National prevalence and risk factors for food allergy and relationship to asthma: results from the National Health and Nutrition Examination Survey 2005-2006

J Allergy Clin Immunol. 2010 Oct;126(4):798-806.e13. doi: 10.1016/j.jaci.2010.07.026.

Abstract

Background: The national prevalence and patterns of food allergy (FA) in the United States are not well understood.

Objective: We developed nationally representative estimates of the prevalence of and demographic risk factors for FA and investigated associations of FA with asthma, hay fever, and eczema.

Methods: A total of 8203 participants in the National Health and Nutrition Examination Survey 2005-2006 had food-specific serum IgE measured to peanut, cow's milk, egg white, and shrimp. Food-specific IgE and age-based criteria were used to define likely FA (LFA), possible FA, and unlikely FA and to develop estimates of clinical FA. Self-reported data were used to evaluate demographic risk factors and associations with asthma and related conditions.

Results: In the United States, the estimated prevalence of clinical FA was 2.5% (peanut, 1.3%; milk, 0.4%; egg, 0.2%; shrimp, 1.0%; not mutually exclusive). Risk of possible FA/LFA was increased in non-Hispanic blacks (odds ratio, 3.06; 95% CI, 2.14-4.36), males (1.87; 1.32-2.66), and children (2.04; 1.42-2.93). Study participants with doctor-diagnosed asthma (vs no asthma) exhibited increased risk of all measures of food sensitization. Moreover, in those with LFA, the adjusted odds ratio for current asthma (3.8; 1.5-10.7) and an emergency department visit for asthma in the past year (6.9; 2.4-19.7) were both notably increased.

Conclusion: Population-based serologic data on 4 foods indicate an estimated 2.5% of the US population has FA, and increased risk was found for black subjects, male subjects, and children. In addition, FA could be an under-recognized risk factor for problematic asthma.

Publication types

  • Research Support, N.I.H., Extramural
  • Research Support, N.I.H., Intramural

MeSH terms

  • Adolescent
  • Adult
  • Allergens / adverse effects
  • Asthma / complications
  • Asthma / epidemiology*
  • Child
  • Child, Preschool
  • Eczema / complications
  • Eczema / epidemiology
  • Female
  • Food / adverse effects
  • Food Hypersensitivity / complications
  • Food Hypersensitivity / epidemiology*
  • Food Hypersensitivity / etiology
  • Humans
  • Immunoglobulin E / blood
  • Infant
  • Male
  • Middle Aged
  • Nutrition Surveys
  • Prevalence
  • Rhinitis, Allergic, Seasonal / complications
  • Rhinitis, Allergic, Seasonal / epidemiology
  • Risk Factors
  • United States / epidemiology
  • Young Adult

Substances

  • Allergens
  • Immunoglobulin E