy or an admissions officer with bias. By the way, I am soy-free and gluten-free. Proud of it, in fact.

Download The Ultimate Guide to Picking the Perfect College Essay Topic—for free!

About Sara Harberson

Sara Harberson is the founder of Application Nation™, which provides personalized advice to college applicants and their families. In her book, SOUNDBITE: The Admissions Secret that Gets You Into College and Beyond, Sara reveals the secrets of her signature college admissions tool, the "Soundbite," and shares tried-and-tested exercises that have helped thousands of students gain admission to their school of choice. She is the former associate dean of admissions at the University of Pennsylvania and the former dean of admissions and financial aid at Franklin & Marshall College. Sara’s philosophy is that every kid applying to college deserves the best advice.

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For students with food allergies, college campuses can be hazardous

The number of young people with food allergies has been surging in the past few decades. This fall, many of them are heading to college.

Living with a food allergy at home is challenging under the best of circumstances. But college students say navigating food allergies on campus is particularly fraught.

Nearly a dozen current and recent college students with food allergies shared stories of encountering allergens in campus dining halls, during dorm-life shenanigans and at off-campus events.

Alyssa Bauder, 25, a doctoral candidate in Chicago with a severe nut allergy, recalls waking up one day in her sophomore year at Ohio State University to find peanut butter splattered across her dorm hallway, including on the carpet and the doors to her bedroom and the communal bathroom. No one living on her floor knew at the time that she and her roommate were severely allergic to peanuts, so they chalked up the incident to “drunk students coming home from the bar.”

Bauder said dorm workers “put minimal effort” into finding out who had vandalized the hallway and in cleaning up the mess, residues of which lingered in carpet fibers before a proper cleaning was finally done.

“Even after the physical allergens were removed from the hallway, the traumatic experience lived on with me,” said Bauder, who launched a blog, All Things Allergies , about food allergy-related mental health struggles. She said the incident reignited feelings of post-traumatic stress related to food allergies that she’s had since childhood.

“I never felt comfortable in that space again," she said. "I was constantly worried my shoes were tracking the peanut butter into the safety of my room.”

The university offered Bauder and her roommate a vacant dorm to live in during the cleaning, but she chose to stay at a family home nearby instead.

An Ohio State spokesman said that he could not discuss specific students but that the health and safety of students, faculty and staff “is a top priority.”

A new landscape for food allergies

The prevalence and severity of food allergies among children increased 50 percent between 1997 and 2011, according to the nonprofit organization Food Allergy Research & Education. Now, at least 1 in 10 adults in the United States have food allergies , according to data published in JAMA Network in 2019. Some researchers have described the surge as a “ food allergy epidemic .”

“They’re all growing up and taking their food allergies into college,” said Ruchi Gupta , a physician and the founding director of the Center for Food Allergy and Asthma Research (CFAAR) at Northwestern Medicine. “We’re talking about 10 percent of a college population learning how to be independent for the first time, making food choices on their own, and that coinciding with wanting to be accepted, make friends, eat out and go to parties.”

The true scope of the problem is unknown, Gupta said, partly because college students are not required to declare their food allergies on applications. It is even harder to quantify how many of them experience anaphylaxis — a life-threatening allergic reaction — while on campus.

A 2016 study described a nearly threefold increase in emergency department visits related to food-induced anaphylaxis among 5- to 17-year-olds from 2005 to 2014.

“What we do know is that about one in five kids and one in 10 adults end up in the emergency room every year for a food allergic reaction,” Gupta said. “And we definitely think it’s higher for college students and young adults at that age.”

Many aspects of the college experience involve food, including welcome buffets during orientation week and dorm gatherings. Parties are among the riskiest environments, Gupta said.

“It’s like kindergarten all over again,” said Caroline Moassessi, the vice president for community relations with the Food Allergy & Anaphylaxis Connection Team (FAACT), and a mother of two college students. “You have to let go and pass the food allergy baton as you hold your breath because you hope they make good decisions.”

Campus dining halls are food-allergy minefields

Some college dining halls have dedicated stations that are free of nine common allergenic foods: peanuts, tree nuts, milk, egg, wheat, soy, fish, shellfish and sesame. (These foods are responsible for 90 percent of all food allergy reactions , according to FAACT.)

But despite precautions, mistakes do occur, a number of anecdotal reports indicate. In one study , students told researchers that they had eaten food that was mislabeled or that they had received the wrong meals in dining rooms.

Some say that campus dining room workers are inadequately trained to understand food allergies.

At the beginning of her freshman year at the University of Toronto in 2016, Jenna Tso struggled to find safe meal options at her dining hall.

One day, Tso, who is severely allergic to milk, eggs, beef and pork, picked a bowl of vegan lentil dal, only to have the dining hall employee top it off with a piece of bread that contained dairy.

“I had to give my meal away to someone else,” said Tso, 24, now a social worker in Los Angeles. “I didn’t feel comfortable going back and ordering the supposedly vegan meal again without the bread, because of the worker’s lack of awareness.”

Cate Weiser, a 19-year-old sophomore at the University of Chicago who is allergic to eggs, peanuts, tree nuts and fish, said she was fortunate to have access to an allergen-free dining station.

A University of Chicago spokesman said “menus follow a 5-week cycle where different meals are introduced each day.” But Weiser said the hardest part about her first year on campus, she said, was the repetitive and limited meal options.

“It’s hard to eat the same thing every day,” Weiser said. “Plus, it’s dining hall food, so it’s not good in the first place.”

The challenges of socializing with food allergies

For those with food allergies, social events and other outings introduce myriad other risks.

Alcohol is one factor. The labels on many alcoholic beverages do not disclose ingredients or potential allergens, setting up exposure risks for those who are allergic to rye, wheat, barley and even peanuts. Not only can alcohol increase the severity of an allergic reaction, but its intoxicating effect also can reduce a person’s ability to notice what is happening, leading to delayed treatment.

But many people with allergies say the biggest challenge is a general lack of support and understanding among peers.

Tso said she avoided talking about her allergies out of fear of “being labeled as difficult or annoying.” She recalled a sorority event at an Italian restaurant during her freshman year when she began having an allergic reaction after taking a bite of a spaghetti dish that she thought was safe.

Tso felt a tingling in her throat and began to have trouble breathing. She said she was too embarrassed to use her EpiPen in front of her companions and instead excused herself to call an Uber to go to a hospital.

She administered her EpiPen in the car but was too late to prevent a severe reaction. She began to vomit. When she arrived at the hospital her airways were nearly closed and her hands and fingers were turning blue because of a lack of oxygen.

“I really downplayed my allergies, which I regret,” said Tso, who now offers food allergy and mental health consulting for students and parents. “I went most of my childhood without having an allergic reaction, but then I went to college and had three in the span of three years because I didn’t have the skills to advocate for myself.”

Finding support on campus

Katelyn Chu, an 18-year-old freshman at the University of Virginia, developed an allergy to soy at 10 years old. As a Korean American, she grew up having to avoid traditional foods like tofu, soybeans and miso.

She joined an Asian students group on campus, but traditional Asian foods are often served at the group’s events. “For some events, they’ll serve sushi or other traditional Asian foods that I can’t eat,” she said. “It’s stressful.”

Two juniors at Northwestern University, Kethan Bajaj and Julia Auerbach, organized College Advocates for Food Allergy Awareness & Education (CAFAE), to support students who have food allergies and other food-related conditions.

Bajaj said he started advocating for students with food allergies after watching his older brother cope with his own during his time as a college student. Auerbach said she has had celiac disease since she was 12 and wanted to help others navigate the transition from high school to college.

CAFAE holds EpiPen training sessions on campus and provides opportunities for students to discuss their food-allergy experiences. The group also plans to extend its work to nearby high schools.

Students at Tulane University in Louisiana are starting their own CAFAE chapter this upcoming school year, and Bajaj and Auerbach are chatting with several universities about new chapters.

Bajaj and Auerbach said they were motivated to start the club after they used an online survey to gain insights into campus allergy experiences. They found that students who did not have allergies were interested in EpiPen training and in learning how to help someone who is having an allergic reaction .

Food Allergy Research & Education (FARE) and FAACT have launched programs to raise allergy awareness among university staffers and in resource centers . They also provide college students with checklists , legal help and other food allergy information.

An app called Spokin recently released a “ Top 100 ” allergy-friendly college ranking based on over 300 student reviews so far. Next month, the app will offer more detailed information about the food allergy policies and practices at various colleges. Participating schools will pay a fee to be included.

“The goal is to make the already daunting school research process far easier,” said Spokin founder and chief executive Susie Hultquist, who also is the mother of a college student with food allergies.

Michael and Rebecca Suhy started the Allison Rose Foundation after their daughter, Allison Rose, a freshman at Ohio University, died in 2017 of complications of an anaphylactic reaction while spending time off-campus with friends.

The foundation offers food allergy awareness and education to more than 60 high schools, colleges, restaurants and other organizations. It also provides schools with epinephrine stock at no cost. Ohio University recently installed yellow allergy emergency kits in every dining hall in Allison’s honor.

“We feel like we have to be pioneers for those parents that are coming behind us so they never experience what we had to,” Rebecca Suhy said.

Sami Sanders, a 17-year-old high school senior in Georgia with multiple severe food allergies, has already started her college application journey.

Sanders’s mother has taught her to call restaurants and companies and send them emails to request information about certain foods, and to talk to friends and family members about her allergies.

“The older I got, I realized my mom isn’t going to be able to talk and do the research for me. I need to do it myself,” Sanders said. “I’m definitely nervous for college, but I’m staying positive. I know I’m going to end up where I am supposed to be.”

What Can Be Done to Ease the College Transition for Food Allergy Sufferers?

By Madeline Whitney

Published: July 31, 2020

“Maddie,” my older brother said quietly as he pulled away from our goodbye hug after visiting for a football game, “Please don’t die.”

I thought he was joking, as older brothers love to do, but as I looked into his eyes and saw the seriousness behind them, I reflected back on the first four months of my college experience.

Prior to coming to Notre Dame, in my sophomore year of high school, I was diagnosed with a food allergy to sesame, after an unfortunate incident with hummus. However, with some precautions and after obtaining emergency medicine, I was able to avoid any issues throughout the remainder of my time at home. This all changed when I went to college.

During my first few months, I went into anaphylactic shock on four separate occasions, received six doses of epinephrine, took two trips to our local emergency room, listened to my parents frightened tears countless times over the phone, and was on a first-name basis with the first responders from Notre Dame Security Police. I had almost died four times, but I had just accepted it as my normal.

My brother’s words stirred something up inside of me and helped me realize that my life and college experience did not have to be like this. Even in this tumultuous time of change, my allergies did not need to define me. I also realized I was not in this alone. There are countless other students struggling with similar allergies, and I began to wonder, what can our universities, our friends, our families, and we ourselves do to help us navigate this transition to college?

12.5% of all food allergy-related deaths occur on college campuses, according to research done by S. Allen Bock, Anne Munoz-Furlong, and Hugh A. Sampson, food allergy and anaphylaxis researchers. But there is minimal data on the actual percentage of college students who suffer from food allergies because many students do not document their allergies (Bock, Munoz-Furlong, Sampson 1016). Students with food allergies have to deal with both the new challenges college brings as well as learning how to stay alive with their allergies in this unfamiliar environment. Brand-new experiences like dining halls, dorms and roommates, social culture, and romantic relationships that every college student has to learn how to navigate become potential deadly obstacles that allergy sufferers must learn to overcome in this unknown space. Many students, like me, may have had full control of their food allergies back home due to accessibility to safe foods and living with a strong support system. However, in this new environment, many students are not taking the appropriate precautions to ensure their safety. Research done at a few major Midwestern universities by Marilyn Karam, Rebecca Scherzer, Princess U. Ogbogu, Todd D. Green, and Matthew Greenhawt, immunologist researchers, shows that only about 36.7% of college students with reported food allergies actually carry their emergency medication with them at all times (Karam, Scherzer, Ogbogu, Green, Greenhawt 504). Without this medication, any interaction with a food someone is allergic to can become a damaging, deadly encounter.

My first experience with allergies here at Notre Dame happened at a common gathering spot for all college students, the dining hall. I sat down for a nice meal with one of my friends, took a bite of a food that I had thought I had eaten before, and immediately knew that it contained sesame oil. However, like many other students, I was not carrying my emergency response medicine, in my case an Epipen, or self-injectable epinephrine. We rushed back to my dorm, grabbed my Epipen, and sat in my rector’s office debating whether or not to use it as my tongue swelled and my throat began to close. I ended up being very lucky. I can only begin to think what would have happened if my friends did not know where my medicine was or if I had been across campus when this occurred. You might think that this experience changed my perspective, and I began to carry my medicine everywhere I went, but besides taking more precautions in the dining halls, I stupidly did not make much change.

Perhaps because there is a stigma surrounding carrying an EpiPen. It can make one feel childish or out of control when in reality even just carrying one’s EpiPen increases user safety. The visual of someone carrying an EpiPen increases the precaution of those around them and reminds the allergy sufferer to be careful. College students, however, often want to be seen as going with the flow and not worried; risk-taking behavior of all sorts thrives in college. Sarah E. Duncan and Rachel A. Annunziato, professors of psychology at Fordham University, claim that “it is possible that general risk-taking behaviors exacerbate college students’ nonadherence to self-management behaviors” (Duncan and Annunziato 332). Basically students feel that because they are already making plenty of potentially dumb decisions, they can take a few more. For food allergy sufferers this normally means not telling their friends about their allergies and forgetting to bring their emergency medication with them.

The easiest solution here is turning carrying emergency medicine from a hassle into just a normal part of daily routine. Getting students in the habit of having an EpiPen in their backpack and making sure their friends know about their allergies is crucial. There needs to be a shift where students understand the necessity of carrying their medicine, and friends are supportive and understanding when they see it or are told about the allergies. Friends of these sufferers just need to be open and understanding when this conversation happens, knowing that the burden is not on them, but that their awareness is helpful overall.

Another complication of food allergies in college researched by allergists John P. McGovern and James A. Knight is that they can be even more dangerous when combined with emotions of stress or anxiety (McGovern and Knight 3). College is not known as the calmest, most comfortable place in the world. In fact, studies done by the American College Health Association show that 49.5% of college students report tremendous or more than average stress levels, and 51% have felt overwhelming anxiety in the past year (NCHA 2017). This combined with the already existing stress from maintaining food safety can be very difficult for sufferers to bear.

My second incident came the week before a big test. Due to the stress of studying and also missing food from home, my friends and I decided to order sushi as a little treat. A little bit after eating, I remember turning to my friends and asking them if my tongue looked swollen. The fearful looks in their eyes gave me all the confirmation I needed, and I was rushed to the emergency room. My resident advisor and one of my friends sat with me all night in the hospital as I received additional medicines to control my symptoms. By the time we finally got home around midnight, I could not even think about doing school work as my body was emotionally and physically exhausted. In addition, many doctors will prescribe steroids after an anaphylactic reaction to reduce the risk of a biphasic reaction, a type of delayed relapse response potentially occurring in the days following initial exposure to the allergen. On these pills, I was a whole different person. I would cry at the drop of a hat, felt like I was going to throw up every second, and was exhausted beyond belief. Just sitting in my classes felt impossible. The whole week I was not only scared of eating food due to the stress that it might unknowingly contain my allergen, but I was also stressed about falling behind in my classes. In sum, I was a mess, and it felt like there was nothing I could do to make it better.

This is not an uncommon feeling among allergy sufferers. In Anne Ersig’s, pediatric RN at the University of Wisconsin Madison, and Janet Williams’, professor of nursing at the University of Iowa, survey of college students with intense food allergies, one student expresses, “‘If I do accidentally ingest something I’m allergic to, I will be forced to miss class for potentially up to a week...and my mental capacity will be noticeably impaired for at least one month’” (Ersig, Williams 447). Knowing how detrimental an attack can be not only on one’s body but also academic performance only enhances existing stress. It is a moment when the only thing that truly matters is staying alive, but due to the atmosphere of college, the food allergy sufferer also worries about their schoolwork and falling behind.

The key solution in terms of dealing with the stress aspect of food allergies relies on universities. A university cannot go in and get a food allergy sniffing dog to check every morsel a student consumes, but they can be understanding when it comes to academics. Obviously, students must maintain the rigor of their course loads, but more times than not a reaction is out of students’ hands and is dumping bucket loads of stress onto said students. Allergies can be considered a disability, and universities are required to provide accommodations for disabilities. Ideally, this would look like more relaxed deadlines or providing a designated nutritional counselor for students to talk to post reactions. Luckily, here at Notre Dame most of my professors have given me extra time on some assignments and our nutritionist on campus, Jocie Antonelli, is kind, caring, and extremely supportive. In these ways, the university has helped me immensely without impacting the other students they must also take care of.

Other common issues for food allergy sufferers include uncertainty about having safe foods especially in busy times and difficulty trusting others around you (Ersig and Williams 448). When students are in a rush or without access to a kitchen to cook for themselves in, there is often a heavier reliance on processed foods than a student with food allergies was probably used to back in their safe home environment. When you only have a fifteen-minute break for lunch, it seems a lot easier to just grab a granola bar on your way, but relying on this processed food that has more potential to be cross-contaminated with an allergen can put these students in a very dangerous position. In his New York Times article, journalist and father to a food allergy sufferer, Eric Athas, exposes how some allergens are not actually required by the FDA to be labeled, making this processed food shift even more detrimental (Athas). My allergy, sesame, is currently not required by the FDA to be labeled for, so it can hide in processed foods as something generic like “natural flavors.” Basically, a food could look completely safe when in reality my allergen is lurking inside.

My third instance of food allergy issues came right as I was sitting down to take a midterm. Rushing out the door to make it across campus for my 8 a.m. exam, I had grabbed a protein bar from my dorm attempting to get some food in my system. I sat down in the exam room and began to feel the familiar signs of an anaphylactic reaction. I went to my professor informing her that I would reschedule and needed to leave. She asked if it was just testing anxiety. At this point, I was stressed, angry, and struggling for air. Not wanting to be that girl I left the room to stab myself with my EpiPen and call NDSP in peace so as to not disturb the other test-takers. I spent the remainder of the day in our on-campus medical facility being monitored and receiving additional epinephrine doses as I was not getting better. After this experience, I lost so much trust in those around me. I began to wonder what would happen if I was physically unable to use my EpiPen myself. Would others take the situation as seriously as it actually is or would they find another reason, like test anxiety, for my troubles breathing and swollen tongue? I feared telling more people about my issue because I felt they too would not understand the extent of my food allergies, and that I would then find myself in dangerous situations.

However, this barrier is one that the food allergy sufferers must take on themselves. They must continue to advocate for their allergy and educate others about it. They need the support of friends and family to bolster their words, but they must also find the strength and courage to speak and bring awareness to this issue. They can start a club or educate their peers by writing an essay about their experiences. They must be the ones to start the conversations with their peers, no matter how scary it might seem, because it is the best way to ensure their overall safety.

It is a general assertion that college is hard, but college with food allergies can often seem impossible and unnecessarily dangerous. Some of these barriers are coming down as more and more dining areas are implementing allergy-friendly zones and increased food labeling is enabling consumers to be more aware of what exactly is in their processed foods. However, many of these obstacles will probably never go away, but that does not mean that attempts at change should not be made. The more students that come forward bringing awareness to their allergy-related struggles, the more people will see the need for change on our college campuses. For me, writing this essay has enabled me to be so much more vocal about my allergies, putting me in a much safer position. I am proud to say that I have not had a severe reaction in the second half of the school year. That being said, the path for me and other students who must manage their food allergies on a college campus is not going to be easy, but every day we make it work we can be an inspiration to a small child being diagnosed with a peanut allergy. If college students with allergies can take comfort in nothing else, those who speak up and educate others should know that they are forging the path for change and allergy-friendly college campuses in the future.

Works Cited

Athas, Eric. “Which Allergens Are in Your Food? You Can't Always Tell From the Labels.” The

New York Times , The New York Times, 28 Jan. 2019, www.nytimes.com/2019/01/28/health/food-allergies-children-labeling.html.

Bock, S. Allen, Munoz-Furlong, Anne, and Sampson, Hugh A. “Further fatalities caused by anaphylactic reactions to food, 2001-2006.” Journal of Allergy and Clinical Immunology, vol. 119, no. 4, April 2007, pp. 1016-1018. University Libraries of Notre Dame, https://www-sciencedirect-com.proxy.library.nd.edu/science/article/pii/S0091674906038140# !

Duncan, Sarah E., and Rachel A. Annunziato. "Barriers to Self-Management Behaviors in College Students with Food Allergies." Journal of American College Health , vol. 66, no. 5, 2018. Taylor & Francis Online , www-tandfonline-com.proxy.library.nd.edu/doi/full/10.1080/07448481.2018.1431898?scroll=top&needAccess=true. Accessed 3 Mar. 2019.

Ersig, Anne L., and Janet K. Williams. "Student and Parent Perspectives on Severe Food Allergies at College." Journal of Pediatric Health , vol. 32, no. 5, Sept.-Oct. 2018, pp. 445-54. University Libraries of Notre Dame , www-sciencedirect-com.proxy.library.nd.edu/science/article/pii/ S0891524518300348. Accessed 3 Mar. 2019. Frehill-Maye, Lynn. "Allergies in 2018: Here's How Smart College Operators Are Leading the Charge on Food Allergies, Special Diets, and beyond." FoodService Director , vol. 31, no. 2, 2018, p. 51, bi.galegroup.com.proxy.library.nd.edu/essentials/article/GALE%7CA526735395/77e3e0ff06fee3bca98fa3afbb2ea1e2?u=nd_ref. Accessed 3 Mar. 2019.

Greenhawt, Matthew J., and Andrew M. Singer. "Food Allergy and Food Allergy Attitudes among College Students." The Journal of Allergy and Clinical Immunology , vol. 124, no. 2, 2009, pp. 323-27, www-sciencedirect-com.proxy.library.nd.edu/science/article/pii/S0091674909008392.

Karam, Marilyn, Scherzer, Rebecca, Ogbogu, Princess U., Green, Todd D., and Greehawt,

Matthew. “Food allergy prevalence, knowledge, and behavioral trends among college students — A 6-year comparison.” The Journal of Allergy and Clinical Immunology: In Practice , vol. 5, no. 2, March-April 2017, pp. 504-506. Science Direct, https://www.jaci-inpractice.org/article/S2213-2198(16)30672-9/abstract

McGovern, John P., and James A. Knight. Allergy and Human Emotions . Springfield, C. C. Thomas, 1967.

Whitney manages the scope of her research topic by focusing on allergy sufferers who are also college students. What did you learn about this demographic of individuals? Did you learn anything that surprised you?
Even though this essay focuses on college students, how might it appeal to a broader audience? Why might someone who does not have allergies or is not a college student want to read this essay? What might they learn?
In what places in the essay do you see Whitney employ the rhetorical virtues of knowledge, honesty, or intellectual courage?
In this essay, Whitney combines personal narrative with academic research. Imagine essays that address the same topic (college students with allergies who transition to college campuses) that are either solely personal narrative or solely research-based. What might be gained or lost in each approach? What does the combination of narrative and research in Whitney’s essay offer to readers?

Feature Article Assignment Prompt

Madeline Whitney

Madeline Whitney is originally from San Jose, California and is currently a member of the class of 2022 living in Breen-Phillips Hall. She is studying Business Analytics with minors in the Hesburgh Program in Public Service and Italian. When asked to write an essay mixing research and personal experience, she felt as if there was no other choice but to talk about her difficult first semester of college, navigating her food allergies. Through this essay, she hopes to bring awareness to college food allergy sufferers and encourage them and their loved ones to advocate for increased support. In the future, Madeline hopes to enter the venture capital and startup sphere, pursuing companies that seek to make positive change in the world. She would like to thank her Writing & Rhetoric professor Joanna Want for her constant support in telling her story and all of the individuals who were there for her during her difficult first semester, including NDSP, her BP friends and rector, and her parents.

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Early Introduction of Food Allergens and Risk of Developing Food Allergy

Elizabeth yakaboski.

1 Division of Rheumatology, Allergy and Immunology, Massachusetts General Hospital, Boston, MA 02114, USA; ude.dravrah.hgm@iksobakaye (E.Y.); ude.dravrah.hgm@nosniborbl (L.B.R.)

Lacey B. Robinson

Anna arroyo.

2 Division of Pulmonary, Allergy and Critical Care Medicine, Stanford University School of Medicine, Stanford, CA 94305, USA

Janice A. Espinola

3 Department of Emergency Medicine, Massachusetts General Hospital, Boston, MA 02114, USA; ude.dravrah.hgm.xileh@ALONIPSE (J.A.E.); ude.dravrah.hgm@rellegjr (R.J.G.); gro.srentrap@navillusfa (A.F.S.)

Ruth J. Geller

Ashley f. sullivan, susan a. rudders.

4 Division of Immunology, Boston Children’s Hospital, Boston, MA 02115, USA; [email protected]

Carlos A. Camargo, Jr.

Associated data.

The data presented in this study are available on reasonable request from the corresponding author. The data are not publicly available due to privacy restriction.

There is increasing evidence that early introduction of allergenic foods may decrease the risk of developing IgE-mediated food allergy. Patterns of food introduction before the 2015 publication of the Learning Early about Peanut Allergy (LEAP) trial are not well-studied, but are important as a baseline for evaluating subsequent changes in infant feeding practices and potentially food allergy. We performed a retrospective longitudinal study using data from a multicenter cohort of infants hospitalized with bronchiolitis between 2011–2014. The primary outcomes were IgE-mediated egg or peanut allergy by age 3 years. Of 770 participants included in the analysis, 635 (82%) introduced egg, and 221 (27%) introduced peanut by age 12 months per parent report. Four participants had likely egg allergy, and eight participants had likely peanut allergy by age 3 years. Regular infant egg consumption was associated with less egg allergy. The association was suggestive for infant peanut consumption with zero peanut allergy cases. Overall, our results suggest that early introduction of peanut was uncommon before 2015. Although limited by the small number of allergy cases, our results suggest that early introduction of egg and peanut are associated with a decreased risk of developing food allergy, and support recent changes in practice guidelines.

1. Introduction

The prevalence of IgE-mediated food allergy is rising, and is currently estimated to affect approximately 5–10% of children in the United States (US) [ 1 , 2 , 3 ]. To address this growing public health burden, strategies for prevention of food allergy development are of great interest [ 4 , 5 , 6 , 7 ]. In addition, to prevent accidental food allergen exposure in both children and adults with known food allergies, several recent industry advances in allergen detection and removal from processed foods have emerged [ 8 ].

Approaches for prevention of food allergy development that have not yielded reproducible results include prenatal maternal dietary avoidance, breastfeeding, the use of extensively hydrolyzed formulas, and pro- and prebiotics [ 4 ]. While there is emerging evidence that optimizing eczema care to maintain a healthy skin barrier and thus prevent food-specific sensitization likely plays an important role in food allergy prevention [ 9 , 10 ], the approach backed by the most convincing data is in regard to early introduction of allergenic foods, most notably egg and peanut [ 11 , 12 , 13 , 14 , 15 , 16 , 17 , 18 ].

Of these studies, the landmark clinical trial Learning Early about Peanut Allergy (LEAP), published in 2015, marked the beginning of a shift in clinical practice towards early introduction of food allergens. In this study, a cohort of infants aged 4 to 10 months with egg allergy, severe eczema, or both, were randomly assigned to consume or avoid age-appropriate peanut-containing foods several times per week up until age 5 years. The study did not include infants who already had peanut allergy. The LEAP study showed that early introduction of peanut decreased the prevalence of IgE-mediated peanut allergy at age 5 years by more than 80% [ 11 ]. In a follow-up two-group comparison study, the Persistence of Oral Tolerance to Peanut (LEAP-On) study showed that participants who introduced peanuts in infancy and continued to consume peanuts until 5 years of age, but then subsequently avoided peanut from age 5 to 6, were still 74% less likely to have peanut allergy than children who had consistently avoided peanut from infancy up until age 6. LEAP-On showed that the peanut tolerance promoted by early introduction to peanut could be long lasting [ 12 ].

Recent guidelines, including the 2021 multi-society Consensus document on approach to the primary prevention of food allergy [ 19 ], recommend early introduction of egg-containing and peanut-containing products starting around 6 months of age (but not before 4 months of age) in all infants, and to not deliberately delay the introduction of other potentially allergenic complementary foods. Similarly, the 2008 American Academy of Pediatrics Clinical Report was updated in 2019 and the 2010 National Institute of Allergy and Infectious Diseases Guidelines were addended in 2017 to recommend the same for peanut, with the caveat that infants at high risk for food allergy undergo evaluation for preexisting peanut sensitization prior to introduction [ 20 , 21 , 22 , 23 , 24 ]. Clinically, evaluation for pre-existing sensitization may be performed through skin-prick-testing and/or through ImmunoCAP specific-IgE either to whole food allergens or to food allergen components. While there is not a standardized definition of high risk for food allergy, the 2021 Consensus document recommends that infants with severe eczema are considered at highest risk of developing food allergy, and infants with mild to moderate eczema, parent(s) with a history of atopy, and a known food allergy have an elevated risk of developing a new food allergy. Although the 2014 food allergy prevention guidelines from the European Academy of Allergy and Clinic Immunology (EAACI)] stated that at the time of its publication, there was insufficient evidence to recommend either withholding or encouraging exposure to potentially allergenic foods after 4 months of age in all infants, with and without atopic heredity [ 25 ], the 2020 updated guidelines now suggest introducing peanut and well-cooked egg as part of complementary feeding [ 26 ].

Patterns of food introduction before the 2015 LEAP publication (and adoption of early allergen introduction), are not well-studied, but are important as a baseline for future changes in food introduction patterns. Our objectives were to first describe the patterns of egg and peanut introduction prior to 12 months of life in a US-based cohort and to then estimate the associations between early introduction of egg or peanut and early childhood IgE-mediated allergy to egg or peanut, respectively. To determine egg and peanut allergy status, allergy physicians reviewed data from multiple sources including primary medical records, serial interviews starting at age 12 months, as well as egg and peanut IgE obtained during infancy and at 3 years of age.

2. Materials and Methods

2.1. study population.

We analyzed data from the ongoing 35th Multicenter Airway Research Collaboration (MARC-35), a multicenter, prospective cohort of infants enrolled during hospitalization for bronchiolitis during the fall/winter seasons of 2011–2014. MARC-35 is coordinated by the Emergency Medicine Network (EMNet; www.emnet-usa.org ). MARC-35 was designed with the primary purpose of studying severe bronchiolitis and recurrent wheezing in early childhood, and also entailed the collection of a substantial amount of food allergy data for secondary studies such as the one presented here. The total number of sites participating was 17, across 14 US states. Full details of initial study inclusion and methods have been previously described [ 27 , 28 ].

2.2. Data Collection

Upon enrollment during infancy, investigators completed a structured interview with parents/guardians to assess patients’ demographic characteristics and medical and environmental history. Telephone interviews were then conducted every 6 months by the EMNet Coordinating Center at Massachusetts General Hospital (Boston, MA, USA), and included annual questions regarding dietary intake. Further clinical data on the patient’s clinical course, including medical records from all primary care and specialty medical visits, were obtained. Records were reviewed by physician reviewers and study data were collected and managed using Research Electronic Data Capture (REDCap) hosted at Mass General Brigham. REDCap is a secure, web-based application designed to support data capture for research studies [ 29 , 30 ]. IgE sensitization to common food allergens (e.g., egg and peanut) were assessed via ImmunoCAP Specific-IgE (sIgE) and immuno-solid-phase allergen chip (ISAC) both at the Phadia Immunology Reference Laboratory (Portage, MI, USA) during infancy and the early childhood examination ( Table S1 ). Both are used to detect allergenic sensitization, but sIgE is considered the gold standard for in vitro diagnosis.

2.3. Exposure—Age 12 Months

Early introduction of egg or peanut was defined as consumption of egg product or peanut product, respectively, at least once per week based on parent report at the 12-month telephone follow-up interview. Specifically, parents were asked, did the participant eat or drink any of the following items at least once per week: (1) egg or egg whites, (2) foods containing egg (e.g., baked goods, pancakes, mayonnaise), (3) peanut butter, and (4) peanuts.

2.4. Outcome—Age 3 Years

Among the 921 participants enrolled in the MARC-35 longitudinal cohort, the 582 (63%) suspected of having food allergy due to at least one of the following were selected for additional outcome assessment: (1) physician diagnosis or evaluation of food allergy on initial chart review up until age 0.9 years, (2) sensitization on either ImmunoCAP sIgE (≥0.1 kU/L) or ISAC (≥0.3 ISU) during infancy or the early childhood examination, (3) parent report of IgE-mediated symptoms (skin or breathing problems such as hives, swelling, itching, cough or wheezing) within two hours after eating at any long-term follow-up interview from age 12 months up until age 60 months, or (4) parent report of doctor-diagnosed IgE-mediated food allergy at any long-term follow-up interview from age 12 months up until age 60 months. We looked at interview data up until age 60 months rather than up until age 36 months to decrease the potential of missing food allergy cases. Among the 582 participants with suspected food allergy, further chart review was performed up until age 3 years and parents were surveyed via website or telephone regarding food allergy and dietary history.

Using all available data, IgE-mediated food allergy status by age 3 years for each participant was classified by allergists (E.Y., L.B.R., A.C.A.) as likely, possible, or unlikely using a standardized protocol ( Figure S1 ). Likely food allergy represents the most definite cases of IgE-mediated food allergy. For example, a participant with parent report of doctor-diagnosed food allergy, testing highly suggestive of IgE-mediated food allergy, IgE-mediated symptoms with consumption of the food allergen, and subsequent avoidance of the food allergen would be categorized as likely food allergy. Possible food allergy represents less certain, but potential food allergic cases. For example, a participant with parent report of doctor-diagnosed food allergy, testing possibly suggestive of IgE-mediated food allergy, but no lifetime clinical exposure to the food, would be categorized as possible food allergy. Unlikely food allergy represents cases that are tolerant of food allergens. For example, participants with IgE-sensitization to a food allergen, but who do not have doctor-diagnosed food allergy and are able to consume the food would be categorized as unlikely to have food allergy. Remaining participants that did not meet criteria for additional food allergy evaluation were deemed unlikely to have IgE-mediated allergy to egg or peanut provided they had negative egg white and peanut sIgE (<0.35 kU/L) at infancy, and no report of either IgE-mediated symptoms after food ingestion or physician diagnosis of food allergy at the age 24 or 36 month interview. Of the 921 participants in the initial longitudinal cohort, one participant died during infancy, and 151 (16%) were excluded due to incomplete exposure data (e.g., age 12-month dietary history) or outcome data (e.g., age 24 or 36 month interview) ( Figure S2 ).

2.5. Analysis

We obtained covariate data from the enrollment interview. Covariates of interest included sex, race/ethnicity, insurance provider, estimated median household income by ZIP code (Esri Business Analyst Desktop, Esri, Redlands, CA, USA), history of eczema at enrollment, parent with a history of food allergy, and number of other children living in the home.

All analyses were performed using Stata 15.1 (Stata Corp, College Station, TX, USA). Data are presented as proportions and medians with interquartile ranges. To evaluate associations between participant characteristics and early introduction of egg or peanut, we used chi-square, Fisher’s exact test, and Wilcoxon rank sum test, as appropriate. We used Fisher’s exact test to evaluate the association between early introduction of egg and development of likely egg allergy by age 3 years, and the association between early introduction of peanut and development of likely peanut allergy by age 3 years. All p -values were two-tailed, with p < 0.05 considered statistically significant.

Of the 921 participants enrolled in the MARC-35 long-term follow-up cohort, 770 (84%) participants were included in the analytic cohort ( Table 1 , Figure S2 ). The median age at enrollment was 3.3 months. There were more male participants ( n = 455, 59%) than female participants ( n = 315, 41%). There were 356 (46%) non-Hispanic white, 163 (21%) non-Hispanic Black, and 223 (29%) Hispanic participants, and 28 (4%) participants identified as other race (including Asian and American Indian). Slightly more participants had public or no insurance ( n = 433, 56%) compared to those with private insurance ( n = 335, 44%), and approximately one-third lived in a ZIP code with median household income < USD 40,000 ( n = 253, 33%). There were 109 (14%) participants with a reported history of eczema at enrollment, 151 (20%) with a reported parental history of food allergy, and the majority reported one or more other children living in the home ( n = 601, 78%).

Demographics and other characteristics of the analytic cohort at enrollment.

Abbreviations : IQR, interquartile range. Demographics and characteristics of analytic cohort overall, and for those with and without early introduction of egg or peanut, as defined by consumption of peanut or egg product at least once per week at age 12 months. Data for participant characteristics were obtained at enrollment. Results are shown as n (%) unless otherwise noted. p -values less than 0.05 are shown in bold font.

Of the 770 participants in the analytic cohort, 635 participants (82%) reported regular consumption of egg product at 12 months of age, and 211 participants (27%) reported regular consumption of peanut product at 12 months of age ( Table 1 , Figure 1 ). There were no significant differences in age at enrollment, sex, or parental history of food allergy according to early introduction of egg or peanut ( Table 1 ). However, participants without early introduction of egg were more likely to have a history of eczema at enrollment. Participants without early introduction of peanut were more often of non-Hispanic white ethnicity, with private insurance, median annual household incomes ≥ USD 40,000, and with fewer other children living in the home as compared to those with early introduction of peanut.

An external file that holds a picture, illustration, etc.
Object name is nutrients-13-02318-g001.jpg

Introduction of egg and peanut at age 12 months.

Bar graph depicting the number and percentage of participants with early introduction of egg as defined by parent report of egg product consumption at least once per week at age 12 months vs. those without (top bar) as well as the number and percentage of participants with early introduction of peanut as defined by parent report of peanut product consumption at least once per week at age 12 months vs. those without (bottom bar). Those with early introduction are depicted by green bars, and those without early introduction are depicted by blue bars.

In total, of the 770 participants in the analytic cohort, four (0.5%) participants had likely egg allergy by age 3 years, and eight (1%) participants had likely peanut allergy by age 3 years (1%) ( Table 2 ). The cumulative incidence of likely egg allergy by age 3 years was 1/635 (0.2%) among subjects with early egg introduction and 3/135 (2.2%) among subjects without early egg introduction. Early introduction of egg prior to 12 months was associated with a lower incidence of IgE-mediated egg allergy by age 3 years. The cumulative incidence of likely peanut allergy by age 3 years was 0/211 (0%) among participants with early peanut introduction and 8/559 (1.4%) among subjects without early peanut introduction. For the participants with known dates of first allergic reaction to egg based on chart review, ages of first reaction ranged from 6 months (the one participant with early introduction of egg and egg allergy) to 21 months. For the participants with known dates of first allergic reaction to peanut based on chart review, ages of first reaction ranged from 18 months to 28 months.

Early introduction of egg or peanut at age 12 months and likely food allergy to egg or peanut by age 3 years.

Participants with likely vs. unlikely or possible food allergy to egg or peanut by age 3 years for the MARC-35 cohort, compared to those with and without early introduction of egg or peanut, respectively. Early introduction of egg or peanut are defined as consumption of egg product or peanut product, respectively, at least once per week at age 12 months. Results are shown as n (%). p-values less than 0.05 are shown in bold font.

4. Discussion

In this study of 770 infants with a history of severe bronchiolitis, 82% introduced egg by age 12 months, and only 27% introduced peanut by age 12 months. In total, four participants (0.5%) had likely egg allergy by age 3 years, and eight participants (1%) had likely peanut allergy by age 3 years. The cumulative incidence of likely egg allergy by age 3 years was 1/635 (0.2%) among subjects with early egg introduction and 3/135 (2.2%) among subjects without early egg introduction. The cumulative incidence of likely peanut allergy by age 3 years was 0/211 (0%) among participants with early peanut introduction and 8/559 (1.4%) among subjects without early peanut introduction. Early introduction of egg was associated with less egg allergy. Early introduction of peanut was suggestive of benefit as there were zero cases of allergy, but the association was not statistically significant.

While the majority of participants in our cohort had early introduction of egg, less than one-third of participants had early introduction of peanut. This is not necessarily unexpected given than the results of the major clinical trials in support of early introduction of egg and peanut emerged after our 2011–2014 study enrollment period. As previously highlighted, the results of the Learning Early about Peanut Allergy (LEAP) study were published in 2015 and showed that in a cohort of infants aged 4 to 11 months with egg allergy, severe eczema, or both, early introduction of peanut decreased the incidence of IgE-mediated peanut allergy [ 11 ]. In a follow-up two-group comparison study, the Persistence of Oral Tolerance to Peanut (LEAP-On) study showed that, among infants with early introduction of peanut and continued peanut consumption until 5 years of age, subsequent avoidance of peanut for 12 months was not associated with an increased risk of developing new peanut allergy [ 12 ]. The results of the Enquiring About Tolerance (EAT) study in 2016 showed, in an intention-to-treat analysis, that introduction of egg and peanut in breastfed infants by age 6 months was associated with a decreased prevalence of egg and peanut allergy by age 3 years [ 16 ].

Outside of the clinical trial setting, there are few real-world observational studies looking at the timing of egg or peanut introduction and the development of food allergy. The Australia-based cross-sectional study using the HealthNuts cohort found a higher risk of egg allergy associated with not introducing egg by age 6 months [ 19 ], similar to our findings of a higher risk of egg allergy associated with not introducing egg by age 12 months. Although our results for peanut were only suggestive, in a prospective Canadian birth cohort study, peanut introduction by age 12 months decreased the odds of peanut sensitization at age 12 months [ 31 ]. However, there are also clinical trials that failed to show a statistically significant association between introduction of egg by age 6 months and egg allergy [ 32 , 33 , 34 ] introduction of egg by age 8 months and egg allergy [ 35 ], or introduction of peanut by age 12 months and peanut allergy [ 36 ].

Although the gold standard for food allergy diagnosis is a double-blind placebo-controlled food challenge, there are several limitations to relying on food challenges, including time, expense, and burden on patients and families. Several notable food allergy studies have relied on alternative criteria such as parental report on questionnaires [ 37 , 38 , 39 , 40 ]. Another approach has been to use a combination of different methods including parental report, IgE sensitization, doctor diagnosis of food allergy, and epinephrine autoinjector prescription [ 17 , 41 ]. A unique strength of our study was the outcome ascertainment by an allergist’s review of multiple data sources including parental report on a food allergy survey, parent report on periodic interviews, review of medical records, and food specific IgE to determine whether IgE-mediated food allergy was likely.

The major limitation of our study was the small number of food allergy cases. This reduced our statistical power and precluded controlling for potential confounding factors in testing the association between early introduction and likely IgE-mediated food allergy. Importantly, eczema is a well-known confounder and effect modifier of egg and peanut allergy, and participants with early introduction of egg were less likely to have a history of eczema at enrollment when compared to those without early introduction of egg. The lower prevalence of eczema at enrollment may be related to the lower incidence of IgE-mediated egg allergy within this group [ 1 , 2 , 3 , 14 , 42 , 43 , 44 , 45 , 46 ]. Additionally, while similar to previous studies, prevalence of likely egg allergy and prevalence of likely peanut allergy within our cohort (0.5% and 1%, respectively) were lower than previously reported estimates in other US-based studies of food allergy in childhood of 0.8–0.9% for egg [ 37 , 38 ], and 1.4–2.2% for peanut [ 37 , 38 , 40 , 41 ]. Our lower prevalence of egg and peanut allergy may partially be explained by the heterogeneity among cohorts with different dietary patterns and food allergy risk factors as well as variation in the age groups studied. Additionally, the low number of participants with early introduction of peanut in this study, while not entirely unexpected in light of the time period in which our participants were enrolled, may have limited our ability to detect a significant association between early peanut introduction and decreased peanut allergy. An additional limitation of our study is that we used data from a severe bronchiolitis infant cohort, which may not necessarily be generalizable to the general population of US infants. However, bronchiolitis is not a rare childhood illness, given that the incidence of bronchiolitis hospitalizations among infants in the United States was 25.5 per 1000 children in 2011 [ 47 ]. The association between bronchiolitis and risk of food allergy is not known, but is of interest.

The present analysis adds to the literature by contributing real-world data in a racially/ethnically and geographically diverse cohort of US infants prior to updates to the food introduction guidelines. While clinical trials, especially of food introduction, are idealized, they are not often reproducible in a real-world setting. Additionally, food introduction has social and cultural ties, which may impact early food introduction and allergen exposure; this consideration supports the importance of studying a racially/ethnically diverse cohort. The real-world data from this study are important for helping researchers and clinicians better understand baseline dietary patterns and food allergy risk prior to revisions in infant feeding practice guidelines. Future comparative studies are needed to assess whether or not there has indeed been an increase in early introduction in clinical practice, and if so, if this increase has been effective in reducing food allergy prevalence.

5. Conclusions

In a cohort of infants hospitalized with bronchiolitis during 2011–2014, there were only four (0.5%) cases of likely egg allergy by age 3 years and eight cases of peanut allergy by age 3 years (1%). Although limited by small number of likely food allergy cases, our results—from a prospective cohort of geographically and racially/ethnically diverse infants—support the notion that early introduction of egg and peanut are associated with decreased risk of developing food allergy. These data lend support to recent major shifts in guidelines on infant food introduction practices. Future analyses are needed with larger numbers of food allergy cases for increased power to detect statistically significant and clinically meaningful differences. Additionally, we encourage validation of these findings in a healthy infant cohort.

Acknowledgments

The Principal Investigators at the 17 participating sites in MARC-35 are listed in Table S2 .

Abbreviations

Supplementary materials.

The following are available online at https://www.mdpi.com/article/10.3390/nu13072318/s1 , Figure S1: Allergist protocol for determination of likely, possible or unlikely food allergy, Figure S2: Flow diagram showing reasons for exclusion, Table S1: Food allergen components tested during infancy and at age 3 years, Table S2: Principal Investigators at the 17 participating sites in MARC-35.

Author Contributions

Conceptualization and methodology, E.Y., L.B.R., A.A., and C.A.C.J.; Investigation, E.Y., L.B.R., and A.A.; formal analysis and visualization, J.A.E.; data curation, J.A.E. and R.J.G.; writing—original draft preparation, E.Y.; writing—review and editing, L.B.R., A.A., S.A.R., R.J.G., J.A.E., A.F.S., S.A.R., and C.A.C.J.; project administration, A.F.S.; supervision and funding acquisition, C.A.C.J. All authors have read and agreed to the published version of the manuscript.

This study was supported by the grants U01 AI-087881, R01 AI-114552, R01 AI-127507, and UG3/UH3 OD-023253 from the National Institutes of Health (Bethesda, MD, USA). Dr. Arroyo was supported by NIH R25 AI-147369. The content of this manuscript is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health.

Institutional Review Board Statement

The study was conducted according to the guidelines of the Declaration of Helsinki, and approved by the Institutional Review Board (or Ethics Committee) of Massachusetts General Hospital (protocol 2009P002310 approved 9 February 2010).

Informed Consent Statement

Informed consent was obtained from all participants involved in the study.

Data Availability Statement

Conflicts of interest.

The authors declare no conflict of interest.

Publisher’s Note: MDPI stays neutral with regard to jurisdictional claims in published maps and institutional affiliations.

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How An Essay About Food Landed Me at My Top College

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May 1st is fast approaching, and the time for the high school class of 2019 to make their final college decisions is dwindling. Choosing which college to go to is overwhelming, but the dozens of essays one has to write to merely apply is even more daunting. It also doesn't help when you apply to way too many schools (13 to be exact), nearly all of which want you to outline what makes their school stand out. It was all too easy to get trapped in the cycle of repetitive phrases and "smart-sounding language."

However, when it came to writing my actual college essay which was to be sent to every school, it seemed to just flow onto the paper. Despite not choosing a specific Common App prompt, I knew exactly what I was going to write about—food.

Unlike fellow applicants, I did not have an incredible story to tell, nor an obstacle that I overcame worth a college admission officer's time. What I did have standing behind me was a passion for peanut butter and jelly , the best desserts in New Jersey , and outlandish food gadgets that probably no one needs .

I am a massive foodie. By definition, I am a person who really appreciates a good meal. It also makes me the person who makes dinner reservations for a vacation before the plane tickets and hotel rooms are booked, and one that celebrates a ten mile run with a slice of Cheesecake Factory’s Ultimate Red Velvet Cheesecake . Is it the most healthy hobby? Probably not. But fun? Of course.

I am not sure what drew me to food, but maybe it is the fact that my earliest memories are of grabbing every sample possible at Sam’s Club, eating holiday dinners of kugel and brisket, and standing on the countertop making a batch of Toll House Chocolate Chip Cookies. I learned to read a nutrition label before I could read a book and I learned the basics of food before I could count to ten. From childhood until now, although my taste buds have changed, and I have grown a liking for broccoli and lasagna, my infatuation with food remains constant.

Or maybe it is because I love how food is a social event. My family makes a point to eat our dinners as a unit. You can even count on my dog joining us in the kitchen when dinner is served. Whether we are eating one of my mom’s extravagant home-cooked meals or scarfing down a delivery pizza before we have to run out of the house, my family congregates at the table to catch up with each other.

Fridays are our nights out to dinner to celebrate the fact that we made it through another week. The choice of restaurant depends on whoever’s turn it is. My brother, not at all a food fanatic, always says anywhere. My dad loves to joke that Anywhere is too far or too expensive or whatever excuse he could make to get a chuckle out of me. To this day, I can always count on Friday night plans, even if it means eating dinner out with my parents. After dinner, you might discover my sister and I binge-watching the latest documentary about the juice cleanse (we’ve seen all three) while munching on a bag of Chex Mix.

This communion continues with my friends. You can find me on any given Saturday night chatting about the latest gossip and sharing our opinions on last night’s Bachelor in Paradise episode. This conversation isn’t complete unless we are chowing down on a smorgasbord of chicken chow mein , mozzarella sticks, and Pringles. Our way of celebrating our gratefulness towards one another is by hosting a Friendsgiving. Our annual feast boasts piles of our favorite foods. Luckily, when you are with friends, calories do not count.

I adore food. Not in the way where I don’t have a limit, but in the way that food just so happens to be a vital part of so many happy moments. I’m not a glutton, I just really like to smile. I cannot remember a time when food did not in one way or another make me or someone else happy. Even during the saddest or most stressful of situations, spending some quality time with Ben and Jerry can make it all better. Food is one of the most basic human needs, but it has grown into an integral aspect of our society where people look to it for comfort. When you are surrounded by foods and people who care for you, you don’t need much more. Although, extra dessert never hurts.

Where the Essay Led Me

After a few rejections, long college road-trips, and some delicious college cookies as seen in the photo above, I have officially committed to Northeastern University. I am so excited to start the next journey of my education as a Husky. Although my time at Spoon High School comes to a close, Spoon Northeastern awaits.

So no one told you Thanksgiving was gonna be this way.

I'm lovin' it., adventurous, no time to wine. buff it out with your ro-say cheeks..

10 Colleges for Students with Food Allergies

Navigating a food allergy can be difficult and often brings its own stressors. While most colleges have created plans to help serve students with food allergies, there are some that stand out from the rest. We’ve curated a small list of colleges with excellent allergy awareness and accommodations to ensure a student will feel comfortable and stay safe! As always, make sure you speak to the colleges you are interested in ahead of time to see if they can adequately serve your needs.

If you are looking for even more information, this article on allergy friendly campuses and this article on gluten free campuses may be extremely helpful! In addition, check out this scorecard system by FARE (Food Allergy Research and Education).

Cornell University - Each food item is clearly labelled for all students. In addition, Cornell offers a 100% certified peanut, tree nut and gluten free dining hall!
University Michigan - Students rave about the clearly labelled food items. They also offer gluten free pantries in 2 dining halls plus a database of 1900 gluten free recipes. All info for each meal served can be found on their MyNutrition tool.
University of Connecticut - The first college to have a 100% certified gluten free bakery. Their pastry chef has helped create some of the yummiest treats for the students. Hint: Their cookbook is amazing!
Vanderbilt University - Students have the option to request separate meal preparation from the campus kitchen as needed In addition, the staff utilizes suggestions from the Student Allergy Advisory Council. In addition, they recently opened up a “top-8 [allergen] free” cafe.
University of Illinois - Besides “Top 8 free” offerings in each dining hall and well-labelled meals, students can fill out a form ahead of a meal and a chef prepares one meal just for them!
University of Texas at Austin - Has a unique Food Allergy Center on campus along with a Food Bar in most dining halls that feature foods free of the Top 8 allergens.
University of Denver - Large TV screens with food listings and allergen notices are posted in the dining hall. In addition, all foods are labelled for allergens and all staff are AllerTrained.
Tulane University - Tulane encourages all students who have food allergies to meet with the on-campus dietician. They also offer dining halls and sections of dining halls that are designated Peanut- and Tree Nut-free!
Loyola Marymount University - One of the first universities in the nation to become an accredited GREAT school by the National Foundation for Celiac Awareness .
University of Colorado - Boulde r - Labels all foods with Top 8 allergens plus gluten. Grab and go allergy-friendly meals are available to students throughout the day along with gluten free snacks and bakery items.

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Spring Allergy Season Is Getting Worse. Here’s What to Know.

Experts explain how to tell if you have allergies, and how to find relief if you do.

A woman wearing a green head scarf leans over and blows her nose into a tissue.

By Nina Agrawal

Spring is here — and if you’re among the estimated one in four adults in the United States who suffers from seasonal allergies, your sneezing and scratching may have already started.

With climate change affecting temperatures and plant growth, you may need to be on the lookout earlier than ever before. It can be hard to distinguish allergy symptoms from those of a cold, but experts point to a few telltale signs.

Is allergy season getting worse?

Spring allergy seasons are beginning about 20 days earlier than they had, according to an analysis of pollen count data from 60 stations across North America from 1990 to 2018.

That shift can have significant health consequences, said William Anderegg, who is an author of the study and an associate professor of biology at the University of Utah. Other research has shown that very early onset of spring is associated with higher prevalence of allergic rhinitis, also known as hay fever. When people end up sick or in the hospital from uncontrolled allergy symptoms, he said, “it’s because they didn’t expect it, and didn’t have medications in hand.”

The researchers also found that pollen concentrations have risen about 20 percent nationwide since 1990, with Texas and the Midwest having the greatest increases. Warmer temperatures, higher concentrations of carbon dioxide and increased precipitation can all contribute to plants’ growing bigger and producing more pollen over longer periods of time, Dr. Anderegg said.

Dr. Gailen Marshall, chair of the allergy and immunology department at the University of Mississippi Medical Center, said that when he began practicing nearly 40 years ago, allergy seasons were confined to about eight weeks each. Tree pollen hit in the spring, grass pollen increased in spring and summer and ragweed pollen picked up in late summer and early fall.

Back then, people “could at least get some relief” between those cycles, said Dr. Marshall, who is also president of the American College of Allergy, Asthma and Immunology, a professional organization. “Now, these seasons end up becoming one long season.”

How can you tell whether it’s allergies or a cold?

Many people with nasal congestion or a runny nose may assume that they have a cold. Though allergy and cold symptoms can be similar, allergies often make the eyes, nose, throat, mouth or ears itchy, said Dr. Rita Kachru, chief of clinical allergy and immunology at UCLA Health. With allergies, the immune system mistakes a trigger, like pollen, for a harmful substance. When repeatedly exposed to that trigger, Dr. Kachru said, immune cells release chemicals, including histamine, that cause itchiness and inflammation.

Patients also often experience congestion and postnasal drip, or mucus dripping down the back of the throat. Some people may develop coughing, wheezing and shortness of breath.

With a viral infection, by contrast, you might have muscle fatigue, joint aches or a fever.

If your symptoms flare up every year around a certain season and last more than a week or two, then there is a good chance they’re being caused by allergies. A personal or family history of allergies, eczema or asthma can also be an important clue, doctors said.

What if I’ve never had allergies before?

Most people first develop symptoms in childhood or young adulthood. But several experts said it’s not uncommon for someone to have seasonal allergies for the first time as an adult.

Moving to a different part of the country and being exposed to different allergens may provoke a response, Dr. Kachru said.

New allergy symptoms in adulthood could also be “an inevitable consequence of really soaring pollen counts,” said Dr. Neeta Ogden, a New Jersey-based allergist.

The increase in winds associated with climate change could be distributing pollen farther, potentially exposing people to new varieties of it, said Dr. Mary Johnson, a research scientist at Harvard.

Research has also shown that hormones, including estrogen, progesterone and testosterone, can affect how allergic diseases develop.

Boys often have food allergies or eczema as babies and seasonal allergies or asthma in childhood but then have those conditions disappear when they hit puberty, Dr. Kachru said. But symptoms can return when they reach their 30s and 40s.

For some women, major hormonal shifts, including those that happen during puberty, pregnancy and menopause and while on birth control, can affect the onset and severity of allergy symptoms, Dr. Kachru said.

How do I manage the symptoms?

The first step is to reduce exposure. Keep your windows shut to prevent pollen from blowing into your home.

“The key is to prevent the outdoor allergens from becoming indoor allergens,” said Dr. William Reisacher, a professor of otolaryngology who treats allergies at Weill Cornell Medicine and New York-Presbyterian.

To help do so, take off the clothes you’ve worn outside when you get home and store them outside your bedroom. Then take a shower to rinse the pollen off your skin. Doctors recommend a saline nasal rinse to flush the pollen out of your nose. (If you make your own, be sure to use boiled, sterile or distilled water. )

Over-the-counter medications fall into two main categories: antihistamines and steroids. Both act on your immune system’s inflammatory response. Antihistamines are available as nasal sprays, eye drops and oral pills, including loratadine (Claritin), cetirizine (Zyrtec), levocetirizine (Xyzal) and fexofenadine (Allegra).

Steroids come as nasal sprays, including fluticasone (Flonase), budesonide (Benacort), triamcinolone (Nasacort) and mometasone (Nasonex).

If you have symptoms for the first time and aren’t sure how bad they’ll be or how long they’ll last, Dr. Kachru said, try an antihistamine to see if it helps.

If the symptoms persist, or you know that you get hit hard with allergy symptoms every spring, doctors recommend nasal sprays. Unlike antihistamines, which should be used only as needed, these steroids work best if you start using them a week or two before symptoms begin.

Doctors caution against using products with pseudoephedrine, such as Sudafed, for more than a day or two because they can increase heart rate and blood pressure. In 2020, a task force of physicians that issues guidelines for treating allergies recommended against using Benadryl to treat allergic rhinitis; doctors said it can have sedative effects and cause confusion.

If avoiding environmental triggers and taking medication don’t work for you, allergy shots or tablets that build your tolerance to allergens might help.

“It’s the only option available that actually makes the body less allergic,” Dr. Reisacher said.

A Guide to Surviving Allergy Season

For many people, springtime equals seasonal allergies. here is some guidance to deal with pollen-induced symptoms..

There are several steps you can take to prevent a bad allergy season. But you have to act early enough .

Studies suggest that allergens could play a role in mood disorders like depression and anxiety. Here’s what to know and how to get help if you need it.

The right products can go a long way in preventing allergy symptoms. Here are a few options for minimizing the allergens around you.

Is your sneezing, sniffling and coughing a sign of allergies or a cold? There are some simple ways to tell what’s causing your symptoms .

When spring comes around, it can be difficult to know if fatigue is the result of allergies or something else. Here’s how to tell what’s making you tired .

IMAGES

Definition of Food Allergy Essay Example
Healthy Eating, Allergies and Intolerances
Food Labeling: Allergy Information
Food Allergy: Causes, Symptoms, Diagnosis, and Treatment
Food Allergies: Causes and Risk Factors
(PDF) Early Introduction of Foods for Food Allergy Prevention

COMMENTS

Food allergy in college and university students: Overview and
INTRODUCTION — Food allergy may affect 7 to 11 percent of college-age individuals [] and can involve life-threatening or fatal reactions [].Teenagers and young adults appear to be at higher risk for fatal allergic reactions, possibly because of risk-taking behavior and reluctance to use epinephrine [].College years may be the first time that young adults are away from parent/caregiver ...
Food allergies on a college campus
There are limited data on food allergies among college students. In this article, we review the most current available studies. These self-reported surveys and qualitative interviews reported overall poor avoidance of known allergens and low rates of carrying self-injectable epinephrine among students with food allergy. College students may exhibit risk-taking food behaviors due to a number of ...
Navigating Food Allergies and the College Admissions Process
In fact, I read a growing number of college essays on food allergies every year. So if you live with a food allergy or have a child who does, here are some tips on what to share, who to share it with, and how colleges will view it. 1. If the student plans to write about their food allergy for their college essay, take a step back.
For students with food allergies, college campuses can be hazardous
Campus dining halls are food-allergy minefields. Some college dining halls have dedicated stations that are free of nine common allergenic foods: peanuts, tree nuts, milk, egg, wheat, soy, fish ...
College Application Essays- Food Allergy Edition
Food allergies, celiac disease, asthma, eosinophilic gastroenteritis and other diseases might be our weakness, but they make us stronger. Here are 7 sample college essays that highlight just that. Porcelain God Essay written for the "topic of your choice" prompt on the 2012 Common App.
Allergies and Special Dietary Restrictions Put College Dining Halls to
Some 6.2 percent of adults in the United States have a food allergy, according to a 2021 report from the Centers for Disease Control and Prevention. But that number reflects only medically ...
Food allergy knowledge among college students majoring in food and
People with food allergies are often managed and treated for allergic reactions by the multidisciplinary health care professionals, including physicians, nurses, and dietitians. Research has revealed that these health care professionals do not have adequate training and proficiency in the management of food allergies.1,2 To assess the food allergy knowledge from students who intend to become ...
College Essay On Food Allergies
If anyone notices that a child develops symptoms after being exposed to certain foods, then the child should avoid such foods. The most common foods that can cause allergies include: peanuts, tree nuts (walnuts, pecans, etc.), fish, shellfish, eggs (especially egg whites), milk, soy, and wheat.
What Can Be Done to Ease the College Transition for Food Allergy
12.5% of all food allergy-related deaths occur on college campuses, according to research done by S. Allen Bock, Anne Munoz-Furlong, and Hugh A. Sampson, food allergy and anaphylaxis researchers. But there is minimal data on the actual percentage of college students who suffer from food allergies because many students do not document their ...
Early Introduction of Food Allergens and Risk of Developing Food Allergy
1. Introduction. The prevalence of IgE-mediated food allergy is rising, and is currently estimated to affect approximately 5-10% of children in the United States (US) [1,2,3].To address this growing public health burden, strategies for prevention of food allergy development are of great interest [4,5,6,7].In addition, to prevent accidental food allergen exposure in both children and adults ...
The College Experience: Food Allergies on Campus
So, in July 2014, I founded the Student Food Allergy Network (SFAN): a student-run organization dedicated to spreading awareness of food allergies and fostering empowerment and change within the community. We create and distribute educational material on campus, invite guest speakers to our biweekly meetings, and discuss common barriers ...
Tips for Navigating Food Allergies as a College Student
Dorm Room. Microwave: A microwave is a must-have for most college students, but it's especially useful to have if you have food allergies. I used mine to cook oatmeal and popcorn, steam vegetables, and even prepare basic meals like lentils with rice using instant microwavable packets. Refrigerator: Just like a microwave, a refrigerator is an ...
27 Outstanding College Essay Examples From Top Universities 2024
This college essay tip is by Abigail McFee, Admissions Counselor for Tufts University and Tufts '17 graduate. 2. Write like a journalist. "Don't bury the lede!" The first few sentences must capture the reader's attention, provide a gist of the story, and give a sense of where the essay is heading.
General 1
Provide documentation for college, university, or trade school acceptance or provide a copy of student ID at current college, university, or trade school. Submit 500-word essay on your experience with food allergies and how it has shaped your life. You have until 11:59pm EST (Eastern Standard Time) June 01 2024 to submit your application.
Homepage
Education. One in 10 Americans has a food allergy, so this disease touches all of us. FARE's goal is to increase public awareness of food allergies while providing trusted resources and community connections to support the 85 million Americans impacted by food allergies and intolerances, including 33 million at risk for life-threatening ...
How An Essay About Food Landed Me at My Top College
Despite not choosing a specific Common App prompt, I knew exactly what I was going to write about—food. Unlike fellow applicants, I did not have an incredible story to tell, nor an obstacle that I overcame worth a college admission officer's time. What I did have standing behind me was a passion for peanut butter and jelly, the best desserts ...
SETTLE A BET
It sounds like your post is related to essays — please check the A2C Wiki Page on Essays to get started. Other useful threads include: Hack the College Essay (external PDF link) The ScholarGrade Essay Series Part 1: How To Start An Essay, "Show Don't Tell" The Top 30 Essay Mistakes To Avoid. Why College Essay tips and some Personal Essay Tips
Food Allergies
College Essay On Food Allergies. 641 Words; 3 Pages; College Essay On Food Allergies. This was a rare day in my everyday life of being allergic to nuts and sesame seeds. Many people have heard about food allergies, but do not actually know what they are. A food allergy is when the immune system produces antibodies in defense against a substance ...
Understanding and Managing Food Allergies in Children
The manifestations of food allergies can range from a runny nose and sore throat to itchy eyes, rashes, and swelling, typically occurring shortly after ingesting the allergen. Surprisingly, research suggests that between six to eight percent of children grapple with food allergies, making it a noteworthy health challenge during early childhood ...
10 Colleges for Students with Food Allergies
University Michigan - Students rave about the clearly labelled food items. They also offer gluten free pantries in 2 dining halls plus a database of 1900 gluten free recipes. All info for each meal served can be found on their MyNutrition tool. University of Connecticut - The first college to have a 100% certified gluten free bakery.
How Your Teen Can Nail Her College Essay
College essays can be one of the most daunting parts of the application process, but they are also an incredible opportunity to shine. ... Since then, I've had students write about playing guitar, food allergies, Bubble Tea, scuba diving, working at a farm stand, being the youngest in a family and everything in between. See, there's not one ...
Food Allergies Essay Example
Food allergy symptoms develop when the antibodies are battling the "invading" food" (WebMD, Feb 2009). Some people form allergies to peanuts, tree nuts, fish, shellfish, milk, eggs, soy products, wheat and other products. Food allergies can be mistake for food intolerance. Food intolerance is a response by the digestive system.
College Essay On Allergy
Allergic Rhinitis Essay. Allergic rhinitis (AR) is now recognized as referring to two significant clinical entities: 1. Rhinitis - inflammation of the nasal mucous membranes; 2. Allergy - the specific cause of the rhinitis. Current research efforts have focused extensively on these two entities.
Spring Allergy Season Is Getting Worse. Here's What to Know
Spring allergy seasons are beginning about 20 days earlier than they had, according to an analysis of pollen count data from 60 stations across North America from 1990 to 2018. That shift can have ...