Prevalence of sensitization to food allergens, reported adverse reaction to foods, food avoidance, and food hypersensitivity among teenagers

Background: There is a paucity of information on food hypersensitivity (FHS) among teenagers. Objectives: We sought to investigate the sensitization rates, perception of FHS, food avoidance, and FHS assessed by means of food challenges among teenagers. Methods: This cohort study recruited 757 eleven-year-olds and 775 fifteen-year-olds in the United Kingdom. Sensitization rates, reported rates of FHS, and rates of food avoidance were measured. The prevalence of FHS was established by using food challenges. Results: The prevalence of reported FHS among the 11- and 15-year-old cohorts was 11.6% (90/775) and 12.4% (94/757), respectively. One hundred twenty-two (15.7%) and 142 (18.7%) of the 11- and 15-year-olds reported they were avoiding some food. The rates of sensitization to the food allergens were 5.1% (36/699) and 4.9% (32/649) for the 11- and 15-year-olds, respectively. FHS was confirmed in 8 (1.0%) 11-year-old children and 8 (1.0%) 15-year-old children by means of open food challenge and in 1 (0.1%) 11-year-old and 4 (0.5%) 15-year-olds by means of double-blind, placebo-controlled food challenge. The prevalence of FHS, as confirmed by using open food challenges and positive skin prick test responses plus a history of adverse reactions, was 18 (2.3%) of 775 in the 11-year-old cohort and 17 (2.3%) of 757 in the 15-year-old cohort. Conclusions: The rate of reported FHS was significantly more than sensitization to the predetermined allergens (odds ratio, 2.17; 95% CI, 1.47-3.18; P < .001 in the 11-year-olds; odds ratio, 2.73; 95% CI, 1.81-4.13; P < .001 in the 15-year-olds). By means of objective assessment, 2.3% of both 11- and 15-year-old children had FHS, with the majority showing immediate reactions.