Understanding the experiences of South Asian adults’ management of food allergy

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Background: Population studies suggest lower food allergy (FA) prevalence in South Asia; however, migration to urbanized, Western environments is associated with higher risk of FA among South Asian (SA) individuals, highlighting the role of environmental and sociocultural factors. Data indicate disproportionate clinical burden for SA populations than for White populations, independent of age, sex, and area-level deprivation. Despite this, the day-to-day experiences of SA adults managing FA remain understudied. Objective: This qualitative study addresses these gaps by exploring the lived experiences of SA adults with FA. Methods: SA patients aged 16 years and older who had been formally diagnosed with FA were recruited via a regional allergy service, advertisements shared by organizations serving patients with allergy, and posters in places of worship. Individual interviews were conducted, transcribed verbatim, and analyzed inductively using reflective thematic analysis. Results: A total of 27 participants representing a broad spectrum of socioeconomic status (52% British Indian, 44% British Pakistani, and 4% Bangladeshi; 59% women; and median age 22 years [interquartile range 20-32 years]) were interviewed. Our analysis generated 4 interlinked themes: (1) adjustment involving pragmatic acceptance alongside risky workarounds; (2) socializing (in particular, regarding hospitality, stigma, and the restaurant problem); (3) support from friends and family, which suggests an asymmetric allyship; and (4) acculturation, which enforces "keeping face," deference, and concealment among participants. Conclusions: The study findings move beyond a generic education deficit narrative to show where and how culture, language, and social norms intersect with allergy safety. Coproduced, culturally responsive tools delivered across clinics, communities, and small businesses may offer a plausible route to closing the gap between knowledge and safe practice.

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