Introduction Infants with food allergy may acquire oral tolerance. There is limited knowledge about the natural history of food allergy during childhood. The incidence, prevalence and trends in food hypersensitivity have been explored in birth cohorts over the first 3 years of life, however the trend over longer periods is still unclear and widely debated. Knowledge of the time trends of food allergy over longer period would provide valuable information on the natural history of food allergy.
Objective We examined the prevalence and time trends of reported food hypersensitivity and food allergy in an unselected birth cohort over the first 18 years of life.
Methods Food allergy information were collected ages 1, 2, 4, 10 and 18 years from the whole population Isle of Wight birth cohort (n = 1456). Food allergy was diagnosed based on strict study criteria: Characteristics of reaction, timing of reaction and type of food causing reaction.
Skin prick testing (SPT) was performed at year 1, 2 for specific food allergens and at 4, 10 and 18 years of age for a panel of food and aeroallergens. SPSS statistical package was used to determine frequencies and prevalence.
Results The prevalence of food allergies based on strict study criteria was 5.3% at 1 year, 4.4% at 2 years, 5% at 4 years, 2.3% at 10 years and 4% at 18 years. This was much lower than reported food allergies.
Based on individual food groups, milk (1.6-3.5%), and eggs (1.1-1.4%) were the most common allergens in the first 10 years and peanut (0.4-1.0%), tree nuts (0.2-0.5%), fruit and wheat (0.3-0.5%) became more prevalent between 10-18 years.
Sensitisation rates to food allergens were 3.2%, 4.5% and 21.4% respectively at 4, 10 and 18 years. There was a significant rise in food allergen sensitisation between 10 and 18 years
Conclusions This is the first study looking into longitudinal patterns of food allergy (using symptom defined study criteria) and food sensitisation. This study provides valuable information on the patterns of various food allergies and their resolution. Prevalence of food allergies shows a significant drop between 4 and 10 years, followed by a significant rise between 10 and 18 years.
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