Understanding Food-Related Allergic Reactions Through a US National Patient Registry

Jamie L. Fierstein, Dannielle Brown, Ruchi Gupta*, Lucy Bilaver

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

7 Scopus citations


Background: Although previous studies have focused on unintentional food-related allergic reactions, few have explored the motivation of intentional exposure to a known food allergen, independent of oral food challenges and/or oral immunotherapy. Still, data on the frequency and context of food-related allergic reactions remain sparse. Objective: To identify the frequency and context of food-related allergic reactions among children and adults. Methods: We analyzed surveys from the Patient Registry established by Food Allergy Research and Education. Multivariable logistic regression evaluated characteristics associated with having frequent food-related allergic reactions as well as intentional food-related allergic reactions. Results: Over one-third of 4075 (37.7%) respondents reported having more than 1 food-related allergic reaction per year, and 12.8% reported having 1 reaction per year. Of the 3054 respondents who completed the most recent reaction survey, 9.9% of food allergen exposures were classified as intentional, 82.1% as unintentional, and 4.8% as medically related. Among children with intentional exposures, the most common reason was that the child had never had a serious reaction (50.0%), and among adults, it was the decision to take the risk anyway (47.8%). Cross-contamination was the most commonly cited reason for unintentional exposure (children: 24.1%; adults: 32.2%). Conclusion: Among patients in a national food allergy registry, reports of food-related allergic reactions were common, and a non-negligible number of intentional reactions were reported. Our findings indicate the need for research on reactions in and out of the emergency department as well as intentional risk-taking behavior.

Original languageEnglish (US)
Pages (from-to)206-215.e1
JournalJournal of Allergy and Clinical Immunology: In Practice
Issue number1
StatePublished - Jan 2021


  • Food allergic reactions
  • Food allergy
  • Intentional exposure
  • Reaction frequency
  • Reaction severity
  • Treatment
  • Unintentional exposure

ASJC Scopus subject areas

  • Immunology and Allergy


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