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Oral food challenge outcomes do not vary by race or ethnicity

Published online May 7, 2025

Previous studies have shown differences in the prevalence and medical management of patients with food allergies based on race and ethnicity. Prior research has utilized patient-reported food allergy data, which have limitations, such as recall bias. This study evaluated differences in oral food challenge (OFC) outcomes based on race and ethnicity. In addition, this study assessed differences between the population who presented for OFCs versus the general food allergy clinic. 

In a recent publication in The Journal of Allergy and Clinical Immunology: In Practice, Buckey et al. evaluated the outcomes of a robust pediatric OFC center at the Children’s Hospital of Philadelphia. From 2003 to 2023, a total of 11,869 OFCs were performed and analyzed. No differences were observed in OFC outcomes by race or ethnicity. 

To the authors’ knowledge, this was one of the largest studies assessing OFC outcomes and one of the first studies to demonstrate that outcomes of OFCs do not vary based on race or ethnicity. By evaluating OFCs recommended by and performed under the supervision of an allergist, this study eliminated the biases of patient reported data. This study showed these demographic characteristics should not be a part of an allergist’s decision on when to recommend an OFC. This study also identified that there were clear differences in patient demographics between the general food allergy clinic population and the population who underwent OFCs. Specifically, 72.4% of the OFC population self-identified as White but 58.4% of the general food allergy clinic identified as White. Of the OFC population, 7.8% were Black or African American, yet 17.9% of the food allergy clinic identified as Black or African American. Understanding why these differences were identified is a topic for future research. In addition, improving access to food allergy medical care and OFCs is an area for future intervention to reduce health disparities. 

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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