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JACI Highlights - April 2008
Zuidmeer, et al. - The prevalence of plant food allergies: a systematic review
Laurian Zuidmeer, PhD, Klaus Goldhahn, Roberto J Rona, FFPH, David Gislason, MD, Charlotte Madsen, DVM, Colin Summers, BSc, Eva Sodergren,PhD, Jorgen Dahlstrom, PhD, Titia Lindner, MD, Sigurveig T Sigurdardottir, MD, Doreen McBride, MBA, Thomas Keil, MD
The prevalence of food allergies, particularly to fruits, vegetables, nuts, and other food plants, has been difficult to establish. Although allergic reactions to edible plants have been recorded for some time, the extent of the problem for patients and their families, schools, food producers and retailers and the catering industry, health professionals, and policy makers remains unclear. This is primarily because there has been no systematic approach to summarizing the prevalence of plant food allergy in the community. In 2005, EuroPrevall, a Europe-wide research project, was launched to evaluate the prevalence, basis, and cost of food allergies. As part of this project, in a study that was recently published in the Journal of Allergy and Clinical Immunology, Laurian Zuidmeer, PhD, and colleagues critically evaluated previously published food allergy studies worldwide since 1990 to summarize allergy prevalence in 6 categories of plant food: fruits, vegetables and legumes, tree nuts, wheat, soy, and sesame/cereals/spices/herbs combined. They found that the use of the gold standard for diagnosis, the double-blind oral food challenge test, has seldom been used to confirm food allergy, and few studies used an objective determination of sensitization through skin prick testing or measurement of specific antibodies against plant food in the blood. The highest prevalence estimates were based upon patients’ or families’ self-reported allergic reactions. Lack of a standard and correct objective method for diagnosing plant food allergies has also contributed to difficulties in determining true prevalence rates. These findings suggest that prevalence estimates of plant food allergies based on self-reported symptoms should be treated with caution, and that suspected allergic reactions to edible plants should be confirmed with double-blind placebo-controlled challenge tests by medical specialists.
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