Background: Studies suggest an increase in food allergy prevalence over the last decade, but the contributing factors remain unknown. The aim of this study was to evaluate the association between the most common food allergies and atopic history, sociodemographic characteristics and lifestyle habits. Methods: We conducted a case-control study nested within the SPAACE study (Surveying Prevalence of Food Allergy in All Canadian Environments) - a cross-Canada, random telephone survey. Cases consisted of individuals with probable food allergy (self-report of convincing symptoms and/or physician diagnosis) to milk, egg, peanut, tree nut, shellfish, fish, wheat, soy, or sesame. Controls consisted of nonallergic individuals, matched for age. Cases and controls were queried on personal and family history of atopy, sociodemographic characteristics and lifestyle habits. Multivariate logistic regression was used to evaluate the association between atopy, sociodemographic characteristics and lifestyle habits with probable food allergy. Results: Between September 2010 and September 2011, 480 cases and 4,950 controls completed the questionnaire. For all 9 allergens, factors associated with a higher risk of probable allergy were as follows: (1) personal history of eczema (in the first 2 years of life), asthma or hay fever (odds ratio, OR 2.3, 95% CI 1.6-3.5; OR 2.8, 95% CI 2.2-3.6, and OR 2.3, 95% CI 1.8-3.0, respectively), (2) maternal, paternal or sibling's food allergy (OR 3.7, 95% CI 2.5-5.6; OR 3.0, 95% CI 1.8-5.1, and OR 3.1, 95% CI 2.2-4.2), (3) high household income (top 20%; OR 1.5, 95% CI 1.2-2.0). Males and older individuals were less likely to have food allergy (OR 0.7, 95% CI 0.6-0.9, and OR 0.99, 95% CI 0.99-1.00). Eczema in the first 2 years of life was the strongest risk factor for egg, peanut, tree nut and fish allergy. Conclusions: This is the largest population-based nested case-control study exploring factors associated with food allergies. Our results reveal that, in addition to previously reported factors, eczema in the first 2 years of life is consistently associated with food allergies.

Keywords:
Food allergy, Eczema, Demographic factors, Lifestyle
1.
Ben-Shoshan M, Turnbull E, Clarke A: Food allergy: temporal trends and determinants. Curr Allergy Asthma Rep 2012;12:346-372.
2.
Prescott SL, Pawankar R, Allen KJ, Campbell DE, Sinn JK, Fiocchi A, et al: A global survey of changing patterns of food allergy burden in children. World Allergy Organ J 2013;6:21.
3.
Keet CA, Savage JH, Seopaul S, Peng RD, Wood RA, Matsui EC: Temporal trends and racial/ethnic disparity in self-reported pediatric food allergy in the United States. Ann Allergy Asthma Immunol 2014;112:222-229.
4.
American Academy of Pediatrics; Committee on Nutrition: Hypoallergenic infant formulas. Pediatrics 2000;106(part 1):346-349.
5.
Frazier AL, Camargo CA Jr, Malspeis S, Willett WC, Young MC: Prospective study of peripregnancy consumption of peanuts or tree nuts by mothers and the risk of peanut or tree nut allergy in their offspring. JAMA Pediatr 2014;168:156-162.
6.
Du Toit G, Katz Y, Sasieni P, Mesher D, Maleki SJ, Fisher HR, et al: Early consumption of peanuts in infancy is associated with a low prevalence of peanut allergy. J Allergy Clin Immunol 2008;122:984-991.
7.
Ben Shoshan M, Harrington DW, Soller L, Fragapane J, Joseph L, St Pierre Y, et al: A population-based study on peanut, tree nut, fish, shellfish, and sesame allergy prevalence in Canada. J Allergy Clin Immunol 2010;125:1327-1335.
8.
Ben-Shoshan M, Knoll M, Soller L, Harrington DW, Fragapane J, Joseph L, et al: Prevalence of common food allergies in Canada: targeting specific demographic groups across Canada. J Allergy Clin Immunol 2012;129:AB235.
9.
Ben-Shoshan M, Harrington DW, Soller L, Fragapane J, Joseph L, St Pierre Y, et al: Demographic predictors of peanut, tree nut, fish, shellfish, and sesame allergy in Canada. J Allergy (Cairo) 2012;2012:858306.
10.
Soller L, Ben-Shoshan M, Harrington DW, Fragapane J, Joseph L, St Pierre Y, et al: Overall prevalence of self-reported food allergy in Canada. J Allergy Clin Immunol 2012;130:986-988.
11.
Knoll M, Soller L, Ben-Shoshan M, Harrington D, Fragapane J, Joseph L, et al: The use of incentives in vulnerable populations for a telephone survey: a randomized controlled trial. BMC Res Notes 2012;5:572.
12.
O'Brien EM, Black MC, Carley-Baxter LR, Simon TR: Sensitive topics, survey nonresponse, and considerations for interviewer training. Am J Prev Med 2006;31:419-426.
13.
Singer E, Kulka R: Paying respondents for survey participation; in Committee on National Statistics, National Research Council (eds): Studies of Welfare Populations: Data Collection and Research Issues. Washington, National Academy Press, 2002, pp 105-128.
14.
Sampson HA, Munoz-Furlong A, Campbell RL, Adkinson NF Jr, Bock SA, Branum A, et al: Second symposium on the definition and management of anaphylaxis: summary report - second National Institute of Allergy and Infectious Disease/Food Allergy and Anaphylaxis Network symposium. Ann Emerg Med 2006;47:373-380.
15.
Gordis L: Epidemiology, ed 4. Philadelphia, Saunders, 2009.
16.
Baek JO, Hong S, Son DK, Lee JR, Roh JY, Kwon HJ: Analysis of the prevalence of and risk factors for atopic dermatitis using an ISAAC questionnaire in 8,750 Korean children. Int Arch Allergy Immunol 2013;162:79-85.
17.
Lack G: Epidemiologic risks for food allergy. J Allergy Clin Immunol 2008;121:1331-1336.
18.
Hassaine A, Clarke A, Alizadehfar R, Joseph L, Shand G, Ben-Shoshan M: Initial allergic reactions to fish and shellfish in children: clinical characteristics and treatment. J Allergy Clin Immunol 2012;129:AB169.
19.
Grimshaw KE, Maskell J, Oliver EM, Morris RC, Foote KD, Mills EN, et al: Introduction of complementary foods and the relationship to food allergy. Pediatrics 2013;132:e1529-e1538.
20.
Hansen TE, Evjenth B, Holt J: Increasing prevalence of asthma, allergic rhinoconjunctivitis and eczema among schoolchildren: three surveys during the period 1985-2008. Acta Paediatr 2013;102:47-52.
21.
Duggan EM, Sturley J, Fitzgerald AP, Perry IJ, Hourihane JO: The 2002-2007 trends of prevalence of asthma, allergic rhinitis and eczema in Irish schoolchildren. Pediatr Allergy Immunol 2012;23:464-471.
22.
Kolokotroni O, Middleton N, Nicolaou N, Pipis S, Priftis KN, Milton DK, et al: Temporal changes in the prevalence of childhood asthma and allergies in urban and rural areas of Cyprus: results from two cross sectional studies. BMC Public Health 2011;11:858.
23.
Weiland SK, Husing A, Strachan DP, Rzehak P, Pearce N: Climate and the prevalence of symptoms of asthma, allergic rhinitis, and atopic eczema in children. Occup Environ Med 2004;61:609-615.
24.
Wavrin S, Bernard H, Wal JM, Adel-Patient K: Cutaneous or respiratory exposures to peanut allergens in mice and their impacts on subsequent oral exposure. Int Arch Allergy Immunol 2014;164:189-199.
25.
Ben-Shoshan M, Soller L, Harrungton D, Knoll M, La Vieille S, Fragapane J, et al: Environmental and sociodemographic factors associated with food allergy: a nested case-control study. J Allergy Clin Immunol 2014;133(suppl):AB205.
26.
Bohme M, Lannero E, Wickman M, Nordvall SL, Wahlgren CF: Atopic dermatitis and concomitant disease patterns in children up to two years of age. Acta Derm Venereol 2002;82:98-103.
27.
Lack G, Fox D, Northstone K, Golding J: Factors associated with the development of peanut allergy in childhood. N Engl J Med 2003;348:977-985.
28.
Fox AT, Sasieni P, Du TG, Syed H, Lack G: Household peanut consumption as a risk factor for the development of peanut allergy. J Allergy Clin Immunol 2009;123:417-423.
29.
Perry TT, Conover-Walker MK, Pomes A, Chapman MD, Wood RA: Distribution of peanut allergen in the environment. J Allergy Clin Immunol 2004;113:973-976.
30.
Dharmage SC, Lowe AJ, Matheson MC, Burgess JA, Allen KJ, Abramson MJ: Atopic dermatitis and the atopic march revisited. Allergy 2014;69:17-27.
31.
Monti G, Muratore MC, Peltran A, Bonfante G, Silvestro L, Oggero R, et al: High incidence of adverse reactions to egg challenge on first known exposure in young atopic dermatitis children: predictive value of skin prick test and radioallergosorbent test to egg proteins. Clin Exp Allergy 2002;32:1515-1519.
32.
Palmer DJ, Metcalfe J, Makrides M, Gold MS, Quinn P, West CE, et al: Early regular egg exposure in infants with eczema: a randomized controlled trial. J Allergy Clin Immunol 2013;132:387-392.
33.
Flohr C, Perkin M, Logan K, Marrs T, Radulovic S, Campbell LE, et al: Atopic dermatitis and disease severity are the main risk factors for food sensitization in exclusively breastfed infants. J Invest Dermatol 2014;134:345-350.
34.
Horimukai K, Morita K, Narita M, Kondo M, Kitazawa H, Nozaki M, et al: Application of moisturizer to neonates prevents development of atopic dermatitis. J Allergy Clin Immunol 2014;134:824-830.
35.
Simpson EL, Chalmers JR, Hanifin JM, Thomas KS, Cork MJ, McLean WH, et al: Emollient enhancement of the skin barrier from birth offers effective atopic dermatitis prevention. J Allergy Clin Immunol 2014;134:818-823.
36.
Ben Shoshan M, Kagan RS, Alizadehfar R, Joseph L, Turnbull E, St Pierre Y, et al: Is the prevalence of peanut allergy increasing? A 5-year follow-up study in children in Montreal. J Allergy Clin Immunol 2009;123:783-788.
37.
Venter C, Hasan AS, Grundy J, Pereira B, Bernie CC, Voigt K, et al: Time trends in the prevalence of peanut allergy: three cohorts of children from the same geographical location in the UK. Allergy 2010;65:103-108.
38.
Silverberg JI, Simpson EL, Durkin HG, Joks R: Prevalence of allergic disease in foreign-born American children. JAMA Pediatr 2013;167:554-560.
39.
Wang HY, Wong GW, Chen YZ, Ferguson AC, Greene JM, Ma Y, et al: Prevalence of asthma among Chinese adolescents living in Canada and in China. CMAJ 2008;179:1133-1142.
40.
Katz Y, Rajuan N, Goldberg MR, Eisenberg E, Heyman E, Cohen A, et al: Early exposure to cow's milk protein is protective against IgE-mediated cow's milk protein allergy. J Allergy Clin Immunol 2010;126:77-82.
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2015
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