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Risk factors for food allergy in adolescents

Published online: February 3, 2018

The rise in prevalence of infantile food allergy as measured by hospital presentations for anaphylaxis now appears to be occurring later in childhood as well including in adolescence. However, risk factors for childhood and adolescent food allergy is understudied.

In this article published in The Journal of Allergy and Clinical Immunology: In Practice, Sasaki and colleagues investigated the risk factors for current adolescent food allergy. Data were used from the SchoolNuts study, a population-based cross-sectional study among 10-to 14-year-old adolescents in Melbourne, Australia. A questionnaire survey was followed by clinic evaluation including oral food challenge to determine the accurate food allergy status of the adolescent.  Data from a total of 4,991 adolescents were used for the analysis.

The authors found that males and adolescents with a history of early onset eczema (before age 1) had a higher risk of food allergy. Those with Asian ethnicity had increased risk compared to Caucasians. However, adolescents born in Asia were paradoxically protected from developing food allergy. The risk of food allergy increased by 2-fold in adolescents who had a single-family member with a history of any allergic disease, and increased by over 4-fold with 2 or more allergic family members. Dog exposure during the first 5 years of life was associated with a decreased risk.

Many of the associations that have been shown for food allergy in early childhood appear to remain relevant to food allergy risk in adolescence. This supports the role of genetic and environmental factors associated with the development of food allergy and the importance of targeting potentially modifiable factors to reverse the rise in the prevalence of childhood food allergy.

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