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Increased risk of peanut allergy in infants of A sian‐born parents compared to those of A ustralian‐born parents
Author(s) -
Koplin J. J.,
Peters R. L.,
Ponsonby A.L.,
Gurrin L. C.,
Hill D.,
Tang M. L. K.,
Dharmage S. C.,
Allen K. J.
Publication year - 2014
Publication title -
allergy
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 3.363
H-Index - 173
eISSN - 1398-9995
pISSN - 0105-4538
DOI - 10.1111/all.12487
Subject(s) - peanut allergy , medicine , allergy , pediatrics , food allergy , immunology
Background Asian infants appear to be over‐represented among patients with clinical food allergy in Australia, but this has not been formally examined at the population level. Any difference in prevalence according to parental country of birth may be secondary to modifiable lifestyle factors. We aimed to quantify (i) differences in the prevalence of peanut allergy by parental country of birth and (ii) contribution of measured environmental exposures to these differences. Methods The population‐based HealthNuts study in Melbourne, Australia, screened 5276 infants (74% participation) with skin prick tests and sensitized infants underwent food challenge. Of these, 535 had a parent born in East Asia and 574 in UK /Europe. Associations between parents' country of birth and offspring peanut allergy were examined using multiple logistic regression. Results Compared to infants with two Australian‐born parents, peanut allergy was more common among infants with parent/s born in East Asia ( OR 3.4, 95% CI 2.2–5.1) but not those with parent/s born in the UK /Europe ( OR 0.8, 95% CI 0.4–1.5). Paradoxically rates of allergic disease were lower among Asian parents. A higher prevalence of eczema among infants of Asian parents explained around 30% of the increase in peanut allergy, while differences in dog ownership explained around 18%. Conclusions The high peanut allergy prevalence among infants of Asian‐born parents appears to have occurred in a single generation and was not present among infants with parents migrating from other countries, suggesting gene–environment interactions are important. The role of eczema and microbial exposure in food allergy prevention warrants exploration.