Abstract
BackgroundCow’s milk, hen’s egg and wheat are staple foods in a typical western diet. Despite the ubiquity of these foods, the impact of staple food allergy on health-related quality of life (HRQL) amongst adolescents is incompletely understood. The aims of this study were to make use of the Swedish version of EuroPrevall’s disease-specific food allergy quality of life questionnaire-teenager form (FAQLQ-TF) and to investigate the association between objectively-diagnosed staple food allergy and HRQL amongst adolescents.MethodsIn this cross-sectional study, 58 adolescents aged 13–17 years [n = 40 (69 %) boys] with objectively-diagnosed allergy to the staple foods cow’s milk, hen’s egg and/or wheat and living in Stockholm, Sweden were included. Adolescents completed the FAQLQ-TF, which has a corresponding scale of 1 = best HRQL, and 7 = worst HRQL. Overall HRQL and domain-specific HRQL were established. Adolescents also reported symptoms, adrenaline auto injector (AAI) prescription and presence of other food allergies. A history of anaphylaxis was defined among those reporting difficulty breathing, inability to stand/collapse, and/or loss of consciousness. Clinically different HRQL was set at a mean difference of ≥0.5.ResultsOverall mean HRQL was poorer than average [mean: 4.70/7.00 (95 % CI 4.30–5.01)]. The domain risk of accidental exposure was significantly associated with clinically better HRQL than the domain allergen avoidance and dietary restrictions (mean difference = 0.76; p < 0.001). Girls had clinically worse, but not statistically significantly different mean HRQL than boys (mean difference = 0.71; p < 0.07). HRQL tended to be worse amongst those with allergies to more than three foods or an AAI prescription. The number and types of symptoms, including a history of anaphylaxis were not associated with worse HRQL.ConclusionsAs ascertained via a food allergy-specific questionnaire, adolescents with staple food allergy report poorer than average HRQL, specifically in relation to emerging independence and the need for support. Girls have clinically worse HRQL than boys. The number and type of previous symptoms and history of anaphylaxis were not associated with worse HRQL.Electronic supplementary materialThe online version of this article (doi:10.1186/s13601-016-0128-5) contains supplementary material, which is available to authorized users.
Highlights
Cow’s milk, hen’s egg and wheat are staple foods in a typical western diet
Inclusion criteria were a convincing history of allergy to one or more of the above-mentioned staple foods ascertained either by a positive food challenge with evident symptoms, or by levels of food specific Immunoglobulin E (IgE) antibodies levels associated with a 95 % probability of a positive result in a double-blind placebo controlled food challenge [13]
The discriminant capacity of the FAQLQ-TF was confirmed as domain-specific floor and ceiling effects were below 15 %
Summary
Cow’s milk, hen’s egg and wheat are staple foods in a typical western diet. Despite the ubiquity of these foods, the impact of staple food allergy on health-related quality of life (HRQL) amongst adolescents is incom‐ pletely understood. Allergies to the staple foods cow’s milk, hen’s egg [11] and wheat [12], typically present in infancy and often exist concomitantly [12] These allergies often resolve by school age [11, 12], those with more severe symptoms or multiple food allergies may experience persistence of staple food allergy through later ages [11, 12]. We hypothesised that adolescents with staple food allergies would have poor HRQL, and that adolescents with a history of severe symptoms would have the worst HRQL To this end, the aims of this study were to make use of the Swedish version of EuroPrevall’s FAQLQ-TF and to investigate the association between objectively-diagnosed staple food allergy and HRQL amongst adolescents
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