Global patterns in anaphylaxis due to specific foods: A systematic review

Conrado B A ,Patel N , Turner J P ,01 May 2021 ,Global patterns in anaphylaxis due to specific foods: A systematic review ,The journal of allergy and clinical immunology ,doi:10.1016/j.jaci.2021.03.048


Background: There are increasing global data relating to prevalence of food allergy and food-induced anaphylaxis; however, this is often based on surrogate measures of sensitization rather than objective symptoms at food challenge. In terms of protecting food-allergic consumers from reactions, to our knowledge, there has been no global survey assessing geographic differences in the proportion of anaphylaxis triggered by specific foods.

Objective: We sought to identify common triggers for food-induced anaphylaxis and how these vary from country to country.

Methods: Systematic review of relevant reports published between January 2010 and November 2020. Results were reported following PRISMA guidelines. Publications were screened and data extracted by 2 independent reviewers, and the risk of bias was assessed.

Results: Sixty-five studies (encompassing 41 countries and all 6 regions as defined by the Food and Agriculture Organization of the United Nations) were included. Significant regional variations in the most common triggers of food anaphylaxis were seen; however, in general, there was good agreement between local legislative requirements for allergen disclosure and the most common allergens for each region or nation.

Conclusions: Local legislation for allergen disclosure generally reflects those allergens commonly responsible for food anaphylaxis. Cow's milk and crustaceans appear to cause a higher proportion of anaphylaxis compared to peanut in some regions.

Keywords: Allergen labeling; Codex; anaphylaxis; epidemiology; food allergy; prevalence.

Copyright © 2020 The Authors. Published by Elsevier Inc. All rights reserved.

DOI: 10.1016/j.jaci.2021.03.048

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