Allergen-Free Food Subscriptions May Aid Families Manage Allergies, with Christopher Warren, PhD

The food-as-medicine intervention, offering $155 monthly benefits for allergen-free groceries, benefited food-insecure families with allergic children. However, despite the observed benefit, the intervention failed to reach statistical significance.

The intervention, assessed in a small pilot study, provided a monthly subscription to allergen-free foods through the Food Equality Initiative’s online marketplace where parents could select foods. A different variation of the intervention with identical outcomes was studied in clinics affiliated with Lurie Children’s Hospital of Chicago, University of Kansas, Baylor/Texas Children’s Hospital, Stanford University, and Northwestern University, which provided a monthly subscription to allergen-free foods through the Food Equality Initiative’s online marketplace where parents could select foods.

The intervention lasted anywhere from 6 to 9 months, depending on the center. Families qualified for the intervention if they struggled to feed their families during the COVID-19 pandemic and had a child with a food allergy. Participants completed surveys at baseline and the 6-month follow-up.

Investigators hoped this program could improve allergy management outcomes, recognizing the psychological and social burden of allergies.

“It’s challenging to navigate daily life [with a severe food allergy], even if you have tons of resources… just because food is everywhere, and it's not always clear where your allergen might lurk,” Christopher Warren, PhD, told HCPLive at the 2025 American Academy of Allergy, Asthma, & Immunotherapy (AAAAI) annual meeting in San Diego. “If you are on a very tight budget and don't often have access to all the latest and greatest supports, you can imagine how that would be even more challenging.”

The sample included 89% of non-White participants, and children had a median age of 8.1 years. The most common food allergies were peanut (n = 12), milk (n = 10), egg (n = 10), and shellfish (n = 10).

This pilot study observed high rates of dropout, with 66 participants initially enrolled and only 26 who retained through the uncontrolled study period which ended in October 2024.

“It wasn't easy to recruit participants into this study, surprisingly enough,” Warren said, “and it wasn't easy to retain participants to this study, even when you might imagine it would be very attractive to be presented with the option of, ‘Here, get $155 worth of free food every week, get a CSA basket of fresh food… shipped to your door. All you need to do is fill out some surveys.’ But it was challenging to successfully communicate that really was the expectation and that that was the nature of the study.”

Food allergy-related healthcare utilization (0.7 to 0.2) and missed school or workdays (0.8 to 0.5) declined over the 6-month intervention. Additionally, caregivers reported a greater composite food security (2.4 to 2.7) and more confidence in their ability to prepare allergy-free meals. The analysis also reported fewer food-related socio-behavioral limitations on the Food Allergy Independent Measure (3.2 to 2.6).

However, despite this, the intervention did not reach statistical significance, which Warren said could have been influenced by the dropout rate.

“Challenges we hadn't anticipated [was] digital literacy with the ordering platform—the idea of checking out a virtual shopping cart was not…something that that many of these families had any prior experience with and that led to more barriers to participation,” he said.

Warren has no relevant disclosures.

References

Warren, C, Bilaver, L, Davis, C. Implementation and Impacts of a Multi-site, Online Food-as-Medicine Intervention for Pediatric Food Allergy Patients at Risk of Food Insecurity. Presented at AAAAI 2025 in San Diego from February 28 – March 3.