Epidemiology of Food Allergy
Section snippets
Reported food allergy
The natural history of FA is such that it is common in early childhood and becomes less common with age. Data from the United States showed that the annual incidence of doctor-diagnosed FA decreased from an average of 4.7% per year during the first 2 years of life to an average of 1.2% for the fifth and sixth years of age.1 Thus, age is a major factor in determining FA prevalence. Even allowing for that, however, there remains considerable variation in the prevalence of FA in different
Allergic sensitization
Allergic sensitization is defined by the presence of IgE antibodies to a specific food allergen. This may be assessed on skin prick test (SPT) or specific IgE as demonstrated in the serum using an immunoassay. The mere presence of IgE, however, does not necessarily mean that the subject will clinically react to the food. Thus, sensitization is often higher than true clinical FA. There is a direct correlation between the degree of sensitization and the likelihood of clinical FA. Previous studies
Increasing prevalence of food allergy
There is some support in the literature of increasing FA prevalence. The number of hospital discharges with a diagnosis of FA among children (<18 years) increased from approximately 2000 to 10,000 between 2004 and 2006, respectively.4 A recent report from Boston suggests that food-induced anaphylaxis has been increasing in recent years, and, in addition to the classical 4 to 5 major foods, other food groups are increasingly associated with anaphylactic reactions. The report showed that the
Milk
Cow’s milk protein allergy (CMA) is an immunologic reaction to the protein in cow’s milk and can be IgE mediated, non–IgE mediated, or a mixture of both.15 CMA is seen in both children16, 17 and adults.18 The pattern of IgE-mediated and non–IgE-mediated allergies and the proportion of children suffering from IgE-mediated versus non–IgE-mediated CMA also seems to vary between countries, with higher rates of non–IgE-mediated allergy seen on the Isle of Wight (United Kingdom)17 and in Denmark19
Summary
FA is commonly reported, but there is a large discrepancy between reported and diagnosed FA. The true prevalence of FA in adults particularly needs further investigation. In children, the prevalence of FAs depends on the food studied and the country involved. It seems that there may be pockets of higher and lower prevalence across the world and FA may be increasing in some countries, such as the United States. Many foods are reported to cause symptoms of FA, but only 6 to 7 foods and
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2021, Journal of Allergy and Clinical Immunology: In PracticeCitation Excerpt :Fish allergy is one of the most common causes of food allergy, especially in children and young adults, with prevalence rates ranging from 0.1% to 0.5%, as assessed by oral challenges,1,2 more so in countries where fish consumption or the number of people working in the fish industry is high.3
Financial disclosure: Dr C. Venter has given academic lectures or written educational articles for Danone, Mead Johnson, and GlaxoSmithKline. Prof. S. H. Arshad has been an advisor to the Phadia Ltd (UK).