Main Article Content
Breast-feeding, smoking, food processing, food allergy, food hypersensitivity, food consumption
Introduction and objectives: In order to investigate food allergy’s prevalence, risk factors and eating behavior of children with relevant anamnesis, a study was performed in Cypriot primary schools.
Patients: A specially composed questionnaire for self-reported adverse reactions to food, cre-ated in the context of the EuroPrevall study, was distributed in 13 representative primary schools across the country. Participants were sub-grouped into three groups; healthy (H), those with unconfirmed food hypersensitivity reactions (FA−) and children with a confirmed diagnosis by a physician IgE-mediated food allergy (FA+). Food habits, family health history and lifestyle factors were assessed and groups’ outcomes were compared with each other.
Results: For the study, 202 questionnaires were completed and returned; 31 children (19 FA-and 12 FA+) reported an adverse food reaction. Significant risk factors for developing FA+ were being the first born or having siblings with asthma, attended a day nursery, but also maternal alcohol drinking during pregnancy, parental smoking and parental occupation in food processing or use of latex gloves. The presence of children in the kitchen during cooking showed a protective role. Dietary habits of FA+ children were significantly diminished in terms of variety and frequency of consumption in comparison to the rest, in which had a greater overlap.
Conclusion: Further research is required for the interesting risk or protective factors revealing from the current investigation. The negative effect of food allergy in the dietary habits of food allergic children documented in the literature, is strongly supported herein.
2. Savage J, Johns CB. Food allergy: Epidemiology and natural history. Immunol Allergy Clin North Am. 2015;35:45–59. https://doi.org/10.1016/j.iac.2014.09.004
3. Nwaru BI, Hickstein L, Panesar SS, Muraro A, Werfel T, Cardona V, et al. The epidemiology of food allergy in Europe: A systematic review and meta-analysis. Allergy. 2014;69:62– 75. https://doi.org/10.1111/all.12305
4. Cochrane S, Beyer K, Clausen M, Wjst M, Hiller R, Nicoletti C, et al. Factors influencing the incidence and prevalence of food allergy. Allergy. 2009;64:1246–55. https://doi. org/10.1111/j.1398-9995.2009.02128.x
5. Bartra J, García-Moral A, Enrique E. Geographical differences in food allergy. Bundesgesundheitsblatt Gesundheitsforsch Gesundheitsschutz. 2016;59:755–763. https://doi.org/10.1007/ s00103-016-2357-0
6. Burks AW, Tang M, Sicherer S, Muraro A, Eigenmann PA, Ebisawa M, et al. ICON: Food allergy. J Allergy Clin Immunol. 2012;129:906–920. https://doi.org/10.1016/j.jaci.2012.02.001
7. Alexandre-Silva GM, Brito-Souza PA, Oliveira ACS, Cerni FA, Zottich U, Pucca MB. The hygiene hypothesis at a glance: Early exposures, immune mechanism and novel therapies. Acta Trop. 2018;188:16–26. https://doi.org/10.1016/j. actatropica.2018.08.032
8. Sicherer SH, Sampson HA. Food allergy: Epidemiology, pathogenesis, diagnosis, and treatment. J Allergy Clin Immunol. 2014;133:291–307. https://doi.org/10.1016/j.jaci.2013.11.020
9. Roehr CC, Edenharter G, Reimann S, Ehlers I, Worm M, Zuberbier T, et al. Food allergy and non-allergic food hypersensi-tivity in children and adolescents. Clin Exp Allergy. 2004;34:1534– 41. https://doi.org/10.1111/j.1365-2222.2004.02080.x
10. Noimark L, Cox HE. Nutritional problems related to food allergy in childhood. Pediatr Allergy Immunol. 2008;19:188– 195. https://doi.org/10.1111/j.1399-3038.2007.00700.x
11. Wassenberg J, Cochard MM, DunnGalvin A, Ballabeni P, Flokstra-de Blok BMJ, Newman CJ, et al. Parent perceived quality of life is age-dependent in children with food allergy. Pediatr Allergy Immunol. 2012;23:412–419. https://doi. org/10.1111/j.1399-3038.2012.01310.x
12. Kavaliûnas A, Surkiene G, Dubakiene R, Zagminas K, Stukas R. Potential risk factors of food allergy in children: EuroPrevall project results in Vilnius, Lithuania. Health. 2013;5:2032–8. https://doi.org/10.4236/health.2013.512275
13. Kummeling I, Mills ENC, Clausen M, Dubakiene R, Frarnãndez Pérez C, Fernández-Rivas M, et al. The EuroPrevall surveys on the prevalence of food allergies in children and adults: Background and study methodology. Allergy. 2009;64:1493–97. https://doi.org/10.1111/j.1398-9995.2009.02046.x
14. Vassilopoulou E, Christoforou C, Andreou E, Heraclides A. Effects of food allergy on the dietary habits and intake of primary schools’ cypriot children. Eur Ann Allergy Clin Immunol. 2017;49:181–185. https://doi.org/10.23822/EurAnnACI.1764-1489.07
15. Templeton GF. A two-step approach for transforming continuous variables to normal: Implications and recommendations for IS research. Commun Assoc Inform Syst. 2011;28. https://doi.org/10.17705/1CAIS.02804
16. Legendre P, Legendre L. Numerical Ecology. 2nd ed. Elsevier; Amsterdam, 1998.
17. Muraro A, Halken S, Arshad SH, Beyer K, Dubois AEJ, Du Toit G, et al. EAACI food allergy and anaphylaxis Guidelines. Primary prevention of food allergy. Allergy. 2014;69:590–601. https://doi.org/10.1111/all.12398
18. Grimshaw KEC, Allen K, Edwards CA, Beyer K, Boulay A, Van Der Aa LB, et al. Infant feeding and allergy prevention: A review of current knowledge and recommendations. A EuroPrevall state of the art paper. Allergy. 2009;64: 1407–16. https://doi.org/10.1111/j.1398-9995.2009.02172.x
19. Rigal N, Reiter F, Morice C, De Boissieu D, Dupont C. Impact du régime d’éviction sur la néophobie dans le cadre d’une allergie alimentaire chez l’enfant: Étude exploratoire. Arch Pediatr. 2005;12:1714–720. https://doi.org/10.1016/j.arcped.2005.02.031
20. Dovey TM, Staples PA, Gibson EL, Halford JCG. Food neophobia and “picky/fussy” eating in children: A review. Appetite. 2008;50:181–193. https://doi.org/10.1016/j.appet.2007.09.009
21. Kutbi HA, Alhatmi AA, Alsulami MH, Alghamdi SS, Albagar SM, Mumena WA et al. Food neophobia and pickiness among children and associations with socioenvironmental and cognitive factors. Appetite. 2019;142:104373. https://doi.org/10.1016/j.appet.2019.104373
22. Amoli MM, Hand S, Hajeer AH, Jones KP, Rolf S, Sting C, et al. Polymorphism in the STAT6 gene encodes risk for nut allergy. Genes Immun. 2002;3:220–224. https://doi.org/10.1038/sj.gene.6363872
23. Hand S, Darke C, Thompson J, Stingl C, Rolf S, Jones KP, et al. Human leucocyte antigen polymorphisms in nut-allergic patients in South Wales. Clin Exp Allergy. 2004;34:720–724. https://doi.org/10.1111/j.1365-2222.2004.1932.x
24. Goldsmith AJ, Koplin JJ, Lowe AJ, Tang MLK, Matheson MC, Robinson M, et al. Formula and breast feeding in infant food allergy: A population-based study. J Paediatr Child Health. 2016;52:377–384. https://doi.org/10.1111/jpc.13109
25. Raherison C, Pénard-Morand C, Moreau D, Caillaud D, Charpin D, Kopferschmitt C, et al. Smoking exposure and allergic sensitization in children according to maternal allergies. Ann Allergy Asthma Immunol. 2008;100:351–357. https://doi.org/10.1016/S1081-1206(10)60598-4
26. Hjern A, Hedberg A, Haglund B, Rosén M. Does tobacco smoke prevent atopic disorders? A study of two generations of Swedish residents. Clin Exp Allergy. 2001;31:908–914. https://doi.org/10.1046/j.1365-2222.2001.01096.x
27. Lack G. Update on risk factors for food allergy. J Allergy Clin Immunol. 2012;129:1187–97. https://doi.org/10.1016/j.jaci.2012.02.036
28. Hirsch AG, Pollak J, Glass TA, Poulsen MN, Baily-Davis L, Mowery J, et al. Early-life antibiotic use and subsequent diagnosis of food allergy and allergic diseases. Clin Exp Allergy. 2017;47:236–244. https://doi.org/10.1111/cea.12807
29. Grady C. Payment of clinical research subjects. J Clin Invest. 2005;115:1681–87. https://doi.org/10.1172/JCI25694