Nietolerancja pokarmowa – Epidemiologia

Nietolerancja pokarmowa
Epidemiologia

Nietolerancja pokarmowa, definiowana jako nieimmunologiczna reakcja na składniki żywności, dotyka 15-20% populacji ogólnej, jednak rzeczywista częstość potwierdzona podwójnie ślepą próbą prowokacyjną jest znacznie niższa, oscylując między 0,8% a 2,4%. Występuje znaczna rozbieżność między danymi z kwestionariuszy samoopisowych a obiektywnymi metodami diagnostycznymi, co wskazuje na zawyżanie częstości występowania nietolerancji pokarmowej nawet trzykrotnie lub czterokrotnie. Częstość występowania jest wyższa u kobiet (4,2% vs 2,9%; P<0,001) oraz u osób pochodzenia azjatyckiego (4,3% vs 3,6%; P<0,001). Nietolerancje pokarmowe są szczególnie powszechne u pacjentów z zespołem jelita drażliwego, gdzie 50-80% zgłasza problemy z określonymi pokarmami. U niemowląt i małych dzieci nietolerancja białek mleka krowiego występuje u 1,9-2,8% populacji do 2 roku życia, z tendencją do ustępowania do 5 roku życia. Epidemiologia nietolerancji pokarmowej wykazuje istotne różnice regionalne i demograficzne, z wyższą częstością w krajach rozwiniętych i obszarach miejskich, co sugeruje wpływ urbanizacji i ekspozycji środowiskowych.

Epidemiologia nietolerancji pokarmowej

Nietolerancja pokarmowa stanowi poważny problem zdrowotny, którego częstość występowania wzrasta na całym świecie. Szacunki dotyczące rozpowszechnienia nietolerancji pokarmowej różnią się znacząco – od 2% do ponad 20% populacji ogólnej¹. W przeciwieństwie do alergii pokarmowych, które są reakcjami immunologicznymi na pokarm, nietolerancje pokarmowe to niealergiczne, nieimmunologiczne reakcje, które dotyczą 15-20% populacji ogólnej².

Częstość występowania w populacji ogólnej

Badania oparte na metodologii podwójnie ślepej próby z placebo (double-blind, placebo-controlled food challenges) wskazują, że rzeczywista częstość występowania nietolerancji pokarmowej jest znacznie niższa niż sugerują to dane z kwestionariuszy samoopisowych. W holenderskich i angielskich badaniach zgłaszane przez pacjentów częstości alergii/nietolerancji pokarmowej wynosiły 12-19%, podczas gdy potwierdzone częstości wahały się od 0,8% do 2,4%. Dla nietolerancji dodatków do żywności częstość występowania wahała się między 0,01 a 0,23%³.

Podobne wyniki zaobserwowano w Norwegii, gdzie spośród 4622 osób, które wypełniły kwestionariusze, 84 osoby (1,8%) zostały włączone do badania z powodu deklarowanych problemów z tolerancją pokarmów. Wśród tych osób 70% zgłaszało objawy związane z przyjmowaniem pokarmów, a 62% ograniczało lub wykluczało określone produkty spożywcze ze swojej diety⁴.

Różnice między nietolerancją pokarmową a alergią pokarmową

Ważne jest rozróżnienie między nietolerancją pokarmową a alergią pokarmową. Alergia pokarmowa obejmuje odpowiedź immunologiczną, podczas gdy nietolerancja pokarmowa dotyczy trudności z trawieniem lub metabolizowaniem określonych składników żywności⁵. Prosty sposób wyjaśnienia różnicy polega na tym, że nietolerancja pokarmowa zazwyczaj dotyczy układu pokarmowego, a ilość spożytego pokarmu jest bezpośrednio związana z nasileniem objawów, które powtarzają się przy każdej ekspozycji na dany pokarm⁶.

Podczas gdy alergie pokarmowe dotyczą około 8% dzieci i 3,7% dorosłych⁷, nietolerancje pokarmowe są znacznie częstsze, szczególnie u pacjentów z zespołem jelita drażliwego i innymi czynnościowymi zaburzeniami żołądkowo-jelitowymi, gdzie 50-80% pacjentów zgłasza stałe problemy z określonymi pokarmami⁸.

Metody zbierania danych epidemiologicznych

Dokładne określenie częstości występowania nietolerancji pokarmowej jest utrudnione ze względu na różnice w metodologii badań. Badania oparte na samoocenie zazwyczaj zawyżają częstość występowania nietolerancji pokarmowej trzy do czterech razy w porównaniu z badaniami wykorzystującymi obiektywne metody diagnostyczne⁹.

W badaniu przeprowadzonym w dużej organizacji opieki zdrowotnej, analizującym dane z elektronicznej dokumentacji medycznej (EHR) między 2000 a 2013 rokiem, zidentyfikowano 97 482 pacjentów (3,6%) z jedną lub więcej alergią lub nietolerancją pokarmową spośród 2,7 miliona pacjentów. Częstość występowania alergii i nietolerancji pokarmowej była wyższa u kobiet (4,2% vs 2,9%; P<0,001) oraz osób pochodzenia azjatyckiego (4,3% vs 3,6%; P<0,001)¹⁰.

Różnice regionalne i demograficzne

Występowanie nietolerancji pokarmowej wykazuje znaczne różnice regionalne i demograficzne. W Stanach Zjednoczonych, według najnowszych badań, 32,5% dorosłych zgłasza nadwrażliwość na żywność, przy czym częściej dotyczy to kobiet (39,1%) niż mężczyzn (24,1%)¹¹. W badaniu przeprowadzonym w Zachodniej Szwecji, 16% badanych było uczulonych na co najmniej jeden z 9 najczęstszych alergenów pokarmowych¹².

Interesujące są też dane dotyczące różnic rasowych w kontekście nietolerancji i alergii pokarmowych. Według danych Centrum Kontroli i Zapobiegania Chorobom (CDC), osoby dorosłe i dzieci rasy czarnej niehiszpańskiej częściej zgłaszają alergie pokarmowe (odpowiednio 8,5% i 7,6%) w porównaniu do osób rasy białej niehiszpańskiej (6,2% i 5,3%) oraz pochodzenia hiszpańskiego (4,4% i 5%)¹³.

Czynniki wpływające na nadwrażliwość pokarmową

W badaniu dotyczącym nadwrażliwości pokarmowej (food hypersensitivity, FHS) wykazano, że 13,5% dorosłych zgłasza tego typu problemy, a spośród osób podających informacje o objawach, 26,4% zgłaszało ciężkie reakcje. Historia astmy (iloraz szans OR 2,12, 95% przedział ufności CI 1,13-3,44) oraz młodszy wiek wystąpienia FHS (OR 1,02, 95% CI 1,01-1,03, na rok) były związane z wyższym ryzykiem wystąpienia ciężkich reakcji pokarmowych w ciągu życia¹⁴.

Co ciekawe, w podgrupie osób z testami IgE wykonanymi w dwóch badaniach w odstępie 10 lat, ogólna częstość występowania uczulenia na pokarmy nie zmieniła się w tym okresie¹⁵. Sugeruje to, że choć zgłaszane przez pacjentów przypadki nietolerancji pokarmowej mogą wzrastać, rzeczywista częstość występowania uczulenia na pokarmy u dorosłych może pozostawać stabilna w dłuższym okresie.

Nietolerancja pokarmowa u dzieci i dorosłych

Nietolerancja pokarmowa dotyczy zarówno dzieci, jak i dorosłych, jednak istnieją istotne różnice w częstości występowania i charakterystyce problemu w zależności od wieku.

Rozpowszechnienie u dzieci

Według danych z 2007 roku, około 3 miliony dzieci poniżej 18 roku życia (3,9%) miało zgłoszoną alergię pokarmową lub nietolerancję pokarmową w ciągu poprzednich 12 miesięcy. W latach 1997-2007 częstość występowania zgłaszanych alergii pokarmowych wzrosła o 18% wśród dzieci poniżej 18 roku życia¹⁶.

Dane wskazują również na wzrost liczby hospitalizacji związanych z alergiami pokarmowymi wśród dzieci. Ten wzrost może być związany ze zwiększoną świadomością, zgłaszaniem i stosowaniem określonych medycznych kodów diagnostycznych dla alergii pokarmowej lub może reprezentować rzeczywisty wzrost liczby dzieci doświadczających reakcji alergicznych na pokarm¹⁷.

Rozpowszechnienie u dorosłych

Najnowsze dane wskazują, że nietolerancje pokarmowe mogą być bardziej rozpowszechnione wśród populacji dorosłych niż wcześniej uznawano, z wieloma zgłaszanymi przypadkami nietolerancji o początku w wieku dorosłym¹⁸. Badania wskazują, że wzorce te są zgodne z niedawnymi ustaleniami przekrojowych badań częstości występowania w USA, które wskazywały na wyższą częstość występowania alergii pokarmowych wśród młodych dorosłych niż wśród dzieci, a także wysoką częstość alergii pokarmowych o początku w wieku dorosłym¹⁹.

Najnowsze dane wskazują również, że dorośli rasy białej mają niższe wskaźniki alergii pokarmowej w porównaniu do osób rasy czarnej, pochodzenia hiszpańskiego, azjatyckiego i wielorasowego, a wskaźniki częstości występowania wydają się podobne wśród dorosłych w najwyższych i najniższych warstwach dochodowych²⁰.

Wzorce specyficzne dla wieku

Nietolerancja białek pokarmowych jest głównie problemem niemowląt i małych dzieci. Alergia na białka mleka krowiego lub nietolerancja zwykle rozwija się we wczesnym niemowlęctwie. W większości przypadków początek objawów jest ściśle związany z czasem wprowadzenia mieszanki opartej na mleku krowim²¹.

Nietolerancja białka mleka krowiego została zdiagnozowana u 1,9-2,8% ogólnej populacji niemowląt w wieku 2 lat lub młodszych w różnych krajach północnej Europy, ale częstość spadała do około 0,3% u dzieci starszych niż 3 lata²². Nietolerancja białek jest ogólnie uważana za ustępującą do 5 roku życia, gdy dojrzewa układ odpornościowy błony śluzowej niemowlęcia i dziecko staje się immunologicznie tolerancyjne na białka mleka; u większości dotkniętych dzieci objawy ustępują do 1-2 roku życia²³.

Nadzór i monitorowanie nietolerancji pokarmowej

Systematyczne monitorowanie nietolerancji pokarmowej jest niezbędne do zrozumienia rzeczywistej skali problemu i opracowania odpowiednich strategii profilaktycznych i terapeutycznych.

Wyzwania w monitorowaniu

Istotnym wyzwaniem w nadzorze nad nietolerancją pokarmową jest brak wysokiej jakości dowodów opartych na złotym standardzie diagnostycznym, jakim są doustne próby prowokacyjne²⁴. Dokładne określenie częstości występowania nietolerancji pokarmowej potwierdzonej złotym standardem próby prowokacyjnej jest kosztowne i wymaga znacznych zasobów, co ogranicza dostępność danych wysokiej jakości²⁵.

Obecnie większość dostępnych danych opiera się na samoocenie, która zazwyczaj zawyża częstość występowania nietolerancji pokarmowej trzykrotnie lub czterokrotnie²⁶. Jest to istotne ograniczenie, ponieważ prowadzi do niedokładnych szacunków epidemiologicznych.

Metody gromadzenia danych do nadzoru

Do monitorowania nietolerancji pokarmowej stosuje się różne metody gromadzenia danych, w tym:

Kwestionariusze samoopisowe²⁷
Dane z elektronicznej dokumentacji medycznej (EHR)²⁸
Dane dotyczące hospitalizacji i wizyt na oddziałach ratunkowych²⁹
Badania kohortowe³⁰
Badania oparte na testach skórnych lub badaniach poziomu IgE w surowicy³¹
Doustne próby prowokacyjne (złoty standard)³²

Każda z tych metod ma swoje zalety i ograniczenia. Na przykład, wykorzystanie danych z elektronicznej dokumentacji medycznej może dostarczyć cennych informacji na temat częstości występowania nietolerancji pokarmowej w populacji klinicznej, ale może nie odzwierciedlać rzeczywistej częstości występowania w populacji ogólnej³³.

Systemy nadzoru

Potrzebne są systematyczne inicjatywy badań epidemiologicznych, zarówno na poziomie krajowym, jak i globalnym, aby lepiej zrozumieć i zmniejszyć obciążenie związane z nietolerancją pokarmową³⁴. Europejska Akademia Alergologii i Immunologii Klinicznej (EAACI) jest w trakcie opracowywania wytycznych EAACI dotyczących alergii pokarmowej i anafilaksji, a przegląd systematyczny jest jedną z siedmiu połączonych syntez dowodów, które są podejmowane w celu zapewnienia nowoczesnego przeglądu aktualnej bazy dowodów w odniesieniu do epidemiologii, zapobiegania, diagnozy i zarządzania klinicznego oraz wpływu na jakość życia³⁵.

Istnieje wyraźna potrzeba przeprowadzenia dużych, populacyjnych, długoterminowych badań z zastosowaniem podwójnie ślepych, kontrolowanych placebo prób prowokacyjnych w celu potwierdzenia diagnozy nietolerancji pokarmowej. Jednocześnie istnieje potrzeba lepszego zrozumienia istniejącej literatury, aby między innymi dostarczyć informacji na temat częstości występowania choroby, zapewnić wgląd w etiologię choroby i umożliwić stratyfikację ryzyka, które mogą być wykorzystane do informowania decyzji dotyczących zarządzania i rozważań na temat rokowania³⁶.

Globalne trendy i wpływ nietolerancji pokarmowej

Nietolerancja pokarmowa stanowi rosnący problem zdrowotny na całym świecie, a jej wpływ wykracza poza bezpośrednie objawy kliniczne, obejmując aspekty ekonomiczne i jakość życia.

Różnice geograficzne

Częstość występowania nietolerancji pokarmowej różni się znacznie w zależności od regionu geograficznego. Wyższe wskaźniki częstości występowania są często raportowane w krajach rozwiniętych w porównaniu do regionów rozwijających się, co sugeruje, że urbanizacja, zmiany nawyków żywieniowych i ekspozycje środowiskowe mogą odgrywać znaczącą rolę w rozwoju nietolerancji³⁷.

Liczne badania wykazały systematyczne różnice w obciążeniu nietolerancją pokarmową między społecznościami miejskimi i wiejskimi, przy czym wyższe wskaźniki występowania są zgłaszane w obszarach miejskich niż w obszarach wiejskich, nawet po uwzględnieniu różnic w składzie rasowym i socjoekonomicznym³⁸.

Wcześniejsza literatura sugerowała, że w miarę jak gęsto zaludnione kraje Azji Południowej i Wschodniej coraz bardziej się urbanizują i/lub przyjmują styl życia bardziej zbliżony do krajów zachodnich i/lub uprzemysłowionych, ich obciążenie chorobami alergicznymi prawdopodobnie wzrośnie, jeśli nie zostaną wdrożone na dużą skalę skuteczne interwencje zapobiegawcze³⁹.

Różnice miejsko-wiejskie

Różnice między środowiskami miejskimi i wiejskimi mogą mieć istotne znaczenie dla zrozumienia etiologii nietolerancji pokarmowej. Rośnie uznanie dla potencjalnych ochronnych efektów zróżnicowanych ekspozycji mikrobiologicznych, biorąc pod uwagę rosnące dowody na immunomodulacyjne efekty mikrobiomu ludzkiego⁴⁰.

Kiedy rozważamy geograficzną zmienność w częstości występowania niektórych alergii pokarmowych i środowiskowych, a także ich podobieństwa strukturalne na poziomie molekularnym, uważa się, że współuczulenie między alergenami pokarmowymi i środowiskowymi może być kluczowym czynnikiem rosnącej częstości występowania alergii pokarmowej⁴¹.

Wpływ ekonomiczny i na jakość życia

Nietolerancja pokarmowa ma znaczący wpływ na jakość życia i koszty ekonomiczne. Chociaż nie jest jasne, jak duża część obecnego obciążenia populacyjnego chorobą wynika z prawdziwej alergii IgE-zależnej, ponieważ wiele danych epidemiologicznych nie uwzględnia klinicznego potwierdzenia częstości występowania choroby, jasne jest, że dotknięte osoby cierpią z powodu upośledzenia jakości życia i ponoszą znaczne koszty ekonomiczne poza fizycznym obciążeniem zdrowotnym⁴²⁴³.

Podsumowując, najnowsze dane sugerują, że nietolerancja pokarmowa dotyka rosnącą liczbę niemowląt, dzieci i dorosłych na całym świecie. Choć tradycyjnie była konceptualizowana głównie jako choroba pediatryczna, najnowsze dane wskazują, że dotyka ona jeszcze większej liczby dorosłych. Ogólne obciążenie populacyjne nietolerancją pokarmową prawdopodobnie wzrośnie w przypadku braku szybkiego wdrożenia skutecznych interwencji zapobiegawczych⁴⁴.

Przyszłe badania i kierunki

Aby lepiej zrozumieć epidemiologię nietolerancji pokarmowej i opracować skuteczne strategie zarządzania, konieczne są dalsze badania w kilku kluczowych obszarach.

Luki badawcze

Istotne luki badawcze w epidemiologii nietolerancji pokarmowej obejmują:

Brak badań z powtarzanymi pomiarami nietolerancji pokarmowej potwierdzonej próbami prowokacyjnymi w krajach zachodnich⁴⁵
Ograniczona wiedza na temat nowych przypadków nietolerancji lub zmian w uczuleniu na pokarm u dorosłych⁴⁶
Niewystarczające dane dotyczące różnic rasowych i etnicznych w częstości występowania i ciężkości nietolerancji pokarmowej⁴⁷
Brak standardowych metodologii do oceny nietolerancji pokarmowej⁴⁸

Potrzeby standaryzacyjne

Istnieje potrzeba bardziej solidnych badań wykorzystujących standardowe metodologie i obiektywne metody oceny w celu dokładnego wykrywania nietolerancji pokarmowej, aby lepiej zrozumieć prawdziwy zakres problemu i jego wpływ na usługi zdrowotne⁴⁹.

Globalnie istniejące badania dotyczące nietolerancji pokarmowej są trudne do porównania ze względu na różnice w definicji nietolerancji i różnice w testowanym panelu pokarmowym⁵⁰. Standaryzacja definicji, metodologii badawczej i kryteriów diagnostycznych jest kluczowa dla lepszego zrozumienia epidemiologii nietolerancji pokarmowej.

Strategie zapobiegania i zarządzania

Jasne jest, że aby częstość występowania nietolerancji pokarmowej ustabilizowała się lub spadła, potrzebne są strategie przyspieszające ustępowanie choroby i zmniejszające częstość występowania choroby⁵¹. Obecnie lekarze w Ameryce Łacińskiej i innych regionach potrzebują więcej informacji o odpowiednich środkach zapobiegawczych nietolerancji pokarmowej⁵².

Główne czynniki ryzyka zidentyfikowane w kohortach urodzeniowych w Ameryce Łacińskiej to rodzinna historia atopii i wczesne odstawienie od piersi, szczególnie z mlekiem i jajami⁵³. Ponieważ czynniki ryzyka i czynniki ochronne różnią się w zależności od populacji, potrzebnych jest więcej badań kohortowych od urodzenia.

Potrzebne są również większe wysiłki w zakresie edukacji zarówno świadczeniodawców, jak i pacjentów. Wyniki badań epidemiologicznych powinny być przekładane na środki edukacyjne dla dostawców usług zdrowotnych i pacjentów⁵⁴.

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Materiały źródłowe

#1 Food intolerance – Wikipedia
https://en.wikipedia.org/wiki/Food_intolerance
Estimates of the prevalence of food intolerance vary widely from 2% to over 20% of the population. […] So far only three prevalence studies in Dutch and English adults have been based on double-blind, placebo-controlled food challenges. The reported prevalences of food allergy/intolerance (by questionnaires) were 12% to 19%, whereas the confirmed prevalences varied from 0.8% to 2.4%. For intolerance to food additives the prevalence varied between 0.01 and 0.23%. […] Food intolerance rates were found to be similar in the population in Norway. Out of 4,622 subjects with adequately filled-in questionnaires, 84 were included in the study (1.8%). Perceived food intolerance is a common problem with significant nutritional consequences in a population with IBS. Of these 59 (70%) had symptoms related to intake of food, 62% limited or excluded food items from the diet. Tests were performed for food allergy and malabsorption, but not for intolerance. There were no associations between the tests for food allergy and malabsorption and perceived food intolerance, among those with IBS. Perceived food intolerance was unrelated to musculoskeletal pain and mood disorders.
#2 Food intolerance and food allergy in adults: An overview – UpToDate
https://www.uptodate.com/contents/food-intolerance-and-food-allergy-in-adults-an-overview
Food allergies are adverse reactions to foods due to immunologic mechanisms. Most adverse food reactions in adults are due to various forms of food intolerance, which are nonimmunologic reactions. […] Food intolerance refers to difficulty digesting or metabolizing a particular food. Food intolerance disorders are a subset of all adverse food reactions and are reported by 15 to 20 percent of the population. Food intolerances are even more common among patients with irritable bowel syndrome and other functional gastrointestinal disorders, with 50 to 80 percent reporting consistent problems with certain foods. […] Food intolerances are not immunologic allergies and do not carry the same risk, although patients may not appreciate this distinction. A simple way to explain the difference is that food intolerance generally involves the digestive system, the amount of food ingested is directly related to the severity of symptoms, and the food causes similar symptoms with each exposure. […] Clinical features of food intolerances traverse a spectrum of organ systems and vary among different disorders, although most involve prominent gastrointestinal symptoms. Excessive intestinal gas, bloating, abdominal pain, and diarrhea are common symptoms.
#3 Food intolerance – Wikipedia
https://en.wikipedia.org/wiki/Food_intolerance
Estimates of the prevalence of food intolerance vary widely from 2% to over 20% of the population. […] So far only three prevalence studies in Dutch and English adults have been based on double-blind, placebo-controlled food challenges. The reported prevalences of food allergy/intolerance (by questionnaires) were 12% to 19%, whereas the confirmed prevalences varied from 0.8% to 2.4%. For intolerance to food additives the prevalence varied between 0.01 and 0.23%. […] Food intolerance rates were found to be similar in the population in Norway. Out of 4,622 subjects with adequately filled-in questionnaires, 84 were included in the study (1.8%). Perceived food intolerance is a common problem with significant nutritional consequences in a population with IBS. Of these 59 (70%) had symptoms related to intake of food, 62% limited or excluded food items from the diet. Tests were performed for food allergy and malabsorption, but not for intolerance. There were no associations between the tests for food allergy and malabsorption and perceived food intolerance, among those with IBS. Perceived food intolerance was unrelated to musculoskeletal pain and mood disorders.
#4 Food intolerance – Wikipedia
https://en.wikipedia.org/wiki/Food_intolerance
Estimates of the prevalence of food intolerance vary widely from 2% to over 20% of the population. […] So far only three prevalence studies in Dutch and English adults have been based on double-blind, placebo-controlled food challenges. The reported prevalences of food allergy/intolerance (by questionnaires) were 12% to 19%, whereas the confirmed prevalences varied from 0.8% to 2.4%. For intolerance to food additives the prevalence varied between 0.01 and 0.23%. […] Food intolerance rates were found to be similar in the population in Norway. Out of 4,622 subjects with adequately filled-in questionnaires, 84 were included in the study (1.8%). Perceived food intolerance is a common problem with significant nutritional consequences in a population with IBS. Of these 59 (70%) had symptoms related to intake of food, 62% limited or excluded food items from the diet. Tests were performed for food allergy and malabsorption, but not for intolerance. There were no associations between the tests for food allergy and malabsorption and perceived food intolerance, among those with IBS. Perceived food intolerance was unrelated to musculoskeletal pain and mood disorders.
#5 Food intolerance and food allergy in adults: An overview – UpToDate
https://www.uptodate.com/contents/food-intolerance-and-food-allergy-in-adults-an-overview
Food allergies are adverse reactions to foods due to immunologic mechanisms. Most adverse food reactions in adults are due to various forms of food intolerance, which are nonimmunologic reactions. […] Food intolerance refers to difficulty digesting or metabolizing a particular food. Food intolerance disorders are a subset of all adverse food reactions and are reported by 15 to 20 percent of the population. Food intolerances are even more common among patients with irritable bowel syndrome and other functional gastrointestinal disorders, with 50 to 80 percent reporting consistent problems with certain foods. […] Food intolerances are not immunologic allergies and do not carry the same risk, although patients may not appreciate this distinction. A simple way to explain the difference is that food intolerance generally involves the digestive system, the amount of food ingested is directly related to the severity of symptoms, and the food causes similar symptoms with each exposure. […] Clinical features of food intolerances traverse a spectrum of organ systems and vary among different disorders, although most involve prominent gastrointestinal symptoms. Excessive intestinal gas, bloating, abdominal pain, and diarrhea are common symptoms.
#6 Food intolerance and food allergy in adults: An overview – UpToDate
https://www.uptodate.com/contents/food-intolerance-and-food-allergy-in-adults-an-overview
Food allergies are adverse reactions to foods due to immunologic mechanisms. Most adverse food reactions in adults are due to various forms of food intolerance, which are nonimmunologic reactions. […] Food intolerance refers to difficulty digesting or metabolizing a particular food. Food intolerance disorders are a subset of all adverse food reactions and are reported by 15 to 20 percent of the population. Food intolerances are even more common among patients with irritable bowel syndrome and other functional gastrointestinal disorders, with 50 to 80 percent reporting consistent problems with certain foods. […] Food intolerances are not immunologic allergies and do not carry the same risk, although patients may not appreciate this distinction. A simple way to explain the difference is that food intolerance generally involves the digestive system, the amount of food ingested is directly related to the severity of symptoms, and the food causes similar symptoms with each exposure. […] Clinical features of food intolerances traverse a spectrum of organ systems and vary among different disorders, although most involve prominent gastrointestinal symptoms. Excessive intestinal gas, bloating, abdominal pain, and diarrhea are common symptoms.
#7 Food Allergies: Practice Essentials, Background, Pathophysiology
https://emedicine.medscape.com/article/135959-overview
General surveys report that as many as 25-30% of households consider at least 1 family member to have a food allergy. […] Comprehensive studies that include oral food challenges are few in number. Considering allergy to milk, egg, peanut, and seafood in a meta-analysis of 6 international studies using oral food challenges, estimated rates of 1-10.8% were obtained. […] In a meta-analysis including allergy to fruits and vegetables (excluding peanut), only 6 international studies included oral food challenges, and estimates of allergy varied widely from 0.1-4.3% for fruits and tree nuts to 0.1-1.4% for vegetables to under 1% for wheat, soy, and sesame. […] Among children, males appear to be more affected; among adults, females are more frequently affected. […] The prevalence of food allergies has been estimated to be up to 8% in infants and children and 3.7% in adults.
#8 Food intolerance and food allergy in adults: An overview – UpToDate
https://www.uptodate.com/contents/food-intolerance-and-food-allergy-in-adults-an-overview
Food allergies are adverse reactions to foods due to immunologic mechanisms. Most adverse food reactions in adults are due to various forms of food intolerance, which are nonimmunologic reactions. […] Food intolerance refers to difficulty digesting or metabolizing a particular food. Food intolerance disorders are a subset of all adverse food reactions and are reported by 15 to 20 percent of the population. Food intolerances are even more common among patients with irritable bowel syndrome and other functional gastrointestinal disorders, with 50 to 80 percent reporting consistent problems with certain foods. […] Food intolerances are not immunologic allergies and do not carry the same risk, although patients may not appreciate this distinction. A simple way to explain the difference is that food intolerance generally involves the digestive system, the amount of food ingested is directly related to the severity of symptoms, and the food causes similar symptoms with each exposure. […] Clinical features of food intolerances traverse a spectrum of organ systems and vary among different disorders, although most involve prominent gastrointestinal symptoms. Excessive intestinal gas, bloating, abdominal pain, and diarrhea are common symptoms.
#9 The Epidemiology of Food Allergy in the Global Context
https://www.mdpi.com/1660-4601/15/9/2043
There is a lack of high-quality evidence based on the gold standard of oral food challenges to determine food allergy prevalence. […] Nevertheless, studies using surrogate measures of food allergy, such as health service utilization and clinical history, together with allergen-specific immunoglobulin E (sIgE), provide compelling data that the prevalence of food allergy is increasing in both Western and developing countries. […] Accurate determination of food allergy prevalence confirmed by the gold standard of food challenge is resource intensive, which limits the availability of quality data, as emphasized in a recent international survey. […] Currently, the majority of available data is based on self-reporting, which generally overestimates food allergy prevalence by a factor of three to four.
#10 Prevalence of food allergies and intolerances documented in electronic health records – PubMed
https://pubmed.ncbi.nlm.nih.gov/28577971/
Food allergy prevalence is reported to be increasing, but epidemiological data using patients’ electronic health records (EHRs) remain sparse. […] We sought to determine the prevalence of food allergy and intolerance documented in the EHR allergy module. […] Using allergy data from a large health care organization’s EHR between 2000 and 2013, we determined the prevalence of food allergy and intolerance by sex, racial/ethnic group, and allergen group. […] Among 2.7 million patients, we identified 97,482 patients (3.6%) with 1 or more food allergies or intolerances (mean, 1.4 0.1). The prevalence of food allergy and intolerance was higher in females (4.2% vs 2.9%; P .001) and Asians (4.3% vs 3.6%; P .001). […] Our findings are consistent with previously validated methods for studying food allergy, suggesting that the EHR’s allergy module has the potential to be used for clinical and epidemiological research.
#11 Prevalence of food hypersensitivity in relation to IgE sensitisation to common food allergens among the general adult population in West Sweden | Clinical and Translational Allergy | Full Text
https://ctajournal.biomedcentral.com/articles/10.1186/s13601-019-0261-z
The prevalence of self-experienced adverse reactions to foods seems to have an increasing trend in both adults and children. […] The prevalence of self-reported food hypersensitivity in West Sweden indicates a rising trend. […] The prevalence of self-reported food hypersensitivity to any of the 56 foods in the questionnaire was 32.5% (95% CI 29.6-35.4) and was more frequent among women in comparison to men (39.1% vs. 24.1%, p<0.001). [...] Sixteen per cent of the subjects (95% CI 13.8-18.3) were IgE-sensitised to any of the 9 common foods, most often to hazelnut (13.3%) and peanut (4.9%). [...] Approximately 6% of adults reported food-related symptoms and were also IgE-sensitised to any of these nine common foods, indicating food allergy. [...] The prevalence of hypersensitivity to any red meat was found to be 0.9%. [...] In conclusion, every third adult reported food hypersensitivity, indicating a tendency for a rising trend compared with previous studies.
#12 Prevalence of food hypersensitivity in relation to IgE sensitisation to common food allergens among the general adult population in West Sweden | Clinical and Translational Allergy | Full Text
https://ctajournal.biomedcentral.com/articles/10.1186/s13601-019-0261-z
The prevalence of self-experienced adverse reactions to foods seems to have an increasing trend in both adults and children. […] The prevalence of self-reported food hypersensitivity in West Sweden indicates a rising trend. […] The prevalence of self-reported food hypersensitivity to any of the 56 foods in the questionnaire was 32.5% (95% CI 29.6-35.4) and was more frequent among women in comparison to men (39.1% vs. 24.1%, p<0.001). [...] Sixteen per cent of the subjects (95% CI 13.8-18.3) were IgE-sensitised to any of the 9 common foods, most often to hazelnut (13.3%) and peanut (4.9%). [...] Approximately 6% of adults reported food-related symptoms and were also IgE-sensitised to any of these nine common foods, indicating food allergy. [...] The prevalence of hypersensitivity to any red meat was found to be 0.9%. [...] In conclusion, every third adult reported food hypersensitivity, indicating a tendency for a rising trend compared with previous studies.
#13 More Than a Quarter of U.S. Adults and Children Have at Least One Allergy
https://www.cdc.gov/nchs/pressroom/nchs_press_releases/2022/20220126.htm
Nearly 1 in 3 U.S. adults and more than 1 in 4 U.S. children reported having a seasonal allergy, eczema, or food allergy in 2021, according to new data from CDCs National Center for Health Statistics. […] Almost 6% of U.S. adults and children have a food allergy, with Black, Non-Hispanic adults, and children one of the most likely to report this type of allergy. […] Black, Non-Hispanic adults are more likely to have a food allergy (8.5%) compared to Hispanic (4.4%); White, non-Hispanic (6.2%), and Asian, non-Hispanic (4.5%) adults. […] Black, non-Hispanic children are more likely to have a food allergy (7.6%) compared to Hispanic (5%) and White, non-Hispanic (5.3%) children.
#14 Food hypersensitivity: an examination of factors influencing symptoms and temporal changes in the prevalence of sensitization in an adult sample | European Journal of Clinical Nutrition
https://www.nature.com/articles/s41430-023-01284-w
Food hypersensitivity (FHS) is common, but little is known about the factors associated with severe reactions, age of onset and whether sensitization persists. This study examines the factors associated with self-reported severe food reactions, onset age and the changes in prevalence of sensitization to foods over time in an adult sample. […] The prevalence of self-reported FHS was 13.5% at ECRHS III. Of those providing information on symptoms, 26.4% reported severe reactions. […] History of asthma (odds ratio OR 2.12 95% confidence interval CI 1.13-3.44) and a younger age of onset of FHS (OR 1.02, 95% CI 1.01-1.03, per year) were associated with higher risks of a lifetime experience of severe food reactions. […] In the subsample with IgE tested in both surveys, the overall prevalence of sensitization to foods did not change over 10 years.
#15 Food hypersensitivity: an examination of factors influencing symptoms and temporal changes in the prevalence of sensitization in an adult sample | European Journal of Clinical Nutrition
https://www.nature.com/articles/s41430-023-01284-w
Food hypersensitivity (FHS) is common, but little is known about the factors associated with severe reactions, age of onset and whether sensitization persists. This study examines the factors associated with self-reported severe food reactions, onset age and the changes in prevalence of sensitization to foods over time in an adult sample. […] The prevalence of self-reported FHS was 13.5% at ECRHS III. Of those providing information on symptoms, 26.4% reported severe reactions. […] History of asthma (odds ratio OR 2.12 95% confidence interval CI 1.13-3.44) and a younger age of onset of FHS (OR 1.02, 95% CI 1.01-1.03, per year) were associated with higher risks of a lifetime experience of severe food reactions. […] In the subsample with IgE tested in both surveys, the overall prevalence of sensitization to foods did not change over 10 years.
#16 Products – Data Briefs – Number 10 – October 2008
https://www.cdc.gov/nchs/products/databriefs/db10.htm
In 2007, approximately 3 million children under age 18 years (3.9%) were reported to have a food or digestive allergy in the previous 12 months. […] From 1997 to 2007, the prevalence of reported food allergy increased 18% among children under age 18 years. […] Recent data show hospitalizations with diagnoses related to food allergies have increased among children. […] Hospitalizations having at least one diagnosis related to food allergy also increased from 1998-2000 through 2004-2006. This finding could be related to increased awareness, reporting, and use of specific medical diagnostic codes for food allergy or could represent a real increase in children who are experiencing food-allergic reactions.
#17 Products – Data Briefs – Number 10 – October 2008
https://www.cdc.gov/nchs/products/databriefs/db10.htm
In 2007, approximately 3 million children under age 18 years (3.9%) were reported to have a food or digestive allergy in the previous 12 months. […] From 1997 to 2007, the prevalence of reported food allergy increased 18% among children under age 18 years. […] Recent data show hospitalizations with diagnoses related to food allergies have increased among children. […] Hospitalizations having at least one diagnosis related to food allergy also increased from 1998-2000 through 2004-2006. This finding could be related to increased awareness, reporting, and use of specific medical diagnostic codes for food allergy or could represent a real increase in children who are experiencing food-allergic reactions.
#18 Epidemiology and Burden of Food Allergy
https://pmc.ncbi.nlm.nih.gov/articles/PMC7883751/
In recent decades, food allergy has become an increasing concern for families, clinicians, and policymakers. This review aims to summarize what is currently known about the epidemiology and population-level burden of IgE-mediated food allergy, including its effects on quality of life. […] Prevalence surveys, healthcare utilization data and findings from longitudinal cohort studies across the globe indicate that food allergy imposes a growing societal burden. Worryingly, recent data indicate that food allergies may be more prevalent among adult populations than previously acknowledged, with many reported cases of adult-onset allergies. […] While it remains unclear how much of the current population-level burden of disease results from true, IgE-mediated allergy, as much epidemiological data does not incorporate clinical confirmation of disease prevalence it is clear that affected individuals suffer substantial impairments in their quality of life and incur substantial economic costs beyond the physical health burden imposed by anaphylaxis.
#19 Epidemiology and Burden of Food Allergy
https://pmc.ncbi.nlm.nih.gov/articles/PMC7883751/
This resulted in elevated prevalence rates at 18 years relative to mid-childhood. […] These patterns are somewhat consistent with recent cross-sectional prevalence survey findings in the US, which reported higher food allergy prevalence rates among young adults than among pediatric samples, as well as high rates of adult-onset food allergy. […] Recent data also indicate that White adults have lower rates of food allergy relative to their Black, Hispanic, Asian, and multiracial counterparts and prevalence rates appear similar among adults in the highest and lowest income strata. […] These epidemiological findings of racial differences are mostly consistent with previous literature, such as the random digit dial telephone survey research by Sicherer et al that demonstrated Black respondents reported higher rates of seafood allergy than other racial/ethnic groups.
#20 Epidemiology and Burden of Food Allergy
https://pmc.ncbi.nlm.nih.gov/articles/PMC7883751/
This resulted in elevated prevalence rates at 18 years relative to mid-childhood. […] These patterns are somewhat consistent with recent cross-sectional prevalence survey findings in the US, which reported higher food allergy prevalence rates among young adults than among pediatric samples, as well as high rates of adult-onset food allergy. […] Recent data also indicate that White adults have lower rates of food allergy relative to their Black, Hispanic, Asian, and multiracial counterparts and prevalence rates appear similar among adults in the highest and lowest income strata. […] These epidemiological findings of racial differences are mostly consistent with previous literature, such as the random digit dial telephone survey research by Sicherer et al that demonstrated Black respondents reported higher rates of seafood allergy than other racial/ethnic groups.
#21 Protein Intolerance: Background, Pathophysiology, Epidemiology
https://emedicine.medscape.com/article/931548-overview
Varying incidences of specific intolerances have been reported in different countries. Whether these differences are due to genetic or cultural factors is unclear. […] To evaluate the prevalence of food allergy among different countries in Europe, the EuroPrevall project was launched in June 2005. Subsequently, the EuroPrevall-INCO project has been developed to evaluate the prevalence of food allergies in China, India, and Russia. […] Gastrointestinal food protein intolerance is mainly a problem in infancy and early childhood. Cow’s milk allergy or intolerance usually develops in early infancy. In most of the cases, the onset of symptoms is closely related to the time of introduction of formula based on cow’s milk. […] An unselected prospective study indicated that 42% of infants who developed cow’s milk protein intolerance were symptomatic within 7 days (70% within 4 wk) following the introduction of cow’s milk.
#22 Protein Intolerance: Background, Pathophysiology, Epidemiology
https://emedicine.medscape.com/article/931548-overview
Cow’s milk protein intolerance has been diagnosed in 1.9-2.8% of general populations of infants aged 2 years or younger in different countries of northern Europe, but incidence fell to approximately 0.3% in children older than 3 years. […] Protein intolerance is generally believed to remit by age 5 years, when the infant’s mucosal immune system matures and the child becomes immunologically tolerant of milk proteins; in most affected children, symptoms resolve by age 1-2 years. However, cow’s milk protein intolerance may persist or may initially manifest in older children, demonstrating characteristic endoscopic and histopathologic features; it occasionally recurs in adults. […] Studies have suggested increased persistence of food allergies (albeit ones possibly affected by selection bias); possible explanations have been primarily focused on peanut intolerance.
#23 Protein Intolerance: Background, Pathophysiology, Epidemiology
https://emedicine.medscape.com/article/931548-overview
Cow’s milk protein intolerance has been diagnosed in 1.9-2.8% of general populations of infants aged 2 years or younger in different countries of northern Europe, but incidence fell to approximately 0.3% in children older than 3 years. […] Protein intolerance is generally believed to remit by age 5 years, when the infant’s mucosal immune system matures and the child becomes immunologically tolerant of milk proteins; in most affected children, symptoms resolve by age 1-2 years. However, cow’s milk protein intolerance may persist or may initially manifest in older children, demonstrating characteristic endoscopic and histopathologic features; it occasionally recurs in adults. […] Studies have suggested increased persistence of food allergies (albeit ones possibly affected by selection bias); possible explanations have been primarily focused on peanut intolerance.
#24 The Epidemiology of Food Allergy in the Global Context
https://www.mdpi.com/1660-4601/15/9/2043
There is a lack of high-quality evidence based on the gold standard of oral food challenges to determine food allergy prevalence. […] Nevertheless, studies using surrogate measures of food allergy, such as health service utilization and clinical history, together with allergen-specific immunoglobulin E (sIgE), provide compelling data that the prevalence of food allergy is increasing in both Western and developing countries. […] Accurate determination of food allergy prevalence confirmed by the gold standard of food challenge is resource intensive, which limits the availability of quality data, as emphasized in a recent international survey. […] Currently, the majority of available data is based on self-reporting, which generally overestimates food allergy prevalence by a factor of three to four.
#25 The Epidemiology of Food Allergy in the Global Context
https://www.mdpi.com/1660-4601/15/9/2043
There is a lack of high-quality evidence based on the gold standard of oral food challenges to determine food allergy prevalence. […] Nevertheless, studies using surrogate measures of food allergy, such as health service utilization and clinical history, together with allergen-specific immunoglobulin E (sIgE), provide compelling data that the prevalence of food allergy is increasing in both Western and developing countries. […] Accurate determination of food allergy prevalence confirmed by the gold standard of food challenge is resource intensive, which limits the availability of quality data, as emphasized in a recent international survey. […] Currently, the majority of available data is based on self-reporting, which generally overestimates food allergy prevalence by a factor of three to four.
#26 The Epidemiology of Food Allergy in the Global Context
https://www.mdpi.com/1660-4601/15/9/2043
There is a lack of high-quality evidence based on the gold standard of oral food challenges to determine food allergy prevalence. […] Nevertheless, studies using surrogate measures of food allergy, such as health service utilization and clinical history, together with allergen-specific immunoglobulin E (sIgE), provide compelling data that the prevalence of food allergy is increasing in both Western and developing countries. […] Accurate determination of food allergy prevalence confirmed by the gold standard of food challenge is resource intensive, which limits the availability of quality data, as emphasized in a recent international survey. […] Currently, the majority of available data is based on self-reporting, which generally overestimates food allergy prevalence by a factor of three to four.
#27 The Epidemiology of Food Allergy in the Global Context
https://www.mdpi.com/1660-4601/15/9/2043
There is a lack of high-quality evidence based on the gold standard of oral food challenges to determine food allergy prevalence. […] Nevertheless, studies using surrogate measures of food allergy, such as health service utilization and clinical history, together with allergen-specific immunoglobulin E (sIgE), provide compelling data that the prevalence of food allergy is increasing in both Western and developing countries. […] Accurate determination of food allergy prevalence confirmed by the gold standard of food challenge is resource intensive, which limits the availability of quality data, as emphasized in a recent international survey. […] Currently, the majority of available data is based on self-reporting, which generally overestimates food allergy prevalence by a factor of three to four.
#28 Prevalence of food allergies and intolerances documented in electronic health records – PubMed
https://pubmed.ncbi.nlm.nih.gov/28577971/
Food allergy prevalence is reported to be increasing, but epidemiological data using patients’ electronic health records (EHRs) remain sparse. […] We sought to determine the prevalence of food allergy and intolerance documented in the EHR allergy module. […] Using allergy data from a large health care organization’s EHR between 2000 and 2013, we determined the prevalence of food allergy and intolerance by sex, racial/ethnic group, and allergen group. […] Among 2.7 million patients, we identified 97,482 patients (3.6%) with 1 or more food allergies or intolerances (mean, 1.4 0.1). The prevalence of food allergy and intolerance was higher in females (4.2% vs 2.9%; P .001) and Asians (4.3% vs 3.6%; P .001). […] Our findings are consistent with previously validated methods for studying food allergy, suggesting that the EHR’s allergy module has the potential to be used for clinical and epidemiological research.
#29 Epidemiology and Burden of Food Allergy
https://pmc.ncbi.nlm.nih.gov/articles/PMC7883751/
Recent national US survey data also indicate that Black adult food allergy patients report higher rates of severe reactions, as well as higher rates of food allergy-related emergency department visits than White adults, even after adjusting for comorbid atopy and a large number of other relevant sociodemographic factors. […] Taken together, these data highlight the importance of better understanding and addressing root causes of these apparent racial differences in food allergy prevalence, and possibly severity. […] The apparent rise in food allergy prevalence among adolescents and young adults is particularly concerning given that these age groups appear disproportionately affected by food-induced anaphylaxis, including fatal reactions. […] Numerous recent analyses of healthcare utilization data are consistent with European, Australian, and US survey research findings indicating rising food allergy burden.
#30
https://link.springer.com/article/10.1007/s11882-020-0898-7
The most recent, nationally-representative epidemiological survey data on the population-level burden of food allergies among US adults. […] The most recent, nationally-representative epidemiological survey data on the population-level burden of food allergies among US children. […] Limitations of reliance on specific IgE for epidemiologic surveillance of food allergy. […] The latest food allergy data from the Isle of Wight Birth Cohort, an unselected longitudinal birth cohort examining the natural history of food allergy at 1, 2, 4, 10 and 18 year follow-up assessments, including skin prick testing of reported allergies. […] A short, thoughtful summary of the latest data comparing food allergy prevalence between urban and rural communities and how it sheds light on the etiology of atopic disease. […] A recent review characterizing the economic impact of food allergies on patients, their families and health care systems.
#31 Epidemiology of food allergy in Latin America | Allergologia et Immunopathologia
https://www.elsevier.es/es-revista-allergologia-et-immunopathologia-105-articulo-epidemiology-food-allergy-in-latin-S0301054613002280
Food allergy is growing worldwide at an alarming rate. A group of eight foods account for over 90% of the reactions in Europe and the United States. However, little is known about the frequency of sensitization to these foods in Latin American, and if other native foods from this region are an important source of sensitization. The objective of this review was to analyse the epidemiological studies in Latin America about food allergy and to compare them with the studies in the United States and Europe. […] Currently, the prevalence of food allergies varies widely between studies: in self-report studies higher frequencies are found (10-15%) than when objective methods such as oral provocation are used (1-3%). In studies that have evaluated food sensitization by skin tests or serum IgE, it was found that 30-40% of the general population is sensitized to at least one food, this being more frequent in children under three years (5-8%) and in people with allergic diseases such as asthma (6-8%) and atopic dermatitis (30-50%).
#32 The Epidemiology of Food Allergy in the Global Context
https://www.mdpi.com/1660-4601/15/9/2043
There is a lack of high-quality evidence based on the gold standard of oral food challenges to determine food allergy prevalence. […] Nevertheless, studies using surrogate measures of food allergy, such as health service utilization and clinical history, together with allergen-specific immunoglobulin E (sIgE), provide compelling data that the prevalence of food allergy is increasing in both Western and developing countries. […] Accurate determination of food allergy prevalence confirmed by the gold standard of food challenge is resource intensive, which limits the availability of quality data, as emphasized in a recent international survey. […] Currently, the majority of available data is based on self-reporting, which generally overestimates food allergy prevalence by a factor of three to four.
#33 Prevalence of food allergies and intolerances documented in electronic health records – PubMed
https://pubmed.ncbi.nlm.nih.gov/28577971/
Food allergy prevalence is reported to be increasing, but epidemiological data using patients’ electronic health records (EHRs) remain sparse. […] We sought to determine the prevalence of food allergy and intolerance documented in the EHR allergy module. […] Using allergy data from a large health care organization’s EHR between 2000 and 2013, we determined the prevalence of food allergy and intolerance by sex, racial/ethnic group, and allergen group. […] Among 2.7 million patients, we identified 97,482 patients (3.6%) with 1 or more food allergies or intolerances (mean, 1.4 0.1). The prevalence of food allergy and intolerance was higher in females (4.2% vs 2.9%; P .001) and Asians (4.3% vs 3.6%; P .001). […] Our findings are consistent with previously validated methods for studying food allergy, suggesting that the EHR’s allergy module has the potential to be used for clinical and epidemiological research.
#34
https://link.springer.com/article/10.1007/s11882-023-01120-y
Food allergies are immune-mediated, complex disorders, which are the source of increasing health concern worldwide. […] Moreover, growing epidemiologic evidence suggests that the population health burden of non-IgE-mediated FAs, such as food protein-induced enterocolitis syndrome, may also be higher than previously reported. […] Systematic epidemiological research initiatives are needed, both nationally and globally, to better understand and reduce the burden of these allergic diseases.
#35 The epidemiology of food allergy in Europe: protocol for a systematic review | springermedizin.de
https://www.springermedizin.de/the-epidemiology-of-food-allergy-in-europe-protocol-for-a-system/9677868
The proportion of a defined population known to have experienced the various IgE-mediated, non-IgE-mediated or combination causes of food allergy. […] The proportion of cases of anaphylaxis that proves fatal (usually defined within a time period). […] The European Academy of Allergy and Clinical Immunology (EAACI) is in the process of developing the EAACI Guideline for Food Allergy and Anaphylaxis, and this systematic review is one of seven inter-linked evidence syntheses that are being undertaken in order to provide a state-of-the-art synopsis of the current evidence base in relation to epidemiology, prevention, diagnosis and clinical management and impact on quality of life, which will be used to inform the formulation of clinical recommendations. […] There is clearly a need for large, population-based, longitudinal studies employing DBPCFCs to secure the diagnosis of food allergy, but in the interim there is also a need to make better sense of the extant literature in order to, amongst other things, inform estimates on the frequency of the disease, provide insights into disease aetiology, and enable risk stratification, which can be used to inform management decisions and deliberations on prognosis.
#36 The epidemiology of food allergy in Europe: protocol for a systematic review | springermedizin.de
https://www.springermedizin.de/the-epidemiology-of-food-allergy-in-europe-protocol-for-a-system/9677868
The proportion of a defined population known to have experienced the various IgE-mediated, non-IgE-mediated or combination causes of food allergy. […] The proportion of cases of anaphylaxis that proves fatal (usually defined within a time period). […] The European Academy of Allergy and Clinical Immunology (EAACI) is in the process of developing the EAACI Guideline for Food Allergy and Anaphylaxis, and this systematic review is one of seven inter-linked evidence syntheses that are being undertaken in order to provide a state-of-the-art synopsis of the current evidence base in relation to epidemiology, prevention, diagnosis and clinical management and impact on quality of life, which will be used to inform the formulation of clinical recommendations. […] There is clearly a need for large, population-based, longitudinal studies employing DBPCFCs to secure the diagnosis of food allergy, but in the interim there is also a need to make better sense of the extant literature in order to, amongst other things, inform estimates on the frequency of the disease, provide insights into disease aetiology, and enable risk stratification, which can be used to inform management decisions and deliberations on prognosis.
#37
https://www.healio.com/clinical-guidance/food-allergies/epidemiology-of-food-allergies-overview
The development of food allergies is influenced by various risk factors, contributing to the variability in prevalence observed worldwide. […] Higher prevalence rates are often reported in developed countries compared to developing regions, suggesting that urbanization, changes in dietary habits, and environmental exposures may play a significant role in allergy development.
#38 Epidemiology and Burden of Food Allergy
https://pmc.ncbi.nlm.nih.gov/articles/PMC7883751/
Cross-sectional data indicating rising food allergy prevalence in the United States were recently corroborated by a longitudinal analysis of national health insurance claims data, which demonstrated the incidence of peanut allergy increased steadily from 2001 to 2006 and is estimated to continue increasing through 2020. […] Numerous studies have reported systematic differences in food allergy burden between urban and rural communities, with higher prevalence rates reported in urban areas than rural areas, even after accounting for differences in racial and socioeconomic composition. […] Previous literature has suggested that as highly populous South and East Asian countries increasingly urbanize and/or adopt lifestyles more akin to those of Western and/or industrialized countries, their burden of allergic disease is likely to increase absent large-scale implementation of effective allergy prevention interventions.
#39 Epidemiology and Burden of Food Allergy
https://pmc.ncbi.nlm.nih.gov/articles/PMC7883751/
Cross-sectional data indicating rising food allergy prevalence in the United States were recently corroborated by a longitudinal analysis of national health insurance claims data, which demonstrated the incidence of peanut allergy increased steadily from 2001 to 2006 and is estimated to continue increasing through 2020. […] Numerous studies have reported systematic differences in food allergy burden between urban and rural communities, with higher prevalence rates reported in urban areas than rural areas, even after accounting for differences in racial and socioeconomic composition. […] Previous literature has suggested that as highly populous South and East Asian countries increasingly urbanize and/or adopt lifestyles more akin to those of Western and/or industrialized countries, their burden of allergic disease is likely to increase absent large-scale implementation of effective allergy prevention interventions.
#40 Food allergy epidemiology and racial and/or ethnic differences: Ingenta Connect
https://www.ingentaconnect.com/content/ocean/jfa/2020/00000002/00000001/art00004
Furthermore, there is a growing appreciation for the potential protective effects of diverse microbial exposures, given mounting evidence for the immunomodulatory effects of the human microbiome. […] Also, when considering the geographic variability in the prevalence of certain food and environmental allergies as well as their structural similarities at the molecular level, it is believed that co-sensitization between food and environmental allergens may be a key driver of rising food allergy prevalence.
#41 Food allergy epidemiology and racial and/or ethnic differences: Ingenta Connect
https://www.ingentaconnect.com/content/ocean/jfa/2020/00000002/00000001/art00004
Furthermore, there is a growing appreciation for the potential protective effects of diverse microbial exposures, given mounting evidence for the immunomodulatory effects of the human microbiome. […] Also, when considering the geographic variability in the prevalence of certain food and environmental allergies as well as their structural similarities at the molecular level, it is believed that co-sensitization between food and environmental allergens may be a key driver of rising food allergy prevalence.
#42 Epidemiology and Burden of Food Allergy
https://pmc.ncbi.nlm.nih.gov/articles/PMC7883751/
In recent decades, food allergy has become an increasing concern for families, clinicians, and policymakers. This review aims to summarize what is currently known about the epidemiology and population-level burden of IgE-mediated food allergy, including its effects on quality of life. […] Prevalence surveys, healthcare utilization data and findings from longitudinal cohort studies across the globe indicate that food allergy imposes a growing societal burden. Worryingly, recent data indicate that food allergies may be more prevalent among adult populations than previously acknowledged, with many reported cases of adult-onset allergies. […] While it remains unclear how much of the current population-level burden of disease results from true, IgE-mediated allergy, as much epidemiological data does not incorporate clinical confirmation of disease prevalence it is clear that affected individuals suffer substantial impairments in their quality of life and incur substantial economic costs beyond the physical health burden imposed by anaphylaxis.
#43
https://link.springer.com/article/10.1007/s11882-020-0898-7
In recent decades, food allergy has become an increasing concern for families, clinicians, and policymakers. This review aims to summarize what is currently known about the epidemiology and population-level burden of IgE-mediated food allergy, including its effects on quality of life. […] Prevalence surveys, healthcare utilization data, and findings from longitudinal cohort studies across the globe indicate that food allergy imposes a growing societal burden. Worryingly, recent data indicate that food allergies may be more prevalent among adult populations than previously acknowledged, with many reported cases of adult-onset allergies. […] While it remains unclear how much of the current population-level burden of disease results from true, IgE-mediated allergy, as much epidemiological data does not incorporate clinical confirmation of disease prevalence it is clear that affected individuals suffer impairments in their quality of life and incur substantial economic costs beyond the physical health burden imposed by anaphylaxis.
#44 Epidemiology and Burden of Food Allergy
https://pmc.ncbi.nlm.nih.gov/articles/PMC7883751/
In sum, recent data suggest that food allergy affects a growing number of infants, children and adults around the world. While it has traditionally been conceptualized as a largely pediatric condition, recent data indicate that an even greater number of adults are impacted. Overall population-level burden of food allergy is likely to increase in the absence of rapid deployment of effective prevention interventions.
#45 The Epidemiology of Food Allergy in the Global Context
https://www.mdpi.com/1660-4601/15/9/2043
An important consideration when evaluating time trends in food allergy prevalence is that the point prevalence is determined by the combined impact of new incident cases and resolution of existing cases. […] Most countries have reported an increase in food allergy prevalence over the last decade. […] There are no studies in Western countries with repeated measures of challenge-proven food allergy, and the majority of studies have instead evaluated changes over time using hospital anaphylaxis admission rates or increasing health care burden as a surrogate measure for food allergy prevalence. […] Food allergy is a growing health concern, with increasing prevalence noted not just in Westernized countries but also in developing countries. […] More robust studies using standardized methodologies and objective methods of assessment are necessary for accurate detection of food allergy in order to better understand the true extent of the problem and its impact on health services. […] It is clear that for the prevalence of food allergy to stabilize or fall, strategies to hasten disease resolution and reduce disease incidence are required.
#46 Food hypersensitivity: an examination of factors influencing symptoms and temporal changes in the prevalence of sensitization in an adult sample | European Journal of Clinical Nutrition
https://www.nature.com/articles/s41430-023-01284-w
We found no evidence of changes in the prevalence of sensitization to food in adults followed for 10 years. […] Changes in sensitization to food with age or over time in populations have been reported in children, but little is known about new onset FHS or changes in sensitization to food in adults. […] Our study showed that one-quarter of the surveyed adults reporting FHS had reactions that can be linked to severe outcomes, with the history of asthma and a younger onset age of FHS as potential risk factors. […] There was no evidence of an increase in overall prevalence of sensitization to foods in this sample in the 10-year period.
#47 Clarifying the Hazy Concepts of Food Allergies and Sensitivities Â â Gastroenterology & Hepatology
https://www.gastroenterologyandhepatology.net/archives/september-2024/clarifying-the-hazy-concepts-of-food-allergies-and-sensitivities/
Food allergies, food sensitivities, and adverse reactions to food represent common reasons for gastroenterology and allergy referral. The epidemiology of these disorders is changing; food allergies are more common than previously thought, and there is a heightened sense of awareness about food sensitivities. […] As many as 6.5% to 13% of US adults self-report at least 1 food allergy. […] Several national surveys in countries across the world have reported an increase in the prevalence of childhood food allergies between 1997 and 2011. […] In the United States, the prevalence increased from 3.4% in 1997 to 5.1% in 2011. […] Similar to other atopic conditions, food allergies seem to be more prevalent in populations other than the White, non-Hispanic population. […] In summary, multiple individual studies and systematic reviews confirm a significant prevalence of food allergies worldwide. Further double-blind, placebo-controlled oral food challenges are needed to establish confidence in food allergy prevalence, especially with regard to racial and ethnic differences.
#48 The Epidemiology of Food Allergy in the Global Context
https://www.mdpi.com/1660-4601/15/9/2043
An important consideration when evaluating time trends in food allergy prevalence is that the point prevalence is determined by the combined impact of new incident cases and resolution of existing cases. […] Most countries have reported an increase in food allergy prevalence over the last decade. […] There are no studies in Western countries with repeated measures of challenge-proven food allergy, and the majority of studies have instead evaluated changes over time using hospital anaphylaxis admission rates or increasing health care burden as a surrogate measure for food allergy prevalence. […] Food allergy is a growing health concern, with increasing prevalence noted not just in Westernized countries but also in developing countries. […] More robust studies using standardized methodologies and objective methods of assessment are necessary for accurate detection of food allergy in order to better understand the true extent of the problem and its impact on health services. […] It is clear that for the prevalence of food allergy to stabilize or fall, strategies to hasten disease resolution and reduce disease incidence are required.
#49 The Epidemiology of Food Allergy in the Global Context
https://www.mdpi.com/1660-4601/15/9/2043
An important consideration when evaluating time trends in food allergy prevalence is that the point prevalence is determined by the combined impact of new incident cases and resolution of existing cases. […] Most countries have reported an increase in food allergy prevalence over the last decade. […] There are no studies in Western countries with repeated measures of challenge-proven food allergy, and the majority of studies have instead evaluated changes over time using hospital anaphylaxis admission rates or increasing health care burden as a surrogate measure for food allergy prevalence. […] Food allergy is a growing health concern, with increasing prevalence noted not just in Westernized countries but also in developing countries. […] More robust studies using standardized methodologies and objective methods of assessment are necessary for accurate detection of food allergy in order to better understand the true extent of the problem and its impact on health services. […] It is clear that for the prevalence of food allergy to stabilize or fall, strategies to hasten disease resolution and reduce disease incidence are required.
#50 Epidemiology of food allergy in Latin America | Allergologia et Immunopathologia
https://www.elsevier.es/es-revista-allergologia-et-immunopathologia-105-articulo-epidemiology-food-allergy-in-latin-S0301054613002280
Globally, existing studies about FA are difficult to compare due to variations in the definition of FA and differences in the food panel tested. […] According to our review, food allergy in Latin America seems to have points in common with studies in other regions but also distinctive features, especially with the frequency of sensitization to some fruits and vegetables. Studies with provocation tests are required to confirm the clinical relevance of these sensitizations. […] In conclusion, this review shows a need for further studies on food allergy in Latin America as their regional characteristics provide a different behaviour and different food sensitization pattern to that observed in Europe and the United States. Furthermore, these results must be translated into educational measures for health providers and patients.
#51 The Epidemiology of Food Allergy in the Global Context
https://www.mdpi.com/1660-4601/15/9/2043
An important consideration when evaluating time trends in food allergy prevalence is that the point prevalence is determined by the combined impact of new incident cases and resolution of existing cases. […] Most countries have reported an increase in food allergy prevalence over the last decade. […] There are no studies in Western countries with repeated measures of challenge-proven food allergy, and the majority of studies have instead evaluated changes over time using hospital anaphylaxis admission rates or increasing health care burden as a surrogate measure for food allergy prevalence. […] Food allergy is a growing health concern, with increasing prevalence noted not just in Westernized countries but also in developing countries. […] More robust studies using standardized methodologies and objective methods of assessment are necessary for accurate detection of food allergy in order to better understand the true extent of the problem and its impact on health services. […] It is clear that for the prevalence of food allergy to stabilize or fall, strategies to hasten disease resolution and reduce disease incidence are required.
#52 Epidemiology of food allergy in Latin America | Allergologia et Immunopathologia
https://www.elsevier.es/es-revista-allergologia-et-immunopathologia-105-articulo-epidemiology-food-allergy-in-latin-S0301054613002280
The objective of this research is to review the articles published about the epidemiology of food allergy made in Latin America. […] The search included all kinds of diseases associated with a food allergic reaction (hives, otitis, etc.), with emphasis in eczema, asthma, rhinitis and gastrointestinal symptoms. […] In recent years some cohort studies of children followed from birth, are being carried out in several Latin American countries; this has allowed a better understanding of the characteristics of allergic diseases in the tropics and to identify potential risk factors for food allergy and food sensitization. […] Currently, medical doctors in Latin America need more information about appropriate prevention measures of food allergy. The main risk factor identified in Latin American birth cohorts were a family history of atopy and early weaning especially with milk and egg. Because the risk and protective factors vary among populations, more birth cohort studies are needed.
#53 Epidemiology of food allergy in Latin America | Allergologia et Immunopathologia
https://www.elsevier.es/es-revista-allergologia-et-immunopathologia-105-articulo-epidemiology-food-allergy-in-latin-S0301054613002280
The objective of this research is to review the articles published about the epidemiology of food allergy made in Latin America. […] The search included all kinds of diseases associated with a food allergic reaction (hives, otitis, etc.), with emphasis in eczema, asthma, rhinitis and gastrointestinal symptoms. […] In recent years some cohort studies of children followed from birth, are being carried out in several Latin American countries; this has allowed a better understanding of the characteristics of allergic diseases in the tropics and to identify potential risk factors for food allergy and food sensitization. […] Currently, medical doctors in Latin America need more information about appropriate prevention measures of food allergy. The main risk factor identified in Latin American birth cohorts were a family history of atopy and early weaning especially with milk and egg. Because the risk and protective factors vary among populations, more birth cohort studies are needed.
#54 Epidemiology of food allergy in Latin America | Allergologia et Immunopathologia
https://www.elsevier.es/es-revista-allergologia-et-immunopathologia-105-articulo-epidemiology-food-allergy-in-latin-S0301054613002280
Globally, existing studies about FA are difficult to compare due to variations in the definition of FA and differences in the food panel tested. […] According to our review, food allergy in Latin America seems to have points in common with studies in other regions but also distinctive features, especially with the frequency of sensitization to some fruits and vegetables. Studies with provocation tests are required to confirm the clinical relevance of these sensitizations. […] In conclusion, this review shows a need for further studies on food allergy in Latin America as their regional characteristics provide a different behaviour and different food sensitization pattern to that observed in Europe and the United States. Furthermore, these results must be translated into educational measures for health providers and patients.