5.10.3. Data description and analysis
A community survey conducted on young adults of 12
European countries plus Australia, New Zealand and the United States in the context of the ECRHS project estimates in 12.2% the prevalence of self-reported
FHS, ranging from 4.6% in Spain to 19.1% in Australia, with the highest
prevalence in Europe corresponding to Sweden (18%) (Figure 5.10.2). The most
commonly identified food items considered responsible for symptoms typically
observed in allergic reactions to food - namely skin rash/urticaria, rhinitis,
vomiting, diarrhoea, intense headache and breathlessness (Woods RK et al, 2001)
- out of 87 different food items, include chocolate (4.8%), followed by apple
and hazelnut (4.7%), strawberries (4.6%), cow’s milk (4.3%), oranges and
tomatoes (3%), shrimps and eggs (2.8), oysters (2.3) and fish (2.2) as the most
frequently cited.
A more recent evaluation of the ECRHS cohorts with the
addition of other individual studies showed that heterogeneity between the
ECRHS cohorts was comparable to that observed for other studies conducted on
adults. Prevalence of self-reported FHS for adults and children was about 12%
(Rona et al, 2007).
Figure
5.10.2. Reported food
allergy/intolerance prevalence rates and 95% Confidence Intervals per country
in selected EUGLOREH countries
There is a wide difference between the number of adults
who perceive they are intolerant to food (see section 5.10.3.1.) and the number
confirmed with food challenge (0.8-2.4%) (EU SCOOP, 1998).
The prevalence of IgE-mediated FA in Europe has been
roughly estimated to be around 4-6 % in children and 1-3% in adults, the female
to male ratio being around 3:2 in the latter (Løvik and Narmok, 2004). In
adults, main foods responsible for about half of all allergic reactions are
fruits of the latex group, fruits of the Rosaceae family, vegetables of
the Apiaceae family, nuts and peanuts, whereas in children three fourths
of reactions are limited to eggs, peanuts, cow’s milk, fish and nuts. However,
no comprehensive data are available on the prevalence of IgE-mediated FA to
individual food items in single European countries, and the generalisation of
data from one country to another is limited due to significant differences in
potential of exposure, cross-reactivity with environmental allergens and other
background factors (EFSA, 2004).
Although very few longitudinal reports have been
published on IgE-mediated allergic reactions to food in Europe (Gupta et al
2003), it is assumed that their frequency may have substantially increased in
the last decades in parallel to the well documented increase in the prevalence
of atopy (Strannegard and Strannegard, 2001; Kosunen
et al, 2002)
5.10.3.3.
Prevalence of non IgE-mediated food allergy
Celiac disease (also known as gluten-induced
entheropathy) is an autoimmune disorder triggered by gluten associated with the
exposure to foods containing wheat, barley and rye alcohol-soluble proteins. It
is life-long disease with permanent gluten intolerance and is characterised by
a severe small intestinal mucosal lesion (villus atrophy) typically exhibiting
a flat mucosa (Fasano and Catassi, 2001; Stern et al, 2001), which is responsive
to elimination of the trigger by a gluten-free diet except for a very few
severe cases of non-responsive adult coeliac disease.
Celiac disease is probably the more widely diffused non
IgE-mediated food allergy worldwide (Figure 5.10.3), with an overall prevalence
as high as 1:200 ( and probably higher) in Europe and the Western World (Fasano
and Catassi, 2001).
Figure 5.10.3. Prevalence of celiac disease
Source: Fasano and Catassi (2005)
