Back in the 1970s I attended a parochial school in suburban Chicago that operated without a cafeteria.  As such, students were compelled to bring their lunches from home.  Were one to go back in time to peek inside my “Star Wars” lunch box, more often than not one would find a thermos of milk, a baggie of Jays-brand ruffled potato chips, a Little Debbie brownie and—squished so badly by the thermos that a quarter-sized purple dot would appear where grape Smuckers had soaked through the bread—a peanut butter and jelly sandwich.

Peanut butter and jelly.  The centerpiece of school lunches nationwide, old reliable for millions of harried moms, a flavor combination that cut across all socioeconomic, racial, political and religious lines.  The first truly universal sandwich!

Or so I thought.  Then I had kids of my own.  Which is how I learned that, sometime between 1975 and 2005, the latter being when my kids began their education, sandwiches involving peanuts had gone the way of the dodo in many schools.

Why?  Food allergies.  The Center for Disease Control & Prevention defines a food allergy as a “potentially serious immune response to eating specific foods or food additives.”  Ninety percent of allergic reactions in affected individuals are attributable to eight types of food:  milk, eggs, peanuts, tree nuts, fish, shellfish, soy, and wheat.  Depending on the severity of the individual’s allergy, reactions to these foods can range from mild, like hives or nausea, to more serious, like shortness of breath, trouble swallowing and chest pain.  Anaphylaxis, which blocks normal breathing, among other symptoms, is the most severe reaction and is potentially fatal.  A very scary of set symptoms, indeed, especially considering that the number of people suffering from food allergies is on the rise.  According to CDC study examining the decade 1997-2007, the number of children with food allergies rose 18 percent.  Amazingly, in its follow-up study, the CDC discovered that, from 2007-2011, the number had increased another 50 percent.

According to WebMD, one out of three people either say that they have a food allergy or that they modify their family’s diet because a member is suspected of having a food allergy.  It’s important to note, however, that only about 5% of children have clinically proven allergic reactions to foods, a number that drops to about 4% in teens and adults.  So then why do 33% of the population claim they have food allergies?  Probably because they’re mistaking a “food intolerance” with a “food allergy.”  The difference between the two is considerable.  Whereas the symptoms of food intolerance can resemble those of a food allergy, only the latter is an abnormal response to a food triggered by the immune system.  So while food intolerance can lead to certain levels of discomfort, food allergies can cause devastating illness and, in some cases, anaphylaxis.  Being truly allergic to milk isn’t the same as not being able to digest it properly because of lactose intolerance.

So why are food allergies on the rise?  The short answer:  we don’t know.  Among some hypotheses, courtesy the UCLA Food & Drug Allergy Care Center:

  • Hygiene – The hygiene hypothesis states that excessive cleanliness interrupts the normal development of the immune system, and this change leads to an increase in allergies.  In short, our “developed” lifestyles have eliminated the natural variation in the types and quantity of germs our immune systems needs for it to develop into a less allergic, better regulated state.  Exposure to germs, dirt and certain types of infection are part of the natural development of our immune response from birth until maturity.  However, when we introduce certain advances of modernization, such as good sanitation and eradicating parasitic infections, we may be fueling the epidemic of allergies.
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  • Delayed introduction of foods – The recent practice of delaying the introduction of some foods such as peanuts may be associated with higher rates of food allergy.  Evidence for this theory comes from the fact that cultures that introduce peanuts earlier have less food allergy while those that delay introduction of potentially allergic foods have seen a increase in food allergy.  But this may be due to other factors.
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  • Form of food we eat – Different forms of the same food appear to be more likely to provoke an allergic response.  For example, a roasted peanut is more likely to cause an allergic reaction than a boiled one.  Also, many people with a milk or egg allergy can tolerate baked forms of these foods.
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  • Increased awareness & reportingHeightened awareness among doctors, parents, teachers and the general public about the symptoms and potential consequences of food allergies may contribute to the reason more people are coming forward with food allergies.  Additionally, clinical research in food allergy is advancing rapidly, and earlier studies may have underestimated the rates of food allergy.

Few topics generate as much passion as food allergies.  A quick scan of the “comments” section below any article, commentary or editorial that dares broach the subject makes this abundantly clear.  Tempers flare, eyes roll, manners and subtly fly out the window.  Those affected by food allergies praise the bans, noting the different ways in which allergies complicate their lives, even put them in mortal danger.  Those unaffected—and even some that are affected—like to point out that it’s not society’s job to protect those allergic, that it falls to individuals, whether kids or adults, to learn to cope and take necessary precautions.  And then there are those who contend that many of those obsessing about food allergies don’t know for sure if they (or theirs) truly have a diagnosable allergy.  Maybe it’s just an intolerance; maybe too much time spent surfing the Web.  All points deserve consideration and debate.

The rise in food allergies affects the restaurant industry, too, of course.  And while there aren’t formalized, industry-wide guidelines at this point, as good a place as any to start is education; a well-informed staff—from manager to chef to line cook to server—is a great way to keep clientele safe.  So is asking a guest if there are any ingredient to avoid and noting this on the ticket.  Or providing a listing of every ingredient used in a dish.  And while this may seem like loads of extra work, there are companies and associations that specialize in easing the process.

MenuTrinfo, a company “dedicated to helping food service businesses protect lives and health,” offers services such as Menu Nutritional Analysis, Certified Gluten Free Menus, Specialty Menu Development, Allergen and Gluten Free Training, Kitchen Audits, Policy Development and Expert Nutritional Consulting.

Also available is the training program developed for restaurants by the Food Allergy Research & Education (FARE) and The National Restaurant Association (NRA).  Both an educational and informational tool, the program not only “helps make restaurants more aware of food allergies, but also what to do in the event that an allergy-related incident occurs.”

All are steps in the right direction.  Said John W. Fischer, associate professor and restaurant manager of Escoffier Restaurant at The Culinary Institute of America, "The awareness of food allergies has definitely increased within the food service industry.”

So while the venerable PB&J sandwich may have given way to boring old ham or turkey in many schools, with a little education, awareness and care there’s no reason the peanut can’t live on in the restaurant industry.