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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 si

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?