Parent-reported Food Allergy Research Articles

Parent-reported offering of allergen foods to infants during complementary feeding: An observational study of New Zealand infants

The prevalence of food allergies in New Zealand infants is uncertain but is believed to be similar to Australia, exceeding 10%. Current recommendations for reducing food allergy risk are to offer all major food allergens to infants from as early as six months of age (start of complementary feeding), and before 12 months of age. However, little is known regarding parental practices around introducing major food allergens. This study aimed to explore parental offering of major food allergens to infants during complementary feeding, and parent-reported food allergies. The cross-sectional study is a secondary analysis of the multi-centre (Auckland and Dunedin) First Foods New Zealand study of 625 parent-infant dyads. Participants were recruited in 2020–2022 when infants were 7–10 months of age. Questionnaires assessed sociodemographic characteristics, complementary feeding approach, infant pouch use and parental responses to five food allergy questions. All major food allergens had been offered to only 17% of infants by 9–10 months of age. Having offered egg, peanut, tree nuts, sesame, soy and seafood was more commonly associated with using a baby-led complementary feeding approach than a parent-led approach (p < 0.001). Frequent baby food pouch use was associated with a lower likelihood of offering egg and peanut (both p < 0.001). Overall, 12.6% of infants had a reported food allergy, with symptomatic response after exposure being the most common diagnostic tool. Most infants are not offered all major food allergens during early complementary feeding, with some parents actively avoiding major food allergens in the first year of life. These results provide up-to-date knowledge of parental practices, highlighting the need for more targeted advice and strategies to improve parental engagement with allergy prevention and diagnosis.

Prevalence of Parent-Reported Food Allergies Among Children in Saudi Arabia.

(1) Background: Food allergy (FA) is an immune-mediated hypersensitivity to foods, significantly contributing to childhood morbidity and mortality. This study aimed to assess the prevalence, characteristics, and influencing factors of parent-reported FAs among children in Saudi Arabia. (2) Methods: This cross-sectional study utilized a validated parental questionnaire distributed across all regions of Saudi Arabia. Data from 2130 participants were collected and analyzed using SPSS v. 26 and Prism software v. 10.3.0. (3) Results: Parent-reported FA prevalence was 15.2%. Egg was the most common allergen (6.2%), followed by tree nuts (4.1%), peanuts (4.0%), milk (3.8%), and sesame (3.2%). Significant geographical variations were observed, with the western region having the highest burden (p < 0.001). Older children had higher rates of shellfish and fish allergies. Parental allergies and co-existing asthma/drug allergies were positively associated with childhood FAs. (4) Conclusions: This study highlights a substantial burden of parent-reported FAs in Saudi Arabia, with regional variations in food allergen distribution. Parental allergies and co-existing allergic conditions may influence FA risk.

Risk factors of food sensitization in young children with atopic dermatitis.

Atopic dermatitis (AD) is a common chronic and relapsing skin disease in children and food allergies have been well documented in one-third of children. However, there are limit data about the risk factors of food sensitization in children with AD. The aim of this study was to evaluate the risk factors associated with food sensitization, among AD children. A cross-sectional study, from the electronic medical records of 119 AD patients, aged from 2 to 5 years were reviewed. The demographic data, onset and severity of AD, family history of atopy, age of first antibiotic usage, age of first applying and frequency of moisturizer used, age of introduction to allergenic foods and food specific IgE levels were recorded. The prevalence of food sensitization was; 60%. The most common food allergens were egg white (56.8%), cow's milk (40%) and wheat (34.7%). The significant factors associated with overall food sensitization were; history of parent-reported food allergies (OR = 4.4, P = 0.001), severe AD (OR = 4.5, P = 0.03) and breast feeding > 6 months (OR = 3.5, P = 0.002). Factors associated with egg white allergies were the history of parent-reported food allergies (OR = 3.8, P = 0.02), and severe AD (OR = 4.2, P = 0.04). There were also significant factors associated with cow's milk allergies this being; severe AD (OR = 6, P = 0.03) and a maternal history of asthma (OR = 10.9, P = 0.01). Severe AD was a factor associated with all food sensitization, egg allergy and cow's milk allergy. Maternal asthma was also significantly associated with cow's milk allergy.

Prevalence of Parent-Reported Food Allergy in a Mexican Pre-School Population.

The magnitude and relevance of food allergies in the preschool population remain unknown in most regions of Mexico and Latin America. Thus, our aim was to estimate the parent-reported prevalence of food allergies in a Mexican preschool population and to characterize their clinical diagnosis and presentation. A cross-sectional survey was conducted in Culiacán City. A validated questionnaire was utilized. A total of 810 parents responded to the questionnaire (valid response rate, 40.7%). The estimated prevalence rates (95% CI) were: "physician-diagnosed Food Allergy (FA), ever" 5.30% (3.86-7.08); "immediate-type FA, ever" 2.96% (1.91-4.38); "immediate-type FA, current" 1.60% (0.86-2.73); and food-dependent anaphylaxis 1.11% (0.51-2.01). The main food allergens were milk (0.49%), strawberries (0.37%), egg, and soy (0.25% each). Atopic diseases and a family history of allergies were significantly associated with immediate-type FA. Among "immediate-type FA, current" cases, 76.9% required emergency room visits, but the prescription of epinephrine autoinjectors was reported in one case only. The food reactions occurred at home (92.35%), in a relative's house (38.5), and at restaurants (23%). Immediate-type FA reactions requiring emergency room visits are not uncommon among the studied population. Actions like proper anaphylaxis management and the prevention of cross-contamination of foods should be encouraged.

Racial, Ethnic, and Socioeconomic Differences in Food Allergies in the US

Food allergies affect approximately 8% of children and 11% of adults in the US. Racial differences in food allergy outcomes have previously been explored among Black and White children, but little is known about the distribution of food allergies across other racial, ethnic, and socioeconomic subpopulations. To estimate the national distribution of food allergies across racial, ethnic, and socioeconomic groups in the US. In this cross-sectional survey study, conducted from October 9, 2015, to September 18, 2016, a population-based survey was administered online and via telephone. A US nationally representative sample was surveyed. Participants were recruited using both probability- and nonprobability-based survey panels. Statistical analysis was performed from September 1, 2022, through April 10, 2023. Demographic and food allergy-related participant characteristics. Stringent symptom criteria were developed to distinguish respondents with a "convincing" food allergy from those with similar symptom presentations (ie, food intolerance or oral allergy syndrome), with or without physician diagnosis. The prevalence of food allergies and their clinical outcomes, such as emergency department visits, epinephrine autoinjector use, and severe reactions, were measured across race (Asian, Black, White, and >1 race or other race), ethnicity (Hispanic and non-Hispanic), and household income. Complex survey-weighted proportions were used to estimate prevalence rates. The survey was administered to 51 819 households comprising 78 851 individuals (40 443 adults and parents of 38 408 children; 51.1% women [95% CI, 50.5%-51.6%]; mean [SD] age of adults, 46.8 [24.0] years; mean [SD] age of children, 8.7 [5.2] years): 3.7% Asian individuals, 12.0% Black individuals, 17.4% Hispanic individuals, 62.2% White individuals, and 4.7% individuals of more than 1 race or other race. Non-Hispanic White individuals across all ages had the lowest rate of self-reported or parent-reported food allergies (9.5% [95% CI, 9.2%-9.9%]) compared with Asian (10.5% [95% CI, 9.1%-12.0%]), Hispanic (10.6% [95% CI, 9.7%-11.5%]), and non-Hispanic Black (10.6% [95% CI, 9.8%-11.5%]) individuals. The prevalence of common food allergens varied by race and ethnicity. Non-Hispanic Black individuals were most likely to report allergies to multiple foods (50.6% [95% CI, 46.1%-55.1%]). Asian and non-Hispanic White individuals had the lowest rates of severe food allergy reactions (Asian individuals, 46.9% [95% CI, 39.8%-54.1%] and non-Hispanic White individuals, 47.8% [95% CI, 45.9%-49.7%]) compared with individuals of other races and ethnicities. The prevalence of self-reported or parent-reported food allergies was lowest within households earning more than $150 000 per year (8.3% [95% CI, 7.4%-9.2%]). This survey study of a US nationally representative sample suggests that the prevalence of food allergies was highest among Asian, Hispanic, and non-Hispanic Black individuals compared with non-Hispanic White individuals in the US. Further assessment of socioeconomic factors and corresponding environmental exposures may better explain the causes of food allergy and inform targeted management and interventions to reduce the burden of food allergies and disparities in outcomes.

Food Allergy in Preschoolers: Parents' Perception and Self-Reported Prevalence.

Food allergy is a potentially fatal condition (in the case of anaphylaxis, for example) and is characterized by an increasing prevalence. The main purpose of this study is to identify preschool children with parent-reported food allergies and characterize this population and type of allergy. This is a cross-sectional study, based on questionnaires to parents/legal guardians. All children who attend daycare or preschool in an area of the city of Porto, Portugal, were included. A total of 740 questionnaires were distributed to nine schools, and responses were obtained from 363 (49.1%). Self-reported food reaction and/or allergy was related in 11.2% of children. The median age of the first reaction was 12 months and the most registered foods were milk, dry seed, and peanut. Cutaneous (48.7%) and gastrointestinal (35.9%) symptoms were the main manifestations. History of parents' and siblings' food allergies had statistically significant associations with food reactions and/or allergies of the child, with OR 3.05 (p=0.04, 95% CI 1.01-8.81) and OR 8.69 (p<0.01, 95% CI 2.11-35.79), respectively. Besides that, children's atopic dermatitis also had a statistically significant association with self-reported food reactions and/or allergies, with OR 2.30 (p<0.05, 95% CI 1.01-5.21). Food reactions and/or allergies were reported in 11.2% of children. The history of parents' and siblings' food allergies and children's atopic dermatitis had statistically significant associations with food reactions and/or allergies, which shows that it may be an important factor to consider.

Prevalence of Parent-Reported Food Allergies and Associated Risk Predictors Among Children in Saudi Arabia.

The worldwide prevalence of food allergies has been increasing recently. Due to limited data on food allergy (FA) in Saudi Arabia, this study was conducted to estimate the prevalence and risk factors of parent-reported food allergies and clinical manifestations in children in Taif, Saudi Arabia. A cross-sectional questionnaire-based observational study was conducted from July 2019 to December 2020. A total of 508 parents of school children (aged five to eight years) responded to the questions based on the child's health and food allergies. FA (16.1%) was observed as the most common type of allergy among children. The prevalence of other atopic diseases was estimated at 30.5%. The most common allergy-causing foods were eggs (4.9%), peanuts (2.7%), and sesame (2.5%). Rash, itching without rash, and vomiting were the most common FA symptoms. The presence of childhood eczema (p< 0.0001), allergic rhinitis (p= 0.005), and the father's history of allergy (p= 0.005) were all significant and independent predictors/risk factors for FA among the studied children. We noted substantial parents' concern with food allergies among children in Saudi Arabia, which necessitates the establishment of effective diagnosis and treatment strategies and primary prevention initiatives.

Clinical characteristics and influencing factors of children with parent-reported food allergy

Objective: To analyze the clinical characteristics and influencing factors of children with parent-reported food allergy (FA), thus providing empirical evidence for facilitating the effective utilization of medical history information and promoting better health education for parents. Methods: A cross-sectional study was conducted, recruiting all 596 children under 3 years of age who underwent physical examinations from July to August 2019 at the Department of Child Health Care, Children's Hospital of Chongqing Medical University. Children were carried out with questionnaires, skin prick test, and diagnosed with FA through oral food challenge (OFC) by pediatricians. The parent-reported incidence rate, symptoms of FA, and the possible influencing factors, including demographic characteristics, family history of allergy, in-utero exposure to smoke and antibiotic use, feeding methods after birth, and residential environment were collected by questionnaire. The differences of clinical characteristics between parent-reported FA and medically diagnosed FA were analyzed by chi-square test. Logistic regression was used to analyze the factors associated with parent-reported FA. Results: A total of 596 children (316 boys and 280 girls) were recruited for this study. The incidence rate of FA by parent-report (22.0%, 131/596) was higher than that by medical diagnosis (9.9%, 59/596) (χ²=32.46, P<0.001). There were 36.6% (48/131) of children with parent-reported FA and 2.4% (11/465) of children without parent-reported FA receiving medical diagnosis of FA. Among children with parent-reported allergic symptoms, 37.5% (24/64) of those with gastrointestinal symptoms and 31.5% (23/73) of those with skin symptoms received medical diagnosis of FA, respectively. Six out of 7 children with co-presenting cutaneous and gastrointestinal symptoms were diagnosed with FA. Univariate Logistic regression analysis showed that family history of allergy (OR=1.83 (95%CI 1.22-2.73), P=0.003) and damp living environments (OR=2.33 (95%CI 1.13-4.79), P=0.022) were associated with higher likelihood of parent-reported FA. Conclusions: The incidence rate of parent-reported FA is higher than medically diagnosed FA. Clinicians should be highly suspicious of the possibility of FA in children with both cutaneous and gastrointestinal symptoms. Family history of allergy and damp living environments may increase the possibility of parent-reported FA.

Exploration of parent-reported food allergy symptoms via breastmilk exposures and likelihood to develop tolerance

BackgroundKnowledge is limited about the relationship between clinical reactivity to foods through breastfeeding and long-term food allergy outcomes. We explored parent-perceived symptoms of food allergy via breastfeeding and the association with future tolerance.MethodsSubjects identified from the Chicago Food Allergy Study (2005–2011) were categorized by parent-reported reactions to maternally ingested foods via breastfeeding (50/898 peanut-allergic, 69/620 egg-allergic, and 153/589 milk-allergic). The primary outcome was tolerance [passed oral food challenge (OFC) or consumption of previously implicated food]. Secondary outcomes included severe reactions (anaphylaxis and/or cardiovascular/respiratory symptoms) and additional concomitant food allergies. Univariate chi-square analyses were performed to assess for association between variables, followed by logistic regression models.ResultsOf the 50 subjects with parent-reported peanut-associated symptoms with breastfeeding, none gained tolerance. There were no significant associations between parent-reported breastfeeding symptoms and development of tolerance for egg and milk (egg: OR 0.46, 95% CI 0.21–1.01, p = 0.053; milk: OR 1.13, 95% CI 0.70–1.81, p = 0.614). All egg-allergic subjects with parent-perceived symptoms while breastfeeding also reported multiple food allergies (n = 69), but milk- and peanut-allergic subjects were not more likely to have multiple allergies (milk: OR 1.89, 95% CI 0.88–4.02, p = 0.10; peanut: OR 2.36, 95% CI 0.72–7.76, p = 0.16). There were no significant associations between parent-reported breastfeeding symptoms and subsequent reaction severity.ConclusionsA significant proportion of parents perceive symptoms of food allergy attributable to indirect breastfeeding exposures. Our exploratory analysis suggests that infants with parent-perceived clinical reactivity to peanut via breastmilk may be less likely to gain tolerance. Infants with parent-reported reactivity to egg via breastmilk exposure were more likely to report multiple food allergies. Further rigorous prospective studies are needed to clarify the true prevalence of IgE-mediated food allergy symptoms attributable to indirect breastfeeding exposures and the association with development of tolerance.

The prevalence and temporal trends of food allergy among preschool children in Northern Thailand between 2010 and 2019

BackgroundAlthough recent studies suggest that the prevalence of food allergy (FA) has not changed, the data from developing countries are limited. This study aimed to investigate time trends in the prevalence of FA among preschool children in 2010 and 2019 in Northern Thailand. MethodsTwo cross-sectional studies were performed, 9 years apart (2010 and 2019), using the same methods, in children aged 3–7 years living in Chiang Mai, Thailand. Parent-reporting questionnaire surveys were conducted. Families with children reporting FA were invited to undergo further investigations with skin prick testing, serum specific IgE, and oral food challenge (OFC). The prevalence of parent-reported FA, food sensitization, and OFC-confirmed FA were compared between the 2 periods. ResultsA total of 1013 out of 1146 questionnaires (452/546 in 2010 and 561/600 in 2019) were returned. The response rate was 88.4%. The prevalence of parent-reported food allergy in 2019 was significantly lower than that in 2010 (5.5% vs 9.3%; p = 0.02). However, there was no significant change in the prevalence of OFC-confirmed FA (0.9% vs 1.1%; p = 0.75). Three leading causative foods of parent-reported FA were cow's milk, shrimp, and eggs. Shrimp was still the most common OFC-confirmed food allergen. Atopic dermatitis was the most significantly parent reported factor associated with FA. ConclusionThe overall prevalence of FA among preschool children in Northern Thailand had not increased during the past decade. There was no significant difference in the prevalence of OFC-confirmed FA between 2010 and 2019.

Contribution to the estimation of the prevalence of food allergy in schoolchildren in the city of Guelma (Algeria)

GoalThe prevalence of food allergy has never been estimated in the city of Guelma (east Algeria). The goal in this work was to determine parent-reported prevalence of food allergy in a population of schoolchildren (5 to 13 years old). MethodsCross-sectional, random, questionnaire based survey was performed from 15th to 29th April 2018 among primary schools of Guelma. Six hundreds questionnaires were distributed in 8 schools of the city. ResultsThe return rate was 88% (528). Forty-five subjects were retained as having probable food allergy at a prevalence of 8.5% (95% CI 6.1–10.8). In total, 49% were boys and 51% girls with no significant difference (P=0.429). The average age of appearance of the potential allergy was 4.41±2.51 years. Among allergic children, 26.7% were aged from 5–7 years old, 64.4% had 8–10 years old and 8.9% had 11–13 years old. The main foods reported by the parents were: chocolate (1.7%), wheat (1.3%), milk (1.1%), eggs (1.1%), strawberry (1.1%), fish and beans (0.9%). The prevalence of the three symptoms according to the observations of the parents were cutaneous (68.6%), digestive (19.6%) and respiratory (11.8%). Among the allergic subjects, 66.6% had at least one of their parents atopic (P=0.0001). ConclusionThe prevalence of parent-reported food allergy in schoolchildren was assessed for the first time in the city of Guelma. It showed a prevalence of 8.5% with no significant difference between the boys and the girls. The main risk factor in the appearance of food allergy was the presence of family history with this pathology.

The Public Health Impact of Parent-Reported Childhood Food Allergies in the United States

This study on a nationally representative sample of US households with children expands on the results of an earlier study from 2009 to 2010 by the same group that comprehensively describes the current public health impact of childhood food allergy.In total, surveys were completed by 51 819 US households. Half (51.1%) of the population-weighted sample was male, with 52.8% white, 24.1% Hispanic, 13.2% African American, and 3.2% Asian American. The majority of children were >5 years of age (68% were 6–17 years). Approximately 16% came from homes with annual incomes <$25 000, and 10% came from homes making >$150 000.The survey added additional questions to the core 2009 to 2010 survey to assess emerging research issues relating to the etiology and management of food allergy and was tested on 345 pilot interviewees. Study participants were recruited first through NORC at the University of Chicago’s probability-based AmeriSpeak Panel, and then participation was expanded by using Survey Sampling International. The survey was administered in English or Spanish via telephone or the Internet. The primary outcome measure was the prevalence of overall and food-specific convincing childhood food allergy. Parent-reported food allergies were considered convincing if the most severe reaction reported to that food included at least 1 symptom on the stringent symptom list developed by an expert panel: hives, swelling (lip and/or tongue or other), difficulty swallowing, throat tightening, chest tightening, trouble breathing, wheezing, vomiting, chest pain, rapid heartbeat, fainting, and low blood pressure. A reaction was considered severe if at least 2 symptoms were reported from 2 different body systems. Isolated itchy mouth or throat after ingestion of associated foods (nuts, seafood, grains, seeds, spice, fruit, vegetable) were considered indicative of oral allergy syndrome and were not considered convincing food allergies.The estimated prevalence of convincing childhood food allergy was 7.6%, although 11.4% of children’s caregivers reported a current food allergy before stringent symptom criteria were used to filter out those lacking a convincing history of food allergy. Food-specific rates included peanut (2.2%), milk (1.9%), shellfish (1.3%), tree nut (1.2%), egg (0.9%), fin fish (0.6%), and sesame (0.2%), with 40% of children reporting multiple food allergies. Among children with convincing food allergy, 42.3% reported severe reactions, which were more common in children with allergy to peanut (59.2%), tree nut (56.1%), and shellfish (48.7%). However, only 40.7% of children with convincing food allergy reported a current prescription for an epinephrine autoinjector. Having multiple food allergies, a current epinephrine prescription, a history of 1 or more lifetime food allergy–related emergency department visits, or comorbid asthma was also significantly associated with increased odds of a severe allergic reaction. Non-Hispanic African American children were at significantly elevated risk of having a convincing food allergy relative to non-Hispanic white children (odds ratio: 1.4 [95% confidence interval: 1.1–1.7]). Rates of other physician-diagnosed atopic conditions were significantly higher (P < .05) among children with convincing food allergy compared with all other children in the study.Food allergy is a major public health concern, affecting ∼8% of US children or 5.6 million children. In addition to the top 8 food allergens recognized by the US Food and Drug Administration, sesame is the ninth most common food allergy and affects ∼150 000 US children. All foods have the potential to cause severe reactions; however, currently only 40% of children with convincing food allergies have an epinephrine autoinjector.This study confirms the epidemiology of childhood food allergy previously reported; however, by eliminating children with symptoms isolated to the mouth or the gastrointestinal tract only (other than vomiting) (especially if they have a history of physician diagnosis of food allergy), the rates may be underestimated. The PRACTALL guidelines offer a standardized scoring system for allergic reactions in the context of oral food challenges and could be adapted as a survey tool. Of note, these guidelines include gastrointestinal or subjective symptoms that last longer than 40 minutes or recur consistently after 3 exposures as indicative of a convincing allergic reaction. Because the National Institutes of Health guidelines changed in 2017 to recommend early, rather than delayed, introduction of peanut into an infant’s diet, this study will serve as an important baseline to which prevalence rates may be compared.

Parent-reported prevalence of food allergies in children with autism spectrum disorder: National health interview survey, 2011-2015.

Food allergies are frequently reported to co-occur with autism spectrum disorder (ASD), but the prevalence of this co-occurrence remains uncertain. In the present study, we examined parent-reported prevalence of co-occurring food allergy and ASD in a nationally representative sample of US children ages 2-17 in the National Health Interview Survey, study years 2011-2015. All analyses used survey weights to account for the complex sampling design. In the analytic sample of 53,365 children ages 2-17, there were 905 children with parent-reported ASD (prevalence of 1.7%) and 2,977 children with parent-reported food allergy (prevalence of 5.6%). Parent-reported food allergies were nearly 2.5 times more common in children with ASD (prevalence of 13.1%) than in children without ASD (5.4%). These results indicate that food allergies commonly co-occur with ASD, which may have etiological implications. Autism Research 2019, 12: 802-805. © 2019 International Society for Autism Research, Wiley Periodicals, Inc. LAY SUMMARY: Food allergies are frequently reported to occur with autism spectrum disorder (ASD), but the prevalence of this co-occurrence remains uncertain. In the present study, we examined parent-reported prevalence of co-occurring food allergy and ASD in a nationally representative sample of United States children. In the sample of 53,365 children ages 2-17, 1.7% of children were reported to have ASD, and 5.6% were reported to have food allergies. Parent-reported food allergies were nearly 2.5 times more common in children with ASD (13.1%) than in children without ASD (5.4%).

Asian children living in Australia have a different profile of allergy and anaphylaxis than Australian-born children: A State-wide survey.

Asian children born in Australia have higher rates of eczema and nut allergy than non-Asian children. However, it is not known whether this country of birth differential exists for other allergies or anaphylaxis risk. We investigated the influence of maternal and child's country of birth on the prevalence of parent-reported eczema, asthma, food allergy and being diagnosed by a doctor as being "at risk of anaphylaxis." We assessed the relationship between mother and child country of birth and allergies using the 2010 School Entrant Health Questionnaire, completed for 57005 5-year old children (85.8% response rate) in Victoria, Australia. Analyses were conducted using logistic regression with results presented as odds ratios (OR) with 95% confidence intervals (CIs). Children born in Australia to Asian-born mothers were more likely to have parent-reported food allergy (OR 2.33, 95%CI 1.96-2.77) and eczema (OR 2.04, 95%CI 1.73-2.41), but not more likely to have asthma (OR 0.87, 95% CI 0.74-1.02) than non-Asian children. By contrast, children born in Asia who subsequently migrated to Australia had a lower risk of food allergy (OR 0.33, 95%CI 0.20-0.55), eczema (OR 0.37, 95%CI 0.24-0.57) and asthma (OR 0.29, 95% CI 0.21-0.40). Patterns of anaphylaxis risk differed depending on the trigger. Compared with Australian-born non-Asian children, Australian-born Asian children were more likely to be diagnosed as being at risk of both food-induced and non-food-induced anaphylaxis. For children born in Asia, risk was lower for anaphylaxis to milk, peanut and tree nuts compared to non-Asian children, but higher for soy, wheat and non-food triggers. Patterns of allergy/anaphylaxis risk and their triggers differed according to both ethnicity and country of birth, suggesting a gene-environment factor is in play. The difference in patterns for asthma compared with other atopic diseases is surprising and warrants further exploration.

National allergy programme had little impact on parent-reported food allergies in children aged 6-7 years.

The ten-year Finnish national allergy programme was launched in 2008 to lessen the disease and psychological burden of allergy. This study assessed the prevalence of parent-reported food allergies requiring avoidance diets at primary school in children aged six and seven years. The cohort comprised 1937 children (51% boys) who started primary school in Tampere, Finland, in August 2016. School health nurses charted parent-reported, doctor-diagnosed food allergies requiring avoidance diets as part of the routine health examination. We found that 127 (6.6%) children had parent-reported, doctor-diagnosed allergies to at least one food and 37 (1.9%) were allergic to basic foods, namely cows' milk, wheat and one other grain. All required an avoidance diet. The figure did not differ significantly from the 2.7% and 2.5% found by studies of this age group in 2009 and 2013, respectively. Allergies to fresh fruit and vegetables decreased from 5.8% in 2009 to 3.6% in 2016. We studied the national allergy programme that started in 2008 and found that there was a nonsignificant overall decrease in the number of children aged six to seven years on avoidance diets for allergies between 2009 and 2016. The only allergies that showed significant decreases were fresh fruit and vegetables.

Quality of life among caregivers and growth in children with parent-reported food allergy.

Some caregivers who believe their children have food allergy avoid feeding certain foods to their children without proper allergy tests. Such actions made without a proper diagnosis can negatively impact the child's health and impose an unnecessary burden on the caregivers. This study aimed to evaluate the caregiver quality of life (QoL) and growth in children with a parent-reported food allergy. An observational cross-sectional study was performed in 200 children younger than five years who had a parent-reported food allergy. The caregivers' QoL was evaluated by two questionnaires: the Food Allergy Quality of Life -Parental Burden and the Scale of Psychosocial Factors in Food Allergy. Growth of the children was evaluated by their weight-for-age and length/height-for-age percentiles. Among the caregivers, 50% expressed worry that their children might be allergic to some foods and 30% were concerned about leaving their children in the care of others. According to the QoL scores, caregivers whose children underwent an oral food challenge (OFC) test were significantly less stressed, while caregivers whose children had multiple food allergies and had experienced at least one anaphylactic reaction were significantly more stressed. The distributions of both weight-for-age and length/height-for-age percentiles were 50th comparable to the general population. Parent-reported food allergy could put caregivers under high stress, but the OFC test could reduce stress among anxious, over-parenting caregivers. Parent-reported food allergy had no impact on a child's growth in our study.

Prevalence and Characteristics of Parent-Reported Food Allergies Among Young Asian Children

Prevalence and Characteristics of Parent-Reported Food Allergies Among Young Asian Children

Impact of Parent-Reported Food Allergies on Children's Growth and Quality of Life of the Caregivers

Impact of Parent-Reported Food Allergies on Children's Growth and Quality of Life of the Caregivers

Stability of parent-reported food allergy in six and 7-year-old children: the first 5 years of the Finnish allergy programme.

The Finnish national allergy programme was introduced in 2008 to decrease the burden of allergy in the population. This study, carried out in 2013, evaluated the prevalence of parent-reported food allergies, treated with an avoidance diet until early school age, and discussed the rates in relation to those found in an identical study in 2009. School health nurses used a structured questionnaire to interview the parents of 1653 children aged of six or seven in the first year of elementary school. The criterion for a parent-reported food allergy was that the parents considered it necessary for their child to follow an avoidance diet at school. In 2013, 6.1% of the children were allergic to at least one food and 2.5% of the children were allergic to basic foods, such as cows' milk, eggs and wheat, compared with 2.7% in 2009. A significant decrease was seen in allergies to nuts, fruits and vegetables. Parent-reported allergies to basic foods, such as cow's milk, eggs and wheat, remained rather stable in first graders of elementary schools during the first 5 years of the Finnish national allergy programme, but allergies to nuts, fruits and vegetables decreased.

Access to health care and food in children with food allergy

Access to health care and food in children with food allergy