Frequency of Food Allergy in School-Aged Children in Eight European Countries—The EuroPrevall-iFAAM Birth Cohort

Abstract

The prevalence of food allergy was estimated in children aged 6 to 10 years in 8 European countries.Children from the EuroPrevall birth cohort managed from birth to 2.5 years to prospectively track food allergy onset were reassessed at the ages of 6 to 10 years (N = 6105) in 8 countries (Iceland, United Kingdom, Netherlands, Germany, Poland, Lithuania, Spain, and Greece).School-aged children from the 2005 multicenter European birth cohort were managed by using an online parental questionnaire (n = 6069), clinical visits including a structured interview (n = 2322) regarding previous and current food reactions and food consumption, a physical examination, and skin-prick testing (SPT) (n = 2188). Double-blind placebo-controlled oral food challenges (DBPCFCs) were performed for children (n = 46 of 238 eligible) whose history and SPT (≥3 mm) suggested possible allergies to cow’s milk, hen’s egg, wheat, soy, peanut, hazelnut, white fish, oily fish, or crustaceans. Whole cohort frequency results were extrapolated from fully assessed children.The prevalence of a food allergy to at least 1 confirmed allergen was 0.8%, adjusted to 1.4% to 3.8% by extrapolating to include children without a DBPCFC. Adverse reactions to foods were reported in 16.2% of online questionnaires, similar to face-to-face interviews. Most children consumed cow’s milk, hen’s egg, and wheat products; fewer consumed soy and crustaceans. A total of 10.2% were sensitized to at least 1 food (positive SPT); sensitization was most common to peanut (5.6%) and hazelnut (5.2%). A total of 10.4% were offered DBPCFC, but only 46 children participated. A total of 20 DBPCFCs were positive in 17 children; positive challenges occurred for hazelnut (n = 7), peanut (n = 3), and hen’s egg (n = 1).The estimated prevalence of food allergy in European children was 1.4% to 3.8%. The most common allergies were to peanut and hazelnut.In this study, researchers estimated the true prevalence of sensitization and food allergy in school-aged children in 8 European countries by using a previously established systematic approach to verify food sensitization and allergies in a large number of children from the participating countries. Although a substantial number of participants declined to a DBPCFC, this study reveals the feasibility, utility, and importance of including testing and DBPCFC evaluation in longitudinal food allergy studies.