Abstract
Background: Immunoglobulin E (IgE)-mediated food allergies (FAs) are increasingly common among US children and adults. Not only can living with FA impose considerable physical health impacts, but it also imposes economic burden and can negatively affect quality of life. Limited data indicate that allergy to multiple foods (multi-FA) also may be common, but much remains unknown about its distribution and determinants. Objective: To characterize the prevalence, characteristics, determinants, psychosocial burden, and distribution of multi-FA among a large, nationally representative sample of US children and adults. Methods: A US population-based survey was administered. Estimates of multi-FA prevalence, conditional frequencies of multi-FA combinations, and associated factors were derived. Latent class analyses were conducted using 9 dichotomized indicators of specific FA prevalence, which were used to determine factors associated with latent class membership and characterize FA-related psychosocial burden within each class. Results: Surveys were completed for 38,408 children and 40,443 adults. Among children and adults meeting established symptom-report criteria for FA, an estimated 40% and 48% had multi-FA, respectively. Among pediatric and adult populations with convincing FAs, the lifetime reported prevalence of physician-diagnosed atopic comorbidities increased significantly as the number of reported current convincing FAs increased, as did the proportion reporting multi-FA–related health care utilization and higher perceived psychosocial burden. Latent class analyses suggested the existence of the following 4 key latent phenotypes of multi-FA: milk and egg-dominant, seafood-dominant, peanut and tree nut-dominant, and broadly multi-food allergic. Conclusion: The US population-level burden of multi-FA is high among both children and adults, and data indicate the presence of 4 major phenotypes of multi-FA in both populations.
| Original language | English (US) |
|---|---|
| Pages (from-to) | 637-648.e5 |
| Journal | Annals of Allergy, Asthma and Immunology |
| Volume | 130 |
| Issue number | 5 |
| DOIs | |
| State | Published - May 2023 |
Funding
Disclosures: Dr Warren reports receiving research support from the National Institutes of Health (NIH), Food Allergy Research & Education (FARE), and the Sunshine Charitable Foundation. He is currently employed by Northwestern University and is an Assistant Professor of Preventive Medicine at the Northwestern University Feinberg School of Medicine. Dr Aktas was employed by the Northwestern University at the time of this work, and she is currently employed by the National Institute of Allergy and Infectious Disease/NIH. Dr Gupta receives research support from the NIH (R21 ID # AI135705, R01 ID # AI130348, U01 ID # AI138907), FARE, Melchiorre Family Foundation, Sunshine Charitable Foundation, The Walder Foundation, UnitedHealth Group, Thermo Fisher Scientific, and Genentech. She serves as a medical consultant/advisor for Genentech, Novartis, Aimmune LLC, Allergenis LLC, and FARE. Dr Gupta has ownership interest in Yobee Care, Inc. She is currently employed by Ann & Robert H. Lurie Children's Hospital of Chicago and is a Professor of Pediatrics & Medicine at the Northwestern University Feinberg School of Medicine. The other authors have no potential conflicts to disclose. Funding: This study was supported by the grant R21AI135702 from the National Institute of Allergy and Infectious Diseases (principal investigator Dr Gupta) and supported in part by the Intramural Research Program of the NIH, National Institute of Allergy and Infectious Diseases.
ASJC Scopus subject areas
- Immunology and Allergy
- Immunology
- Pulmonary and Respiratory Medicine