title: Impaired health-related quality of life in adolescents with allergy to staple foods.
abstract: BACKGROUND
  Cow's milk, hen's egg and wheat are staple foods in a typical western diet. Despite the ubiquity of these foods, the impact of staple food allergy on health-related quality of life (HRQL) amongst adolescents is incompletely understood. The aims of this study were to make use of the Swedish version of EuroPrevall's disease-specific food allergy quality of life questionnaire-teenager form (FAQLQ-TF) and to investigate the association between objectively-diagnosed staple food allergy and HRQL amongst adolescents.
  
  
  METHODS
  In this cross-sectional study, 58 adolescents aged 13-17 years [n = 40 (69 %) boys] with objectively-diagnosed allergy to the staple foods cow's milk, hen's egg and/or wheat and living in Stockholm, Sweden were included. Adolescents completed the FAQLQ-TF, which has a corresponding scale of 1 = best HRQL, and 7 = worst HRQL. Overall HRQL and domain-specific HRQL were established. Adolescents also reported symptoms, adrenaline auto injector (AAI) prescription and presence of other food allergies. A history of anaphylaxis was defined among those reporting difficulty breathing, inability to stand/collapse, and/or loss of consciousness. Clinically different HRQL was set at a mean difference of ≥0.5.
  
  
  RESULTS
  Overall mean HRQL was poorer than average [mean: 4.70/7.00 (95 % CI 4.30-5.01)]. The domain risk of accidental exposure was significantly associated with clinically better HRQL than the domain allergen avoidance and dietary restrictions (mean difference = 0.76; p < 0.001). Girls had clinically worse, but not statistically significantly different mean HRQL than boys (mean difference = 0.71; p < 0.07). HRQL tended to be worse amongst those with allergies to more than three foods or an AAI prescription. The number and types of symptoms, including a history of anaphylaxis were not associated with worse HRQL.
  
  
  CONCLUSIONS
  As ascertained via a food allergy-specific questionnaire, adolescents with staple food allergy report poorer than average HRQL, specifically in relation to emerging independence and the need for support. Girls have clinically worse HRQL than boys. The number and type of previous symptoms and history of anaphylaxis were not associated with worse HRQL.
authors.affiliation: The Centre for Allergy Research, Karolinska Institutet, P.O. Box 287, 17177 Stockholm, Sweden ; Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden.
authors.forename: Jennifer Lisa Penner
authors.initials: JL
authors.lastname: Protudjer
authors.affiliation: The Centre for Allergy Research, Karolinska Institutet, P.O. Box 287, 17177 Stockholm, Sweden ; Department of Public Health and Clinical Medicine, Umeå University, Umeå, Sweden.
authors.forename: Sven-Arne
authors.initials: SA
authors.lastname: Jansson
authors.affiliation: The Centre for Allergy Research, Karolinska Institutet, P.O. Box 287, 17177 Stockholm, Sweden ; Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden.
authors.forename: Roelinde
authors.initials: R
authors.lastname: Middelveld
authors.affiliation: The Centre for Allergy Research, Karolinska Institutet, P.O. Box 287, 17177 Stockholm, Sweden ; Sachs' Children and Youth Hospital, Södersjukhuset, Stockholm, Sweden ; Department of Clinical Research and Education, Södersjukhuset, Karolinska Institutet, Stockholm, Sweden.
authors.forename: Eva
authors.initials: E
authors.lastname: Östblom
authors.affiliation: The Centre for Allergy Research, Karolinska Institutet, P.O. Box 287, 17177 Stockholm, Sweden ; Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden.
authors.forename: Sven-Erik
authors.initials: SE
authors.lastname: Dahlén
authors.affiliation: Swedish Council on Health Technology Assessment, SBU, Stockholm, Sweden ; Department of Learning, Informatics, Management and Ethics, and Medical Management Centre, Karolinska Institutet, Stockholm, Sweden.
authors.forename: Marianne Heibert
authors.initials: MH
authors.lastname: Arnlind
authors.affiliation: Allergy Unit, Sahlgrenska University Hospital, Gothenburg, Sweden.
authors.forename: Ulf
authors.initials: U
authors.lastname: Bengtsson
authors.affiliation: The Swedish Asthma and Allergy Foundation, Stockholm, Sweden.
authors.forename: Ingrid
authors.initials: I
authors.lastname: Kallström-Bengtsson
authors.affiliation: Department of Health and Caring Sciences, Linnaeus University, Kalmar, Sweden.
authors.forename: Birgitta
authors.initials: B
authors.lastname: Marklund
authors.affiliation: Allergy Unit, Sahlgrenska University Hospital, Gothenburg, Sweden.
authors.forename: Georgios
authors.initials: G
authors.lastname: Rentzos
authors.affiliation: Sachs' Children and Youth Hospital, Södersjukhuset, Stockholm, Sweden.
authors.forename: Ann-Charlotte
authors.initials: AC
authors.lastname: Sundqvist
authors.affiliation: Allergy Unit, Sahlgrenska University Hospital, Gothenburg, Sweden.
authors.forename: Johanna
authors.initials: J
authors.lastname: Åkerström
authors.affiliation: The Centre for Allergy Research, Karolinska Institutet, P.O. Box 287, 17177 Stockholm, Sweden ; Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden.
authors.forename: Staffan
authors.initials: S
authors.lastname: Ahlstedt
keywords: Adolescents; Food allergy; Health-related quality of life