Risk Of Food Allergy Research Articles

Maternal vitamin D supplementation and its impact on allergy.

To the Editor, With great interest, we read the recent article by Gur et al. (1), “The effect of place of residence and lifestyle on vitamin D deficiency in pregnancy: Comparison of eastern and western parts of Turkey”. The authors discussed the prevalence and the predictive factors of vitamin D deficiency in pregnancy and the compliance with “The National Vitamin D Support Program” in Turkey’s easternmost and westernmost provinces. They found that clothing style, seaside holiday duration, consuming fish, living in high-altitude cold regions, and 1200 IU/day vitamin D supplementation affected vitamin D levels. They also showed that vitamin D deficiency in pregnancy is high in Turkey. They recommended increasing compliance with “The National Vitamin D Support Program” at the follow-up of all pregnant women. Vitamin D supplementation in early life is recommended to prevent vitamin D deficiency in many countries, raising important questions about the safety and benefit for immune development and the implications for allergic risk. The impact of vitamin D deficiency on the risk of developing an allergy and a child’s immune status in childhood has been controversial and lacking. We want to mention that vitamin D supplementation during pregnancy may promote the evolution of allergic diseases in offspring during childhood. In recent studies, vitamin D was found to be positively associated with the risk for the development of allergic diseases in children during their first 2 years of life. Weisse et al. demonstrated that in pregnancy and at birth, higher levels of vitamin D may contribute to a higher risk for allergic outcomes. A questionnaire was answered by parents during pregnancy and yearly thereafter about children’s atopic findings in the first 2 years of life. They also found a positive association between maternal and cord blood vitamin D concentrations with children’s risk for food allergy within the first years of life (2). In a prospective study, 596 pregnant women’s vitamin D concentrations were evaluated in pregnancy, and their children were followed about allergic diseases and growth parameters. An association was not found between maternal vitamin D level and the child’s anthropometric data or intelligence. Children whose mothers had a higher concentration of vitamin D had an increased risk of atopic dermatitis and asthma compared to children whose mothers had a lower concentration of vitamin D (3). Rothers et al. (4) found that those with cord blood vitamin D ≥100 nmol/L, when compared to children with cord vitamin D 50–74.9 nmol/L, had a greater risk of a positive response to a skin prick test. They also reported a non-linear relationship between cord vitamin D and IgE (allergen-specific and total).The highest levels of IgE were identified in children with a cord vitamin D concentration <50 nmol/L and ≥100 nmol/L. Increased risk of aeroallergen sensitization and elevated total IgE levels are associated with both low and high levels of vitamin D in cord blood. Nielsen et al. (5) reported that postpartum depression is associated with high levels of 25(OH)D3. They speculated that 24-hydroxylase is the main determinant of this situation. High levels of 25(OH)D3 stimulate the 24-hydroxylase enzyme, which degrades the active form of vitamin D, 1,25(OH)2D3, to the inactive 1,24,25-trihydroxyvitamin D3 metabolite. This results in low concentrations of intracellular 1,25(OH)2D3. So, they propose that either a low level of 25(OH)D3 or high level of 25(OH)D3 cause a low level of 1.25(OH)2D and subsequent insufficient stimulation of vitamin D receptors. Although the data to support this are still limited and heterogeneous, according to data, especially large doses of vitamin D supplementation during pregnancy should be used carefully. We hope that the items mentioned above will add to the value of the well-written article of Gur et al. (1) regarding vitamin D deficiency in pregnancy.

Breastfeeding for the prevention of overweight and obesity in children and teenagers; systematic review

Breastfeeding is a recommended practice from national and international institutions due to the health benefits that it provides, both for the nursling and for the mother. Nowadays, overweight and obesity result in greater morbidity along different life periods. The goal of this systematic review is to explore the characteristics of breastfeeding in the prevention of overweight and obesity during childhood. A systematic search has been carried out and 113 papers have been selected: 20 meta-analysis and reviews, 6 original papers of clinical trials, 42 cohort or longitudinal studies, 19 correlational studies, 24 descriptive studies and 2 books. According to the analysed papers, there is a causal relationship between breastfeeding and the prevention of childhood obesity. In the various studies explored, it has been observed that the maximum benefits of breastfeeding are obtained when its duration is longer than 6 months and when it extends for two years, complemented with other foodstuffs. Other studies show that breastfeeding is effective in obesity prevention, even when its duration is limited. It is also important that complementary foods are introduced after the first six months of age, so as to reduce food allergy risk and to prevent obesity. Similarly, the weight of the mother during pregnancy has been associated with childhood obesity, as well as the weight of the child when he was born and other factors like maternal smoking and socioeconomic status.

Role of Maternal Elimination Diets and Human Milk IgA in the Development of Cow's Milk Allergy in the Infants.

KM Jarvinen, JE Westfall, MS Seppo. Clin Exp Allergy. 2014;44(1):69–78 The goal of this study was to evaluate the association of maternal cow’s milk (CM) avoidance during breastfeeding with specific IgA levels in human milk and the development of CM allergy in infants. This prospective birth cohort study evaluated 145 mother–infant pairs who were recruited at birth and followed up prospectively at 0 to 2 weeks and at 1, 3, 6, 12, and 18 months to determine development of food allergy in the infants. Infants were all term and classified into 2 groups: high risk because of sibling(s) with food allergy and low risk, defined as having only nonatopic first-degree relatives. …

Effects of Egg White Consumption on Allergy, Immune Modulation, and Blood Cholesterol Levels in BALB/c Mice.

We previously demonstrated that water-soluble egg yolk extract is not related to elevation of serum immunoglobulin E, which can initiate allergic reactions; however, it increases the level of high density lipoprotein (HDL)-cholesterol and the activity of B lymphocytes. In this study, egg white (EW) was fed to BALB/c mice to determine its influence on growth efficiency, immune modulation, and changes in serum lipid levels. A total of 50 five-wk-old BALB/c male mice were divided into 5 groups, 4 of which were fed 0, 10, 50, or 100 mg/d EW for 4 wk. Mice with an uptake of 10, 50 and 100 mg/d EW showed no significant changes in daily weight gain, feed efficiency rate, or populations of white blood cells. However, the activities of both B and T lymphocytes were significantly increased in all three EW groups at the final week of treatment. Interestingly, serum levels immunoglobulin E were not altered by EW consumption, but the IgG level was significantly increased in the 100 mg/d EW group. Serum lipid profile analyses showed no significant changes in total cholesterol, HDL, low density lipoprotein, or triglyceride levels by EW consumption. Taken together, these data demonstrate that consumption of EW promotes immune cell activities and the upregulation of serum IgG levels. However, we found no changes in serum lipid profiles and IgE levels. Therefore, our study suggests that consumption of EW might not be related to the risk of food allergy, but could be an excellent candidate for the maintenance of physiological homeostasis.

Risk factors for the development of atopic dermatitis and early wheeze.

A global assessment of allergic diseases and prenatal and postnatal exposure to various environmental risk factors is needed to enable early prevention of allergic diseases. This study was designed to evaluate an inner-city urban birth cohort to identify early environmental factors associated with atopic dermatitis and food allergy, as well as the incidence of wheezing during the 1st year of life. We evaluated 501 children from the Polish Mother and Child Cohort Study (2007-2011). The children's health, socioeconomic status, and housing conditions were assessed using a questionnaire. Exposure to tobacco was assessed based on questionnaire data and cotinine measurements. Multiple regression analysis showed that parental atopy, higher paternal education, and more frequent house cleaning significantly predicted atopic dermatitis in the 1st year of life; odds ratio (OR) for the variables was 2.7 (95% CI, 1.3-1.57), 2.8 (95% CI, 1.5-5.0), and 1.8 (95% CI, 1.1-2.9), respectively. Keeping a pet at home during pregnancy increased the risk of food allergy (OR, 1.48; 95% CI, 1.02-2.16). Longer breast-feeding decreased the risk of both food allergy (OR, 0.88; 95% CI, 0.82-0.95) and atopic dermatitis (OR, 0.9; 95% CI, 0.8-0.95) in the 1st year of life. Positive association between maternal exposure to increased concentrations of particulate matter 10 and atopic dermatitis in univariate analyses was found. Atopic dermatitis/food allergy and wheezing/inhaled corticosteroid use had distinct risk factors. The risk factor profile of atopic dermatitis/food allergy in early childhood that is defined in this study support the following recommendations: (i) longer breast-feeding, (ii) avoid pets during gestation, (iii) avoid too frequent house cleaning, and (iv) living in an area with decreased traffic density. This study was a part of the clinical trial NCT01861548 registered in www.clinicaltrials.gov.

Exploring Perceptions and Experiences of Food Allergy among New Canadians from Asia.

Introduction. In Canada, perceived prevalence of food allergy surpasses systematic estimates. Canadian immigrants have been found more likely to rate the risk of food allergy as “high” compared to nonimmigrants. Methods. Qualitative interviews were conducted with 3 key informants and 18 allergic individuals of East and Southeast Asian descent in order to capture their lived experience with food allergies. Results. Participants found food allergies to be more common in Canada than in Asia. Participants also agreed that having a food allergy is more manageable in Canada as a result of the policy environment (e.g., food labelling and school policies). In addition, participants had dealt with skepticism and disbelief about their food allergy in Asia, resulting in social exclusion and impacting quality of life. Discussion. Findings demonstrate the need to recognize the varied impacts and experiences of food allergy among new Canadians, given that immigrants represent a large and growing proportion of the Canadian population.

Early Introduction of Foods for Food Allergy Prevention

The identification of food allergy prevention strategies has become an important public health issue given the increase in hospital presentations for food allergic reactions in young children. In particular, there has been an increasing interest in whether the timing of introduction of solids (particularly allergenic solids such as egg and peanuts) plays a role in development of early-onset food allergy. To date, research in the area has primarily been limited to observational birth cohort studies, which have generated data to suggest that delayed introduction of allergenic solids may actually increase rather than decrease the risk of food allergy. However, findings from these studies must be viewed with caution since it is difficult to eliminate the potential for confounding factors to generate spurious associations between infant feeding choices and food allergy risk. The emergence of a number of in progress randomised trials of early introduction of allergenic foods is likely to contribute significantly to understanding of this area as results come to light. This review discusses the current evidence for a role of early introduction of foods in the prevention of food allergy, including emerging results from the first clinical trials, and discusses the implications of these findings for population guidelines and for further research.

Active or Passive Exposure to Tobacco Smoking and Allergic Rhinitis, Allergic Dermatitis, and Food Allergy in Adults and Children: A Systematic Review and Meta-Analysis

Allergic rhinitis, allergic dermatitis, and food allergy are extremely common diseases, especially among children, and are frequently associated to each other and to asthma. Smoking is a potential risk factor for these conditions, but so far, results from individual studies have been conflicting. The objective of this study was to examine the evidence for an association between active smoking (AS) or passive exposure to secondhand smoke and allergic conditions. We retrieved studies published in any language up to June 30th, 2013 by systematically searching Medline, Embase, the five regional bibliographic databases of the World Health Organization, and ISI-Proceedings databases, by manually examining the references of the original articles and reviews retrieved, and by establishing personal contact with clinical researchers. We included cohort, case-control, and cross-sectional studies reporting odds ratio (OR) or relative risk (RR) estimates and confidence intervals of smoking and allergic conditions, first among the general population and then among children. We retrieved 97 studies on allergic rhinitis, 91 on allergic dermatitis, and eight on food allergy published in 139 different articles. When all studies were analyzed together (showing random effects model results and pooled ORs expressed as RR), allergic rhinitis was not associated with active smoking (pooled RR, 1.02 [95% CI 0.92-1.15]), but was associated with passive smoking (pooled RR 1.10 [95% CI 1.06-1.15]). Allergic dermatitis was associated with both active (pooled RR, 1.21 [95% CI 1.14-1.29]) and passive smoking (pooled RR, 1.07 [95% CI 1.03-1.12]). In children and adolescent, allergic rhinitis was associated with active (pooled RR, 1.40 (95% CI 1.24-1.59) and passive smoking (pooled RR, 1.09 [95% CI 1.04-1.14]). Allergic dermatitis was associated with active (pooled RR, 1.36 [95% CI 1.17-1.46]) and passive smoking (pooled RR, 1.06 [95% CI 1.01-1.11]). Food allergy was associated with SHS (1.43 [1.12-1.83]) when cohort studies only were examined, but not when all studies were combined. The findings are limited by the potential for confounding and bias given that most of the individual studies used a cross-sectional design. Furthermore, the studies showed a high degree of heterogeneity and the exposure and outcome measures were assessed by self-report, which may increase the potential for misclassification. We observed very modest associations between smoking and some allergic diseases among adults. Among children and adolescents, both active and passive exposure to SHS were associated with a modest increased risk for allergic diseases, and passive smoking was associated with an increased risk for food allergy. Additional studies with detailed measurement of exposure and better case definition are needed to further explore the role of smoking in allergic diseases.

Prospective Study of Peripregnancy Consumption of Peanuts or Tree Nuts by Mothers and the Risk of Peanut or Tree Nut Allergy in Their Offspring

The etiology of the increasing childhood prevalence of peanut or tree nut (P/TN) allergy is unknown. To examine the association between peripregnancy consumption of P/TN by mothers and the risk of P/TN allergy in their offspring. Prospective cohort study. The 10,907 participants in the Growing Up Today Study 2, born between January 1, 1990, and December 31, 1994, are the offspring of women who previously reported their diet during, or shortly before or after, their pregnancy with this child as part of the ongoing Nurses' Health Study II. In 2006, the offspring reported physician-diagnosed food allergy. Mothers were asked to confirm the diagnosis and to provide available medical records and allergy test results. Two board-certified pediatricians, including a board-certified allergist/immunologist, independently reviewed each potential case and assigned a confirmation code (eg, likely food allergy) to each case. Unadjusted and multivariable logistic regression analyses were used to evaluate associations between peripregnancy consumption of P/TN by mothers and incident P/TN allergy in their offspring. Peripregnancy consumption of P/TN. Physician-diagnosed P/TN allergy in offspring. Among 8205 children, we identified 308 cases of food allergy (any food), including 140 cases of P/TN allergy. The incidence of P/TN allergy in the offspring was significantly lower among children of the 8059 nonallergic mothers who consumed more P/TN in their peripregnancy diet (≥ 5 times vs <1 time per month: odds ratio = 0.31; 95% CI, 0.13-0.75; P(trend) = .004). By contrast, a nonsignificant positive association was observed between maternal peripregnancy P/TN consumption and risk of P/TN allergy in the offspring of 146 P/TN-allergic mothers (P(trend) = .12). The interaction between maternal peripregnancy P/TN consumption and maternal P/TN allergy status was statistically significant (P(interaction) = .004). Among mothers without P/TN allergy, higher peripregnancy consumption of P/TN was associated with lower risk of P/TN allergy in their offspring. Our study supports the hypothesis that early allergen exposure increases tolerance and lowers risk of childhood food allergy.

Increased food allergy and vitamin D: Randomized, double‐blind, placebo‐controlled trial

To elucidate whether maternal vitamin D supplementation during lactation improves infantile eczema and other subsequent allergic disorders, a randomized, double-blind, placebo-controlled trial was performed. Mothers (n = 164) of infants with facial eczema at 1 month check-up were randomly assigned to receive vitamin D3 supplements (n = 82; 800 IU/day) or placebo (n = 82) for 6 weeks from May 2009 to January 2011. The primary outcome was infantile eczema quantified on Scoring Atopic Dermatitis (SCORAD) index at 3 month check-up, and the secondary outcomes were atopic dermatitis, food allergy, and wheeze diagnosed by doctors up to 2 years of age. There was no significant difference in SCORAD at 3 month check-up between the two groups. Doctor-diagnosed food allergy was significantly more common up to age 2 years in the vitamin D group (10/39, 25.7%) than in the placebo group (3/40, 7.5%; risk ratio (RR), 3.42; 95% confidence interval [CI]: 1.02-11.77; P = 0.030). Moreover, at least one secondary outcome was also significantly more common in the vitamin D group (17/39, 43.6%) than in the placebo group (7/40, 17.5%; RR, 2.49; 95%CI: 1.16-5.34; P = 0.012). Vitamin D supplementation may not decrease the severity of infantile eczema at 3 months of age, but may rather increase the risk of later food allergy up to 2 years of age. Because a large number of subjects was lost to follow up, further study is needed to confirm the findings.

Orofecal Infections and Risk Of Food Allergy In Children

Orofecal Infections and Risk Of Food Allergy In Children

Świadomość kobiet w zakresie żywności powodującej alergię u niemowląt i małych dzieci

The subject of this study was issues related to the food that causes allergies in infants and young children. The study gathered information on the awareness of mothers and future mothers on the risk of food allergies and knowledge of major products that cause allergies in infants and young children. A hundred correctly completed questionnaires were analysed, allowing the authors to determine the level of knowledge the women possessed on this subject. They also concluded that there was a range of ability, depending on the age of the respondents, to recognise early symptoms of allergy, the predisposition to inherit allergies and the duration of an allergy. There was no correlation between knowledge and the place of residence or the level of educational of either present or future mothers.

Пищевая аллергия. Рекомендации по введению прикорма пациентам с пищевой аллергией и детям из группы риска: что и когда?

научный биометрический журнал, который знакомит читателя с клиническими рекомендациями и особенностями применения лекарственных и вакцинных средств у детей, предоставляет исчерпывающую информацию о воздействии лекарственных средств на плод, о проводимых в

Prevalence of Food Allergy and the Sensitization Rates of Food Allergens in School-Aged Children in Jeju

Objectives : This study is to survey school-aged children's prevalence of food allergy and to investigate sensitization rates to common food allergens. Methods : The self-administered questionnaire survey and skin prick tests with 12 food allergens were applied to school children in Jeju, Korea. From 3 elementary schools, 1,189 children were enrolled with informed consent. Results : The lifetime prevalence of self-reported food allergy were 10.5%. The period prevalence of self-reported food allergy(last 12 months), the lifetime prevalence of clinician-diagnosed food allergy and the period prevalence of clinician-treated food allergy(last 12 months) were 4.8%, 5.8% and 2.6%, respectively. The sensitization rate to one or more food allergens was 3.7%. Male(4.8%) showed more sensitized than female (2.5%)(p=0.043). Shrimps(1.1%), egg white(0.6%), mussels(0.5%), yolk(0.4%) and milk(0.4%) were commonly sensitized food allergens. The commonly associated allergens in the lifetime prevalence of food allergy include egg white, yolk, tuna, chicken and soybeans. The multivariate analysis revealed that the allergens most significantly related with the lifetime prevalence of food allergy were eggs, showing the risk of food allergy was 10.53 times higher in the cases with sensitization to egg. Conclusion : Compared to those in other regions, the school-aged children in Jeju show no difference in the prevalence of food allergy, but, with a gradual increase in frequency. Among the food allergens, egg is one of the most commonly sensitizing allergen as well as cause of food allergy. Serial epidemiological investigations and customized educational programs concerning food allergy are necessary at school.

Maternal fish and shellfish consumption and wheeze, eczema and food allergy at age two: a prospective cohort study in Brittany, France

BackgroundEnvironmental exposures, including dietary contaminants, may influence the developing immune system. This study assesses the association between maternal pre-parturition consumption of seafood and wheeze, eczema, and food allergy in preschool children. Fish and shellfish were studied separately as they differ according to their levels of omega-3 polyunsaturated fatty acids (which have anti-allergic properties) and their levels of contaminants.MethodsThe PELAGIE cohort included 3421 women recruited at the beginning of pregnancy. Maternal fish and shellfish intake was measured at inclusion by a food frequency questionnaire. Wheeze, eczema, and food allergy were evaluated by a questionnaire completed by the mother when the child was 2 years old (n = 1500). Examination of the associations between seafood intake and outcomes took major confounders into account. Complementary sensitivity analyses with multiple imputation enabled us to handle missing data, due mostly to attrition.ResultsModerate maternal pre-parturition fish intake (1 to 4 times a month) was, at borderline significance, associated with a lower risk of wheeze (adjusted OR = 0.69 (0.45-1.05)) before age 2, compared with low intake (< once/month). This result was not, however, consistent: after multiple imputation, the adjusted OR was 0.86 (0.63-1.17). Shellfish intake at least once a month was associated with a higher risk of food allergy before age 2 (adjusted OR = 1.62 (1.11-2.37)) compared to low or no intake (< once/month). Multiple imputation confirmed this association (adjusted OR = 1.52 (1.05-2.21)).ConclusionsThis study suggests that maternal pre-parturition shellfish consumption may increase the risk of food allergy. Further large-scale epidemiologic studies are needed to corroborate these results, identify the contaminants or components of shellfish responsible for the effects observed, determine the persistence of the associations seen at age 2, and investigate potential associations with health effects observable at later ages, such as allergic asthma.

The Potential Link between Gut Microbiota and IgE-Mediated Food Allergy in Early Life

There has been a dramatic rise in the prevalence of IgE-mediated food allergy over recent decades, particularly among infants and young children. The cause of this increase is unknown but one putative factor is a change in the composition, richness and balance of the microbiota that colonize the human gut during early infancy. The coevolution of the human gastrointestinal tract and commensal microbiota has resulted in a symbiotic relationship in which gut microbiota play a vital role in early life immune development and function, as well as maintenance of gut wall epithelial integrity. Since IgE mediated food allergy is associated with immune dysregulation and impaired gut epithelial integrity there is substantial interest in the potential link between gut microbiota and food allergy. Although the exact link between gut microbiota and food allergy is yet to be established in humans, recent experimental evidence suggests that specific patterns of gut microbiota colonization may influence the risk and manifestations of food allergy. An understanding of the relationship between gut microbiota and food allergy has the potential to inform both the prevention and treatment of food allergy. In this paper we review the theory and evidence linking gut microbiota and IgE-mediated food allergy in early life. We then consider the implications and challenges for future research, including the techniques of measuring and analyzing gut microbiota, and the types of studies required to advance knowledge in the field.

Food Allergy

Food allergy has established itself as a matter of significant public health importance and relevance. It has had substantial impacts across the world and continues to represent the most common cause of anaphylaxis seen in emergent settings. However, its increasing incidence has yielded a silver lining of increased interest and investment, which has powered major research in the field. Much has been learned about food allergy as a result. Recent work has elicited increased understanding about food allergy prevalence, mechanisms, and risk factors. In turn, this has allowed for application of this understanding to potential treatments. Current practice of food allergy treatment through restricted exposure may ultimately be replaced with novel therapies including, perhaps ironically, introduction of the allergenic foods in question. This review presents broad highlights of the rapidly increasing understanding into food allergy mechanisms and experimental therapies.

Biological Safety Assessment of Mutant Variant of Allium sativum Leaf Agglutinin (mASAL), a Novel Antifungal Protein for Future Transgenic Application

Genetic engineering has established itself to be an important tool for crop improvement. Despite the success, there is always a risk of food allergy induced by alien gene products. The present study assessed the biosafety of mutant Allium sativum leaf agglutinin (mASAL), a potent antifungal protein generated by site directed mutagenesis of Allium sativum leaf agglutinin (ASAL). mASAL was cloned in pET28a+ and expressed in E. coli, and the safety assessment was carried out according to the FAO/WHO guideline (2001). Bioinformatics analysis, pepsin digestion, and thermal stability assay showed the protein to be nonallergenic. Targeted sera screening revealed no significant IgE affinity of mASAL. Furthermore, mASAL sensitized Balb/c mice showed normal histopathology of lung and gut tissue. All results indicated the least possibility of mASAL being an allergen. Thus, mASAL appears to be a promising antifungal candidate protein suitable for agronomical biotechnology.

Overview of evidence in prevention and aetiology of food allergy: a review of systematic reviews.

The worldwide prevalence of food allergy appears to be increasing. Early life environmental factors are implicated in the aetiology of this global epidemic. The largest burden of disease is in early childhood, where research efforts aimed at prevention have been focused. Evidence synthesis from good quality systematic reviews is needed. We performed an overview of systematic reviews concerning the prevention and aetiology of food allergy, retrieving 14 systematic reviews, which covered three broad topics: formula (hydrolysed or soy) for the prevention of food allergy or food sensitization; maternal and infant diet and dietary supplements for the prevention of food allergy or food sensitization and hygiene hypothesis-related interventions. Using the AMSTAR criteria for assessment of methodological quality, we found five reviews to be of high quality, seven of medium quality and two of low quality. Overall we found no compelling evidence that any of the interventions that had been systematically reviewed were related to the risk of food allergy. Updating of existing reviews, and production of new systematic reviews, are needed in areas where evidence is emerging for interventions and environmental associations. Furthermore, additional primary studies, with greater numbers of participants and objective food allergy definitions are urgently required.

The Impact of Family History of Allergy on Risk of Food Allergy: A Population-Based Study of Infants

The apparent rapid increase in IgE-mediated food allergy and its implications are now widely recognized, but little is known about the relationship between family history (an indirect measure of genetic risk) and the risk of food allergy. In a population-based study of 5,276 one year old infants (HealthNuts), the prevalence of oral food challenge-confirmed food allergy was measured. Associations between family history of allergic disease and food allergy in infants were examined using multiple logistic regression. Food allergy was diagnosed in 534 infants. Compared to those with no family history of allergic disease, children meeting the current definition of “high risk” for allergic disease (one immediate family member with a history of any allergic disease) showed only a modest increase (OR 1.4, 95% CI 1.1–1.7) in food allergy, while having two or more allergic family members was more strongly predictive of food allergy in the child (OR 1.8, 95% CI 1.5–2.3). There were also differences in the associations between family history and egg and peanut allergy in the child. Re-defining “high risk” as two or more allergic family members may be more useful for identification of groups with a significantly increased risk of food allergy both clinically and within research studies.