The Relationship Between Dietary Patterns and the Epidemiology of Food Allergy

Abstract

Food allergies are increasing globally, particularly in Asia; however, the etiologies of allergic diseases remain poorly understood despite comprehensive studies conducted across a variety of populations. Epidemiological research demonstrates that food allergy is more prevalent in Westernized or urbanized societies than in rural or developing ones. As such, comparing the distribution and patterns of food allergies as well as the environmental exposures between regions may provide insight into potential causal and protective factors of food allergy. Diet is an important exposome that has been shown to modulate the immune system both directly and indirectly via pathways involving the microbiota. Changes in dietary patterns, especially the shift to a Westernized diet with reduced dietary fiber and an abundance of processed foods, impact the gut and skin epithelial barrier and contribute to the development of chronic inflammatory diseases, such as food allergy. Although dietary intervention is believed to have tremendous potential as a strategy to promote immunological health, it is essential to recognize that diet is only one of many factors that have changed in urbanized societies. Other factors, such as pollution, microplastics, the use of medications like antibiotics, and exposure to biodiversity and animals, may also play significant roles, and further research is needed to determine which exposures are most critical for the development of food allergies.

Keywords: SCFA; emulsifier; epithelial barrier; fiber; food allergy; modernization; nutritional transition; ultra‐processed foods.

FIGURE 1

The changing prevalence of food allergies in eastern and western regions over time. In Japan, the overall prevalence of food allergies increased from 0.325% in 2010 (95% CI, 0.311–0.339) to 0.797% in 2019 (95% CI, 0.790–0.804) [11]. For peanut and tree nut allergies among children under 18 years, the prevalence rose from 0.6% in 1997 to 1.2% in 2002, reaching 2.1% in 2008 in the United States [12]. Additionally, studies by Gupta et al. indicated that the prevalence of peanut allergies was 2.0% in 2011 (95% CI, 1.8–2.2) and increased to 2.2% in 2018 (95% CI, 2.0–2.5) [13, 14].

FIGURE 2

The potential risk factors and protective elements related to various dietary practices, and how different foods and dietary patterns may influence the likelihood of developing food allergies.

FIGURE 3

The mechanisms by which diet can both protect against and contribute to the risk of food allergies. It illustrates how certain dietary components may enhance immune tolerance, whereas others could trigger allergic responses, highlighting the complex interplay between nutrition and allergy development.

FIGURE 4

The global food supply quantity (kg/capita/year) of (A) infant food and (B) sweeteners between 2010 and 2020 [99]. Although the total supply of commercial infant formula and sweeteners in Asia remained low, there has been a notable increase in sales of infant formula in Asia.

FIGURE 5

The global ratio of vegetable‐to‐meat supply (kg/capita/year) [99], showing that this ratio has consistently remained higher in Asia over time compared to other regions over time.