Patients associate their food allergy development with multiple factors
Click Here to Manage Email Alerts
Key takeaways:
- The survey included 38,408 children and 40,443 adults.
- Caregivers associated food allergy development with viral infections in 23.8% of children aged 0 to 10 years.
ANAHEIM, Calif. — Patients may associate their food allergy with diet, genetics, family history and infection, according to a presentation at the American College of Allergy, Asthma & Immunology Annual Scientific Meeting.
“There has been so much research around what could be causing food allergies, what causes people to develop them,” Rachelle Liu, BA, third-year medical student at Northwestern University Feinberg School of Medicine, told Healio. “But no one has really looked at what patients and caregivers actually think.”
A cross-sectional phone and web survey polled caregivers of 38,408 children as well as 40,443 adults in both English and Spanish between 2015 and 2016.
The researchers classified respondents into three groups: self- or parent proxy-reported food allergy, convincing food allergy based on reported food-allergic reaction symptoms consistent with an IgE-mediated response, and convincing food allergy diagnosed by a physician via skin prick testing, specific IgE blood testing, and/or oral food challenge.
“We found that patients and caregivers had really diverse perspectives,” Liu said.
Respondents believed the development of their food allergy was associated with eating too much of the allergenic food (19.1%; 95% CI, 17.9%-20.5%), genetics and family history (13.1%; 95% CI, 12%-14.3%), antibiotic use (7.8%; 95% CI, 7.1%-8.6%), eating too little of the allergenic food (7.6%; 95% CI, 6.7%-8.5%) and antacid use (6.7%; 95% CI, 5.9%-7.5%).
“Interestingly, there’s a proportion of people that associated it with genetics and family history, but it’s a much smaller proportion than we might have expected,” Liu said.
Also, the development of food allergy was believed to be associated with a viral infection for 23.8% (95% CI, 21.1%-26.7%) of the population aged 0 to 10 years and 25.6% (95% CI, 22%-29.5%) of the population aged 11 to 17 years.
“People do think that behavior and the environment contribute and are related to food allergy development,” Liu said.
By understanding these perceptions, the researchers said, physicians may be able to better target interventions and patient education to improve food allergy management and prevention.
“It’s just really valuable insight to have about what people actually understand and then remember about the onset of their food allergies,” Liu said.
Providers would not necessarily cite these data during their conversations with patients, she continued, but they could use it to frame their counseling, especially regarding the fears and anxieties that caregivers may be experiencing.
For example, caregiver perceptions that eating too much of an allergen could affect whether they introduce allergens into their infants’ diets.
“That’s something we could use to target guidance, and say, ‘No, actually. The new guidelines say that you should be introducing earlier, by 6 months,’” Liu said.
These parental attitudes do have an impact on behavior, according to Christopher M. Warren, PhD, director of population research, Center for Food Allergy & Asthma Research, Northwestern University, Feinberg School of Medicine.
“We know we can impact them as clinicians. We can impact attitudes just by bringing it up in the clinic and giving it your seal of approval as the child’s doctor. This is a good thing. It’s safe. It’s healthy,” Warren told Healio.
Looking ahead, Liu would like to continue this research.
“There’s a lot that we could really explore here, because for each of these existing associations, there’s existing knowledge around it,” she said.
Also, Liu noted that the survey was completed in 2015 and 2016 and that an update may be timely.
“As we’re approaching 10 years from that mark, how have perceptions changed?” she said. “Has patient education improved? Are guidelines being better disseminated?”
Longitudinal studies may indicate the factors that impact these associations as they are followed over the course of an allergy’s development, Liu said.
“That would be super valuable to have, because a lot of this is recall, and I think recall bias can definitely play a big factor in what people are remembering or what they associated as the more important factors that they would put down on a survey,” she said.
Liu additionally emphasized the importance of these data.
“This is really just the first look into what are patients thinking, what are families thinking,” Liu said. “How can we use that to better educate and have better communication?”
Reference:
- New study examines potential factors related to the development of adult-onset food allergy. https://acaai.org/news/new-study-examines-potential-factors-related-to-the-development-of-adult-onset-food-allergy. Published Nov. 9, 2023. Accessed Nov. 9, 2023.