Living with Food Hypersensitivity as an Adolescent Impairs Health Related Quality of Life Irrespective of Disease Severity: Results from a Population-Based Birth Cohort

Abstract

Food hypersensitivity (FHS) refers to food-related symptoms, with or without concurrent Immunoglobulin E (IgE) antibodies related to food(s). It remains unclear how different FHS phenotypes affect health-related quality of life (HRQoL). We examined self-reported HRQoL (with the generic instrument EQ-5D (dimensions and a Visual Analogue Scale (VAS), range 0–100) in association with phenotypes of FHS, and food-specific symptoms among adolescents (n = 2990) from a population-based birth cohort. Overall, 22% of the adolescents had FHS. Compared to adolescents without FHS, those with FHS reported more problems in the dimensions of pain/discomfort (p < 0.001), and anxiety/depression (p = 0.007). Females with FHS reported more problems than males in these dimensions (p < 0.001). Different FHS phenotypes (IgE-sensitization, allergic co-morbidity, and severity of symptoms) were not associated with differences in HRQoL. EQ-VAS scores were lowest for adolescents with symptoms for wheat vs. no wheat, median 80 vs. 89, p = 0.04) and milk vs. no milk (median 85 vs. 90, p = 0.03). Physician-diagnosed lactose intolerance median EQ-VAS was 80 vs. 90, p = 0.03 and also associated with more problems in the dimension of anxious/depression. In conclusion, FHS is associated with lower HRQoL in adolescence, irrespective of phenotypes, but differentially affects females vs. males, and those with vs. without symptoms for milk or wheat.

Impact of Presumed Tree Nut and Peanut Allergy on Quality of Life at Different Ages

“…We did not find any association between the number or the severity of reactions (assessed by adrenaline use or the experience of a life-threatening reaction) and the FAQLQ scores, in line with some previous studies on food allergy [30,31,36] or TNPA [9,15]. The experience of a life-threatening reaction correlated with FAIM scores, as expected.…”

“…This was in line with previous studies [30], showing that the burden of food allergy more greatly affects the female population. This was not the case in children and adolescents, even though other studies have reported sex and gender differences in QoL of younger patients with food allergy [15,[30][31][32], possibly because of the male dominance in our pediatric and adolescent population. The impact of sex in allergic diseases has been reported before and has been attributed to the influence of sex steroids on immune responses [33,34].…”

Management of children with allergies in preschool and school—Potential for improvements

“…1 They may impair school performance, reduce quality of life, and cause severe reactions. 2,3 Parents have frequently concern over the safety of their child at school. Only few studies examine the management of children with allergies at school.…”

The Role of the Mind-Body Connection in Children with Food Reactions and Identified Adversity: Implications for Integrating Stress Management and Resilience Strategies in Clinical Practice

“…Though evidence suggests a close relationship between psychosocial stress and GI conditions, unexplained food reactions in general, and as potentially related to stress, remain understudied. Unexplained food reactions, or non-allergic food intolerances, which have been defined as non-immunological GI symptoms resulting from the pharmacological response to food components [ 10 , 11 ], are particularly common (15–25%) and underdiagnosed in children [ 12 , 13 , 14 ]. The diagnosis and treatment of unexplained food reactions is potentially challenged because such reactions may be in part related to experiences of stress; however, this remains understudied.…”