Low Food Allergy Prevalence Despite Delayed Introduction of Allergenic Foods—Data from the GUSTO Cohort

Publication date: Available online 19 July 2017
Source:The Journal of Allergy and Clinical Immunology: In Practice
Author(s): Elizabeth Huiwen Tham, Bee Wah Lee, Yiong Huak Chan, Evelyn Xiu Ling Loo, Jia Ying Toh, Anne Goh, Oon Hoe Teoh, Fabian Yap, Kok Hian Tan, Keith M. Godfrey, Mary Foong Fong Chong, Hugo P.S. Van Bever, Yap Seng Chong, Lynette Pei-chi Shek
BackgroundThere is mounting evidence that early introduction of allergenic food decreases the risk of food allergy development, especially in high-risk infants with eczema. However, there is a lack of data to suggest whether this association holds true in Asian populations.ObjectiveTo investigate the relationship between the timing of introduction of allergenic foods and food allergy outcomes in infants in the Growing Up in Singapore Towards healthy Outcomes (GUSTO) study.MethodsThe GUSTO cohort recruited 1152 mothers of Chinese, Malay, and Indian ethnicity who had singleton, naturally conceived pregnancies and followed their offspring prospectively. Information on demographic characteristics, child health, infant feeding practices, and a convincing history of IgE-mediated food allergy was obtained from interviewer-administered questionnaires at multiple time points. Corroborative skin prick tests to food allergens were performed at 18 and 36 months.ResultsMost of the infants were introduced to egg (49.6%), peanut (88.7%), and shellfish (90.2%) after age 10 months. Food allergy prevalence was, however, very low between age 12 and 48 months: egg, 0.35% to 1.8%; peanut allergy, 0.1% to 0.3%; and shellfish, 0.2% to 0.9%. There were no significant associations between the timing of introduction of allergenic foods and the development of food allergy, adjusted for confounders including breast-feeding and eczema.ConclusionsFood allergy rates in Singapore are low despite delayed introduction of allergenic foods. Early introduction of allergenic foods may thus not be necessary in populations in which overall food allergy prevalence is low, and thus infant feeding recommendations should be carefully tailored to individual populations.

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