Soy Allergy Research Articles

Gut microbiome features in pediatric food allergy: a scoping review.

Increasing evidence suggests that alterations in the gut microbiome (GM) play a pivotal role in the pathogenesis of pediatric food allergy (FA). This scoping review analyzes the current evidence on GM features associated with pediatric FAs and highlights the importance of the GM as a potential target of intervention for preventing and treating this common condition in the pediatric age. Following the Preferred Reporting Items for Systematic Reviews and Meta-Analysis guidelines, we searched PubMed and Embase using the keywords (gut microbiome OR dysbiosis OR gut microbiota OR microbiome signatures) AND (food allergy OR IgE-mediated food allergy OR food protein-induced allergic proctocolitis OR food protein-induced enterocolitis OR non-IgE food allergy OR cow milk allergy OR hen egg allergy OR peanut allergy OR fish allergy OR shellfish allergy OR tree nut allergy OR soy allergy OR wheat allergy OR rice allergy OR food sensitization). We included 34 studies reporting alterations in the GM in children affected by FA compared with healthy controls. The GM in pediatric FAs is characterized by a higher abundance of harmful microorganisms (e.g., Enterobacteriaceae, Clostridium sensu stricto, Ruminococcus gnavus, and Blautia spp.) and lower abundance of beneficial bacteria (e.g., Bifidobacteriaceae, Lactobacillaceae, some Bacteroides species). Moreover, we provide an overview of the mechanisms of action elicited by these bacterial species in regulating immune tolerance and of the main environmental factors that can modulate the composition and function of the GM in early life. Altogether, these data improve our knowledge of the pathogenesis of FA and can open the way to innovative diagnostic, preventive, and therapeutic strategies for managing these conditions.

Fortification of Pea and Potato Protein Isolates in Oat-Based Milk Alternatives; Effects on the Sensory and Volatile Profile.

Oat-based milk alternatives (OMAs) are an important alternative to bovine milk, with prevalence of lactose intolerance, as well as soy and nut allergies limiting consumers options. However, OMAs are typically lower in protein content than both bovine milk and soy-based alternatives, with protein quality limited by low lysine levels, which can reduce protein digestibility. Addition of alternative plant proteins may increase the quantity of protein, as well as balancing the amino acid profile. However, plant-based proteins have additional sensory qualities and off-flavours, which may lead to undesirable characteristics when introduced to OMAs. This study aimed to assess the effect of pea and potato protein addition on the sensory profile, volatile profile, colour, and particle size in an OMA control product. Results demonstrated that pea protein contributed to a bitter and metallic taste, astringent aftertaste, and a significantly increased overall aroma correlated with higher levels of key volatiles. Whilst potato protein resulted in less flavour changes, it did lead to increased powdery mouthfeel and mouthcoating supported by a substantially increased particle size. Both protein fortifications led to detectable colour changes and a staler flavour. Fortification of OMA product with the pea protein led to significant sensory, volatile and physical changes, whilst the potato protein led to predominantly physical changes. Further investigation into alternative plant-based proteins is necessary to optimise sensory qualities whilst increasing protein content and the amino acid profile.

Tolerance of Infants Fed a Hydrolyzed Rice Infant Formula with 2'-Fucosyllactose (2'-FL) Human Milk Oligosaccharide (HMO).

The purpose of this research was to assess the growth, tolerance, and compliance outcomes associated with the consumption of a hydrolyzed rice infant formula (HRF) enriched with 2'-Fucosyllactose (2'-FL) a Human Milk Oligosaccharide (HMO), and nucleotides in an intended population of infants. This was a non-randomized single-group, multicenter study. The study formula was a hypoallergenic HRF with 2'-FL, Docosahexaenoic acid (DHA), Arachidonic acid (ARA), and nucleotides. Infants 0-90 days of age who were formula fed and experiencing persistent feeding intolerance symptoms, symptoms of suspected food protein (milk and/or soy) allergy, or other conditions where an extensively hydrolyzed infant formula was deemed an appropriate feeding option were recruited by pediatricians from their local populations. The primary outcome was maintenance of weight-for-age z-score. Weight, length, head circumference, formula intake, tolerance measures, clinical symptoms and questionnaires were collected. Thirty-three infants were enrolled, and 27 completed the study, on study product. Weight-for-age z-scores of infants showed a statistically significant improvement from Visit 1 to Visit 4 (p = 0.0331). There was an adequate daily volume intake of 762 ± 28 mL/day, average daily number of stools of 2.1 ± 0.3, and mean rank stool consistency of 2.38 ± 0.18. After 28 days of switching to a HRF, 86.8 ± 5.9% of the symptoms resolved or got better by Visit 4 as reported by parents. HRF with 2'-FL HMO was safe, well tolerated, and supported weight gain in infants with suspected cow's milk allergy or persistent feeding intolerance.

Unveiling the potential of micronized dehulled sunflower press‐cake: a breakthrough in sustainable plant‐based protein‐rich sport beverages

SummaryIn the sports protein beverage market, the demand for plant‐based substitutes is rising. Sunflower press‐cake, a protein‐rich by‐product, offers a compelling alternative to traditional options like soy, pea, or rice proteins. With its natural allergen‐free composition, sunflower proteins are suitable for individuals with soy or nut allergies, broadening the market of allergen‐free protein products. This study focuses on the characterisation of micronized dehulled sunflower press‐cake (DSPC) and preliminary explores its valorization in a protein‐rich beverage. Micronization treatment was applied to the DSPC, since the reduction in particle size positively influences sensory attributes. The comprehensive analysis of micronized industrial DSPC revealed a high protein content (44.35 g/100 gDB), elevated polyphenol levels (33.75 mgGAE/gDB) and positive outcomes in water and oil holding capacities. However, proteins showed low in vitro digestibility (42.82%) and poor solubility (~10%). Additionally, the high phytate content (5.00 g/100 g) prompted consideration for nutritional implications, whether positive or negative. From the analysis of the volatile profile, the diverse array of compounds revealed the absence of off‐odours typically formed during autoxidation. In view of the potential application within a functional beverage formulation intended for athletes, four aqueous dispersions, featuring two different percentages of micronized DSPC (25% and 16% w/v) and pH levels (6.5 and 3.5), were prepared and tested for rheological properties.

Soybean, Gly m 4, and Birch Pollen Allergy

Several types of soy foods are consumed worldwide. Soybean products have shown some potential benefits for health, but soy allergy can cause life-threatening allergic reactions. Pollens of birch trees can be associated with food allergy-related disease such as pollen/food allergy syndrome.

Relationship between the diagnosis of food protein-induced enterocolitis syndrome and postemetic procalcitonin levels.

There are no reports on the relationship between food protein-induced enterocolitis syndrome (FPIES) diagnosis and procalcitonin levels. Our study sought to demonstrate a correlation between the presence or absence and severity of FPIES symptoms and postemetic procalcitonin levels. The subjects were 53 patients with FPIES (44 with hen's egg allergy, 4 with milk allergy, 4 with wheat allergy, and 3 with soy allergy), who collectively underwent a total of 75 oral food challenges (OFCs). Procalcitonin levels at 5 hours after antigen ingestion were compared between patients with a positive OFC result and those with a negative OFC result and between patients who experienced mild or moderate events and those who experienced severe events. At 5 hours after ingestion of the causative food, the median procalcitonin levels in patients with a negative OFC result, patients who experienced a mild or moderate event, and patients who experienced a severe event were 0.02, 0.03, and 0.16 ng/mL, respectively. The procalcitonin level was significantly higher in the groups with a positive OFC result than in the groups with a negative OFC result (P< .001), and it was significantly higher in those who experienced severe events than in those who experienced mild or moderate events (P= .012). Measurement of procalcitonin levels has the potential to provide a quantitative and objective assessment of FPIES diagnosis and severity.

Modulation of soy protein immunoreactivity by different matrix structures of lactic acid bacterium-induced soy protein gels: Epitope destruction during in vitro gastroduodenal digestion and absorption

Soy allergy is a common health problem. Food structure may change the gastroduodenal digestion and absorption of soy proteins, thus leading to the modulation of the immunoreactivity of soy proteins. In this study, lactic acid bacterium (LAB)-fermented soy protein isolates (FSPIs) were prepared at four concentrations (0.2 %–5.0 %, w/v) to present various matrix structures (nongel, NG; weak gel, WG; medium gel, MG; and firm gel, FG) and subjected to in vitro dynamic gastroduodenal digestion model. The results of sandwich enzyme-linked immunosorbent and human serum IgE binding capacity assays demonstrated that FSPI gels, especially the FSPI-MG/WG digestates obtained at the early and medium stages of duodenal digestion (D-5 and D-30), possessed greater potency in immunoreactivity reduction than FSPI-NG and reduced to 1.9 %–68.3 %. The transepithelial transport study revealed that the immunoreactivity of FSPI-MG/WG D-5 and D-30 digestates decreased through the stimulation of interferon-γ production and the induction of dominant Th1/Th2 differentiation. Peptidomics and bioinformatics analyses illustrated that compared with FSPI-NG, the FSPI-gel structure promoted the epitope degradation of the major allergens glycinin G2/G5, β-conglycinin α/β subunit, P34, lectin, trypsin inhibitor, and basic 7S globulin. Spatial structure analysis showed that FSPI-gel elicited an overall promotion in the degradation of allergen epitopes located in interior and exterior regions and was dominated by α-helix and β-sheet secondary structures, whereas FSPI-MG/WG promoted the degradation of epitopes located in the interior region of glycinin/β-conglycinin and exterior region of P34/basic 7S globulin. This study suggested that the FSPI-gel structure is a promising food matrix for decreasing the allergenic potential of allergenic epitopes during gastroduodenal digestion and provided basic information on the production of hypoallergenic soy products.

Natural course of IgE-mediated food allergy in children.

The prevalence of food allergy and food-induced anaphylaxis in children is increasing worldwide. Cow's milk, hen's eggs, and wheat allergies in young children have a more favorable prognosis with a relatively early outgrow, while allergies to peanuts, tree nuts, and seafood are more likely to be persistent. Although our understanding of the mechanism underlying the resolution of food allergy is incomplete, the roles of dendritic cells, regulatory T cells, and regulatory B cells are important. Many past studies on the natural course of food allergy were retrospective analyses of specific study groups, but large-scale population-based prospective studies are now being published. This review summarizes recent studies of the natural course of cow's milk, hen's eggs, wheat, peanuts, tree nuts, soy, sesame, and seafood allergies. The potential factors affecting the natural course of food allergy include symptom severity on ingestion, age at diagnosis, allergic comorbidities, skin prick test reaction size or serum food-specific immunoglobulin (Ig) E levels, changes in sensitization degree, IgE epitope specificity, ratio of food-specific IgE to IgG4, food-specific IgA levels, component-resolved diagnostic profile, diet, gut microbiome, and interventions such as immunotherapy. Since food allergy places a significant burden on patients and their caregivers in daily life, clinicians should be able to provide relevant knowledge on the natural course of food allergy, appropriately evaluate its resolution, and offer therapeutic options whenever possible.

Soy Gly m 8 sIgE Has Limited Value in the Diagnosis of Soy Allergy in Peanut Ara h 2-Sensitized Adults

Introduction: Recently, specific IgE (sIgE) sensitization against Gly m 8 (soy 2S albumin) has been described as a good diagnostic marker for soy allergy (SA). The aim of this study was to evaluate the diagnostic value of Gly m 8 by determining the sensitization profiles based on the homologues soy allergens Bet v 1, Ara h 1, Ara h 2, and Ara h 3. Methods: Thirty soy-allergic adults were included; sIgE to total soy extract, Gly m 8, Gly m 4, Gly m 5, Gly m 6, Bet v 1, Ara h 1, Ara h 2, and Ara h 3 were determined. Sensitization patterns were analyzed and determined. The clinical relevance of sIgE of Gly m 8 sensitization was measured by assessing its capacity to degranulate basophils in Gly m8-sensitized patients by an indirect basophil activation test (iBAT). Results: Based on the sIgE patterns of sensitization, two groups of SA patients were identified: (i) peanut-associated SA group (all patients were sensitized to one or more of the peanut compounds) and (ii) non-peanut/PR-10-associated SA group (22 patients were sensitized to Gly m 4 and Bet v 1 but not to any of the peanut compounds). A high and significant correlation between total soy extract and Gly m 6 (R2 = 0.97), Gly m 5 (R2 = 0.85), and Gly m 8 (R2 = 0.78) was observed. A nonsignificant correlation was observed between the levels of sIgE of Gly m 8 versus Ara h2. The iBAT results showed that Gly m 8 did not induce basophil degranulation in any of the peanut-associated patients, indicating that the Gly m8 sensitizations were not clinically relevant. Conclusions: Gly m 8 was not a major allergen in the selected soy-allergic population. The iBAT results indicated that Gly m 8 was not able to induce basophil degranulation in sIgE Gly m 8-sensitized soy-allergic patients. Thus, Gly m 8 would have no added value in the diagnosis of SA in the present study population.

Usefulness of Gly m 4‐specific IgE test in the diagnosis of Rosaceae fruit‐oral allergy syndrome caused by Betulaceae pollen sensitization

AbstractBackgroundPollen‐food allergy syndrome (PFAS) is caused by the cross‐reaction of the specific IgE to pollen allergens with similar allergens contained in fruits, vegetable, and nuts. The representative allergen responsible for this cross‐reaction is pathogenesis‐related protein (PR)‐10. Specific IgE test using Gly m 4, soybean PR‐10, is widely used to diagnose soy allergy. We aimed to investigate whether the Gly m 4‐specific IgE test is useful for predicting oral allergy symptoms (OAS) to Rosaceae fruits in PFAS caused by Betulaceae pollen sensitization.MethodsForty‐one patients with suspected PFAS were enrolled. Specific IgE levels were measured against alder pollen, apple, peach, pear, and Gly m 4, and correlation between test results and allergic symptoms was assessed to compare the accuracy of these allergen‐specific IgE tests.ResultsOf the 41 patients, 32 were positive for alder pollen‐specific IgE. Of those, 16 showed OAS to at least one of apple, peach, and pear (OAS (+) group), and the rest 16 cases showed no symptoms (OAS (−) group). The Gly m 4‐specific IgE value was significantly higher in the OAS (+) group (p = .014), and the highest in area under the receiver operating characteristics curve. The cut‐off value for detection of the OAS (+) group was 2.65 UA/ml, with a sensitivity of 62.5% and a specificity of 81.3%. Other allergen‐specific IgE values were not significantly different between the two groups.ConclusionsIn the subjects sensitized to Betulaceae pollen allergens, the Gly m 4‐specific IgE test is useful for predicting OAS of Rosaceae fruits.

Peanut, soy, and emerging legume allergy in Canada.

Individuals with 1 legume allergy may be cosensitized to other legumes and thus may potentially have other legume allergies as well. Although the use of emerging legumes (eg, pea, lentils, chickpeas) in commercial food production is increasingly common, the literature has largely focused on peanut and soy, both of which are priority allergens in Canada. We aimed to describe the distribution of priority and emerging legume allergies in Canada, with consideration for patient age. Cross-sectional survey data collected between 2019 and 2021 from families who follow food allergy-related social media platforms were queried for demographics, as well as for food allergy (including by type and number of foods and by age [0-5 vs ≥6 years]). Data were described and then analyzed by using logistic regression and adjusted for sex, age at diagnosis, and number of food allergies. Of the 115 participating children, the majority (64.6%) were boys. Nearly all of the children (109 of 115 [94.8%]) had peanut allergy, whereas soy and emerging legume allergies were reported by 15.7% and 13.0% of the children, respectively. Of these 115 children, 85 had mono-peanut allergy, 6 had mono-soy allergy, none had emerging legume allergy in the absence of peanut or soy, 12 had peanut and emerging legume allergy, 9 had peanut and soy allergy, and 3 had peanut, soy, and emerging legume allergy. Compared with children aged 0 to 5 years, children aged 6 years or older were significantly less likely tohave peanut plus soy or emerging legume allergy (odds ratio= 0.22 [95% CI= 0.05-0.94]; P= .04). Of the children with peanut allergy, a considerable number also had peanut allergy and soy allergy and/or another legume allergy. Younger children have higher odds of multiple legume allergy.

Successful recording of direct cortical motor-evoked potential from a pediatric patient under remimazolam anesthesia: a case report

BackgroundIntraoperative motor-evoked potential (MEP) monitoring reduces postoperative motor deficits. Propofol-based total intravenous anesthesia is the gold standard for intraoperative myogenic MEPs. Although there is no contraindication to administering propofol in adults with peanut, soy, or egg allergies, its safety in children with these allergies remains unclear.Case presentationA 12-year-old girl required general anesthesia under intraoperative direct cortical MEP (dc-MEP) monitoring due to supratentorial glioma. Remimazolam-based anesthesia was selected, instead of propofol, due to the patient’s egg hypersensitivity. Stable myogenic MEPs were recorded throughout the surgery with remimazolam at 0.9 mg/kg/h and remifentanil at 0.35 μg/kg/min, following adjustments of stimulation intensity and titration of remimazolam infusion. Neither intraoperative memory nor motor deficits were present after surgery.ConclusionsWe present a pediatric case whose dc-MEP was recorded under remimazolam anesthesia. The cardiovascular stability and avoidance of propofol infusion syndrome with remimazolam were superior to propofol.

Utility of the Basophil Activation Test Using Gly m 4, Gly m 5 and Gly m 6 Molecular Allergens for Characterizing Anaphylactic Reactions to Soy.

There are two major clinically described forms of IgE-dependent soy allergy: (i) a primary dietary form, linked to sensitization against soy storage proteins Gly m 5 and Glym 6, and (ii) a form included in birch-soy syndromes linked to Gly m 4, a PR-10-like allergen. This second form sometimes causes severe systemic reactions, even anaphylaxis, especially on consuming certain forms of soy such as soymilks or smoothies. Skin prick tests and specific IgE assays against soy whole extracts lack sensitivity. Assays of anti-Gly m 4, Gly m 5 and Gly m 6 specific IgEs have been developed to overcome this obstacle, but they unfortunately lack specificity, especially for anti-Gly m 4. We hypothesized that the basophil activation test (BAT) using molecular soy allergens Gly m 4, Gly m 5 and Gly m 6 would both remedy the lack of sensitivity of other tests and offer, through its mechanistic contribution, greater specificity than the assay of anti-Gly m 4 specific IgEs. This would enable the two types of soy allergy to be separately identified. In a characteristic clinical example of PR-10-induced anaphylactic reaction after consuming soymilk, we report preliminary results of Gly m 4-exclusive positivity of BAT supporting our hypothesis. It will be necessary to confirm these results on more patients in subsequent studies, and to specify the place of the BAT in an overall diagnostic strategy. Meanwhile, soy BAT using molecular allergens is a promising diagnostic tool for soy allergy and probably also for follow-up in specific immunotherapies.

Peanuts, the Immune System, and Food Safety

In an age-appropriate remote learning activity developed by a researcher-teacher team, junior high school students learned about the link between human health and food safety. The students were introduced to basic concepts about the innate immune system and food safety through a learning activity that focused on peanut allergens in food products. The students (a) learned how to distinguish between the concepts of immunity and allergy; (b) learned about cross-contamination and the link between allergies and food safety; (c) learned what antibodies are and how they can be used for science; (d) applied basic knowledge about the immune system and food safety to screen for peanut residues in suspect non-peanut food products using a commercial test kit; and (e) applied basic knowledge about the immune system and food safety to create individual poster presentations on other types of allergies, such as soy or dairy allergies.

Rapid and accurate electrochemical sensor for food allergen detection in complex foods

Food allergies are estimated to affect about 2–5% of adults and 6–8% of children, globally. Currently, the most effective strategy for food allergy management is stringent avoidance of the offending allergen. Unlike other major food allergens, soy is uniquely challenging to avoid due to its prevalence and insidiousness in a wide variety of foods, such as infant formulas. Recently, we demonstrated a simple, accurate, and consumer-friendly sensor using molecularly imprinted polymers (MIPs) for rapid detection of soy allergenic tracers in complex food matrices at clinically relevant levels. In this work, we build on these findings by subjecting MIP-based soy allergen sensors to test trials in 42 different food products, representing over 300 ingredients. Foods were selected based on their compositional complexity to capture a wide range of preparatory methods and processing conditions. In each case, the Allergy Amulet correctly reported on the presence or absence of soy allergen tracer in investigated samples and were subjected to immunoassay confirmatory analysis. The outcome of this research will help resolve persistent difficulties with commercial technologies in detecting allergenic tracers with minimal cross-interference in foods, and will give those with soy allergies the ability to easily, rapidly, and accurately identify and avoid foods with soy allergens.

26908 The safety of isotretinoin treatment in patients with peanut or cashew allergies—A case series

Background: The gold standard treatment for nodulocystic acne vulgaris, isotretinoin, is contraindicated in patients with a soy allergy as its capsule contains hydrogenated soybean oil. This has raised concern for its use in patients with peanut and cashew allergies due to the potential for cross-reactivity. Cashew allergy has been reported to confer a greater risk of cross-reactivity to soy, resulting in rare allergic reactions to isotretinoin. This case series sought to further evaluate the safety of isotretinoin use in eleven patients with a history of peanut or cashew allergy.

Nutritional properties and health aspects of pulses and their use in plant-based yogurt alternatives.

Plant-based yogurt alternatives are increasing in market value, while dairy yogurt sales are stagnating or even declining. The plant-based yogurt alternatives market is currently dominated by products based on coconut or soy. Coconut-based products especially are often low in protein and high in saturated fat, while soy products raise consumer concerns regarding genetically modified soybeans, and soy allergies are common. Pulses are ideally suited as a base for plant-based yogurt alternatives due to their high protein content and beneficial amino acid composition. This review provides an overview of pulse nutrients, pro-nutritional and anti-nutritional compounds, how their composition can be altered by fermentation, and the chemistry behind pulse protein coagulation by acid or salt denaturation. An extensive market review on plant-based yogurt alternatives provides an overview of the current worldwide market situation. It shows that pulses are ideal base ingredients for yogurt alternatives due to their high protein content, amino acid composition, and gelling behavior when fermented with lactic acid bacteria. Additionally, fermentation can be used to reduce anti-nutrients such as α-galactosides and vicine or trypsin inhibitors, further increasing the nutritional value of pulse-based yogurt alternatives.

The Psychosocial Burden of Food Allergy Among Adults: A US Population-Based Study

Food allergy (FA) affects >25 million US adults, resulting in substantial health care utilization. Data suggest that patients with FA suffer impairments in FA-related quality of life (FAQoL); however, little is known regarding psychosocial impacts of FA among US adults. To characterize FAQoL among a large, nationally representative adult sample, and its determinants, including sociodemographic characteristics, severity, comorbid conditions, allergic symptoms, number and type of allergens, and health care utilization. A survey was administered between October 2015 and September 2016 to a nationally representative sample of US households. Survey constructs included the Food Allergy Independent Measure (FAIM), which was developed to quantify adverse impacts of living with FA on patient quality of life. FAIM responses were analyzed from adults reporting current FA (N= 6207). Linear regression models examined associations with sociodemographic and FA characteristics. The overall estimated mean FAIM score was 2.87 (95% confidence interval: 2.83-2.90). FAIM scores (range= 1-7) in adjusted models were invariant by race/ethnicity, private/public insurance status, and census division. Significant differences (P < .05) by lower household income, lower age, and greater education emerged, resulting in higher FAIM scores indicating FAQoL impairment. Among major food allergens, wheat, soy, and milk allergies were each associated with the greatest increases in adjusted FAIM scores. Reporting a current epinephrine autoinjector (EAI) prescription, severe allergic reaction history, history of EAI use, FA-related emergency department visits, or more FAs were also associated with significantly higher FAIM scores. The population-level psychosocial burden of adults with FA is substantial, broadly distributed, and differs by demographic and allergic disease characteristics.

Urticaria due to natto (fermented soybeans)

Natto is a traditional Japanese food of fermented soybeans, in which Bacillus subtilis produces natto-mucilage as metabolic product. Different from soy allergy, natto-mucilage has been reported as a cause of natto-induced late-onset anaphylaxis occurring 5-12 hours after ingestion. Anaphylaxis was the primary clinical manifestation reported in natto-induced hypersensitivity. Here, we report that natto can cause urticaria as a sole symptom without developing into anaphylaxis.

IgE mediated food allergy in Turkey: different spectrum, similar outcome.

Food allergies (FAs) potentially differ across cultures. All medical records of 534 children and adolescents with IgE-mediated FA over a 5-year period were reviewed to document the regional characteristics with regard to spectrum and outcome. According to their last visit, the most common FAs were tree nuts (TNs) (52.4%), cow`s milk (27.3%), seeds (24.7%), egg white (23.2%) and peanuts (14.9%). Hazelnut and Anacardia nuts were the most common etiologies for TN allergies, whereas lentils and chickpeas for legumes and sesame and pumpkin seed for seeds were most common, respectively. TN allergy was in first place in school-age children (55.3%) and adolescents (57.1%) while in the second place in preschoolers (57.7%) after egg white (60%). Of these 534 children, 59.2% had at least one resolved FA (mainly egg white, cow`s milk) and 21% had no residual FA during the study period. Emerging FAs (fish, shellfish, fruit, TN and seed) after the age of 3 years was reported in 94 children. The prevalence of current asthma (22.3%, 38.2%, 40%) and allergic rhinitis (11.6%, 45.2%, 60%) increased, while current atopic dermatitis (17.5%, 8.6%, 8,6%) decreased in preschoolers, school age children and adolescents, respectively. The FA spectrum of Turkish children and adolescents differs from many regions of the world with high rates of TN (hazelnut, Anacardia nuts), seed (sesame, pumpkin seed) and lentils, and low rates of soy, peanut and seafood allergies. However, resolution, emergence and persistence of allergies and comorbidities are similar, which points to the limited role of the environment in the outcome.