Factors associated with reported food allergy tolerance among US children

Background: Limited studies exist on predictors of food allergy tolerance.

Objective: To describe factors associated with tolerance to 9 common food allergens based on caregiver report in a nationally representative survey.

Methods: Data from children with current and outgrown food allergies were identified for analysis from a randomized, cross-sectional survey administered in US households with children from June 2009 through February 2010. Allergies were analyzed based on type of allergy, age at which allergies were outgrown, and reaction history. Adjusted models were formulated to examine the association of child and food allergy characteristics with odds of reporting an allergy as being outgrown.

Results: Of 40,104 children surveyed, 1,245 cases of outgrown food allergy were identified. The frequency of tolerance in children with food allergy was 26.6% at a mean age of 5.4 years. Children with milk (41.1%), egg (40.2%), or soy (35.7%) allergy had significantly higher frequencies of tolerance, whereas children with shellfish (13.0%), tree nut (14.3%), and peanut (15.6%) allergies had significantly lower frequencies (P < .05). Factors significantly associated with a report of outgrowing an allergy included a mild to moderate reaction history, being allergic to only 1 food, eczema as the sole allergy symptom, and white compared with black race (P < .05). Probability of tolerance also was significantly higher at younger ages of first reaction and decreased for first reactions occurring later in life, irrespective of allergen, severity, or presentation (P < .05).

Conclusion: Multiple factors were associated with a report of outgrowing an allergy. Understanding factors associated with outgrowing an allergy can improve disease management and counseling.