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The consumption of dairy products, soy beverages, and apples and pears, but not of nutrients per se, was associated with a range of asthma definitions. Dietary modification after diagnosis is one possible explanation for this finding. Intervention studies using whole foods are required to ascertain whether such modifications of food intake could be beneficial in the prevention or amelioration of asthma.

Objective: The aim of this study was to report the prevalence, type and reported symptoms associated with food intolerance. Design: A cross-sectional epidemiological study involving 15 countries using standardized methodology. Participants answered a detailed interviewer-administered questionnaire and took part in blood, lung function and skin prick tests to common aeroallergens. Setting: Randomly selected adults who took part in the second phase of the European Community Respiratory Health Survey (ECRHS). Subjects: The subjects were 17 280 adults aged 20 ± 44 y. Results: Twelve percent of respondents reported food allergyaintolerance (range 4.6% in Spain to 19.1% in Australia). Atopic females who had wheezed in the past 12 months, ever had asthma or were currently taking oral asthma medications were signi®cantly more likely to report food allergyaintolerance. Participants from Scandinavia or Germany were signi®cantly more likely than those from Spain to report food allergyaintolerance. Respondents who reported breathlessness as a food-related symptom were more likely to have wheezed in the past 12 months, to have asthma, use oral asthma medications, be atopic, have bronchial hyperreactivity, be older and reside in Scandinavia. Conclusion: Self-reported food allergyaintolerance differed signi®cantly across multiple countries. The reasons for these differences were not explored in this study, but are likely to be largely due to cultural differences.

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Objective: To determine the extent to which perceived adverse food reactions were associated with IgE mediated food allergy, as defined by skin prick testing (SPT). Design: A cohort epidemiological study. Participants underwent SPT to five common food allergens (cow's milk, peanut mix, egg white, shrimp and whole grain wheat mix) and were asked whether they had ever suffered any food 'illness=trouble', and if so to list such food(s). A positive SPT was defined as wheal diameter of 3 mm. Cohen's kappa (k) was used to assess the agreement between SPT and self-reported reactions to food(s) which contained the allergen of interest. Setting: Randomly selected adults who took part in the follow-up of the European Community Respiratory Health Survey (ECRHS) in 1998. Subjects: The subjects were 457 adults aged 26 -50 y. Results: Fifty-eight (13%) adults were sensitised to at least one food allergen whilst 99 adults (22%) reported illness to food(s) nearly always. However, only seven subjects who reported illness to a food also had a positive SPT to the same food. The prevalence of adverse food reactions associated with IgE mediated allergy in the adult general population would be less than 1.5% (7=457). The agreement between SPT and self-reported illness to food(s) was poor for cow's milk (k ¼ 0) and wheat (k ¼ 0), slight for shrimp (k ¼ 0.16) and egg white (k ¼ 0.09) and fair for peanut mix (k ¼ 0.37). Conclusions: There was little agreement between self-reported perceived illness to food(s) known to contain the food allergen of interest, and positive SPT, suggesting that most reactions are not due to IgE mediated food allergy.