When Sharon Wong’s son was 4 months old, his skin erupted in itchy red patches, and he developed wheezing coughs that lingered for weeks. His first pediatrician dismissed the symptoms as a recurring cold. Then one evening, as a toddler, Wong’s son ate a spoonful of Thai-inspired peanut soup, triggering him to retch and claw at his stomach. Panicked, Wong called her new pediatrician, who recognized the signs of anaphylaxis.
“Our second doctor was very clear about the severity of the situation and what I needed to do: get Benadryl, an allergist and an EpiPen,” Wong remembered of the incident 19 years ago. “That probably saved my son’s life.”
Today, 6 million American children live with food allergies, and young Asian Americans like Wong’s son, now in college, are 40% more likely to develop one compared to the general population. Scientists have struggled to explain this disparity since it was first documented in a landmark 2011 study.
Now, a recent Stanford University study of nearly half a million California pediatric records is one of the first to look at subgroups of Asians in the U.S. under 18 to try to understand why Asian Americans are so at risk. The study found Filipino, Vietnamese and Native Hawaiians and Pacific islanders are particularly vulnerable. “Existing allergy research often overlooks Asian Americans or treats them as a monolith,” said Dr. Charles Feng, the study’s lead author.
For immigrant communities, where language and cultural divides often separate generations, food represents connection, Feng added. “That’s why solving this mystery, which is ultimately a problem of health inequity, feels so urgent.”
Why might Asian American, Pacific Islander and Native Hawaiian children be vulnerable to food allergies?
Wong and her husband, who live in California, have no known allergies, yet their two sons are allergic to a daunting list of foods: peanuts, tree nuts, eggs, shellfish, sesame, tomatoes and certain fruits. Their family reflects a broader, baffling trend: Between 2007 and 2021, the prevalence of food allergies among American children jumped 50%.
.
Courtesy of Sharon WongWhere Asian American children fit into this trend remains unclear. Few longitudinal studies include them, an oversight Dr. Ruchi Gupta, a pediatrician and allergist at Northwestern University, calls a missed opportunity. As the fastest-growing racial group in the U.S., Asian Americans provide a unique window into nationwide food allergy trends, she said.
Genetics alone can’t explain the dramatic rise or the disproportionate impact on Asian American children. The time frame — just a few decades — is too short for significant genetic changes. Additionally, Gupta’s research in countries like India hasn’t identified the same allergy patterns seen in American children with similar ancestry. “Studying Asian Americans might uncover the missing link to rising allergy rates for all children,” Gupta said.
Most likely, a child’s genes interact with environmental and dietary shifts, said Dr. Latha Palaniappan, a Stanford University physician who studies health disparities. For instance, adopting Westernized diets may alter children’s gut microbiomes, which play a key role in immune responses.
To test these gene-environment hypotheses, granular data on food allergy rates within Asian American subgroups is essential. Recent research, including the new Stanford study co-authored by Palaniappan, offers promising direction. The study demonstrated that food allergy rates vary markedly, ranging from 2.9% among Indian American children to 8.2% among Filipino children. (The rate for all U.S. children is 5.8%.) These findings highlight the importance of investigating how country of origin and culture-specific practices, like common cooking methods, might influence allergy patterns.
Still, much of the puzzle remains unsolved, leaving families to adapt to the immediate challenges posed by food allergies. “I see a growing number of Asian patients with various allergic conditions,” Feng said. “Providing evidence-based care is harder because we just don’t have the data.”
The cultural strains of food allergies
Food allergies can take a child from seemingly fine to unconscious in minutes. For children without a formal diagnosis, and no EpiPen to pull out in an emergency, the risks are even greater.
That danger is pronounced for Asian American children, who are 30% less likely to be diagnosed with food allergies despite their heightened vulnerability. Doctors might overlook symptoms, or parents — especially those from communities where allergies are rarely discussed — may not recognize warning signs. “Families may not connect the reaction to a specific food or recognize it as anaphylaxis until it becomes severe,” explained Dr. Anna Chen Arroyo, an allergist at Stanford University. Language barriers, limited familiarity with specialist services, and cultural hesitancy to seek medical advice can also impede access to allergy care.
Even with a diagnosis, managing food allergies often involves navigating cultural hurdles. Asian American families experience a sharper drop in quality of life from food allergies than other racial groups. Arroyo hypothesizes this is partly due to food’s role in many Asian cultures, where shared meals are cornerstones of community and tradition.
Wong experienced this strain. She pored over food labels and called manufacturers of Asian cooking ingredients, a daunting task when terms like “antihistamine” and “anaphylaxis” don’t translate easily to Cantonese. She created allergen-safe versions of the beloved dishes from her childhood, like nian gao cake and lo han jai vegetable stew.
But cultural celebrations proved especially difficult. During Chinese New Year, peanut-studded desserts and sesame-coated snacks symbolize prosperity, but they were life-threatening for Wong’s son. “He couldn’t even be in the same room as nuts, but our relatives didn’t want to remove these lucky ingredients,” Wong said. They started skipping family gatherings altogether.
How families are advocating for change
Advocating for a child with food allergies starts close to home. In some Asian American families, older relatives may be unfamiliar with dietary accommodations, especially if they come from countries where allergies that are common in the West, like peanut allergies, are less prevalent or underdiagnosed. Wong began hosting family potlucks herself, using the opportunity to teach skeptical relatives about food safety. She shares her experiences and allergen-friendly Asian recipes on her blog, Nut Free Wok, and has successfully pushed for legislation to improve EpiPen access in schools.
Other parents, like Ina K. Chung, are pushing back against stereotypes. After her daughter was diagnosed with peanut, dairy and egg allergies at 6 months old, Chung joined Facebook groups for allergy parents, where she found both support and rampant misinformation about Asian cuisine. Some parents, including other Asian Americans, posted blanket warnings against Asian restaurants, writing that they “couldn’t trust the food.”
“Why can’t you trust what the restaurant workers say about how the food was prepared?” Chung wondered, especially troubled by how some Asian American parents distanced themselves from their own cuisines. “The assumption that all Asian food is dangerous reflects a lack of understanding and unfair stereotypes.” Through her Instagram page, @theasianallergymom, she counters these misconceptions. Her posts feature classic dishes from her childhood, like Korean chicken soup with kimchi, which are naturally free of common allergens. “I want people to know that Asian cuisine isn’t monolithic, just like Asian people aren’t monolithic,” Chung said. She has also written a children’s book to help parents teach kids about food allergies and self-advocacy.
Chung has seen this empowerment reflected back in her family. When her daughter was 5, she attended a friend’s birthday party and asked the host’s mother: “Is this cake safe for me? What did you use to make it?”
“You could see the pride radiating off of me,” Chung said. “Those little victories are my North Star when it comes to allergy advocacy.”
New treatments and hope
In Gupta’s office, a comic strip hangs on the wall. One panel shows an adult telling a child, “When I was your age, there were no food allergies.” In the next, the now-grown child tells another kid, “When I was your age, there were food allergies.”
Just a decade ago, treatments for food allergies didn’t exist. Today, oral immunotherapy and skin patches can desensitize children to allergens, reducing the risk of severe reactions. Still, Gupta said, many Asian American families she sees remain unaware of these options, highlighting the importance of early diagnosis and education.
In 2014, Wong’s son completed a clinical trial that increased his allergen tolerance from 1 mg to 1,440 mg of peanut protein, or about six peanuts. Although the family still avoids peanuts and carries epinephrine, he’s no longer reactive to trace amounts in the air.
Wong shares this story to encourage other families to seek testing, treatment and tools like EpiPens — to take control, rather than live in isolated anxiety. Now, she cooks alongside her son, re-creating the dishes she once watched her parents make. Together, they’ve found a way to reclaim tradition and savor a new beginning.
