Top Doctors: Are kids' allergies on the rise?

More children than ever are being diagnosed with food allergies, and scientists have various theories about why.

"The question is, 'Is that just more recognition based on the fact that we are more aware of these things now, or is there something new in the environment?' " said Dr. Vincent Bonagura, chief of allergy and immunology and associate chairman for academic development in the pediatric department at the Steven and Alexandra Cohen Children's Medical Center in New Hyde Park.

Food allergy occurs when a child's immune system treats proteins in certain foods as if they were germs. The body produces antibodies against the threat of attack. The antibodies trigger the release of chemicals in the bloodstream that induce allergic symptoms.

The most common food allergens are milk, eggs, peanuts, tree nuts, fish, shellfish, wheat and soy, according to the Food Allergy & Anaphylaxis Network, a research and advocacy organization in Fairfax, Va.

SYMPTOMS

Allergic reactions may be mild to deadly and can occur within minutes or hours of consuming a food, according to the federal National Institute of Allergy and Infectious Diseases.

Symptoms include itching in the mouth, swelling of the tongue and throat, hives, vomiting and diarrhea.

At its worst, food allergy can cause a whole-body reaction called anaphylaxis, resulting in low blood pressure and breathing difficulties. A child in anaphylactic shock could lose consciousness or die without immediate treatment with epinephrine, an injectable hormone that counteracts the body's allergic response.

RISK FACTORS

Bonagura said that food allergies tend to run in families.

Overall, about 4 percent of children younger than 18 years have a food allergy, versus just 2 percent of adults, reports the U.S. Centers for Disease Control and Prevention. Infants and toddlers are particularly at risk. As many as 8 percent of children younger than 3 have food allergies, according to the allergy institute.

Most children outgrow allergies to milk, egg, soy and wheat. But just 20 percent outgrow peanut allergy, and only 10 percent overcome tree nut allergies, the food allergy network reports.

CURRENT THINKING

Food allergies in U.S. children increased 18 percent from 1997 to 2006, according to the Centers for Disease Control. A separate study by New York City researchers found that the rate of peanut allergy in kids tripled from 1997 to 2008.

However, a recent review of scientific literature published in the Journal of the American Medical Association casts doubt on the prevalence of food allergies. The researchers concluded that a lack of uniform criteria for defining and diagnosing food allergy has created the potential for overdiagnosis.

The standard treatment for a food allergy is to avoid the offending food, but in an experimental approach called oral immunotherapy, researchers are giving study participants tiny amounts of an offending food in increasing doses to desensitize them to the allergen.

THE LONG ISLAND SCENE

Protect Allergic Kids, a Holtsville-based education and support group, holds an annual Halloween party and other events for children with food allergies or other allergic diseases. The group also convenes monthly support group meetings at Nokomis Elementary School in Holbrook.

Cristina Stainkamp, the group's president, said the meetings let parents and caregivers share concerns and pick up new information.

For more on the group, call 631-207-1681 or go online to protectallergickids.org.

Who's who

This is the 14th installment of a 26-week series in which Newsday presents Castle Connolly's list of top L.I. doctors. Today: pediatric allergy & immunology, pediatric cardiology, pediatric critical care medicine, pediatric endocrinology, and pediatric gastroenterology specialists.

PEDIATRIC ALLERGY & IMMUNOLOGY

Dr. Vincent Bonagura,

865 Northern Blvd., Great Neck; 516-622-5070

Dr. James Fagin,

Steven & Alexandra Cohen Children's Med. Ctr., Div. of Allergy/Immunology, 865 Northern Blvd., Great Neck; 516-622-5070

PEDIATRIC CARDIOLOGY

Dr. Donna Better

120 Mineola Blvd., Mineola; 516-663-4600

Dr. Thomas Biancaniello

Stony Brook Univ. Med. Ctr., Dept. Pediatrics, Stony Brook; 631-444-5437

Dr. Fredrick Bierman

Steven and Alexandra Cohen Children's Heart Center, 269-01 76th Ave., New Hyde Park; 718-470-7350

Dr. Sean Levchuck

100 Port Washington Blvd., Roslyn; 516-365-3340

Dr. Milton Reitman

100 Port Washington Blvd., Roslyn; 516-365-3340

Dr. Angela Romano

Dept. Pediatric Cardiology, 269-01 76th Ave., New Hyde Park; 718-470-7350

Dr. Russell Schiff

120 Mineola Blvd., Mineola; 516-663-4600

Dr. Yehuda Shapir

Steven and Alexandra Cohen Children's Medical Center, 269-01 76th Ave., New Hyde Park; 718-470-7350

Dr. Ambrose Vallone

100 Port Washington Blvd., Roslyn; 516-365-3340

PEDIATRIC CRITICAL CARE MEDICINE

Dr. Mayer Sagy

Steven and Alexandra Cohen Children's Medical Center, 269-01 76th Ave., New Hyde Park; 718-470-3330

PEDIATRIC ENDOCRINOLOGY

Dr. Dennis Carey

Pediatric Endocrinology, 400 Lakeville Rd., New Hyde Park; 718-470-3290

Dr. Mariano Castro-Magana

Winthrop Univ. Hospital, Div. Pediatric Endocrinology., 120 Mineola Blvd., Mineola; 516-663-3069

Dr. Pavel Fort

Steven and Alexandra Cohen Children's Medical Center, Pediatric Endocrinology, 400 Lakeville Rd., New Hyde Park; 718-470-3290

Dr. Graeme Frank

Steven and Alexandra Cohen Children's Medical Center, Pediatric Endocrinology, 400 Lakeville Rd., New Hyde Park; 718-470-3290

Dr. Paula Kreitzer

Steven and Alexandra Cohen Children's Medical Center, Dept. Pediatric Endocrinology, 400 Lakeville Rd., New Hyde Park; 718-470-3292

Dr. Thomas Wilson

Stony Brook Univ., Dept. Pediatric Endocrinology, Stony Brook; 631-444-5437

PEDIATRIC GASTROENTEROLOGY

Dr. Anupama Chawla

Stony Brook Univ. Medical Ctr., Nicolls Road, Stony Brook; 631-444-5437

Dr. Fredric Daum

120 Mineola Blvd., Mineola; 516-663-8534

Dr. David Gold

655 Deer Park Ave., Babylon; 631-321-2190

Dr. Bradley Kessler

655 Deer Park Ave., Babylon; 631-321-2190

Dr. Jeremiah Levine

Dept. GI & Nutrition, 269-01 76th Ave., New Hyde Park; 718-470-3430

Dr. Mark Lowenheim

Long Island Pediatric Gastroenterology 1174 Route 112 Port Jefferson Station, NY 11776 631- 403-4507

Dr. James Markowitz

269-01 76th Ave., New Hyde Park; 718-470-3430

Dr. Michael Pettei

Steven and Alexandra Cohen Children's Medical Center, 269-01 76th Ave., New Hyde Park; 718-470-3430

Dr. Toba Weinstein

Steven and Alexandra Cohen Children's Medical Center, 269-01 76th Ave., New Hyde Park; 718-470-3430

How they were picked

Castle Connolly Medical Ltd. is a health care research and information company founded in 1991 by a former medical college board chairman and president to help guide consumers to America's top doctors and hospitals. Castle Connolly's established survey and research process, under the direction of a doctor, involves tens of thousands of doctors and the medical leadership of leading hospitals.

Castle Connolly's team of researchers follows a rigorous screening process to select doctors on national and regional levels. Using mail and telephone surveys, and electronic ballots, they ask physicians and the leadership of top hospitals to identify exceptional doctors. Careful screening of doctors' educational and professional experience is essential to the committee. Newsday is not part of the selection process.

Doctors do not and cannot pay to be selected and profiled as Castle Connolly Top Doctors.

To see the whole list . . .

Who else is on the list of Top Doctors? More than 6,000 listings are in the New York Metro Area edition of "Top Doctors," published by Castle Connolly Medical Ltd. The soft-cover list price is $34.95. For more information, go to castleconnolly.com, or call 800-399-DOCS.