The burden of food allergy on children and teens: A systematic review

Abstract

Background Over the last two decades, researchers have placed increasing attention on understanding how food allergy affects the health‐related quality of life (HRQL) and psychosocial well‐being of children and teens. In response, a number of reviews have been published that aim at synthesizing the literature. However, many of these papers focus narrowly on HRQL or suffer from methodological limitations. Method The current review aims to fill this gap by providing a comprehensive overview of the burden of pediatric food allergy by synthesizing the quantitative and qualitative literature. Results Findings from the present review provide evidence of reduced HRQL among children and teens with food allergy, particularly older children and those with more severe manifestations of the condition. In comparison to HRQL, the link between food allergy and psychosocial functioning is less clear; however, some evidence can be cited linking food allergy to greater levels of psychological distress. Qualitative evidence suggests that the burden of pediatric food allergy largely stems from worries surrounding exposures outside of the home and the social consequences of the condition. The current review also highlights several gaps in the literature, including a paucity of longitudinal research, research focused on predictors of psychological distress among children and teens with food allergy as well as a dearth of studies comparing rates of bullying in food‐allergic and non‐food‐allergic samples. Conclusion More emphasis should be placed on not only alleviating the social and psychological consequences of food allergy, but also on identifying and assisting those most acutely burdened by the condition.

Editorial comments on: “The burden of food allergy on children and teens: A systematic review”

“…1 While there are several reviews which address healthrelated quality of life (HRQL) and psychosocial functioning of parents of children with food allergy, 2 few reviews have comprehensively assessed the burden experienced by children and adolescents living with food allergy themselves.We highlight here an article by Golding et al, who provide a comprehensive overview of the burden of food allergy as experienced by children and adolescents by systematically reviewing both the quantitative and qualitative literature. 3 As expected, the review found that food allergy had a negative impact on HRQL of children and adolescents and specifically the domains of social, emotional, and physical functioning. Of concern, and with relevance to the transition to self-care, HRQL appeared to decline further as children age with a greater burden experienced by adolescents.…”

“…We highlight here an article by Golding et al, who provide a comprehensive overview of the burden of food allergy as experienced by children and adolescents by systematically reviewing both the quantitative and qualitative literature 3 . As expected, the review found that food allergy had a negative impact on HRQL of children and adolescents and specifically the domains of social, emotional, and physical functioning.…”

“…The themes identified suggested that the impact of food allergy on HRQL was largely due to the impact of food allergy on their social lives and the concerns that result from the inherent unpredictability of food allergy. A third theme emerged which described a propensity for children and teens to downplay the adverse consequences of their food allergy; while on the one hand, this could reflect resilience or only minor challenges experienced, the authors highlight that “downward comparisons and positive reframing can also be seen as emotion‐focused coping techniques that aim to mitigate the negative emotions associated with the burdens that fail to improve with time and experience.” 3 …”

“…A third theme emerged which described a propensity for children and teens to downplay the adverse consequences of their food allergy; while on the one hand, this could reflect resilience or only minor challenges experienced, the authors highlight that "downward comparisons and positive reframing can also be seen as emotion-focused coping techniques that aim to mitigate the negative emotions associated with the burdens that fail to improve with time and experience." 3 There were notable discrepancies depending on who reported the outcomes with parents appearing to overreport the impact of food allergy on HRQL compared to their offspring. This has important implications for future research regarding the choice of informant for child and teen outcomes.…”

Young Child Nutrition: Knowledge and Surveillance Gaps across the Spectrum of Feeding

“…However, micronutrient deficiencies and poor growth frequently occur [ 23 ]. The burden of food allergies ranges from lower quality of life, increased caregiver burden and greater anxiety, social consequences, and financial costs [ 24 ].…”