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. 2018 Apr;48(4):394-402.
doi: 10.1111/cea.13088. Epub 2018 Feb 8.

Prevalence and longitudinal trends of food allergy during childhood and adolescence: Results of the Isle of Wight Birth Cohort study

D Venkataraman  1 , M Erlewyn-Lajeunesse  1   2 , R J Kurukulaaratchy  1   2   3 , S Potter  3 , G Roberts  1   2   3 , S Matthews  3 , S H Arshad  1   2   3
Affiliations

Prevalence and longitudinal trends of food allergy during childhood and adolescence: Results of the Isle of Wight Birth Cohort study

D Venkataraman et al. Clin Exp Allergy. 2018 Apr.

Abstract

Background: The prevalence and time trends of food allergy change during childhood depending on the age of the child and the type of food.

Objective: To study prevalence and longitudinal trends in food allergy from birth to 18 years in an unselected birth cohort in the Isle of Wight.

Method: Information on food allergy was collected at ages 1, 2, 4, 10 and 18 years from the Isle of Wight Birth Cohort (n = 1456). Skin prick testing (SPT) was performed at the age of 1 and 2 years in symptomatic children. At 4, 10 and 18 years of age, participants were tested to a panel of food and aeroallergens. Food allergy was diagnosed based on the criteria: symptoms suggestive of a typical IgE-mediated reaction and reaction <4 hours following exposure to a known food allergen. McNemar's test was used to determine significance of changes in prevalence over time.

Results: The prevalence of food allergy remained relatively constant in early childhood (5.3%, 4.4% and 5.0% at 1, 2 and 4 years, respectively), with significant decline at 10 years (2.3%, P < .001 vs 4 years) followed by significant rise at 18 years (4%, P = .02 vs 10 years). Cow's milk (1.6%-3.5%) and egg (1.1%-1.4%) were the most common allergens in the first 10 years with peanut (1%) and tree nuts (0.5%) becoming more prevalent beyond 10 years. Fruit and wheat allergy were less common at 10 years, and shellfish and kiwi emerged during adolescence. The prevalence of food allergy plus positive SPT was 1.3%, 0.8%, 0.8%, 0.9% and 2.2% at 1, 2, 4, 10 and 18 years, respectively.

Conclusion: Food allergy is highly prevalent in infancy with partial resolution during late childhood. However, a number of children acquire new food allergy during adolescence resulting in a relatively higher prevalence at 18 years.

Keywords: IgE; epidemiology; food allergy; paediatrics.

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Conflict of interest statement

Conflict of interest statement

None of the authors have any conflicts of interests to declare.

Figures

Figure 1
Figure 1
Participation data/ availability of information at ages 1, 2, 4, 10 and 18 years in the Isle of Wight birth cohort (Consort diagram)
Figure 2
Figure 2
Prevalence of cow’s milk and hen’s egg allergy based on study criteria (known food allergen, typical immediate allergy symptoms, and timing <4 hrs) at 1, 2, 4, 10 and 18 years.
Figure 3
Figure 3
Prevalence of other food allergies (wheat, peanut, tree nuts, fish, shellfish, fruits and vegetables) at different ages in the Isle of Wight Birth Cohort
Figure 4
Figure 4
Sensitisation patterns to aeroallergens and food allergens at 4, 10 and 18 years, based on SPT results. Aeroallergen sensitisation increases with age and reaches a maximum of 40.2% by 18 years and food allergen sensitisation reaches a maximum of 21.4% by 18 years of age. The majority of the food allergen sensitised population are also sensitised to aeroallergens, while there were few who were sensitised only to food allergens. FA: food allergens AA: aeroallergens AA+FA: aero- plus food allergens
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