Overview
- Pooling 190 studies from 40 countries and roughly 2.8–3 million children, researchers estimated a 4.7% incidence of childhood food allergy confirmed by food challenges, with rates around 10% in Australia versus about 1.8% in Africa.
- Markers of impaired skin barrier and early allergic disease were among the strongest predictors, with atopic dermatitis in the first year linked to about fourfold higher odds and higher transepidermal water loss tied to roughly threefold higher odds.
- Antibiotic exposure showed notable associations, including approximately fourfold higher odds with systemic antibiotics in the first month of life, about 30% higher with prenatal exposure, and roughly 40% higher with exposure during the first year.
- Introducing common allergens late was associated with higher risk, as peanut introduction after 12 months more than doubled the odds, and coverage highlighted existing trial evidence that early peanut introduction can cut peanut allergy risk by up to 80%.
- Family and sociodemographic patterns were influential, with parental or sibling allergy linked to higher odds, parental migration exceeding threefold higher odds, and higher odds reported for Black children versus White children, while factors like birth weight and breastfeeding showed no important associations and many studies carried bias concerns.