posted on 2025-01-29, 11:22authored byLeung A.S.-Y., Wong G.W.-K.
Background
The global epidemiology of food allergies and anaphylaxis exhibits complex, heterogeneous patterns. While food allergy prevalence has stabilized in Western countries, anaphylaxis incidence continues to rise. In developing regions, data is limited, but urban centers show increasing food allergy prevalence, contrasting with lower rates in rural areas. These disparities likely stem from differences in environmental factors and urbanization levels across the globe. Furthermore, the dominant food allergens vary significantly by region. Peanuts and tree nuts are the primary triggers in the U.S. and Europe, whereas eggs, milk, and shellfish are more common in Asia and Latin America.
Summary
In this upcoming review, we will delve into the recommendations for preventing food allergies across Eastern and Western regions. These regional differences in allergen profiles and dietary patterns underscore the need for tailored food allergy prevention strategies. Current prevention guidelines focus on the timing and route of allergen exposure in early life. In high-prevalence regions, early oral exposure is recommended to promote oral tolerance and reduce allergy risk. Conversely, in lower-prevalence areas, non-delayed introduction of allergenic solids is preferred. Moreover, early skin exposure may increase allergy risk, and the role of early, whole-body use of specialized emollients requires further study. Proactive treatment of atopic dermatitis may reduce the incidence of food allergies in infants. Adapting prevention approaches to local contexts and continuously updating guidelines based on emerging evidence is crucial to comprehensively addressing the global burden of food allergies.
Key messages
1. The global epidemiology of food allergies exhibits complex patterns, with food allergy prevalence stabilizing in Western countries but continuing to rise for anaphylaxis, while developing regions show increased prevalence in urban areas but limited data, and notable regional variations in the most common food allergens.
2. Current prevention strategies focus on the timing and route of allergen exposure, recommending early oral exposure to promote tolerance in high-prevalence regions and non-delayed introduction of allergenic solids in low-prevalence areas, while cautioning against early skin exposure and calling for more evidence on early, whole-body use of specialized emollients for the prevention of food allergies.
3. Our review highlights the need for robust, globally-adaptable guidelines that are continuously updated and personalized to individual and population factors, using a multifaceted approach to comprehensively address the dual allergen exposure hypothesis.