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Controlled Clinical Trial
. 2019 Jul-Aug;7(6):1920-1928.e11.
doi: 10.1016/j.jaip.2019.02.044. Epub 2019 Mar 19.

Food Allergy in Adults: Substantial Variation in Prevalence and Causative Foods Across Europe

Sarah A Lyons  1 , Peter G J Burney  2 , Barbara K Ballmer-Weber  3 , Montserrat Fernandez-Rivas  4 , Laura Barreales  5 , Michael Clausen  6 , Ruta Dubakiene  7 , Cristina Fernandez-Perez  5 , Philipp Fritsche  8 , Monika Jedrzejczak-Czechowicz  9 , Marek L Kowalski  9 , Tanya Kralimarkova  10 , Ischa Kummeling  11 , Tihomir B Mustakov  10 , Ans F M Lebens  11 , Harmieke van Os-Medendorp  11 , Nikolaos G Papadopoulos  12 , Todor A Popov  13 , Alexandros Sakellariou  14 , Paco M J Welsing  15 , James Potts  2 , E N Clare Mills  16 , Ronald van Ree  17 , André C Knulst  11 , Thuy-My Le  11
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Free article
Controlled Clinical Trial

Food Allergy in Adults: Substantial Variation in Prevalence and Causative Foods Across Europe

Sarah A Lyons et al. J Allergy Clin Immunol Pract. 2019 Jul-Aug.
Free article

Abstract

Background: According to the community-based EuroPrevall surveys, prevalence of self-reported food allergy (FA) in adults across Europe ranges from 2% to 37% for any food and 1% to 19% for 24 selected foods.

Objective: To determine the prevalence of probable FA (symptoms plus specific IgE-sensitization) and challenge-confirmed FA in European adults, along with symptoms and causative foods.

Methods: In phase I of the EuroPrevall project, a screening questionnaire was sent to a random sample of the general adult population in 8 European centers. Phase II consisted of an extensive questionnaire on reactions to 24 preselected commonly implicated foods, and measurement of specific IgE levels. Multiple imputation was performed to estimate missing symptom and serology information for nonresponders. In the final phase, subjects with probable FA were invited for double-blind placebo-controlled food challenge.

Results: Prevalence of probable FA in adults in Athens, Reykjavik, Utrecht, Lodz, Madrid, and Zurich was respectively 0.3%, 1.4%, 2.1%, 2.8%, 3.3%, and 5.6%. Oral allergy symptoms were reported most frequently (81.6%), followed by skin symptoms (38.2%) and rhinoconjunctivitis (29.5%). Hazelnut, peach, and apple were the most common causative foods in Lodz, Utrecht, and Zurich. Peach was also among the top 3 causative foods in Athens and Madrid. Shrimp and fish allergies were relatively common in Madrid and Reykjavik. Of the 55 food challenges performed, 72.8% were classified as positive.

Conclusions: FA shows substantial geographical variation in prevalence and causative foods across Europe. Although probable FA is less common than self-reported FA, prevalence still reaches almost 6% in parts of Europe.

Keywords: Adults; Causative foods; Europe; Food allergy; Prevalence.

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