Food Allergy Impact on Military Excellence: Epidemiology and Operational Outcomes

Food allergy (FA) commonly disqualifies applicants from United States military service, though military members diagnosed with FA during service often continue to serve. The impact of FA on military operations is unknown.

We aim to investigate the impact of FA on military operations by examining epidemiologic trends, demographics, and severe outcomes.

We completed a retrospective study including active-duty service members with diagnostic codes for food anaphylaxis, food allergy, and food adverse reactions between 2017 and 2024. We collected epidemiologic data, demographics, and outcomes including medical encounters and evacuations.

FA prevalence increased over time, peaking at 33,557 or approximately 2.4% of service members in 2024. FA prevalence was higher in women (4.5%), Black individuals (3.7%), individuals with either longer time in service or >2 deployments (3.9-4%). Prevalence was lower in Marines (1.2%), pilots/aircrew (1.9%), and combat/artillery/infantry (1.5%). In total over our 8-year study there were 4,275 emergency department (ED) visits, 143 hospitalizations, and 7 medical evacuations, averaging approximately 534 ED visits, 18 hospitalizations, and less than one medical evacuation annually.

This study examining FA in the military reveals that although prevalence has increased, FA-related hospitalizations and medical evacuations remain uncommon. Although military accession policy nominally disqualifies many individuals with FA from service, the prevalence of FA in service members has increased over time. Based on our results, FA-related severe outcomes such as hospitalizations and medical evacuations are rare and do not currently pose substantial risk to military operations, supporting possible revision to current accession policy.