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Meta-Analysis
. 2023 Feb;78(2):351-368.
doi: 10.1111/all.15560. Epub 2022 Nov 7.

Frequency of food allergy in Europe: An updated systematic review and meta-analysis

Giulia C I Spolidoro  1 , Yohannes Tesfaye Amera  2 , Mohamed Mustafa Ali  2 , Sungkutu Nyassi  3 , Daniil Lisik  3 , Athina Ioannidou  3 , Graciela Rovner  4   5 , Ekaterina Khaleva  6 , Carina Venter  7 , Ronald van Ree  8 , Margitta Worm  9 , Berber Vlieg-Boerstra  10   11 , Aziz Sheikh  12 , Antonella Muraro  13 , Graham Roberts  6   14 , Bright I Nwaru  3   15
Affiliations
Meta-Analysis

Frequency of food allergy in Europe: An updated systematic review and meta-analysis

Giulia C I Spolidoro et al. Allergy. 2023 Feb.

Abstract

Food allergy (FA) is increasingly reported in Europe, however, the latest prevalence estimates were based on studies published a decade ago. The present work provides the most updated estimates of the prevalence and trends of FA in Europe. Databases were searched for studies published between 2012 and 2021, added to studies published up to 2012. In total, 110 studies were included in this update. Most studies were graded as moderate risk of bias. Pooled lifetime and point prevalence of self-reported FA were 19.9% (95% CI 16.6-23.3) and 13.1% (95% CI 11.3-14.8), respectively. The point prevalence of sensitization based on specific IgE (slgE) was 16.6% (95% CI 12.3-20.8), skin prick test (SPT) 5.7% (95% CI 3.9-7.4), and positive food challenge 0.8% (95% CI 0.5-0.9). While lifetime prevalence of self-reported FA and food challenge positivity only slightly changed, the point prevalence of self-reported FA, sIgE and SPT positivity increased from previous estimates. This may reflect a real increase, increased awareness, increased number of foods assessed, or increased number of studies from countries with less data in the first review. Future studies require rigorous designs and implementation of standardized methodology in diagnosing FA, including use of double-blinded placebo-controlled food challenge to minimize potential biases.

Keywords: Europe; epidemiology; food allergy; sensitization; systematic review.

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Conflict of interest statement

Carina Venter reports: grants (Reckitt Benckiser, Food Allergy Research and Education, and National Peanut Board) and personal fees (Reckitt Benckiser, Nestle Nutrition Institute, Danone, Abbott Nutrition, Else Nutrition, Sifter, and Before Brands). Ronald van Ree reports: consultancies (HAL Allergy BV, Citeq BV, Angany Inc., Reacta Healthcare Ltd., Mission MightyMe, and AB Enzymes), speaker's fees (HAL Allergy BV, ThermoFisher Scientific, and ALK), and stock options (Angany Inc.). Margitta Worm reports: grants and personal fees (Stallergens, HAL Allergie, Bencard Allergie, Allergopharma, ALK‐Abello, Mylan Germany, Actelion Pharmaceuticals Deutschland, Biotest, AbbVie Deutschland, Lilly Deutschland Aimmune, DBV Technologies SA, Regeneron Pharmaceuticals, Sanofi Aventis, Leo Pharma, Novartis, and Viatris) outside of the submitted work and being past WAO co‐chair of the anaphylaxis committee and past chair of the food allergy interest group of EAACI. Berber Vlieg‐Boerstra reports: personal fees (Marfo Food Group, Nestlé, and Nutricia) and grants (Nutricia). Antonella Muraro reports: grants and speaker's fees (Aimmune), speaker's fees (DVB Technologies SA, Viatris [Mylan], ALK, and Nestlé), and being member of the Executive Committee of GA2LEN and past president of EAACI. Graham Roberts reports grants (Asthma UK and National Institutes of Health Research). Bright I, Nwaru reports unrestricted grants and personal fees from DBV Technologies and AstraZeneca, respectively. Giulia C.I. Spolidoro, Yohannes Tesfaye Amera, Mohamed Mustafa Ali, Sungkutu Nyassi, Daniil Lisik, Athina Ioannidou report fee from ACT Institutet Sweden. The other authors report no conflicting interests related to this work. The funder played no role in the content and decision to submit this manuscript.

Figures

FIGURE 1
FIGURE 1
PRISMA flow diagram for updated systematic review on prevalence of food allergy in Europe, 2000–2021.
FIGURE 2
FIGURE 2
Pooled estimates for self‐reported any food allergy in Europe for lifetime (top) and point prevalence (bottom) between 2000 and 2021, 2000 and 2012, and 2012 and 2021.
FIGURE 3
FIGURE 3
Pooled estimates for self‐reported physician diagnosed any food allergy (i.e., doctor‐diagnosed FA reported by a subject in a questionnaire) for lifetime (left) and point prevalence (right) between 2012 and 2021.
FIGURE 4
FIGURE 4
Pooled estimates for sIgE (top) or SPT (bottom) sensitization to any food allergy in Europe between 2000 and 2021, 2000 and 2012, and 2012 and 2021.
FIGURE 5
FIGURE 5
Pooled estimates for symptoms plus sIgE (top) or SPT (bottom) sensitization to any food allergy in Europe between 2000 and 2021, 2000 and 2012, and 2012 and 2021.
FIGURE 6
FIGURE 6
Pooled estimates for clinical history or food challenge positive any food allergy (top) and for food‐challenged verified any food allergy (bottom) in Europe between 2000 and 2021, 2000 and 2012, and 2012 and 2021.
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References

    1. Nwaru BI, Hickstein L, Panesar SS, et al. The epidemiology of food allergy in Europe: a systematic review and meta‐analysis. Allergy. 2014;69(1):62‐75. - PubMed
    1. Nwaru BI, Hickstein L, Panesar SS, Roberts G, Muraro A, Sheikh A. Prevalence of common food allergies in Europe: a systematic review and meta‐analysis. Allergy. 2014;69(8):992‐1007. - PubMed
    1. Newcombe R. Two‐sided confidence intervals for the single proportion: comparison of seven methods. Stat Med. 1998;17:857‐872. - PubMed
    1. Arshad SH, Patil V, Mitchell F, et al. Cohort profile update: the Isle of Wight whole population birth cohort (IOWBC). Int J Epidemiol. 2020;49(4):1083‐1084. - PMC - PubMed
    1. Baccioglu A, Sogut A, Kilic O, Beyhun E. The prevalence of allergic diseases and associated risk factors in school‐age children and adults in Erzurum, Turkey. Turk Thorac J. 2015;16(2):68‐72. - PMC - PubMed

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