Dear Doctor: My boyfriend wants to take me to his favorite Thai restaurant, but I'm a little worried; Thai cuisine uses a lot of peanuts and I'm allergic. For people with food allergies, how dangerous is it to eat meals made with equipment also used to cook allergen-containing foods?

Dear Reader: Food allergies in the United States appear to be on the rise, which makes your question increasingly relevant. For individuals with allergies, even a tiny amount of the allergen can set off a reaction. This includes consuming food that doesn't actually contain the problem ingredient, but has been produced on equipment where the allergen is present in some form. This is known as cross-contact, and it can cause serious problems.

If you accidentally consume a food that your immune system has identified as dangerous, you're in for a physical reaction. This can be as mild and manageable as itchy skin, a headache or an upset stomach, or as severe as anaphylaxis, which can lead to death.

Although the steady uptick in allergies is worrisome, the newest research, which analyzed data from the medical records of 2.7 million patients, actually dials back the previous estimate of people with food allergies in the U.S. Instead of the widely quoted 5 percent, this study pegs the number at an average of 3.6 percent.

More women (4.2 percent) than men (2.9 percent) have food allergies. Asians had the highest incidence at 4.3 percent. Latinos had the lowest rates at 2.8 percent. Still, identifying and diagnosing a food allergy can be difficult, so all estimates are just that -- a researcher's best guess.

Your peanut allergy is in the top five of food reactions. Shellfish is first, followed by fruits or vegetables, dairy, then peanuts. Needless to say, the range of foods that can cause an allergic reaction is far more diverse.

To help people with allergies, the U.S. Department of Agriculture requires food labels to clearly identify the presence of any of the major food allergens. Also, if a product uses nuts, the specific nut must be named. But -- and this is important -- the "this product may contain" language on a food label, which warns of possible cross-contact, is voluntary. That means the absence of that warning doesn't necessarily eliminate the chance of cross-contact.

When it comes to dining out, where the preparation of your food is out of your control, your best defense is to be your own advocate. Call ahead to the restaurant and ask to speak to the chef or manager about your concerns. Ask for details about the precautions the restaurant takes to prevent any trace of an allergen from finding its way to your plate. (You'll get the most relaxed response when you call during off-peak hours.)

During spur-of-the-moment restaurant visits, enlist the aid of your server. Clearly explain what you're allergic to and how it may affect you, and ask him or her to let the kitchen know as well. Find out how the kitchen handles potential cross-contact. And, because we live in an imperfect world, please remember to always carry an EpiPen.

(Send your questions to askthedoctors@mednet.ucla.edu, or write: Ask the Doctors, c/o Media Relations, UCLA Health, 924 Westwood Blvd., Suite 350, Los Angeles, CA, 90095. Owing to the volume of mail, personal replies cannot be provided.)

Dear Doctor: I know of several older women who have died within a year after a hip fracture. But why? Is this due to a cause and effect of a bone fracture, or something else entirely?

Dear Reader: Hip fractures are common as we get older. The lifetime risk of a hip fracture in a woman is 17.5 percent; for men, it's 6 percent. Women have greater rates of osteoporosis than men and thus the greater risk of fractures. Now let's look at why hip fractures increase the rate of death.

Let's start with the most common reason for an older person to get a fracture -- a fall. Such a fall doesn't usually occur from hiking mountainous terrain, but rather from a misstep or a loss of balance within the home. In fact, 90 percent of hip fractures in the elderly occur because of a fall from a standing position. The loss of balance that precipitates a fall occurs because of weakness in hip girdle muscles, and/or generalized weakness due to illness, medication and/or a prior stroke. To put it simply, the more debility one has, the greater their chance of falling; the hip fracture is often the consequence of that debility. So this debility, in itself, can be a major reason for the increased death rates seen among people with hip fractures.

Next, the majority of displaced hip fractures will require surgery to repair. The surgery can be either a total hip replacement or a surgery to bring the misaligned pieces of bone together using metal screws, rods and plates. Surgeries are fraught with possible complications, leading to a greater risk of debility and even death. Complications include blood loss, cardiac arrest, stroke, problems with anesthesia, infection and blood clots.

However, waiting too long to have a surgery for a hip fracture can also lead to prolonged bedrest, resulting in an increased chance of blood clots in the legs, bed sores, urinary tract infections, pneumonia and, again, death.

Another problem, before and after surgery for a hip fracture, is that elderly patients are especially likely to become delirious. One study found that 61 percent of elderly patients with a hip fracture had an acute state of confusion. This confusion leads to greater agitation, an inability to eat and limited ability to recover from a hip fracture. In addition, confusion can lead to medications to sedate an agitated patient, further delaying recovery.

For some, recovery from a hip fracture can take months. Long hospital and rehabilitation facility stays lead to an even greater risk of complications.

When you add pre-fracture problems to post-fracture problems, it's no surprise that the mortality rates are so high. A 2017 European study found that, in people older than 60, 15.1 percent of 463 patients died within one year of a hip fracture. A 2010 American study of the same age group found that 21.2 percent of 758 patients died within one year of a hip fracture.

So prevention is crucial. Regular exercise, use of calcium and maintaining good vitamin D levels are absolutely necessary. So is good overall health. Encourage it in yourself, and do what you can for those you love.

(Send your questions to askthedoctors@mednet.ucla.edu, or write: Ask the Doctors, c/o Media Relations, UCLA Health, 924 Westwood Blvd., Suite 350, Los Angeles, CA, 90095. Owing to the volume of mail, personal replies cannot be provided.)

Dear Doctor: Are organic foods better for you than ordinary foods? I say yes because there are no hormones or pesticides involved. My husband says that once you wash your produce carefully, the only difference between an organic peach and a regular one is the price tag.

Dear Reader: Welcome to a long-running and robust debate. Whether organic foods provide health benefits over and above those grown by conventional methods has been under discussion for decades. (And here we're being polite -- both sides of this battle can get pretty worked up.)

Before we wade into the fray, let's take a stab at some definitions. That's actually easier said than done. At its most basic, when something is organically grown, it is understood to have been raised without the use of synthetic pesticides, herbicides or fertilizers; without antibiotics; and with seeds or products that have not been genetically engineered or altered.

Dig a little deeper (sorry) and the word "organic" takes a detour into the legal realm. In order to market their products as organic, farmers must adhere to specific guidelines put forth by the U.S. Department of Agriculture. So to simplify our discussion, let's go with the basic spirit of the word. That is, fruits and vegetables raised without conventional pesticides or synthetic fertilizers, and farm animals raised without the use of hormones, and with access to the outdoors and to pasture.

Are organically raised foods better for your health? Studies say maybe. Will we ever get a definitive answer? Probably not. The challenge is that the topic is so vast as to be virtually unmanageable. Even studies that have broken the question down into discrete parts come up with mixed results.

So what is known for sure?

When you buy organic produce, you're getting fruits and vegetables with measurably less pesticide residue than when you buy the same produce that has been conventionally grown. But before you take a victory lap, conventionally grown produce in the United States generally exceeds the minimum tolerance levels for pesticides set by the Food and Drug Administration.

As to why organic produce has any pesticide residue at all, some have been OK'd for organic farming. Drift from conventional farms, plus lingering DDT in the soil, are believed to account for the rest of the pesticide residue found on organic produce.

Studies show that organically grown produce also has higher levels of antioxidants and lower levels of the heavy metal cadmium than does conventional produce. And when it comes to beef, the FDA's feeding guidelines that call for organic cattle to be raised on grass and alfalfa lead to meat that is higher in omega-3 fatty acids. Increased levels of omega-3's are also found in organic dairy and eggs. On the minus side: Organically produced milk tends to be lower in iodine, an essential nutrient, than conventional milk.

In a paper published this year, researchers did the heavy lifting and systematically examined the published literature on the benefits of organic versus conventional food. Their findings: "It is therefore currently not possible to quantify to what extent organic food consumption may affect human health."

Bottom line: The "organic vs. conventional" battle rages on.

(Send your questions to askthedoctors@mednet.ucla.edu, or write: Ask the Doctors, c/o Media Relations, UCLA Health, 924 Westwood Blvd., Suite 350, Los Angeles, CA, 90095. Owing to the volume of mail, personal replies cannot be provided.)