Abstract

BackgroundRisk factors for persistence of food-related symptoms (FRS) and food allergy (FA) from early life to adolescence are incompletely understood. The aim of this study was to identify risk factors for FRS and FA in adolescence amongst children with FRS or FA in the first four years of life (early life).MethodsIn children enrolled in a Swedish birth cohort and followed to 16 years (n = 2572), we defined children with early life FRS in the absence of FA, and FA. Corresponding phenotypes were defined at 16 years. Associations between potential risk factors at 4 years and FRS and FA at 16 years were investigated using logistic regression.ResultsEarly life FRS and FA prevalences were 12.2% and 6.8%, respectively. Amongst children with early life FRS, 35.7% had FRS or FA at 16 years, whereas 74.3% of the children with early life FA had FA at 16 years. For each of the early life phenotypes, parental allergy, early life allergic multimorbidity, early life reactions to peanuts/tree nuts and IgE reactivity at 4 years were statistically significantly associated with FRS or FA at 16 years. In contrast, male sex was associated with an increased risk of FA at 16 years among children with early life FA only.ConclusionsIn early life, food-related symptoms are twice as common as food allergy. Unlike food allergy, food-related symptoms often remit by adolescence. Yet, these phenotypes have many common risk factors for persistence to adolescence.

Highlights

  • Adverse reactions to foods are common amongst children [1]

  • For each of the early life phenotypes, parental allergy, early life allergic multimorbidity, early life reactions to peanuts/tree nuts and Immunoglobulin E (IgE) reactivity at 4 years were statistically significantly associated with food-related symptoms (FRS) or food allergy (FA) at 16 years

  • Male sex was associated with an increased risk of FA at 16 years among children with early life FA only

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Summary

Introduction

Food-related symptoms (FRS) that are not clinically diagnosed as allergy affect more children [2,3,4] than food allergy (FA) [5,6,7], but FA reactions tend to be more severe [1, 8]. Health-related quality of life does not appear to differ between the phenotypes [18]. Both phenotypes burden healthcare systems [19, 20], society [21] and households [21, 22]. Risk factors for persistence of food-related symptoms (FRS) and food allergy (FA) from early life to adolescence are incompletely understood. The aim of this study was to identify risk factors for FRS and FA in adolescence amongst children with FRS or FA in the first four years of life (early life)

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