title: Changes in Food-Specific IgE Over Time in the National Health and Nutrition Examination Survey (NHANES).
abstract: Food allergy prevalence appears to have recently risen, with larger increases among non-Hispanic blacks. However, it is unclear whether these trends represent shifts in recognition of food allergy or in sensitization.
  
  
  
  The objective of this study was to determine whether sensitization to common food allergens increased in US children from 1988-1994 to 2005-2006 and whether these trends differed by race and/or ethnicity.
  
  
  
  Food-specific immunoglobulin E (IgE; to peanut, milk, egg, and shrimp) was measured by ImmunoCAP in stored sera from subjects aged 6-19 in the National Health and Nutrition Examination Survey (NHANES) III (1988-1994) and was compared with NHANES 2005-2006. Sensitization to foods was defined as overall (IgE ≥ 0.35 kU/L), moderate level (IgE ≥ 2 kU/L), and high level (IgE ≥ commonly used 95% predictive values). Sensitization to individual and combined foods was compared between surveys, with analyses further stratified by race and/or ethnicity.
  
  
  
  A total of 7896 subjects (NHANES III: n = 4995, NHANES 2005-2006: n = 2901) were included. In NHANES III, the prevalence of food sensitization was 24.3% (95% confidence interval [CI]: 22.1-26.5) compared with 21.6% (95% CI: 19.5-23.7) in NHANES 2005-2006. There were no significant changes in the prevalence of any level of milk, egg, or peanut sensitization, but shrimp sensitization at all levels decreased markedly; overall sensitization NHANES III: 11.2% (95% CI: 10.0-12.5) versus NHANES 2005-2006: 6.1% (95% CI: 4.5-7.7). There was a trend toward the increased prevalence of moderate- and high-level sensitization to the combination of milk, egg, and peanut among non-Hispanic blacks but not other groups.
  
  
  
  In contrast to our expectations, sensitization to common food allergens did not increase between the late 1980s/early 1990s and the mid-2000s among US 6-19 year olds, and in fact decreased to shrimp.
authors.affiliation: Division of Allergy and Clinical Immunology, Johns Hopkins University School of Medicine, Baltimore, Md; Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, Md.
authors.forename: Emily C
authors.initials: EC
authors.lastname: McGowan
authors.affiliation: Department of Biostatistics, Johns Hopkins Bloomberg School of Public Health, Baltimore, Md.
authors.forename: Roger D
authors.initials: RD
authors.lastname: Peng
authors.affiliation: The Division of Intramural Research, National Institute of Environmental Health Sciences, National Institutes of Health, Research Triangle Park, NC.
authors.forename: Päivi M
authors.initials: PM
authors.lastname: Salo
authors.affiliation: The Division of Intramural Research, National Institute of Environmental Health Sciences, National Institutes of Health, Research Triangle Park, NC.
authors.forename: Darryl C
authors.initials: DC
authors.lastname: Zeldin
authors.affiliation: Division of Pediatric Allergy and Immunology, Johns Hopkins University School of Medicine, Baltimore, Md. Electronic address: ckeet1@jhmi.edu.
authors.forename: Corinne A
authors.initials: CA
authors.lastname: Keet
mesh_terms: D000293:Adolescent; D000328:Adult; D000818:Animals; D010367:Arachis / Q000276:immunology; D002648:Child; D004531:Eggs; D005260:Female; D005512:Food Hypersensitivity / Q000097:blood / Q000453:epidemiology* / Q000276:immunology; D006801:Humans; D007073:Immunoglobulin E / Q000097:blood; D008297:Male; D008892:Milk / Q000276:immunology; D009749:Nutrition Surveys; D015995:Prevalence; D017747:Seafood; D014481:United States / Q000453:epidemiology; D055815:Young Adult
chemical_list: D007073:Immunoglobulin E
keywords: Epidemiology; Food allergy; Food sensitization; NHANES