Frequency of Food Allergy in School-Aged Children in Eight European Countries—The EuroPrevall-iFAAM Birth Cohort

The prevalence of food allergy was estimated in children aged 6 to 10 years in 8 European countries.

Children from the EuroPrevall birth cohort managed from birth to 2.5 years to prospectively track food allergy onset were reassessed at the ages of 6 to 10 years (N = 6105) in 8 countries (Iceland, United Kingdom, Netherlands, Germany, Poland, Lithuania, Spain, and Greece).

School-aged children from the 2005 multicenter European birth cohort were managed by using an online parental questionnaire (n = 6069), clinical visits including a structured interview (n = 2322) regarding previous and current food reactions and food consumption, a physical examination, and skin-prick testing (SPT) (n = 2188). Double-blind placebo-controlled oral food challenges (DBPCFCs) were performed for children (n = 46 of 238 eligible) whose history and SPT (≥3 mm) suggested possible allergies to cow’s milk, hen’s egg, wheat, soy, peanut, hazelnut, white fish, oily fish, or crustaceans. Whole cohort frequency results were extrapolated from fully assessed children.

The prevalence of a food allergy to at least 1 confirmed allergen was 0.8%, adjusted to 1.4% to 3.8% by extrapolating to include children without a DBPCFC. Adverse reactions to foods were reported in 16.2% of online questionnaires, similar to face-to-face interviews. Most children consumed cow’s milk, hen’s egg, and wheat products; fewer consumed soy and crustaceans. A total of 10.2% were sensitized to at least 1 food (positive SPT); sensitization was most common to peanut (5.6%) and hazelnut (5.2%). A total of 10.4% were offered DBPCFC, but only 46 children participated. A total of 20 DBPCFCs were positive in 17 children; positive challenges occurred for hazelnut (n = 7), peanut (n = 3), and hen’s egg (n = 1).

The estimated prevalence of food allergy in European children was 1.4% to 3.8%. The most common allergies were to peanut and hazelnut.

In this study, researchers estimated the true prevalence of sensitization and food allergy in school-aged children in 8 European countries by using a previously established systematic approach to verify food sensitization and allergies in a large number of children from the participating countries. Although a substantial number of participants declined to a DBPCFC, this study reveals the feasibility, utility, and importance of including testing and DBPCFC evaluation in longitudinal food allergy studies.