The frequency of food allergy in Australia and Asia

Hill, David; Hosking, C. S.; Zhie, Chen Yu; Leung, Roland; Baratwidjaja, Karnen; Iíkura, Yoji; Iyngkaran, N; Gonzalez-Andaya, Agnes M.; Wah, Lee Bee; Hsieh, K. H.

doi:10.1016/s1382-6689(97)10049-7

Cited by 109 publications

(73 citation statements)

References 9 publications

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“…Unfortunately, the only prior data for comparison was in 6-12-year-olds, where the rates (also by questionnaire) were estimated to be 4%-5% in 1999. (10) Given that the prevalence of food allergy tends to decrease with age, using this data, we surmise that food allergy has probably not increased in Singapore over a 14-year period.…”

Section: Epid Em Io Lo Gymentioning

confidence: 88%

Food allergy in Singapore: opening a new chapter

Lee¹

2014

smedj

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R ev iew A r tic le 244 I NTRO D U C TIO NSingapore has rapidly evolved into a modernised city state and currently faces the health burden of noncommunicable diseases (NCDs), resembling that of developed Western nations.(1) In children, allergic diseases, including food allergy, are among the most common NCDs.(2) Food allergy rates are reported to be more than 10% in challenge-proven studies among Australian infants, (3) while in the United Kingdom (UK) (4) and the United States of America (USA), Singapore have not met the expected rise experienced by other highly industrialised countries, it is also uncertain whether the food allergy epidemic will hit our nation. This unclear prediction, together with ever-changing cultural practices and eating habits due to immigration and overseas influence, has opened a new chapter of food allergy in Singapore.A PubMed search of the terms "food allergy" and "Singapore" generated a total of 45 results from January 1999 to January 2014. All the articles generated are in English. Of these, 12 articles are not food-allergy focused, and two are focused on food testing methodology that is not unique to Singapore. Of the remaining 31 articles found, 16 are studies conducted on children, and 9 are review articles on food allergy in Asia or Singapore. EPID EM IO LO GYIn Asia, food allergy data is just beginning to emerge, providing no satisfactory trend. One study from Chongqing, China, reported a doubling in the challenge-proven prevalence rates from 3.5% to 7.7% among 0-2-year-olds over a ten-year period. (8) Conversely, a South Korean study reported that the prevalence of food allergy symptoms in 6-12-year-olds had decreased from 10.9% to 8.9% over five years.(9) Preliminary findings in an ongoing study of young Singaporean children aged 11-30 months demonstrated that overall, self-reported food allergy prevalence could be as high as 5.4% (Lee AJ, unpublished). Unfortunately, the only prior data for comparison was in 6-12-year-olds, where the rates (also by questionnaire) were estimated to be 4%-5% in 1999.Given that the prevalence of food allergy tends to decrease with age, using this data, we surmise that food allergy has probably not increased in Singapore over a 14-year period. SPECIFIC FOOD ALLERGIES IN SINGAPOREWorldwide and regional differences in food allergies mainly depend on diet and culture (although this may not always be the case). For example, shellfish is the most common food allergen in Singapore and is ubiquitous in Southeast Asia, likely by virtue of its high consumption. However, fish, also eaten abundantly in Singapore, is a rare allergen here. Allergy to egg and cow's milk, despite their high consumption worldwide, is comparatively lower in Singapore than in the West. The reverse is true of peanut allergy, which is epidemic in the West compared to Asia. However, the pattern of food allergy in Singapore appears to have changed over the last decade, with peanut allergy increasing in prevalence and being the most common cause of anaphylaxis in Singaporean childr...

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Section: Epid Em Io Lo Gymentioning

confidence: 88%

Food allergy in Singapore: opening a new chapter

Lee¹

2014

smedj

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“…The estimated prevalence is 0.5 5.0% in early childhood, [42,43] decreasing significantly to <0.5% in older children and adults. [43,44] The prevalence of egg allergy in the preliminary data on 1 3yearold SA children is 1.4%.…”

Section: Eggmentioning

confidence: 96%

“…[42,43,46,47] It can manifest in both IgEmediated and nonIgEmediated symptoms. The natural history of wheat allergy is less well studied, but the majority of patients tend to become tolerant by adolescence.…”

Section: Wheatmentioning

confidence: 99%

Epidemiology of IgE-mediated food allergy

Gray¹,

Goddard

Karabus

et al. 2014

S Afr Med J

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True food allergy is less prevalent than common ly perceived. Up to 34% of individuals or parents think that they or a family member has a food allergy and 22% avoid particular foods because the food may possibly contain an allergen. However, only 1 6% of persons test positive on full evaluation, which may include doubleblind placebocontrolled food challenges. [14] Epidemiology of IgEmediated food allergyThe prevalence of food allergy varies significantly based on geographical region, allergens tested, diagnostic criteria, population age and concurrent atopic conditions.[5] Variations in food allergy definitions and inconsistencies in study design make studies on food allergy prevalence difficult to compare. Self reporting significantly overestimates food allergy prevalence up to 10fold; [4] hence, objective measurements are necessary to establish a true food allergy diagnosis. Similarly, sensitisation to foods is much higher than clinically relevant allergies; therefore, sensitisation should always be combined with more objective information to prove allergies. Food challenge testing is the optimal way of proving food allergy, albeit labour and cost intensive. Recent large populationbased studies, such as the EuroPrevall study in Europe [6] and HealthNuts study in Australia, [7] have used food challenge testing and can be considered flagship studies of food allergy prevalence. Prevalence of food allergyDespite the large number of foods that can cause immunoglobulin E (IgE)mediated reactions, most prevalence studies have focused on the most common allergenic foods, i.e. cow's milk, hen's egg, peanut, tree nut, wheat, soya, fish and shellfish. [8] Food allergy peaks during the first two years of life, and then diminishes towards late childhood as tolerance to several foods develops over time. Based on metaanalyses and large populationbased studies, the true prevalence of food allergy varies from 1% to >10%, depending on the geographical area and age of the patient.[919] Allergy prevalence to the most common allergenic foods is summarised in Table 1. The prevalence of food allergy in South Africa (SA) is currently being studied. An unselected population of 211 Xhosa highschool students showed an overall sensitisation to foods of 5%. [20,21] Preliminary data from the South African Food Sensitisation and Food Allergy (SAFFA) study, [22] which is investigating food allergy in an unselected cohort of 1 3yearolds, show a prevalence of skin prick tests of ≥1 mm (11.6%), ≥3 mm (9.9%) and ≥7 mm (4.2%) to all foods tested. Challengeproven food allergy to any food is 1.8% after the preliminary analysis; recruitment is ongoing. Correspondence to : C Gray (claudiagray.paediatrics@gmail.com) Despite the large number of foods that may cause immunoglobulin E (IgE)mediated reactions, most prevalence studies have focused on the most common allergenic foods, i.e. cow's milk, hen's egg, peanut, tree nut, wheat, soya, fish and shellfish. ARTICLE Epidemiology of IgEFood allergy peaks during the first two years of life, and then dim...

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“…The incidence of CMA varies with age. CMA is prevalent in early childhood with reported incidences between 2 and 6% [10][11][12] and decreases into adulthood to an incidence of 0.1-0.5% [13][14]. It has been suggested that infants have milk allergies because milk is usually the first source of foreign antigens that they ingest in large quantities, and the infant intestinal system is insufficiently developed to digest and immunologically react to milk proteins.…”

Section: Milk Allergymentioning

confidence: 99%