Liat Nachshon1, Naama Schwartz2, Arnon Elizur3, Yossi Schon4, Michael Cheryomukhin4, Yitzhak Katz5, Michael R Goldberg6. 1. Allergy Clinic, Israel Defense Forces, Medical Corps, Zerifin, Israel; Institute of Allergy, Immunology and Pediatric Pulmonology, Assaf Harofeh Medical Center, Zerifin, Israel. Electronic address: liatna2@gmail.com. 2. School of Public Health, University of Haifa, Haifa, Israel. 3. Institute of Allergy, Immunology and Pediatric Pulmonology, Assaf Harofeh Medical Center, Zerifin, Israel; Department of Pediatrics, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel. 4. Israel Defense Forces Medical Corps, Zerifin, Israel. 5. Department of Pediatrics, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel. 6. Institute of Allergy, Immunology and Pediatric Pulmonology, Assaf Harofeh Medical Center, Zerifin, Israel.
Abstract
BACKGROUND: Information regarding the prevalence of food allergy (FA) among adults is limited due to their inaccessibility for thorough epidemiological evaluations. OBJECTIVE: To evaluate the prevalence of FA among Israeli young adults. METHODS: All recruits (n = 12,592, ages 17-18 years) signing up over 6 months at a single recruitment center of the Israeli army were evaluated for FA. The evaluation included a frontal interview by physicians who used a focused screening set of questions, medical documentation collection, tests of IgE reactivity, and oral food challenges. The latter were performed at an allergy care institute in ambiguous cases. A prediction model for the identification of individuals with true allergy among recruits eliminating foods due to suspected FA was developed using multivariable logistic regression. RESULTS: Foods elimination due to suspected FA was reported by 148 recruits (1.2%). After diagnostic testing, FA was confirmed in 0.67% (84 of 12,592). The prevalence of food elimination versus diagnosed allergy was 0.2%/0.16% milk, 0.2%/0.14% peanuts, 0.13%/0.09% fish, 0.1%/0.09% sesame, 0.04%/0.015% egg, and 0.36%/0.28% tree nuts, respectively. On multivariable logistic regression analysis, male gender (adjusted odds ratio [OR] = 3.2, 95% confidence interval [CI]: 1.4-7.7), report of a common food allergen (OR = 3.6, 95% CI: 1.4-9.3), previous allergist evaluation for FA (OR = 7.8, 95% CI: 3-20.2), and FA reactions within the past 2 years (OR = 2.8, 95% CI: 1.2-6.7) were significantly identified as independent predictors of true FA. CONCLUSIONS: The prevalence of FA among Israeli young adults is lower than reported for other western countries. Reliance on food elimination alone does not accurately rule in FA. The use of the identified predictors for FA can facilitate large-scale epidemiological studies in adults.
BACKGROUND: Information regarding the prevalence of food allergy (FA) among adults is limited due to their inaccessibility for thorough epidemiological evaluations. OBJECTIVE: To evaluate the prevalence of FA among Israeli young adults. METHODS: All recruits (n = 12,592, ages 17-18 years) signing up over 6 months at a single recruitment center of the Israeli army were evaluated for FA. The evaluation included a frontal interview by physicians who used a focused screening set of questions, medical documentation collection, tests of IgE reactivity, and oral food challenges. The latter were performed at an allergy care institute in ambiguous cases. A prediction model for the identification of individuals with true allergy among recruits eliminating foods due to suspected FA was developed using multivariable logistic regression. RESULTS: Foods elimination due to suspected FA was reported by 148 recruits (1.2%). After diagnostic testing, FA was confirmed in 0.67% (84 of 12,592). The prevalence of food elimination versus diagnosed allergy was 0.2%/0.16% milk, 0.2%/0.14% peanuts, 0.13%/0.09% fish, 0.1%/0.09% sesame, 0.04%/0.015% egg, and 0.36%/0.28% tree nuts, respectively. On multivariable logistic regression analysis, male gender (adjusted odds ratio [OR] = 3.2, 95% confidence interval [CI]: 1.4-7.7), report of a common food allergen (OR = 3.6, 95% CI: 1.4-9.3), previous allergist evaluation for FA (OR = 7.8, 95% CI: 3-20.2), and FA reactions within the past 2 years (OR = 2.8, 95% CI: 1.2-6.7) were significantly identified as independent predictors of true FA. CONCLUSIONS: The prevalence of FA among Israeli young adults is lower than reported for other western countries. Reliance on food elimination alone does not accurately rule in FA. The use of the identified predictors for FA can facilitate large-scale epidemiological studies in adults.