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JAMA Netw Open. 2019 Jan 4;2(1):e185630. doi: 10.1001/jamanetworkopen.2018.5630.

Prevalence and Severity of Food Allergies Among US Adults.

Author information

1
Institute for Public Health and Medicine, Northwestern University Feinberg School of Medicine, Chicago, Illinois.
2
Department of Pediatrics, Northwestern University Feinberg School of Medicine, Chicago, Illinois.
3
Mary Ann & J. Milburn Smith Child Health Research, Outreach, and Advocacy Center, Ann & Robert H. Lurie Children's Hospital, Chicago, Illinois.
4
Department of Medicine, Northwestern University Feinberg School of Medicine, Chicago, Illinois.
5
Department of Preventive Medicine, University of Southern California Keck School of Medicine, Los Angeles.
6
Center for Innovation for Complex Chronic Healthcare, Edward J. Hines Jr Veterans Affairs Hospital, Hines, Illinois.
7
Department of Medical Social Sciences, Northwestern University Feinberg School of Medicine, Chicago, Illinois.
8
Department of Preventive Medicine, Northwestern University Feinberg School of Medicine, Chicago, Illinois.
9
Sean N. Parker Center for Allergy and Asthma Research, Stanford University School of Medicine, Stanford, California.

Abstract

Importance:

Food allergy is a costly, potentially life-threatening condition. Although studies have examined the prevalence of childhood food allergy, little is known about prevalence, severity, or health care utilization related to food allergies among US adults.

Objective:

To provide nationally representative estimates of the distribution, severity, and factors associated with adult food allergies.

Design, Setting, and Participants:

In this cross-sectional survey study of US adults, surveys were administered via the internet and telephone from October 9, 2015, to September 18, 2016. Participants were first recruited from NORC at the University of Chicago's probability-based AmeriSpeak panel, and additional participants were recruited from the non-probability-based Survey Sampling International (SSI) panel.

Exposures:

Demographic and allergic participant characteristics.

Main Outcomes and Measures:

Self-reported food allergies were the main outcome and were considered convincing if reported symptoms to specific allergens were consistent with IgE-mediated reactions. Diagnosis history to specific allergens and food allergy-related health care use were also primary outcomes. Estimates were based on this nationally representative sample using small-area estimation and iterative proportional fitting methods. To increase precision, AmeriSpeak data were augmented by calibration-weighted, non-probability-based responses from SSI.

Results:

Surveys were completed by 40 443 adults (mean [SD] age, 46.6 [20.2] years), with a survey completion rate of 51.2% observed among AmeriSpeak panelists (n = 7210) and 5.5% among SSI panelists (n = 33 233). Estimated convincing food allergy prevalence among US adults was 10.8% (95% CI, 10.4%-11.1%), although 19.0% (95% CI, 18.5%-19.5%) of adults self-reported a food allergy. The most common allergies were shellfish (2.9%; 95% CI, 2.7%-3.1%), milk (1.9%; 95% CI, 1.8%-2.1%), peanut (1.8%; 95% CI, 1.7%-1.9%), tree nut (1.2%; 95% CI, 1.1%-1.3%), and fin fish (0.9%; 95% CI, 0.8%-1.0%). Among food-allergic adults, 51.1% (95% CI, 49.3%-52.9%) experienced a severe food allergy reaction, 45.3% (95% CI, 43.6%-47.1%) were allergic to multiple foods, and 48.0% (95% CI, 46.2%-49.7%) developed food allergies as an adult. Regarding health care utilization, 24.0% (95% CI, 22.6%-25.4%) reported a current epinephrine prescription, and 38.3% (95% CI, 36.7%-40.0%) reported at least 1 food allergy-related lifetime emergency department visit.

Conclusions and Relevance:

These data suggest that at least 10.8% (>26 million) of US adults are food allergic, whereas nearly 19% of adults believe that they have a food allergy. Consequently, these findings suggest that it is crucial that adults with suspected food allergy receive appropriate confirmatory testing and counseling to ensure food is not unnecessarily avoided and quality of life is not unduly impaired.

PMID:
30646188
PMCID:
PMC6324316
DOI:
10.1001/jamanetworkopen.2018.5630
[Indexed for MEDLINE]
Free PMC Article

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