JAMA Netw Open. 2019;2(1):e185630. doi:10.1001/jamanetworkopen.2018.5630
Ruchi S. Gupta, MD, MPH1,2,3,4; Christopher M. Warren, BA5; Bridget M. Smith, PhD1,6; et al Jialing Jiang, BA1; Jesse A. Blumenstock, BS1; Matthew M. Davis, MD, MAPP1,2,3,4,7,8; Robert P. Schleimer, PhD4; Kari C. Nadeau, MD, PhD9
Strange telephone survey:
Seems to me that more than 1% of US adults are allergic to milk or wheat
Perhaps avoidance does, somehow, not mean allergic
Food Allergy – Children
- Childhood Food Allergies (UK 1 in 14) – huge recent increase (low vitamin D) - Dec 2018
- Food allergies are associated with Vitamin D thru genes, etc. – March 2018
- Food allergies 6 times higher in South Australia - 2009
- Food allergies in children may be due to earlier low Vitamin D, Omega-3 and Zinc – Aug 2017
- 11X more non-immigrant children allergic to peanuts if vitamin D less than 20 ng – Feb 2013
- 30 to 40 ng of vitamin D associated with the least peanut allergy – Nov 2012
- Less sun (less vitamin D) more anaphylaxis (severe allergic reaction) – June 2014
- 3X more allergy to peanuts if child born with low UV – Feb 2011
- Immune modulation by Vitamin D, food allergy, chart of genes – July 2015
- Hypothesis – Australia has highest rate of food allergy due to avoiding the sun – Sept 2015
- Peanut and Food allergies prevented by Vitamin D
Question What are the prevalence and severity of food allergy in US adults?
Findings In a population-based survey study of 40 443 US adults, an estimated 10.8% were food allergic at the time of the survey, whereas nearly 19% of adults believed that they were food allergic. Nearly half of food-allergic adults had at least 1 adult-onset food allergy, and_38% reported at least 1 food allergy–related emergency department visit in their lifetime.
Meaning The findings suggest that food allergies are common and severe among US adults, often starting in adulthood.
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.