Prevalence and clinical features of adverse food reactions in Portuguese adolescents

Background & aims: The objective of the present study was to determine, for the first time, the prevalence and clinical features of food allergy in Portuguese adolescents. Methods: Cross-sectional study performed in various secondary schools in central Portugal. Randomly selected adolescents replied to a validated food allergy questionnaire. Those who reported an adverse food reaction were seen at participating hospitals, where clinical history was taken, skin prick (SPT) and prick-prick skin (SPPT) tests were performed, and food allergen-specific IgE levels (sIgE) were determined. An open oral challenge was performed in selected cases. Cases of positive clinical history of immediate (up to 2 h after ingestion) reaction in association with positive food sIgE levels and/or SPT were classified as IgE-associated probable food allergy and as confirmed IgE-mediated food allergy if food challenges were positive. Cases of positive clinical history of delayed (more than 2 h after ingestion) and negative food sIgE levels independently of positive SPT or SPPT results, were classified as non-IgE associated probable food allergy. Results: The prevalence of probable food allergy in Portuguese adolescents was 1.41% (95% CI: 0.90-2.03%), with fresh fruits, shellfish, nuts, and peanut as the most frequently implicated foods. IgE-mediated probable food allergy occurred in 1.23% (95% CI: 0.67-1.72%) of cases, with fresh fruits, shellfish, and nuts mainly involved. Cutaneous symptoms were most frequently reported. Conclusions: The prevalence of probable food allergies in Portuguese adolescents is low, is mostly related to fresh fruits, shellfish, nuts, and peanut, and most frequently involves cutaneous symptoms.Y