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1 Food Allergy in the Past 7 Years Nearly 4% of North Americans have food allergies, many more than recorded in the past Incidence of food allergy much higher in children (8%) than adults (2%) Prevalence of peanut allergy doubled in American children younger than 5 years of age in the years 2002 - 2007 第1页/共51页 2 Food Allergy in the Past 7 Years Prevalence of food allergy highest in infants and toddlers Cow’s milk allergy incidence: 2.5% of infants Up to 8% of children under 3 years have allergy to a limited number of foods: Cow’s milk Wheat Egg Shellfish Soy Fish Peanut Tree nuts For every child who actually had a food allergy, over three more children were believed wrongly by their parents to suffer from the condition ______________ Venter et al 2008 第2页/共51页 3 Age Relationship Between Food Allergy and Atopy 1 2 3 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 Age (in years) 0 Relative Incidence Asthma Rhinitis Eczema Food Allergy Anaphylaxis Effect of Food Allergens Effect of Air-borne Allergens 第3页/共51页 4 Historical Perspective Sensitization to food allergens was thought to be the start of the “allergic march” Food allergy Atopic dermatitis/eczema Asthma Rhinitis Reducing sensitization to foods was therefore considered the essential first step in allergy prevention 第4页/共51页 5 Historical Perspective Measures of prevention were all designed to avoid sensitization to allergens during what were considered the most vulnerable periods: Intra-uterine life From birth to 2-3 years This meant reduction in exposure to highly allergenic foods: Mother’s diet during pregnancy and lactation Delay in introduction of highly allergenic foods during weaning In spite of these stringent measures to prevent allergy, incidence of all types of allergies have increased significantly 第5页/共51页 6 Change in Direction During the Past Five Years Understanding of the importance of immunological sensitization and tolerance Recognition that tolerance not
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