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Are statistics on food allergies exaggerated?

Philadelphia writer Meredith Broussard has been on a tear in the last couple of years, trying to point out that many of the most-quoted statistics about food allergies — the ones that have been used to pass legislation on this issue — come from a single questionable source: the Food Allergy and Anaphylaxis Network (FAAN), a nonprofit organization based in Fairfax, Va.

When she wrote on this topic in Harper’s magazine last year, the response from people with food allergies was fast, furious, and, frankly, ugly. On Monday, she wrote about the topic again in Slate — with similar results.

Now, I haven’t read widely on this topic, nor have I listened to Broussard’s media interviews (which her critics claim demonstrate her ignorance of the issue), but I found her main points in the Slate article to be worthy of discussion.

For, as Mark Twain famously quipped: “There are three kinds of lies: lies, damned lies, and statistics.”

And when it comes to the business of health care (and it is a business), we encounter all three. That’s why it’s so important — indeed, essential — to know who’s behind the production of a particular statistic. And why.

The source of the problem
According to Broussard, “most of what we know about food allergy danger, from the medical literature and in the popular press, comes from [FAAN].” And that group, she claims, has serious conflicts of interest.

As an example, Broussard points to a 2004 paper published in the Journal of Allergy and Clinical Immunology, which concluded that about 6.6 million Americans (2.3 percent of the general population) were allergic to seafood. The article also claimed seafood allergies represented “a significant health concern.”

Who wrote the article? One author was FAAN’s founder, Anne Munoz-Furlong, a one-time Time-Life Books researcher and parent of a child with a food allergy. [Full disclosure: I used to write for Time-Life Books, although I don’t recall ever working with Munoz-Furlong.]

The other two authors were two members of FAAN’s advisory board, Hugh Sampson (also the father of a child with a food allergy) and Scott Sicherer. Sampson and Sicherer are both (as Broussard herself points out) highly regarded allergists at the Jaffe Food Allergy Institute at Mount Sinai Medical Center in New York.

Following the money
Broussard raises legitimate questions about the 2004 study’s methodology. (The findings were based on a phone survey that asked people if anybody in their household were allergic to seafood — not if anybody had been diagnosed with a seafood allergy.) But her article focuses mainly on the study’s funding, which came primarily from the Food Allergy Initiative (FAI), a private foundation that also finances Sampson and Sicherer’s research and clinical practice (including $1.6 million in 2004, says Broussard). FAI has also made substantial contributions to FANN.

Furthermore, notes Broussard, the editor of the journal that published the 2004 paper sits with Sampson on the FAI medical advisory board, receiving as much as $10,000 a year for those services.

And then there’s the big grant that FAAN received from the pharmaceutical company Dey to create a video news release about seafood allergies. Dey is the maker of the EpiPen, a small pen-like device that can be used in emergencies to self-administer a dose of epinephrine to stop anaphylactic shock. (That video aired more than 300 times in more than 200 U.S. markets, reaching more than 30 million viewers — raising a whole other issue about the lazy state of television news.)

Such financial conflicts of interest beg the question: Are the statistics being exaggerated to keep the funding coming?

Broussard, of course, thinks the answer to that question is yes.

A small group of people is manipulating the scientific perspective on food allergies, exaggerating the perception of risk, and profiting from the flood of sympathetic private and government money. It’s time to re-examine the statistics and question the media spin on food allergies. This time, we need to be hyperaware of potential bias and exaggeration. Food allergies deserve respect and awareness, sure — but we make unwise decisions when we’re guided by fear.

What do you think, readers?

Comments (5)

  1. Submitted by Karl Pearson-Cater on 09/03/2009 - 09:33 am.

    Just yesterday, my son was told he can’t bring peanut butter sandwiches to school anymore. Apparently, it is being poorly communicated (their words) that Seward Montessori is now “Peanut Free.” Not quite the same as the shellfish situation in your post, but it seems it could be a similar situation. Allergies suck, especially when they can kill you. We’ll figure something else out lunch, nbd. But your post does raise my eyebrow a little.

  2. Submitted by Susan Clemens on 09/04/2009 - 05:45 am.

    Meredith Broussard seems to enjoy this topic a little too much. As you note, she wrote on this topic for a few years now and really she isn’t saying anything new here.

    One has to ask why she feels it’s time raise this issue again. I suspect that attacking vulnerable children at the start of school is good for her ratings as many parents of children with severe (life threatening) food allergies will feel compelled to respond and isn’t by ‘hits’ that a website’s worth is determined?

    If you want to read FAAN’s respons to Ms. Broussard’s acusation, it can be found here.

  3. Submitted by Jessie Bennett on 09/07/2009 - 08:57 am.

    Susan, personally attacking the author’s intentions doesn’t really add anything to the debate. It also makes it look like you’re trying to deflect attention from the real substance of the argument, which is not that allergies and their very serious dangers to individuals are not real, but rather that the impact of allergies on the population as a whole has been exaggerated, and that the reasons behind this misinformation look a little shady.

    When we are trying to solve serious medical problems in a profit-based society, it is all too easy for groups and doctors, even those with the best intentions, to exaggerate in order to create more attention for their cause. It is our duty to serve the medical needs of all of our citizens, and to do this we must look critically at the ways we are spending money on research and advocacy to ensure that we are not funding based on who is the most emotionally compelling or manipulative, but rather where the need is most urgent. FAAN has only itself to blame if it has been sloppy in its methodology, and members would do well to demand more honesty and accountability in its leadership to ensure that their actions and motives are less likely to be questioned in the future. As the old fairy tale illustrates, crying wolf never works out in the long run.

    By trying to demonize the author, you may make it easier for yourself to dismiss her views, but you do not make a case against the troubling problems she brings up in her articles.

  4. Submitted by Karen Sandness on 09/10/2009 - 08:50 pm.

    I know that anaphylactic shock due to food allergies is real. Thirty years ago, I had a fellow student who would go into shock if he ingested the least bit of egg or anything made with eggs. He was very careful to find out what was in the recipes at the university dining halls, but one day, he had an allergy attack because the servers in the cafeteria line accidentally switched the spatulas used to dish up hamburger patties and the ones used to dish up omelets.

    But the idea that children with food allergies cannot even be in the same room as the allergen is new. I first heard of it about 10 or 15 years ago, when I was told that I couldn’t eat a Snickers bar during the evening in a room that was used for day care during the day, because one of the children had a peanut allergy.

    I would never feed an allergic person something that they were allergic, too, but as I recall the article in Harper’s, one of the doctors interviewed said that he frequently ran into parents who were hysterically overprotective of their child who had a peanut allergy. He cured them of their worry-wart concerns by smearing peanut butter on the child’s arm, to no ill effect.

  5. Submitted by Susan Peterson on 09/10/2009 - 09:07 pm.

    Karen — I don’t know how many parents are overprotective of kids with peanut allergies, but I can say that in some cases, their protectiveness is absolutely warranted. One adult friend with a severe peanut allergy was at a picnic and participated in a sack race, and went into anaphylactic shock because the gunny sack had held peanuts once upon a time.

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