Comparison of food allergy prevalence among Chinese infants in Chongqing, 2009 versus 1999

Hu, Yan; Jing, Chen; Li, Haiqi

doi:10.1111/j.1442-200x.2010.03166.x

Cited by 126 publications

(99 citation statements)

References 22 publications

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“…Fish meat is one of the foods most commonly provoking severe anaphylaxis (Sampson, 2000;Lopata and Lehrer, 2009). There are also a number of reports on anaphylactic reactions to caviar and roe from various fishes (Untersmayr et al, 2002;Makinen-Kiljunen et al, 2003;Flais et al, 2004;Kondo et al, 2005;Escudero et al, 2007;Perez-Gordo et al, 2008;Chen et al, 2009;Gonzalez-De-Olano et al, 2011).…”

Section: Severe Reactions/anaphylaxismentioning

confidence: 99%

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Scientific Opinion on the evaluation of allergenic foods and food ingredients for labelling purposes

Products¹

2014

EFS2

115

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Following a request from the Food Safety Authority of Ireland, the EFSA Panel on Dietetic Products, Nutrition and Allergies (NDA Panel) was asked to deliver a scientific opinion on the evaluation of allergenic foods and food ingredients for labelling purposes. In view of the request, the NDA Panel decided to update its previous opinions relative to food ingredients or substances with known allergenic potential listed in Annex IIIa of 2003/89/EC, as amended. These include cereals containing gluten, milk and dairy products, eggs, nuts, peanuts, soy, fish, crustaceans, molluscs, celery, lupin, sesame, mustard and sulphites. The opinion relates to immunoglobulin (Ig)E-and non-IgE-mediated food allergy, to coeliac disease and to adverse reactions to sulphites in food, and it does not address non-immune-mediated adverse reactions to food. It includes information on the prevalence of food allergy in unselected populations, proteins identified as food allergens, cross-reactivities, the effects of food processing on the allergenicity of foods and ingredients, methods for the detection of allergens and allergenic foods, doses observed to trigger adverse reactions in sensitive individuals and risk assessment methodologies that have been used to derive individual and population thresholds for selected allergenic foods. The present opinion relates to immunoglobulin (Ig)E-and non-IgE-mediated food allergy, to coeliac disease and to adverse reactions to sulphites in food, and it does not address non-immune-mediated adverse reactions to food. For each food ingredient or substance listed in Annex IIIa, it includes information on the prevalence of food allergy in unselected populations, on proteins identified as food allergens, on cross-reactivities, on the effects of food processing on the allergenicity of foods and ingredients, on methods for the detection of allergens and allergenic foods, and on doses observed to trigger adverse reactions in sensitive individuals.Immune-mediated adverse reactions to foods manifest with clinical signs and symptoms of variable severity and duration, which may affect different organs and systems. Anaphylactic reactions to food are IgE mediated and may occur at any age. Non-IgE-mediated food allergy includes a wide range of diseases, including protein-induced enterocolitis and eosinophilic oesophagitis.A careful family and clinical history are the basis for diagnosis of food allergy. Food diaries, skin prick tests (SPTs), allergen-specific IgE measurements, food elimination diets and food challenges are part of the standard protocol for the diagnosis of food allergy. A positive SPT indicates sensitisation to the tested food, but it is not diagnostic of food allergy. Allergen-specific serum IgE antibodies similarly denote sensitisation to a particular food, but they are not diagnostic without a clinical history or food challenge. The use of atopy patch tests for the diagnosis of food allergy is controversial. Other available tests have no current role in the diagnosis of food allergy. Diag...

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Section: Severe Reactions/anaphylaxismentioning

confidence: 99%

“…Fish roe-allergic individuals will often tolerate fish (Makinen-Kiljunen et al, 2003;Escudero et al, 2007;Chen et al, 2009). …”

Section: Identified Allergensmentioning

confidence: 99%

Scientific Opinion on the evaluation of allergenic foods and food ingredients for labelling purposes

Products¹

2014

EFS2

115

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Section: Epid Em Io Lo Gymentioning

confidence: 99%

“…One study from Chongqing, China, reported a doubling in the challenge-proven prevalence rates from 3.5% to 7.7% among 0-2-year-olds over a ten-year period. (8) Conversely, a South Korean study reported that the prevalence of food allergy symptoms in 6-12-year-olds had decreased from 10.9% to 8.9% over five years. (9) Preliminary findings in an ongoing study of young Singaporean children aged 11-30 months demonstrated that overall, self-reported food allergy prevalence could be as high as 5.4% (Lee AJ, unpublished).…”

Section: Epid Em Io Lo Gymentioning

confidence: 99%

“…(21) The prevalence in a Hong Kong cohort of 2-7-year-olds was 0.25% (doctor diagnosed), (22) while that in China was 0.17%-0.21% among 0-2-year-olds (challenge proven). (8) However, variance in the population age and methodology makes it difficult to compare the different studies. More challenge-proven food allergy studies with consistent criteria are required in order to establish the prevalence of fish allergy and whether early introduction of fish is indeed a protective factor.…”

Section: Fishmentioning

confidence: 99%

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Food allergy in Singapore: opening a new chapter

Lee¹

2014

smedj

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R ev iew A r tic le 244 I NTRO D U C TIO NSingapore has rapidly evolved into a modernised city state and currently faces the health burden of noncommunicable diseases (NCDs), resembling that of developed Western nations.(1) In children, allergic diseases, including food allergy, are among the most common NCDs.(2) Food allergy rates are reported to be more than 10% in challenge-proven studies among Australian infants, (3) while in the United Kingdom (UK) (4) and the United States of America (USA), Singapore have not met the expected rise experienced by other highly industrialised countries, it is also uncertain whether the food allergy epidemic will hit our nation. This unclear prediction, together with ever-changing cultural practices and eating habits due to immigration and overseas influence, has opened a new chapter of food allergy in Singapore.A PubMed search of the terms "food allergy" and "Singapore" generated a total of 45 results from January 1999 to January 2014. All the articles generated are in English. Of these, 12 articles are not food-allergy focused, and two are focused on food testing methodology that is not unique to Singapore. Of the remaining 31 articles found, 16 are studies conducted on children, and 9 are review articles on food allergy in Asia or Singapore. EPID EM IO LO GYIn Asia, food allergy data is just beginning to emerge, providing no satisfactory trend. One study from Chongqing, China, reported a doubling in the challenge-proven prevalence rates from 3.5% to 7.7% among 0-2-year-olds over a ten-year period. (8) Conversely, a South Korean study reported that the prevalence of food allergy symptoms in 6-12-year-olds had decreased from 10.9% to 8.9% over five years.(9) Preliminary findings in an ongoing study of young Singaporean children aged 11-30 months demonstrated that overall, self-reported food allergy prevalence could be as high as 5.4% (Lee AJ, unpublished). Unfortunately, the only prior data for comparison was in 6-12-year-olds, where the rates (also by questionnaire) were estimated to be 4%-5% in 1999.Given that the prevalence of food allergy tends to decrease with age, using this data, we surmise that food allergy has probably not increased in Singapore over a 14-year period. SPECIFIC FOOD ALLERGIES IN SINGAPOREWorldwide and regional differences in food allergies mainly depend on diet and culture (although this may not always be the case). For example, shellfish is the most common food allergen in Singapore and is ubiquitous in Southeast Asia, likely by virtue of its high consumption. However, fish, also eaten abundantly in Singapore, is a rare allergen here. Allergy to egg and cow's milk, despite their high consumption worldwide, is comparatively lower in Singapore than in the West. The reverse is true of peanut allergy, which is epidemic in the West compared to Asia. However, the pattern of food allergy in Singapore appears to have changed over the last decade, with peanut allergy increasing in prevalence and being the most common cause of anaphylaxis in Singaporean childr...

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Assessment of Evidence About Common Infant Symptoms and Cow’s Milk Allergy

et al. 2020

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Symptoms, such as crying, vomiting, and rashes, during infancy are not new, but in the 21st century, many parents attribute them to an underlying cow's milk allergy (CMA). In this Special Communication article, we explore the evidence for managing common infant symptoms by avoiding cow's milk. Prescriptions of specialized formula products for managing CMA have risen steeply since the turn of the 21st century; for example, data from Australia and England show 10-fold rises in amino acid formula prescriptions between 2000 and 2010 and 2005 and 2018, respectively (Figure 1). 1,2 This increased demand for products used to manage CMA is not matched by evidence of an increase in disease prevalence. Although one small Chinese study 3 suggested that CMA and allergic sensitization to milk in children aged up to 2 years may have increased between 1999 (3.2% sensitized and 1.6% allergic; n = 314) and 2009 (6.2% sensitized and 3.5% allergic; n = 401), 3 this was not supported by a larger Australian study 4 that found no change in allergic sensitization to cow's milk at age 12 months in high-risk infants between 1990 and 1994 (2.4%; 95% CI, 1.6-3.1; n = 541) and 2006 and 2010 (2.6%; 95% CI, 2.0-3.4; n = 1893). Similarly, in the United States, there was no change in allergic sensitization to milk (specific IgE Ն2 kU/L) in children aged 6 to 19 years between National Health and Nutrition Exami-IMPORTANCE Sales of specialized formula for managing cow's milk allergy (CMA) have increased, triggering concern that attribution of common infant symptoms, such as crying, vomiting, and rashes, to CMA may be leading to overdiagnosis, which could undermine breastfeeding.OBJECTIVE To understand whether CMA guideline recommendations might promote CMA overdiagnosis or undermine breastfeeding.EVIDENCE REVIEW We reviewed recommendations made in CMA guidelines and critically appraised 2 key recommendations. First, we reviewed relevant literature summarizing whether maternal or infant dietary exclusion of cow's milk is effective for managing common infant symptoms. Second, we reviewed published data on breastmilk composition and thresholds of reactivity in CMA to estimate the probability that cow's milk protein in human breastmilk can trigger symptoms in infants with CMA. We also documented the level of commercial involvement in CMA guidelines.FINDINGS We reviewed 9 CMA guidelines published from 2012 to 2019. Seven suggest considering CMA as a cause of common infant symptoms. Seven recommend strict maternal cow's milk exclusion for managing common symptoms in breastfed infants. We found CMA proven by food challenge affects approximately 1% of infants, while troublesome crying, vomiting, or rashes are each reported in 15% to 20% of infants. We found clinical trials do not provide consistent support for using maternal or infant cow's milk exclusion to manage common symptoms in infants without proven CMA. We estimated that for more than 99% infants with proven CMA, the breastmilk of a cow's milk-consuming woman contains insufficient milk allergen ...

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Comparison of food allergy prevalence among Chinese infants in Chongqing, 2009 versus 1999

Abstract: This is the first study in China to indicate time trends in food allergy prevalence and characteristics. Our data show that in the 10-year period from 1999 to 2009, the prevalence of food allergy seems to have increased in China.

Cited by 126 publications

References 22 publications

Scientific Opinion on the evaluation of allergenic foods and food ingredients for labelling purposes

Scientific Opinion on the evaluation of allergenic foods and food ingredients for labelling purposes

Food allergy in Singapore: opening a new chapter

Assessment of Evidence About Common Infant Symptoms and Cow’s Milk Allergy

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