The Epidemiology of Food Allergy in the Global Context
Allergy and Immune Disorders, Murdoch Children’s Research Institute, Melbourne 3052, Australia
Allergy Service, Department of Paediatrics, KK Women’s and Children’s Hospital, Singapore 229899, Singapore
Department of Allergy and Immunology, The Royal Children’s Hospital, Melbourne 3052, Australia
Department of Paediatrics, University of Melbourne, Melbourne 3010, Australia
Author to whom correspondence should be addressed.
Int. J. Environ. Res. Public Health 2018, 15(9), 2043; https://doi.org/10.3390/ijerph15092043
Received: 2 August 2018 / Revised: 6 September 2018 / Accepted: 13 September 2018 / Published: 18 September 2018
(This article belongs to the Special Issue The Epidemiology of Allergy)
There is a lack of high-quality evidence based on the gold standard of oral food challenges to determine food allergy prevalence. Nevertheless, studies using surrogate measures of food allergy, such as health service utilization and clinical history, together with allergen-specific immunoglobulin E (sIgE), provide compelling data that the prevalence of food allergy is increasing in both Western and developing countries. In Western countries, challenge-diagnosed food allergy has been reported to be as high as 10%, with the greatest prevalence noted among younger children. There is also growing evidence of increasing prevalence in developing countries, with rates of challenge-diagnosed food allergy in China and Africa reported to be similar to that in Western countries. An interesting observation is that children of East Asian or African descent born in a Western environment are at higher risk of food allergy compared to Caucasian children; this intriguing finding emphasizes the importance of genome-environment interactions and forecasts future increases in food allergy in Asia and Africa as economic growth continues in these regions. While cow’s milk and egg allergy are two of the most common food allergies in most countries, diverse patterns of food allergy can be observed in individual geographic regions determined by each country’s feeding patterns. More robust studies investigating food allergy prevalence, particularly in Asia and the developing world, are necessary to understand the extent of the food allergy problem and identify preventive strategies to cope with the potential increase in these regions.