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Which food allergies dominate in school-age children across Europe?

Published online: March 18, 2019

In Europe, self-reported food allergy (FA) seems to be much more common than probable FA, where reported symptoms to a specific food are matched by food sensitization. Food sensitization entails the presence of IgE antibodies against the culprit food in the blood, and is a prerequisite for FA. Prevalence of food sensitization and allergy appear to vary geographically, as do the most common causative foods, but the results from previous European studies in school-age children cannot be realistically compared because of different methodological approaches.

A study recently published by Lyons et al. in The Journal of Allergy and Clinical Immunology: In Practice, presents prevalence estimates of self-reported FA, food sensitization, and probable FA in 7- to 10-year-old children from eight European countries. These estimates were obtained through analyses of uniformly collected data from the EuroPrevall population surveys.  

Regarding self-reported FA, prevalence ranged from 6.5% in Greece to 24.6% in Poland. Food sensitization occurred least frequently in Iceland (11.0%) and most frequently in Switzerland (28.7%). The prevalence of probable FA was much lower than the prevalence of self-reported FA and of food sensitization, and was found to range from 1.9% in Iceland, to 2.0% in Greece, 2.3% in Switzerland, 3.0% in the Netherlands and Lithuania, 3.9% in Spain, and 5.6% in Poland. Probable FA to milk and egg was observed frequently throughout Europe. Fish and shrimp probable FA was mainly found in the Mediterranean countries and Reykjavik. Peach, kiwi and peanut were prominent sources of plant FA in most countries, along with notably hazelnut, apple, carrot and celery in Central-Northern Europe, and lentils and walnut in the Mediterranean.

Overall, a remarkable percentage of 7- to 10-year-old children across Europe appear to be food sensitized, and to a somewhat lesser extent, food allergic. Cow’s milk and hen’s egg allergy are common throughout Europe in this age group, but considerable geographical variation is observed in the occurrence of plant food and seafood allergy, for which country-specific pollen and food exposure are the most likely explanations. Compared to previously published adult data, prevalence of FS was higher in the current cohort of children, whereas probable FA was equally or more common in the adult cohort. This indicates a rise in prevalence of FS over time, which could suggest a rise in the prevalence of FA is still to come.

The Journal of Allergy and Clinical Immunology: In Practice is an official journal of the AAAAI, focusing on practical information for the practicing clinician.

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