title: High incidence and remission of reported food hypersensitivity in Swedish children followed from 8 to 12 years of age - a population based cohort study.
abstract: BACKGROUND
  Few population-based cohort studies have examined reported food hypersensitivity longitudinally. We investigated prevalence, incidence and remission of perceived food hypersensitivity among schoolchildren from 8 to 12 years of age, and risk factors associated with incidence and remission.
  
  
  METHODS
  A population-based cohort including all 7-8 year-old children in three Swedish towns was recruited in 2006. A total of 2,585 (96% of invited) children participated in a parental questionnaire. The children in two of the towns, n = 1,700 (90% of invited) also participated in skin-prick-testing with airborne allergens. The cohort was followed using the same methods at 11-12 years of age. At study follow up, specific IgE to foods was analyzed in a randomized subset of children (n = 652).
  
  
  RESULTS
  The prevalence of perceived food hypersensitivity increased from 21% at 8 years to 26% at 12 years of age. During this four-year-period, the cumulative incidence of food hypersensitivity was high (15%), as was remission (33%). This pattern was particularly evident for hypersensitivity to cow´s milk, while the incidence of hypersensitivity to other foods was lower. Female sex, allergic heredity, current rhinitis and allergic sensitization were associated with the incidence of food hypersensitivity and allergic sensitization was negatively associated with remission. Risk-factor-patterns for both incidence and remission were different for hypersensitivity to milk compared with hypersensitivity to other foods. Generally, the agreement between reported food hypersensitivity and IgE-sensitization to the implicated food was poor.
  
  
  CONCLUSIONS
  In this longitudinal, population-based cohort-study perceived food hypersensitivity was common among children between ages 8 and 12, often transient and not well correlated with food-specific IgE. While these findings suggest an overestimated prevalence of food hypersensitivity, the public-health-significance remains high as they reflect the perceived reality to which the children adapt their life and food intakes.
authors.affiliation: Department of Clinical Sciences, Pediatrics, UmeÅ University, UmeÅ, Sweden.
authors.forename: Anna
authors.initials: A
authors.lastname: Winberg
authors.affiliation: Department of Public Health and Clinical Medicine, Occupational and Environmental Medicine, The OLIN Unit, UmeÅ University, UmeÅ, Sweden.
authors.forename: Åsa
authors.initials: Å
authors.lastname: Strinnholm
authors.affiliation: Department of Public Health and Clinical Medicine, Occupational and Environmental Medicine, The OLIN Unit, UmeÅ University, UmeÅ, Sweden.
authors.forename: Linnea
authors.initials: L
authors.lastname: Hedman
authors.affiliation: Department of Clinical Sciences, Pediatrics, UmeÅ University, UmeÅ, Sweden.
authors.forename: Christina E
authors.initials: CE
authors.lastname: West
authors.affiliation: Department of Environmental Health Sciences, Mailman School of Public Health, Columbia University, Columbia, USA.
authors.forename: Matthew S
authors.initials: MS
authors.lastname: Perzanowski
authors.affiliation: Department of Public Health and Clinical Medicine, Occupational and Environmental Medicine, The OLIN Unit, UmeÅ University, UmeÅ, Sweden.
authors.forename: Eva
authors.initials: E
authors.lastname: Rönmark
keywords: Food hypersensitivity; Incidence; Remission; Risk factors; Sensitization