Chapter 3 : The Big Eight Foods: Clinical and Epidemiological Overview

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Peanuts, tree nuts, cow’s milk, soy, wheat, hen’s egg, fish, and crustaceans are considered the “Big Eight” foods in discussions of immunoglobulin E (IgE)-mediated or -associated food allergy both internationally and in the United States. These foods account for approximately 90% of food allergies in the best-studied group in the United States: children with atopic dermatitis. Although the Big Eight foods account for about 90% of clinical reactions in children with atopic dermatitis in referral centers, the pattern of foods causing reactions prompting emergency department visits is somewhat different in the United States. However, the Big Eight foods remain highly useful for labeling rules because the vast majority of individuals with food allergy will be helped, and specific fruits or vegetables are easier to avoid once the allergy is identified and the patient receives appropriate education on avoidance. The chapter reviews the eight dominant foods associated with food allergic reactions along with sesame. Cow's milk allergy is the most common food allergy in infants reported from developed Western nations. Most infants with IgE-mediated or IgE-associated allergy to cow’s milk protein will do well on isolated soy protein-based formula and that there is no need to spend money on more expensive, less-palatable formulas.

Citation: Teuber S, Beyer K, Comstock S, Wallowitz M. 2006. The Big Eight Foods: Clinical and Epidemiological Overview, p 49-79. In Maleki S, Burks A, Helm R (ed), Food Allergy. ASM Press, Washington, DC. doi: 10.1128/9781555815721.ch3

Key Concept Ranking

Fruits and Vegetables
Food and Beverages
Yellow Fever Vaccine
Peanut Butter
Atopic Dermatitis
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Table 1.

The big eight foods plus sesame

Citation: Teuber S, Beyer K, Comstock S, Wallowitz M. 2006. The Big Eight Foods: Clinical and Epidemiological Overview, p 49-79. In Maleki S, Burks A, Helm R (ed), Food Allergy. ASM Press, Washington, DC. doi: 10.1128/9781555815721.ch3

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