EUGLOREH project
THE STATUS OF HEALTH IN THE EUROPEAN UNION:
TOWARDS A HEALTHIER EUROPE

FULL REPORT

PART II - HEALTH CONDITIONS

5. HEALTH IMPACTS OF NON COMMUNICABLE DISEASES AND RELATED TIME-TRENDS

5.10. Food allergy and intolerance

5.10.3. Data description and analysis

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5.10.3. Data description and analysis

 

Prevalence of food hypersensitivity

 

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

 

Prevalence of IgE-mediated food allergy

 

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 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)