Management Of Food Allergy Research Articles

Proposed solutions by the American College of Allergy, Asthma, and Immunology and advocacy experts to address racial disparities in atopic dermatitis and food allergy

Atopic dermatitis (AD) and food allergies are more prevalent and more severe in people with skin of color than White individuals. The American College of Allergy, Asthma, and Immunology (ACAAI) sought to understand the effects of racial disparities among patients with skin of color with AD and food allergies. The ACAAI surveyed its members (N = 200 completed), conducted interviews with health care providers and advocacy leaders, and hosted a roundtable to explore the challenges of diagnosis and management of AD and food allergies in people with skin of color and to discuss potential solutions. Most of the survey respondents (68%) agreed that racial disparities make it difficult for people with skin of color to receive adequate treatment for AD and food allergies. The interviews and roundtable identified access to care, burden of costs, policies and infrastructure that limit access to safe foods and patient education, and inadequate research involving people with skin of color as obstacles to care. Proposed solutions included identifying ways to recruit more people with skin of color into clinical trials and medical school, educating health care providers about diagnosis and treating AD and food allergy in people with skin of color, improving access to safe foods, creating and disseminating culturally appropriate materials for patients, and working toward longer appointment times for patients who need them. Challenges in AD and food allergy in persons with skin of color were identified by the ACAAI members. Solutions to these challenges were proposed to inspire actions to mitigate racial disparities in AD and food allergy.

Successful management of chronic urticaria and food allergies in a pediatric population using integrative traditional Chinese medicine therapy: a case series

BackgroundFood allergy is becoming increasingly common among the pediatric population. Despite strict avoidance of food allergens, a subgroup of sensitive individuals still develops frequent, persistent, and difficult to treat hives (FPDTH) for which there is no curative therapy. Although these cases are rare, these patients are in most need of therapy.Case presentationsThis is a retrospective review of 3 pediatric patients with highly sensitive food allergies who initially presented with hives daily or every other day, or multiple times a day, but achieved marked remission after traditional Chinese medicine (TCM) therapies. Patient 1 (P1) is a 5-year-old who has experienced 140 reactions in his lifetime. Reactions were mostly hives with 4 episodes of anaphylaxis. P1 had used Prednisone 20 times, had an Epinephrine injection 4 times, and had 3 emergency room (ER) visits. Patient 2 (P2) is a 12-year-old who had experienced hives since age 3. Despite daily antihistamine use, P2 had > 730 reactions in his lifetime at the time of presentation including 2 episodes of anaphylaxis. He had been prescribed prednisone 4 times, an Epinephrine injection 2 times, and had 1 ER visit. Patient 3 (P3) is a 20-month-old girl who had experienced > 120 reactions including 1 episode of anaphylaxis. She was on daily desonide and frequently used an antihistamine, yet still had required a course of prednisone once, an Epinephrine injection once, and had 1 ER visit to manage her reaction. After presenting to our clinic, patients received internal and external TCM treatments, including herbal baths and creams (Remedy A-D) as basic remedies to reduce food reactions, including but not limited to frequent hives. Within 7–9 months of TCM treatment, remarkably all patients had complete remission of atopic symptoms. All three patients also experienced an improvement in other conditions including food intolerance, diarrhea, anxiety, eczema, and environmental allergies. After 1 year of treatment, all three patients had reductions in food-specific IgE levels that had been previously elevated, and additionally, P1 and P3, who initially had high total IgE levels, experienced a marked decrease in total IgE levels as well. All three patients continued to introduce foods into their diet that they previously had reactions to, and all 3 patients remain symptom-free.ConclusionsThree pediatric patients with a known history of multiple food sensitivities and physician-diagnosed food allergies that presented with FPDTH underwent a TCM regimen and experienced dramatic improvement in symptoms and reduction in their IgE levels. This regimen appears to be effective in FPDTH population although a further study in a controlled clinical setting is required.

Development and Evaluation of a Mobile Web-based Food Allergy and Anaphylaxis Management Educational Program for Parents of School-aged Children with Food Allergy: A Randomized Controlled Trial

This study aimed to develop a mobile web-based food allergy (FA) and anaphylaxis management educational program for parents of school-aged children with food allergies and evaluate its effectiveness. A mobile program was developed based on a web-based teaching-learning system model. Its effectiveness was subsequently evaluated using a parallel, randomized controlled pre- and post-test design. This study included 73 parents of school-aged children with food allergies. These parents were randomly assigned to either the experimental (n=37) or control (n=36) groups. The experimental group participated in a 2-week mobile web-based educational program that covered major topics in FA and anaphylaxis management. These topics included an understanding of food allergies and anaphylaxis, learning techniques for using an epinephrine auto-injector, and developing an emergency action plan. An educational booklet was provided to the control group. Participants completed a pre-test and two post-test questionnaires to evaluate the impact of the program. The assessment tools were the Food Allergy Knowledge Test, Food Allergy Self-Efficacy for Parents, and Food Management and Adaptation Scale. The data were analyzed using descriptive statistics, a test of homogeneity for the pre-test, an independent t-test, and repeated measures ANOVA. The experimental group experienced greater improvement in the knowledge of FA (post-intervention t=14.51, p<.001; 2weeks post-intervention, t=16.15, p<.001), FA self-efficacy (post-intervention t=77.99, p<.001; 2weeks post-intervention, t=76.09, p<.001), and practice behavior in FA management (post-intervention t=28.10, p<.001; 2weeks post-intervention, t=27.98, p<.001) after web-based FA education. This study revealed improvements in the knowledge, self-efficacy, and practice behaviors of parents regarding FA and anaphylaxis management. Therefore, the mobile web-based educational program can contribute to the effective management of food allergies and anaphylaxis for parents of school-aged children. CRIS registration: KCT0007491.

DEVELOPMENT OF AN AGE AND CULTURALLY RELEVANT FOOD FREQUENCY QUESTIONNAIRE FOR FOOD ALLERGENS

<h3>Introduction</h3> Well-designed and implemented food frequency questionnaires (FFQs) can provide useful measures of food, nutrient, food allergen, and diet diversity intake. However, current validated diet screening assessment tools are limited in their ability to accurately measure food allergen intake in early childhood eating patterns. Therefore, our group aimed to develop and validate an age-appropriate, culturally relevant, and user-friendly FFQ to measure food allergen intake. <h3>Methods</h3> Over 18-months, a group of international dietitians, food allergy experts, epidemiologists, and pediatricians collaborated with Vioscreen to revise an existing FFQ to make the questionnaire more relevant to infants and toddlers, as well as assess intake of food allergens. This tool could be parent-administered online and facilitate user-friendly reporting of food allergen intake including type of food, frequency of consumption, and quantity consumed. <h3>Results</h3> The allergen-focused Vioscreen questionnaire assess >300 food options. Through branching and skip logic, families only review food options relevant to their diet—greatly reducing participant burden compared with other FFQs. Information on overall diet, breast and formula feeding, and allergenic foods are obtained in age-appropriate portion sizes. The FFQ was adapted to offer preferred cultural foods with a section on "early introduction foods." Data can be incorporated into REDCap, a secure data collection tool, alongside other participant data. <h3>Conclusion</h3> Our team developed an innovative self- or parent-administered FFQ that assesses real-time intake of foods including potential allergens during early childhood. This tool can be used by the food allergy research community to advance understanding about the impact of nutrition on food allergy management and outcomes.

THE LEARN EARLY PROJECT: LEARNING EDUCATORS ANAPHYLAXIS RESPONSE NEEDS

<h3>Introduction</h3> With the Incidence of food allergies on the rise, and more studies demonstrating the disproportionate impact on Black and Hispanic children, it is crucial that allergists investigate and begin to address these disparities. A significant gap in this area is the role that daycares and preschools may play in helping to prevent anaphylaxis and death. <h3>Method</h3> The LEARN Early Project partnered with 17 Head-Start centers to investigate barriers they face in managing food allergies. Individual needs assessments were performed as well as food allergy knowledge tests. The results of these were then discussed in focus groups to identify potential areas for improvement as well as solutions. <h3>Results</h3> Significant variability exists in the structure of each Head Start center which presents implementation dilemmas. Additionally, there is no standardization of epinephrine training or food allergy training. In general, educators tended to over-estimate their food allergy knowledge as well as their capability of managing food allergy emergencies in comparison to that of center directors. Finally, despite some legislation appearing to support policies surrounding food allergy, such as stock epinephrine, early childcare centers are sometimes considered exceptions to these policies. <h3>Conclusion</h3> Identifying barriers that early learning centers face in providing for children with food allergies is critical in ensuring equitable, and safe care. These barriers are likely distinct for each center, but general themes were identified. It is likely that these needs will continue to evolve, and it is important to continue to reassess these needs to ensure we are implementing appropriate solutions.

Out-of-hospital health care costs of childhood food allergy in Australia: A population-based longitudinal study.

Australia has one of the highest prevalence of childhood food allergy in the world, but there are no data on its economic burden in Australia. We used data from the HealthNuts study, a population-based longitudinal study undertaken in Melbourne, Australia. Infants were recruited at age 12 months between Sept 2007 and Aug 2011 with food allergy diagnosed using oral food challenges. Health care costs of out-of-hospital services were collected through data linkage to Australia's universal health insurance scheme Medicare. Two-part model was used to compare costs after controlling for potential confounders. 2919 children were included, and 390 (13.4%) had challenge-confirmed food allergy at age 1year. Compared with children without food allergy, children with food allergy had significantly higher costs for GP visits, specialist visits, tests, and prescriptions in the first four years of life. The total Medicare cost associated with food allergy from age 1 to 4 years was estimated to be AUD$889.7 (95% CI $566.1-$1188.3) or €411.0 (95% CI €261.5-€549.0) per child. This was projected into an annual Medicare cost of AUD$26.1 million (95% CI $20.1-$32.3 million) or €12.1 (95% CI €9.3-€14.9 million) based on population size in 2020. Childhood food allergy causes considerable Medicare costs for out-of-hospital services in the first four years after birth in Australia. These findings can help anticipate the financial impact on the health care system associated with childhood food allergy, act as a useful costing resource for future evaluations, and inform management of childhood food allergy internationally.

DIAGNOSIS AND MANAGEMENT OF FOOD ALLERGIC PATIENTS ACROSS SEVERITY AND ALLERGENS: A NATIONWIDE US SURVEY

<h3>Introduction</h3> Food allergies affect millions of Americans and may result in life-threatening outcomes. In this study we aimed to understand food allergy diagnosis and management patterns of US Allergists. <h3>Methods</h3> In November 2021, a nationwide survey was emailed to US-practicing allergists (N=2850) to determine their diagnosis and management patterns. Providers were screened to ensure management of at least 1 food-allergic patient per month, with >25% of patients representing a pediatric population. <h3>Results</h3> The survey was completed by 125 allergists; the majority of allergists (81%) were community practitioners who saw an average of 74 food-allergic patients per month, of which 58% were pediatric. Allergists' top priorities for managing patients included preventing serious allergic reactions and maximizing patients' quality of life. Only 40% of allergists rate the severity of food allergies in their patients: main factors to determine disease severity were the severity/type of symptoms, history of requiring intervention (epinephrine), and number of organ systems involved in the reaction following exposure. Less important factors were skin prick test wheal size, presence of comorbid allergic diseases, and impact on quality of life. <h3>Conclusion</h3> Among US-based allergists that manage food-allergic patients, preventing serious allergic reactions was a top priority. Less than half of allergists categorize food allergy severity, and reaction severity weighs predominantly in how the overall disease severity is characterized. Further research on the impact of how definitions of food allergy disease severity impact shared decision making is warranted.

EXPLORING PARENTAL INTEREST IN IDENTIFYING THE ELICITING DOSE OF PEANUT FOR THEIR PEANUT ALLERGIC CHILD

<h3>Introduction</h3> The eliciting dose (ED) of a food allergen, or minimum dose at which a patient is likely to react, is increasingly being used to inform precautionary allergen labeling (PAL), assess individual risk, and improve management of food allergies. However, conducting a low-dose oral food challenge to determine a patient's ED is not commonly done as part of the diagnostic work-up. Limited literature exists on parental desire to know their food-allergic child's ED. <h3>Methods</h3> We performed a prospective survey of parents with peanut-allergic children to determine their interest in performing a single-dose 10mg peanut challenge and explore variables that may be related to their interest. <h3>Results</h3> Parents of 51 peanut-allergic children were surveyed to date. Demographics of children are as follows: 62% male, 59% African American, median age of 7 years, 73% were insured by Medicaid, and 76% reported other food allergies. 69% reported avoiding foods with PAL for peanut allergy. Of all respondents, 69% reported interest in performing a one-time 10mg challenge to peanut (understanding peanut content in products with PAL likely contain less than 1mg of peanut). No variable correlated with interest in performing the challenge. <h3>Conclusion</h3> In this study to date, the majority of parents express interest in performing a low-dose challenge to peanut. Further research is needed to explore this area as it may have an impact on anxiety, social limitations, and desire to pursue therapy if parents know their child is at low risk of reaction to accidental ingestion of small amounts of peanut.

Management of IgE-mediated food allergy in the 21st century.

The 21st century has seen the propulsion of research in the field of food allergy, which has driven real changes in the clinical approach. Allergen immunotherapy has been recommended for the active management of food allergy. Data have shown promising additional methods of treatment, including biologics. Efforts have been devoted to the risk stratification of food allergy and the standardization of the assessment of food-allergic severity. Alternative routes of administration of epinephrine are under investigation to minimize any mechanical issue and the fear of injections. Evidence-based guidelines have been published by the main international societies in the field of anaphylaxis and food allergy management and new updates are in preparation. In the coming years, treatment options that are currently in pre-clinical or early clinical evaluation will hopefully lead to safe and effective disease-modifying therapies for food allergy in clinical practice. The identification of reliable biomarkers and the standardization of definitions and measurement approaches, alongside a shared decision-making with patients and families, will be key for the development of personalized care and to help minimize the substantial burden of food allergy.

Achieving Racial Representation in Food Allergy Research: A Modified Delphi Study

The overrepresentation of White participants in food allergy research contributes to the development of research questions and interventions not driven by those disproportionately affected by the condition. This ultimately limits the generalizability of research findings and affects the development of knowledge about food allergy and food allergy management. To develop recommendations to combat inequitable research paradigms and increase participation of racially underrepresented populations in food allergy research. This study used a modified consensus development method, known as a Delphi method, to assemble the expertise of food allergy clinicians, advocacy leaders, community-engaged researchers, and patients. Findings resulted in 18 recommendations within four domains: community partnership, intentional engagement and messaging, recruitment activities, and dissemination. Findings from this study provide food allergy researchers with specific recommendations for examining their efforts more critically toward recruiting and engaging with racially underrepresented populations, effectively transitioning from a research-on to a research-with relationship with individuals and families living with food allergy.

Children's Perspectives on Food Allergy in Schools: A Qualitative Study.

Approximately 7% of children live with food allergy, a condition that requires dietary avoidance to prevent an allergic reaction. In this qualitative study, we aimed to understand food allergy-related experiences, beliefs and learning preferences among children with and without food allergies, to inform a school-based, food allergy education program. Data were analysed thematically. We virtually interviewed children in Kindergarten-Grade 8 in Manitoba, Canada, with (n = 7) and without (n = 9) parent-reported, physician-diagnosed food allergies. We identified three themes: Naive reliance on peers and school staff to assist with food allergy management; Limited food allergy knowledge; and, Recommended food allergy curricula: complementary perspective. Our findings will help inform the development of a school-based, food allergy education program, with a long-term goal of minimizing food allergy-related worries and optimizing safety for children with food allergy. Ongoing, school-based food allergy education is needed.

Application of Trisootra Principles in the Management of Acute Food Allergy - A Case Report

Food allergies are thought to affect up to 4% of adults and 8% of children under the age of five. Although there is no treatment, some kids outgrow their food allergies as they age. Foods can be contaminated by a wide range of diseasecausing microbes, leading to a wide range of foodborne illnesses (also known as foodborne sickness or food poisoning) and food allergies. An immune system response called a food allergy happens quickly after consuming a certain meal. Even a small amount of the food that causes the allergy can result in signs and symptoms like skin issues, hives, or enlarged airways. Some people may experience severe symptoms from a food allergy, including the potentially fatal anaphylactic reaction. In Ayurveda , rules for intake of food, preparation and sign and symptoms of visha misritha anna and their treatments are well explained. Proper history taking is an essential method in all these cases. In present case a 19-year male patient with the chief complaints of, severe itching and appearance of rashes over the neck, back ,arms and chest region of the body after ingesting food hence diagnosed as an acute food allergy have shown encouraging results when treated with Trisutra principles.

Information needs of patients considering oral immunotherapy for food allergy.

While the historic management of food allergy includes avoidance strategies and allergic reaction treatment, oral immunotherapy (OIT) approaches have become more commonly integrated into therapeutic approaches. International guidelines, phase 3 trials and real-world experience have supported the implementation of this procedure. However, OIT is an elective, rarely curative procedure with inherent risks that necessitates an increased degree of health literacy for the patients and families. Families assume the responsibility of amateur healthcare providers to ensure the daily safe administration of the allergenic food. As such, it is incumbent upon physicians to ensure that families are prepared for this role. A thorough educational and shared decision-making approach is necessary during the counselling and consent process to adequately inform the families. Educated discussion about the efficacy and patient-centred effectiveness, therapeutic alternatives and family goals is required to align physician and patient expectations. A frank discussion about the struggles, practical challenges, risks and contraindications can help to develop an understanding of the risk mitigation strategies employed to maintain safety. Physicians should develop a proactive approach to educate families about this, at times, burdensome procedure. This educational approach should encourage ongoing support starting prior to consent through the maintenance visits. By preparing families for their unique management role, physicians can help ensure the safe and successful integration of OIT into the therapeutic offering for the management of food allergies.

A qualitative study of food choice behaviors among college students with food allergies in the US

PurposeThis study explored how food allergies have affected food-related behaviors and quality of life of college students with food allergies and identified factors influencing food choice decisions among this group of individuals.Design/methodology/approachOne-on-one interviews were conducted with 26 college students with self-reported or clinically diagnosed food allergies, recruited from two universities located in the southern region of the United States. The participants were asked a series of questions based on a semi-structured discussion guide. Each interview lasted about 30 min; all interviews were audio-recorded and transcribed verbatim. The transcriptions were coded independently by three researchers, and themes were identified.FindingsFood allergies affected the participants' food-related behaviors, including eating, food preparation and shopping, as well as some aspects of their quality of life. Individual factors, such as mood, other diseases, cultural background and sensory properties, also influenced food choices. Friends and families were the two most important social influencers of food choices. Regarding physical environmental factors, cost, convenience, value and variety were considered important in selecting food. However, the participants' food choices were less influenced by food advertisements and social media. Additionally, experiences and complex cuisines were also key factors in making food choices.Research limitations/implicationsTheoretically, this qualitative study applied a food choice decision framework in the context of college students with food allergies. Practical recommendations are provided, particularly to campus dining facilities, to fulfill the needs of college students with food allergies.Originality/valueThis study advanced the understanding of the complexity of food choice decision-making among college students with food allergies. A path diagram specific to food choice among college students with food allergies was developed based on the results of this study. This study also highlighted that food allergy management would involve various behavioral changes and revealed that the food choices are influenced by a wide range of factors.

Investigating self‐reported food allergy prevalence in Waterloo Region, Canada

While food allergy prevalence has been studied at the national level, we know little of food allergy prevalence or perceptions of prevalence/management at the local level. This paper uses Waterloo Region as a case study to 1) document self‐reported individual and household food allergy and sensitivity prevalence at the local level; 2) investigate perceptions of food allergy prevalence; and 3) explore perceived confidence in anaphylaxis management. Survey data were collected from January to March 2019. Respondents (n = 500) self‐reported individual and household food allergy and sensitivity, estimated the percentage of Canadians with food allergy, and were queried about their knowledge of food allergy management. Prevalence estimates were weighted to the structure of the 2016 Canadian Census, and univariate and bivariate analysis were conducted. Prevalence of self‐reported food allergy was 12.1% (95%CI, 8.8%‐15.3%), and prevalence of self‐reported food sensitivity was 26.3% (95%CI, 21.9%‐30.7%). When asked to estimate the percentage of Canadians with food allergy, the mean perceived percentage was 35.1% (SD = 22.96). Self‐reported prevalence of food allergy appears higher in Waterloo Region, and the estimated percentage of Canadians with food allergy is inflated. Understanding prevalence and perceptions at the local level is important for targeted allocation of public health resources to ensure safe spaces for individuals with food allergy.

Managing food allergies in children and young people

Suneeta Kochhar looks at how nurses can diagnose and manage these increasingly common allergies

The Development of Age-Based Food Allergy Educational Handouts for Caregivers and Patients: A Work Group Report of the AAAAI Adverse Reactions to Foods Committee

Food allergy education is an ongoing process that must address unique safety concerns and psychosocial challenges at each developmental stage. Families require reliable information that is targeted to specific developmental stages to support the integration of food allergy management into daily life. The purpose of this project was to develop age-specific, evidence-based patient education handouts with practical recommendations for managing and coping with food allergies at different developmental stages. Handout content was based on: (1) practice guidelines for food allergy management; (2) literature addressing psychosocial and educational needs of patients with food allergy and their caregivers; and (3) clinical experience of the project team. Fifty-seven caregivers of patients (aged 0-21 years) with food allergy and 2 young adults with food allergy reviewed a draft of the handouts and completed an online survey to assess handout acceptability and usability and identify areas for improvement. Handouts were revised based on participant feedback. The majority of participants (79%) rated the amount of information in the age-specific handouts as "just right," versus "not enough" (9%) or "too much" information (12%). Sixty-three percent reported that they would be "very likely" to use the handouts as a resource and 35% "somewhat likely." Almost all participants (88%-100% by item) agreed that the handouts used elements of plain language writing and clear communication. Caregivers rated the age-based food allergy education handouts as understandable and useful. We anticipate that these handouts could be used during health care visits and directly accessed online by families.

IL-4 receptor alpha signaling alters oral food challenge and immunotherapy outcomes in mice

Food allergy diagnosis and management causes a number of social and emotional challenges for individuals with food allergies and their caregivers. This has led to increased interest in developing approaches to accurately predict food allergy diagnosis, severity of food allergic reactions, and treatment outcomes. However, the utility of these approaches is somewhat conflicting. We sought to develop and utilize a murine model that mimics the disease course of food allergy diagnosis and treatment in humans and to identify biomarkers that predict reactivity during food challenge (FC) and responsiveness during oral immunotherapy (OIT) and how these outcomes are modified by genetics. Skin-sensitized intestinal IL-9 transgenic (IL9Tg) and IL9Tg mice backcrossed onto the IL-4RαY709F background received a single intragastric exposure of egg antigen (ovalbumin), underwent oral FC and OIT; food allergy severity, mast cell activation, and ovalbumin-specific IgE levels were examined to determine the predictability of these outcomes in determining reactivity and treatment outcomes. Subcutaneous sensitization and a single intragastric allergen challenge of egg antigen to BALB/c IL9Tg mice and Il4raY709F IL9Tg induced a food allergic reaction. Enhanced IL-4Rα signaling altered the symptoms induced by the first oral exposure, decreased the cumulative antigen dose, increased the severity of reaction during oral FC, and altered the frequency of adverse events and OIT outcomes. Biomarkers after first oral exposure indicated that only the severity of the initial reaction significantly correlated with cumulative dose of oral FC. Collectively, these data indicate that single nucleotide polymorphisms in IL-4Rα can alter clinical symptoms of food allergic reactions, severity, and reactive dose during FC and OIT, and that severity of first reaction can predict the likelihood of reaction during FC in mice with IL-4Rα gain of function.

Changes in food-related costs during the COVID-19 pandemic among families managing food allergy.

BackgroundThe COVID-19 pandemic has affected the supply, cost, and demand for certain foods, but it is not clear how these changes have affected food-allergic households.ObjectiveTo describe the changes in food-related costs that have followed COVID-19, as reported by higher- and lower-income households with a food-allergic member.MethodsBetween May 1-June 30, 2020, Canadian households, with at least one food-allergic member, completed an online survey on food shopping and preparation habits before and during the COVID-19 pandemic. The sample was divided into binary groups, either higher or lower than the sample median income. Data were analyzed using descriptive statistics and multiple regression.ResultsThe sample was comprised of 102 participants (i.e., 51/ income group). The three most common food allergies amongst both groups were peanuts, tree nuts and milk. Since the start of the pandemic, both groups reported greater monthly direct grocery costs, although costs amongst the higher-income group were twice as high as the lower-income group ($212.86 vs. $98.89, respectively). Indirect food preparation costs were similarly elevated. Higher-income households with food procurement difficulties reported increased indirect shopping costs following the outbreak of COVID-19, whereas those without such difficulties reported decreased costs. Lower-income households with allergies to milk, wheat, or eggs (i.e., staple allergy) experienced a larger change in indirect food preparation costs following the outbreak of COVID-19 relative to those with other food allergies ($244.58 vs. –$20.28, respectively; p = 0.03).ConclusionBoth higher and lower income households with food allergy reported greater direct food costs and indirect food preparation costs following the COVID-19. Households with staple allergy and those with difficulties finding their typical food items were particularly affected.

Understanding, Preventing and Managing Food Allergy in Preschool Children

This 3-part series will discuss food allergy prevention in preschool children through early nutrition and eczema management. In Part 1, the prevalence of food allergy along with factors contributing to its rise and its impact on quality of life are presented. Part 2 in this series will examine the topic of food allergy prevention through early infant nutrition and early management of eczema. Finally, in Part 3, we will focus on adverse food reactions in children, symptoms of immunoglobulin E (IgE)-mediated food allergy in preschool children, food-specific IgE testing and management of food allergy.