Epidemiology of food allergy/food intolerance in adults: associations with other manifestations of atopy.
BACKGROUND
Food allergy and food intolerance (FA/FI) are believed to be frequent medical problems; however, information from epidemiologic studies in adults is scarce. The objective was to determine the frequency of FA/FI and allergic sensitization to food in a large adult sample. Furthermore, the associations between FA/FI and other outcomes of atopy were studied.


METHODS
Within a population-based, nested, case-control study, a standardized interview was performed to obtain detailed information on FA/FI and the history of atopic diseases. In addition, a skin prick test with 10 common food and nine aeroallergens was performed.


RESULTS
Overall, 20.8% of the 1537 studied subjects (50.4% female, age median 50 years) reported FA/FI (women 27.5%, men 14.0%; OR 2.35, CI 1.80-3.08). Nuts, fruits, and milk most frequently led to adverse effects, and the sites of manifestation were oral (42.9%), skin (28.7%), gastrointestinal (13.0%), systemic (3.2%), and multiple (12.2%). One-quarter of the subjects (25.1%) were sensitized to at least one food allergen in the prick test, with hazelnut (17.8%), celery (14.6%), and peanut (11.1%) accounting for most of the positive reactions. The corresponding frequency estimates for the representative study base (n=4178) were 15.5% for reported adverse reactions and 16.8% for allergic sensitization. Relevant concomitant sensitization to food and aeroallergens was observed. Food-allergic subjects (positive history and sensitization to corresponding allergen) suffered significantly more often from urticaria, asthma, atopic eczema, and especially hay fever (73.1%) than controls (3.0%). Furthermore, hay fever was treated significantly more often in subjects who suffered from concomitant food allergy.


CONCLUSIONS
FA/FI in adults is frequently reported and associated with other manifestations of atopy. Hay fever in conjunction with FA/FI tends to be clinically more severe since therapeutic needs are enhanced.
Schäfer
T
T
Institute of Social Medicine, Medical University Lübeck, Beckergrube 43047, 23552 Lübeck, Germany.
Böhler
E
E
Ruhdorfer
S
S
Weigl
L
L
Wessner
D
D
Heinrich
J
J
Filipiak
B
B
Wichmann
H E
HE
Ring
J
J
D000328:Adult; D000368:Aged; D000485:Allergens / Q000009:adverse effects; D000818:Animals; D016022:Case-Control Studies; D005260:Female; D005512:Food Hypersensitivity / Q000453:epidemiology* / Q000209:etiology; D005638:Fruit / Q000009:adverse effects; D005858:Germany / Q000453:epidemiology; D006801:Humans; D006969:Hypersensitivity, Immediate / Q000453:epidemiology* / Q000209:etiology; D008297:Male; D008875:Middle Aged; D008892:Milk / Q000009:adverse effects; D009754:Nuts / Q000009:adverse effects; D011159:Population Surveillance; D015995:Prevalence; D012882:Skin Tests; D011795:Surveys and Questionnaires
D000485:Allergens