Prevalence of parentally perceived adverse reactions to food in young children

Abstract

A substantial number of parents perceive that their children have adverse reactions to food, but it is well documented that objective assessments agree with only one-quarter to one-half of parentally reported reactions. In order to prevent wrong diagnoses and curtail unnecessary or inadequate diets, primary health care providers need to deal with the parental perception of adverse reactions to food. A description of the prevalence and pattern of parentally perceived adverse reactions to food in children is needed to meet this challenge. The aim of the present study was to estimate the prevalence, incidence and cumulative incidences of parentally perceived adverse reactions to food in children younger than 2 years of age, and to study the duration of the reactions. A population-based cohort of 3623 children born in Norway was followed from birth until the age of two. At 6-month intervals, the parents completed questionnaires regarding the occurrence and type of any reaction to food. Information was available on the outcome measure at all age points for 77.4% of the families and these were used in the analyses; 3.8% of the cohort were entirely lost to follow-up. The cumulative incidence of adverse reactions to food was 35% by age two. Fruits, milk and vegetables accounted for nearly two-thirds of all reported reactions. Milk was the single food item most commonly incriminated, the cumulative incidence being 11.6%. The cumulative incidences of reported reactions to fruits and vegetables were 20.4% and 7.3%, respectively, with citrus fruits, strawberry and tomatoes as the most common food items in these groups. The cumulative incidences were less for food reactions associated with eggs (4.4%), fish (3%), nuts (2.1%) and cereals (1.4%). The duration of the reactions was short - approximately two-thirds of the reactions were not reported again 6 months later. However, the probability of remission depended on the food item concerned, the age at onset of reactions, and whether the reaction had been reported previously or not. Adverse reactions to food are reported by the parents of one-third of children in Norway before the age of two. The most striking feature of this study is the short duration of the food reactions, as approximately two-thirds of the reactions are not reported again 6 months later. Nevertheless, the high frequency of reactions attributable to milk is of concern. Milk is an important part of the Norwegian diet for children, and if removed from the diet its nutritional value is not easily replaced. Further studies are needed to assess the degree to which parents alter the diet of their children based upon perceived reactions to food.

Scientific Opinion on the evaluation of allergenic foods and food ingredients for labelling purposes

“…No data were available in adult populations. The estimated prevalence of cereal allergy ranged from 0.2 % at 18 months in Norway (Eggesbo et al, 1999) to 2.3 % at one year in Finland (Pyrhonen et al, 2009). Based on a clinician's diagnosis, the estimated prevalence of cereal allergy was 1.1 % at one year, 0.9 % at two years and 2 % at three and four years in Finland (Pyrhonen et al, 2009).…”

O conhecimento de pediatras sobre alergia alimentar: estudo piloto

“…Tem sido observada oscilação na prevalên-cia ou incidência da alergia alimentar em crianças do nascimento aos dois anos de vida desde 35%, quando se baseia fundamentalmente em informações referidas pelos pais com relação aos seus fi lhos, a menos de 1%, quando se utiliza o desencadeamento oral (aberto ou cego) para confi rmação diagnóstica (6)(7)(8) . Em crianças holandesas de quatro a 15 anos de idade, avaliadas durante a consulta médica de rotina, a prevalência de reações adversas a alimentos foi de 7,2%, segundo informações fornecidas por seus pais e/ou responsáveis.…”

Alergia a la leche y al huevo: diagnóstico, manejo e implicaciones en América Latina

“…Las reacciones adversas a los alimentos se producen por una gran variedad de mecanismos que incluyen el sistema inmunitario, los procesos enzimáticos, las reacciones fisiológicas y los componentes psicológicos (1). Cuando se demuestra un mecanismo inmune, se le denomina alergia a alimentos, y si se encuentran niveles elevados de inmunoglobulina E (IgE) específica para alérgenos de alimentos con relevancia clínica, se habla de alergia alimentaria mediada por IgE (2).…”