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Food allergy across the globe

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Vanitha Sampath, Elissa M. Abrams, Bahman Adlou, Cezmi Akdis, Mübeccel Akdis, Helen A. Brough, Susan Chan, Pantipa Chatchatee, R. Sharon Chinthrajah, Renata Rodrigues Cocco, Antoine Deschildre, Philippe Eigenmann, Cesar Galvan, Ruchi Gupta, Elham Hossny, Jennifer J. Koplin, Gideon Lack, Michael Levin, Lynette P. Shek, Mika Makela & 17 more David Mendoza-Hernandez, Antonella Muraro, Nikolaos G. Papadopoulous, Ruby Pawankar, Kirsten P. Perrett, Graham Roberts, Cansin Sackesen, Hugh Sampson, Mimi L.K. Tang, Alkis Togias, Carina Venter, Christopher Michael Warren, Lisa M. Wheatley, Gary W.K. Wong, Kirsten Beyer, Kari C. Nadeau, Harald Renz

Original languageEnglish
Pages (from-to)1347-1364
Number of pages18
JournalJournal of Allergy and Clinical Immunology
Issue number6
PublishedDec 2021

Bibliographical note

Funding Information: Disclosure of Significant Relationships with Relevant Commercial Companies/Organizations: E. M. Abrams is an employee of the Public Health Agency of Canada (PHAC). C. Akdis reports grants from the Swiss National Science Foundation, EU CURE, and Novartis Research Institutes (Basel Switzerland); is Chair of the European Academy of Allergy and Clinical Immunology (EAACI) Guidelines on Environmental Science in Allergic diseases and Asthma; and is Editor-in-Chief of Allergy. M. Akdis reports grants from the Swiss National Science Foundation, EU CURE, and Novartis Research Institutes (Basel Switzerland). H. A. Brough reports receiving research grants from the National Institutes of Health (NIH), Aimmune, and DBV Technologies and speaker fees from DBV Technologies and Sanofi; is Pediatric Section Chair, the EAACI; and is President Elect Royal Society of Medicine. S. Chan reports grants from the NIH and Aimmune and has received a medical device from Primus. R. S. Chinthrajah reports grants from the National Institute of Allergy and Infectious Diseases (NIAID), CoFAR, Aimmune, DBV Technologies, Astellas, Regeneron, Stanford Maternal and Child Health Research Institute, and Food Allergy Research & Education (FARE) and is an Advisory Board Member at Alladapt Therapeutics, Novartis, Genentech, Sanofi, Allergenis, and Nutricia. A. Deschildre receives consulting fees, honoraria, or support for attending meetings/travel from Aimmune Therapeutics, DBV Technologies, Nestlé Health Science, Nutricia, Novartis, and AstraZeneca; participated on a Data Safety Monitoring Board or Advisory Board at Aimmune and Novartis; has a leadership role at SFA (société Française d'Allergologie) (ongoing), and SP2A (Société Pédiatrique de Pneumologie et Allergologie) (stopped in 2019); and is past president of the Cercle d'investigations Cliniques et Biologiques en Allergie Alimentaire. P. Eigenmann receives grants, consulting fees, speaking fees, honorarium, royalties, stock options, or travel support from Ulrich Muller Gierock Foundation, Thermo Fisher Scientific, DBV Technologies, Nestlé, Danone, Novartis, Abbott, Alexia, University Hospitals of Geneva, ALK, UpToDate, Elsevier, and EAACI. C. Galvan reports payment from Reckitt Benckiser Mead Johnson. D. Mendoza-Hernandez reports payment or honoraria from Nestlé and Thermo Fisher Scientific. J. J. Koplin reports grants from the National Health and Medical Research Council of Australia. G. Lack receives grants from NIAID, NIH, FARE, MRC & Asthma UK Centre, UK Department of Health through the National Institute for Health Research, National Peanut Board, The Davis Foundation, UK Food Standards Agency, and Medical Research Council; consulting fees, payment, honorarium, or travel support from Novartis, Sanofi-Genyzme, Regeneron, ALK-Abelló, Lurie Children's Hospital, ALK-Abelló, Northwestern University Feinberg School of Medicine, DBV Technologies, the American Academy of Allergy, Asthma & Immunology (AAAAI), and Nestlé; is on the Scientific Advisory Board in DBV Technologies, Lurie Children's Hospital, ALK-Abelló, and Novartis; and holds stock or stock options for DBV Technologies and Mighty Mission Me. A. Muraro discloses speaker's fee from Mylan, Viatris, Aimmune, DVB Technologies, Nestlé Health Institute, Nestlé Purina, and Nutricia. N. G. Papadopoulous reports grants from Gerolymatos International SA and Capricare; payment or honoraria from HAL, Menarini/Faes Farma, MSD, Biomay, Novartis, Nutricia, Sanofi, Boehringer Ingelheim, Mylan/Meda, and Asit Biotech; and participating on the Advisory Board at HAL, Menarini/Faes Farma, Novartis, Nutricia, GlaxoSmithKline (GSK), AstraZeneca, and Mylan/Meda. K. P. Perrett reports grants from Melbourne Children's Clinician-Scientist Fellowship; research grants from the National Health and Medical Research Council, the Immune Tolerance Network, DBV Technologies, and GSK; consulting fees from Aravax; and serving as Chair of the Scientific Advisory Board for AllergyPal. G. Roberts reports grants from United Kingdom Food Standards Agency to assess the epidemiology of food allergy and is a member of the EAACI Food Allergy Guideline Group. C. Sackesen reports payment, honoraria, or travel support from Abbott Company and Nutricia; is the head of a food allergy group at the Turkish Society of Allergy and Clinical Immunology; and has patents planned for a twice-baked cow's milk product as a hypoallergenic milk food. H. Sampson reports grants, consulting fees, stock options, and travel support from NIAID, NIH, Elsevier, DBV Technologies, N-Fold LLC, Siolta Therapeutics, and DBV Technologies. M.L.K. Tang reports grants, drugs received, contracts, travel support, leadership or fiduciary role, stocks or stock options, or consulting fees from the National Health and Medical Research Council (Australia), Prota Therapeutics Pty Ltd, Murdoch Children's Research Institute, Pfizer, Prota Therapeutics, the EAAACI, the Asia Pacific Association of Allergy, Asthma and Clinical Immunology, the AAAAI, the International Union of Immunological Societies, the Australasian Society of Clinical Immunology and Allergy, Anaphylaxis Australia Incorporated, the Melbourne Academic Centre for Health, and the World Allergy Organization; is member of the International Expert Panel on Guidelines for Food Allergy in Schools, Health World Ltd; has patents including “A method of including tolerance to an antigen and allergy treatment”; and is an employee of Prota Therapeutics. A. Togias is a paid employee of the US Federal Government, which funds food allergy research in the United States and across the globe. C. Venter reports grants, payment, or honoraria from Danone, Nestle Nutrition Institute, Reckitt Benckiser, Abbott, Before Brands, Sifter, and Else Nutrition and leadership or fiduciary role at the American Academy of Asthma, Allergy and Immmunology, the European Academy of Asthma, Allergy and Immunology, and Food Allergy Research and Education. C. M. Warren reports grants from the NIAID and FARE. K. Beyer received support (grants, consulting or speaker fees) from Aimmune Therapeutics, ALK, DBV, Bencard, Nestlé, Novartis, and Allergopharma; was on the Advisory Board or the Data Safety Monitoring Board of Aimmune Therapeutics, Bencard, DBV, Nestlé, and Novartis; has a leadership or fiduciary role at AGATE (Anaphylaxis Training and Education), GPA (German Society for Pediatric Allergology & Environmental Medicine), DGKJ (German Society for Allergology & Clinical Immunology), and DAAB (German Allergy and Asthma Association). K. C. Nadeau reports grants from the NIAID, the National Heart, Lung, and Blood Institute, the National Institute of Environmental Health Sciences, and FARE; is Director of the World Allergy Organization; Advisor at Cour Pharma; consultant for Excellergy, Red tree ventures, and Phylaxis; cofounder of Before Brands, Alladapt, Latitude, and IgGenix; and National Scientific Committee member at the Immune Tolerance Network, and NIH clinical research centers, outside the submitted work; patents include “Mixed allergen composition and methods for using the same,” “Granulocyte-based methods for detecting and monitoring immune system disorders,” “Methods and assays for detecting and quantifying pure subpopulations of white blood cells in immune system disorders,” and “Methods of isolating allergen-specific antibodies from humans and uses thereof.” H. Renz reports grants from Deutsche Zentrum für Lungenforschung (DZL, German Lung Center, no. 82DZL00502) and Deutsche Forschungsgemeinschaft (DFG)-funded SFB 1021. The rest of the authors declare that they have no relevant conflicts of interest. Z. K. Ballas (editor) disclosed no relevant financial relationships. Publisher Copyright: © 2021 American Academy of Allergy, Asthma & Immunology

King's Authors


The prevalence of food allergy (FA) is increasing in some areas of the globe, highlighting the need for better strategies for prevention, diagnosis, and therapy. In the last few decades, we have made great strides in understanding the causes and mechanisms underlying FAs, prompting guideline updates. Earlier guidelines recommended avoidance of common food allergens during pregnancy and lactation and delaying the introduction of allergenic foods in children aged between 1 and 3 years. Recent guidelines for allergy prevention recommend consumption of a healthy and diverse diet without eliminating or increasing the consumption of allergenic foods during pregnancy or breast-feeding. Early introduction of allergenic foods is recommended by most guidelines for allergy prevention after a period of exclusive breast-feedng (6 months [World Health Organization] or 4 months [European Academy of Allergy and Clinical Immunology]). New diagnostics for FA have been developed with varied availability of these tests in different countries. Finally, the first oral immunotherapy drug for FA was approved by the US Food and Drug Administration and European Medicines Agency in 2020. In this review, we will address the global prevalence of FA, our current understanding of the causes of FA, and the latest guidelines for preventing, diagnosing, and treating FA. We will also discuss similarities and differences between FA guidelines.

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