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. 2010 Oct;126(4):798-806.e13.
doi: 10.1016/j.jaci.2010.07.026.

National prevalence and risk factors for food allergy and relationship to asthma: results from the National Health and Nutrition Examination Survey 2005-2006

Andrew H Liu  1 , Renee Jaramillo, Scott H Sicherer, Robert A Wood, S Allan Bock, A Wesley Burks, Mark Massing, Richard D Cohn, Darryl C Zeldin
Affiliations

National prevalence and risk factors for food allergy and relationship to asthma: results from the National Health and Nutrition Examination Survey 2005-2006

Andrew H Liu et al. J Allergy Clin Immunol. 2010 Oct.

Abstract

Background: The national prevalence and patterns of food allergy (FA) in the United States are not well understood.

Objective: We developed nationally representative estimates of the prevalence of and demographic risk factors for FA and investigated associations of FA with asthma, hay fever, and eczema.

Methods: A total of 8203 participants in the National Health and Nutrition Examination Survey 2005-2006 had food-specific serum IgE measured to peanut, cow's milk, egg white, and shrimp. Food-specific IgE and age-based criteria were used to define likely FA (LFA), possible FA, and unlikely FA and to develop estimates of clinical FA. Self-reported data were used to evaluate demographic risk factors and associations with asthma and related conditions.

Results: In the United States, the estimated prevalence of clinical FA was 2.5% (peanut, 1.3%; milk, 0.4%; egg, 0.2%; shrimp, 1.0%; not mutually exclusive). Risk of possible FA/LFA was increased in non-Hispanic blacks (odds ratio, 3.06; 95% CI, 2.14-4.36), males (1.87; 1.32-2.66), and children (2.04; 1.42-2.93). Study participants with doctor-diagnosed asthma (vs no asthma) exhibited increased risk of all measures of food sensitization. Moreover, in those with LFA, the adjusted odds ratio for current asthma (3.8; 1.5-10.7) and an emergency department visit for asthma in the past year (6.9; 2.4-19.7) were both notably increased.

Conclusion: Population-based serologic data on 4 foods indicate an estimated 2.5% of the US population has FA, and increased risk was found for black subjects, male subjects, and children. In addition, FA could be an under-recognized risk factor for problematic asthma.

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Figures

Figure 1
Figure 1
Clinical FA prevalence estimates in the United States (2005-2006) by age
Figure 2
Figure 2
FA and asthma risk in United States (2005–2006). Adjusteda odds ratios for diagnosed asthmab, current asthmac, and ER visitd for asthma in the prior year in those with UFA, PFA and LFA. a: Adjusted model: Asthma outcome = Food Sensitization + Inhalant Sensitization + Age + Gender + Race + Poverty Income Ratio b: Diagnosed Asthma modeled against all participants without asthma. c: Current Asthma modeled against all participants diagnosed with asthma but not currently having asthma. d: ER Asthma modeled against all participants diagnosed with asthma or currently having asthma but not having an ER visit related to asthma.
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