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Hashimoto M, Nakamura N, Sato N. Development Process of a Learning Program to Improve Health Literacy in Social Eating Situations for Adolescents With Food Allergies. J Pediatr Health Care 2025:S0891-5245(25)00059-8. [PMID: 40196973 DOI: 10.1016/j.pedhc.2025.02.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/19/2024] [Revised: 01/23/2025] [Accepted: 02/16/2025] [Indexed: 04/09/2025]
Abstract
INTRODUCTION This study aimed to use the ADDIE (Analysis, Design, Development, Implementation, Evaluation) model to clarify the process of developing a learning program for adolescents with food allergies to increase their health literacy in social eating situations. METHOD The procedure for developing instructional materials followed the first three stages (Analysis, Design, Development) of the ADDIE model. RESULTS The need to promote the ability of adolescents with food allergies to build relationships in various dining environments and to utilize and share knowledge about their own condition was analyzed. Subsequently, three units and their lesson plans, as well as teaching materials, were designed. The sub-items of "attention," "relevance," "confidence," and "satisfaction" in the ARCS model had an average score of 1.0-5.0 each. DISCUSSION This learning program may help adolescents with allergies to build relationships, acquire skills to communicate about food allergy, and promote health literacy in social dining situations.
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Octawijaya IH, Kondo M, Hori A, Ichikawa M. Parent Willingness to Pay for School Feeding Programs in Junior High Schools in Malang Regency, Indonesia. Nutrients 2023; 15:3212. [PMID: 37513630 PMCID: PMC10384078 DOI: 10.3390/nu15143212] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2023] [Revised: 07/12/2023] [Accepted: 07/16/2023] [Indexed: 07/30/2023] Open
Abstract
In Indonesia, school feeding programs have not been established nationally due to the government's limited budget. To examine the possibility of copayment for school feeding programs, parents' intentions to use the school feeding programs and their willingness to pay (WTP) for these programs should be considered. We conducted an online questionnaire survey among the parents of junior high school students in all five public junior high schools in the Kepanjen District of Malang Regency, East Java Province, Indonesia. We used the contingent valuation method to elicit parents' WTP for school feeding and calculated the price elasticity of school feeding. Factors associated with the WTP were examined using logistic regression analysis. Of the 940 participants, 90% intended to use school feeding programs, and 30% were willing to pay Rp 15,000 (USD 1.05) or higher per meal. Of the 944 students (participants' children), all but two students consumed meals or snacks at school, with 74% consuming foods three or more times daily. Higher WTP for school feeding was associated with frequent food consumption at school, higher income, and a better perception of meals at school. In contrast, lower WTP was associated with more household members. Most parents intended to use school feeding programs with certain WTP irrespective of the price of school feeding. Therefore, school feeding in Indonesia might be expanded through copayment.
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Affiliation(s)
- Ishak Halim Octawijaya
- Graduate School of Comprehensive Human Sciences, University of Tsukuba, 1-1-1 Tennodai, Tsukuba 305-8577, Ibaraki, Japan
- School of Nutrition and Dietetics, Faculty of Health and Social Services, Kanagawa University of Human Services, 1-10-1 Heiseicho, Yokosuka 238-8522, Kanagawa, Japan
| | - Masahide Kondo
- Faculty of Medicine, University of Tsukuba, 1-1-1 Tennodai, Tsukuba 305-8577, Ibaraki, Japan
| | - Ai Hori
- Faculty of Medicine, University of Tsukuba, 1-1-1 Tennodai, Tsukuba 305-8577, Ibaraki, Japan
| | - Masao Ichikawa
- Faculty of Medicine, University of Tsukuba, 1-1-1 Tennodai, Tsukuba 305-8577, Ibaraki, Japan
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Newman KL, Chater A, Knibb RC. Beliefs about food allergies in adolescents aged 11-19 years: A systematic review. Clin Transl Allergy 2022; 12:e12142. [PMID: 35414890 PMCID: PMC8984676 DOI: 10.1002/clt2.12142] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2022] [Revised: 03/10/2022] [Accepted: 03/18/2022] [Indexed: 11/20/2022] Open
Abstract
Aims Research suggests of people with food allergy (FA), adolescents have the highest risk of fatal allergic reactions to food, yet understanding of this population and how they manage their condition is limited. Understanding beliefs and how they affect behaviour could inform ways to reduce risk taking behaviour and fatal reactions in adolescents. This systematic review aimed to explore beliefs adolescents hold about their FA, and how these may be associated with FA management. Demographics Adolescents aged 11-19 years with FA. Methodology A systematic search of seven databases was conducted. Papers of any design were included that reported on the beliefs about FA in adolescents aged 11-19 years. Data was systemised by narrative thematic analysis. Findings 20 studies were included. Themes included navigating FA in different environments, carriage and use of adrenaline auto-injectors, management of the risk of anaphylaxis, behaviour and understanding of others, and food-allergic identity. Implications Adolescents with FA hold a variety of condition beliefs; some beliefs were related to behaviour that could lead to an allergic reaction, while other beliefs were related to protective behaviours. Further research into understanding adolescent beliefs in order to inform clinical management and reduce the risk of potential fatal reactions is essential.
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Affiliation(s)
- Kristina L. Newman
- Psychology DepartmentSchool of Life and Health SciencesAston UniversityBirminghamUK
- Department of PsychologySchool of Social SciencesNottingham Trent UniversityNottinghamUK
| | - Angel Chater
- Department for Sport Science and Physical ActivityUniversity of BedfordshireBedfordUK
| | - Rebecca C. Knibb
- Psychology DepartmentSchool of Life and Health SciencesAston UniversityBirminghamUK
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Jafri S, Frykas TL, Bingemann T, Phipatanakul W, Bartnikas LM, Protudjer JL. Food Allergy, Eating Disorders and Body Image. JOURNAL OF AFFECTIVE DISORDERS REPORTS 2021; 6:100197. [PMID: 36381295 PMCID: PMC9665877 DOI: 10.1016/j.jadr.2021.100197] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022] Open
Abstract
Background/Introduction Food allergy (FA) management involves avoiding allergenic foods to prevent an adverse reaction. Affected individuals spend substantial amounts of time thinking about food and the impact it has on their bodies. As such, we posit sustained awareness of food choices may contribute to distorted body image and disordered eating. We performed a narrative review to glean insight into associations between FA, body image and eating disorders. Methods A literature search of Scopus, PsycINFO, PubMed and Google Scholar was conducted connecting terms for "food allergy" with terms for "body image" and "eating disorders". Title and abstract screening were independently performed by two reviewers, with relevant abstracts carried forward to full text screening. Results 159 articles were eligible for full text screening and a total of 12 publications were ultimately included in this narrative review, and 1 article from the grey literature. Adolescents and adults both reported feeling as though their bodies were "defective" and were found to have integrated their FA as a stable facet of their identities. In addition, FA was overwhelmingly associated with prevalence of eating disorders and eating disorder-like symptoms. Disturbed body image was found to be a mediating variable for the development of disordered patterns of eating in food allergic individuals. Limitations Few studies appeared to consider comorbidities as confounders. Also, many studies employed convenience sampling, which does limit generalizability of conclusions. Discussion/Conclusion Based on a small body of literature, there appears to be a potential association between FA and distorted body image and disordered eating.
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Affiliation(s)
- Syeda Jafri
- Pediatrics and Child Health, University of Manitoba, 501G-715 McDermot Avenue, Winnipeg, MB, Canada R3E 3P4
- College of Medicine, Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, MB, Canada
| | - Tara Lynn Frykas
- Pediatrics and Child Health, University of Manitoba, 501G-715 McDermot Avenue, Winnipeg, MB, Canada R3E 3P4
- Department of Food and Human Nutritional Sciences, University of Manitoba, Winnipeg, MB, Canada
- Children’s Hospital Research Institute of Manitoba, Winnipeg, MB, Canada
| | - Theresa Bingemann
- Pediatrics and Child Health, University of Manitoba, 501G-715 McDermot Avenue, Winnipeg, MB, Canada R3E 3P4
- Department of Medicine, and Department of Pediatrics, University of Rochester Medical Center, Rochester, NY, United States
| | - Wanda Phipatanakul
- Pediatrics and Child Health, University of Manitoba, 501G-715 McDermot Avenue, Winnipeg, MB, Canada R3E 3P4
- Division of Immunology, Department of Pediatrics, Harvard Medical School, Boston, MA, United States
| | - Lisa M. Bartnikas
- Pediatrics and Child Health, University of Manitoba, 501G-715 McDermot Avenue, Winnipeg, MB, Canada R3E 3P4
- Division of Immunology, Department of Pediatrics, Harvard Medical School, Boston, MA, United States
| | - Jennifer L.P. Protudjer
- Pediatrics and Child Health, University of Manitoba, 501G-715 McDermot Avenue, Winnipeg, MB, Canada R3E 3P4
- Department of Pediatrics and Child Health, The University of Manitoba, Winnipeg, MB, Canada
- Centre for Healthcare Innovation, Winnipeg, MB, Canada
- The Children’s Hospital Research Institute of Manitoba, Winnipeg, MB, Canada
- Department of Food and Human Nutritional Sciences, The University of Manitoba, Winnipeg, MB, Canada
- Centre for Allergy Research, Karolinska Institutet, Stockholm, Sweden
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Ziegler AM, Kasprzak CM, Mansouri TH, Gregory AM, Barich RA, Hatzinger LA, Leone LA, Temple JL. An Ecological Perspective of Food Choice and Eating Autonomy Among Adolescents. Front Psychol 2021; 12:654139. [PMID: 33967917 PMCID: PMC8097152 DOI: 10.3389/fpsyg.2021.654139] [Citation(s) in RCA: 57] [Impact Index Per Article: 14.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2021] [Accepted: 03/12/2021] [Indexed: 11/13/2022] Open
Abstract
Adolescence is an important developmental period marked by a transition from primarily parental-controlled eating to self-directed and peer-influenced eating. During this period, adolescents gain autonomy over their individual food choices and eating behavior in general. While parent-feeding practices have been shown to influence eating behaviors in children, little is known about how these relationships track across adolescent development as autonomy expands. The purpose of this qualitative study was to identify factors that impact food decisions and eating autonomy among adolescents. Using the food choice process model as a guide, four focus groups were conducted with 34 adolescents. Focus group discussion was semi-structured, asking teens about influences on their food choices across different food environments, their involvement with food purchasing and preparation, and perceived control over food their choices. Focus group transcripts were analyzed using deductive and inductive code creation and thematic analysis. This study found six leading influences on adolescents' food choices and identified additional factors with prominence within specific environmental contexts. This study distinguished a broader spectrum of factors influencing adolescent food choice that extend beyond “convenience” and “taste” which have previously been identified as significant contributors. The degree of control that teens reported differed by eating location, occasion, and social context. Finally, adolescents demonstrated various levels of engagement in behaviors related to their eating autonomy. Identifying the emergent themes related to adolescent autonomy was the first step toward the goal of developing a scale to evaluate adolescent eating autonomy.
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Affiliation(s)
- Amanda M Ziegler
- Nutrition and Health Research Lab, University at Buffalo, Buffalo, NY, United States.,Department of Exercise and Nutrition Sciences, University at Buffalo, Buffalo, NY, United States.,Department of Community Health and Health Behavior, University at Buffalo, Buffalo, NY, United States
| | - Christina M Kasprzak
- Department of Community Health and Health Behavior, University at Buffalo, Buffalo, NY, United States.,Community Health Interventions Lab, University at Buffalo, Buffalo, NY, United States
| | - Tegan H Mansouri
- Nutrition and Health Research Lab, University at Buffalo, Buffalo, NY, United States.,Department of Exercise and Nutrition Sciences, University at Buffalo, Buffalo, NY, United States
| | - Arturo M Gregory
- Nutrition and Health Research Lab, University at Buffalo, Buffalo, NY, United States.,Department of Exercise and Nutrition Sciences, University at Buffalo, Buffalo, NY, United States
| | - Rachel A Barich
- Nutrition and Health Research Lab, University at Buffalo, Buffalo, NY, United States.,Department of Exercise and Nutrition Sciences, University at Buffalo, Buffalo, NY, United States
| | - Lori A Hatzinger
- Nutrition and Health Research Lab, University at Buffalo, Buffalo, NY, United States.,Department of Exercise and Nutrition Sciences, University at Buffalo, Buffalo, NY, United States
| | - Lucia A Leone
- Department of Community Health and Health Behavior, University at Buffalo, Buffalo, NY, United States.,Community Health Interventions Lab, University at Buffalo, Buffalo, NY, United States
| | - Jennifer L Temple
- Nutrition and Health Research Lab, University at Buffalo, Buffalo, NY, United States.,Department of Exercise and Nutrition Sciences, University at Buffalo, Buffalo, NY, United States.,Department of Community Health and Health Behavior, University at Buffalo, Buffalo, NY, United States
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D'Auria E, Abrahams M, Zuccotti GV, Venter C. Personalized Nutrition Approach in Food Allergy: Is It Prime Time Yet? Nutrients 2019; 11:E359. [PMID: 30744105 PMCID: PMC6412250 DOI: 10.3390/nu11020359] [Citation(s) in RCA: 31] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/27/2018] [Revised: 02/03/2019] [Accepted: 02/05/2019] [Indexed: 02/06/2023] Open
Abstract
The prevalence of food allergy appears to be steadily increasing in infants and young children. One of the major challenges of modern clinical nutrition is the implementation of individualized nutritional recommendations. The management of food allergy (FA) has seen major changes in recent years. While strict allergen avoidance is still the key treatment principle, it is increasingly clear that the avoidance diet should be tailored according to the patient FA phenotype. Furthermore, new insights into the gut microbiome and immune system explain the rising interest in tolerance induction and immunomodulation by microbiota-targeted dietary intervention. This review article focuses on the nutritional management of IgE mediated food allergy, mainly focusing on different aspects of the avoidance diet. A personalized approach to managing the food allergic individual is becoming more feasible as we are learning more about diagnostic modalities and allergic phenotypes. However, some unmet needs should be addressed to fully attain this goal.
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Affiliation(s)
- Enza D'Auria
- Department of Pediatrics, Children's Hospital V. Buzzi, University of Milan, Milan 20154, Italy.
| | - Mariette Abrahams
- Faculty of Social Sciences, University of Bradford, Bradford BD7 1DP, UK.
| | - Gian Vincenzo Zuccotti
- Department of Pediatrics, Children's Hospital V. Buzzi, University of Milan, Milan 20154, Italy.
| | - Carina Venter
- Section of Allergy and Immunology, Children's Hospital Colorado, University of Colorado, Aurora, CO 80045, USA.
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Maslin K, Venter C, MacKenzie H, Vlieg-Boerstra B, Dean T, Sommer I. Comparison of nutrient intake in adolescents and adults with and without food allergies. J Hum Nutr Diet 2017; 31:209-217. [PMID: 28707418 DOI: 10.1111/jhn.12495] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
BACKGROUND Exclusion diets for the management of food allergy pose a risk of nutritional deficiencies and inadequate growth in children, yet less is known about their effect in adolescents and adults. The present study aimed to compare the dietary intake of adolescents and adults with food allergies with that of a control group. METHODS A food allergic and a control group were recruited from Portsmouth and the Isle of Wight in the UK. Participants were recruited from a food allergy charity, allergy clinics, a local school and university, and previous research studies. Macro and micronutrient intake data were obtained using a 4-day estimated food diary. Sociodemographic and anthropometric data was collected via a constructed questionnaire. RESULTS This cross-sectional study included 81 adolescents (48 food allergic and 33 controls) aged 11-18 years and 70 adults aged 19-65 years (23 food allergic and 47 controls). Overall, 19 (22.8%) adolescents and 19 (27.1%) adults took dietary supplements, with no difference according to food allergic status. Adolescents with food allergy had higher intakes of niacin and selenium than adolescents without (P < 0.05). This difference persisted when dietary supplements were removed from the analysis. Adults with food allergies had higher intakes of folate and zinc than those without (P < 0.05); however, this difference did not persist when dietary supplements were removed from the analysis. Across all participants, the intake of several micronutrients was suboptimal. There was no difference in protein or energy intake, or body mass index, according to food allergic status. CONCLUSIONS The dietary intake of food allergic participants was broadly similar and, in some cases, better than that of control participants. However, suboptimal intakes of several micronutrients were observed across all participants, suggesting poor food choices.
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Affiliation(s)
- K Maslin
- School of Health Sciences and Social Work, University of Portsmouth, Portsmouth, UK.,MRC Lifecourse Epidemiology Unit, University of Southampton, Southampton, UK
| | - C Venter
- School of Health Sciences and Social Work, University of Portsmouth, Portsmouth, UK.,David Hide Asthma and Allergy Research Centre, Newport, Isle of Wight, UK.,Division of Allergy and Immunology, Cincinnati Children's Hospital Medical Centre, Cincinnati, OH, USA
| | - H MacKenzie
- School of Health Sciences and Social Work, University of Portsmouth, Portsmouth, UK.,Graduate School, University of Portsmouth, Portsmouth, UK
| | | | - T Dean
- School of Health Sciences and Social Work, University of Portsmouth, Portsmouth, UK.,David Hide Asthma and Allergy Research Centre, Newport, Isle of Wight, UK
| | - I Sommer
- School of Health Sciences and Social Work, University of Portsmouth, Portsmouth, UK.,Department for Evidence-Based Medicine and Clinical Epidemiology, Danube University Krems, Krems, Austria
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8
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Johnson SF, Woodgate RL. Qualitative research in teen experiences living with food-induced anaphylaxis: A meta-aggregation. J Adv Nurs 2017; 73:2534-2546. [DOI: 10.1111/jan.13325] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/20/2017] [Indexed: 11/30/2022]
Affiliation(s)
- Sara F. Johnson
- College of Nursing; Rady Faculty of Health Sciences; University of Manitoba; Winnipeg MB Canada
| | - Roberta L. Woodgate
- College of Nursing; Rady Faculty of Health Sciences; University of Manitoba; Winnipeg MB Canada
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9
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Protudjer JLP, Jansson SA, Middelveld R, Östblom E, Dahlén SE, Arnlind MH, Bengtsson U, Kallström-Bengtsson I, Marklund B, Rentzos G, Sundqvist AC, Åkerström J, Ahlstedt S. Impaired health-related quality of life in adolescents with allergy to staple foods. Clin Transl Allergy 2016; 6:37. [PMID: 27733903 PMCID: PMC5045620 DOI: 10.1186/s13601-016-0128-5] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2016] [Accepted: 09/19/2016] [Indexed: 12/16/2022] Open
Abstract
Background Cow’s milk, hen’s egg and wheat are staple foods in a typical western diet. Despite the ubiquity of these foods, the impact of staple food allergy on health-related quality of life (HRQL) amongst adolescents is incompletely understood. The aims of this study were to make use of the Swedish version of EuroPrevall’s disease-specific food allergy quality of life questionnaire-teenager form (FAQLQ-TF) and to investigate the association between objectively-diagnosed staple food allergy and HRQL amongst adolescents. Methods In this cross-sectional study, 58 adolescents aged 13–17 years [n = 40 (69 %) boys] with objectively-diagnosed allergy to the staple foods cow’s milk, hen’s egg and/or wheat and living in Stockholm, Sweden were included. Adolescents completed the FAQLQ-TF, which has a corresponding scale of 1 = best HRQL, and 7 = worst HRQL. Overall HRQL and domain-specific HRQL were established. Adolescents also reported symptoms, adrenaline auto injector (AAI) prescription and presence of other food allergies. A history of anaphylaxis was defined among those reporting difficulty breathing, inability to stand/collapse, and/or loss of consciousness. Clinically different HRQL was set at a mean difference of ≥0.5. Results Overall mean HRQL was poorer than average [mean: 4.70/7.00 (95 % CI 4.30–5.01)]. The domain risk of accidental exposure was significantly associated with clinically better HRQL than the domain allergen avoidance and dietary restrictions (mean difference = 0.76; p < 0.001). Girls had clinically worse, but not statistically significantly different mean HRQL than boys (mean difference = 0.71; p < 0.07). HRQL tended to be worse amongst those with allergies to more than three foods or an AAI prescription. The number and types of symptoms, including a history of anaphylaxis were not associated with worse HRQL. Conclusions As ascertained via a food allergy-specific questionnaire, adolescents with staple food allergy report poorer than average HRQL, specifically in relation to emerging independence and the need for support. Girls have clinically worse HRQL than boys. The number and type of previous symptoms and history of anaphylaxis were not associated with worse HRQL. Electronic supplementary material The online version of this article (doi:10.1186/s13601-016-0128-5) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Jennifer Lisa Penner Protudjer
- The Centre for Allergy Research, Karolinska Institutet, P.O. Box 287, 17177 Stockholm, Sweden ; Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden
| | - Sven-Arne Jansson
- The Centre for Allergy Research, Karolinska Institutet, P.O. Box 287, 17177 Stockholm, Sweden ; Department of Public Health and Clinical Medicine, Umeå University, Umeå, Sweden
| | - Roelinde Middelveld
- The Centre for Allergy Research, Karolinska Institutet, P.O. Box 287, 17177 Stockholm, Sweden ; Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden
| | - Eva Östblom
- The Centre for Allergy Research, Karolinska Institutet, P.O. Box 287, 17177 Stockholm, Sweden ; Sachs' Children and Youth Hospital, Södersjukhuset, Stockholm, Sweden ; Department of Clinical Research and Education, Södersjukhuset, Karolinska Institutet, Stockholm, Sweden
| | - Sven-Erik Dahlén
- The Centre for Allergy Research, Karolinska Institutet, P.O. Box 287, 17177 Stockholm, Sweden ; Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden
| | - Marianne Heibert Arnlind
- Swedish Council on Health Technology Assessment, SBU, Stockholm, Sweden ; Department of Learning, Informatics, Management and Ethics, and Medical Management Centre, Karolinska Institutet, Stockholm, Sweden
| | - Ulf Bengtsson
- Allergy Unit, Sahlgrenska University Hospital, Gothenburg, Sweden
| | | | - Birgitta Marklund
- Department of Health and Caring Sciences, Linnaeus University, Kalmar, Sweden
| | - Georgios Rentzos
- Allergy Unit, Sahlgrenska University Hospital, Gothenburg, Sweden
| | | | | | - Staffan Ahlstedt
- The Centre for Allergy Research, Karolinska Institutet, P.O. Box 287, 17177 Stockholm, Sweden ; Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden
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Abstract
Food allergy has increased in developed countries and can have a dramatic effect on quality of life, so as to provoke fatal reactions. We aimed to outline the socioeconomic impact that food allergy exerts in this kind of patients by performing a complete review of the literature and also describing the factors that may influence, to a greater extent, the quality of life of patients with food allergy and analyzing the different questionnaires available. Hitherto, strict avoidance of the culprit food(s) and use of emergency medications are the pillars to manage this condition. Promising approaches such as specific oral or epicutaneous immunotherapy and the use of monoclonal antibodies are progressively being investigated worldwide. However, even that an increasing number of centers fulfill those approaches, they are not fully implemented enough in clinical practice. The mean annual cost of health care has been estimated in international dollars (I$) 2016 for food-allergic adults and I$1089 for controls, a difference of I$927 (95 % confidence interval I$324–I$1530). A similar result was found for adults in each country, and for children, and interestingly, it was not sensitive to baseline demographic differences. Cost was significantly related to severity of illness in cases in nine countries. The constant threat of exposure, need for vigilance and expectation of outcome can have a tremendous impact on quality of life. Several studies have analyzed the impact of food allergy on health-related quality of life (HRQL) in adults and children in different countries. There have been described different factors that could modify HRQL in food allergic patients, the most important of them are perceived disease severity, age of the patient, peanut or soy allergy, country of origin and having allergy to two or more foods. Over the last few years, several different specific Quality of Life questionnaires for food allergic patients have been developed and translated to different languages and cultures. It is important to perform lingual and cultural translations of existent questionnaires in order to ensure its suitability in a specific region or country with its own socioeconomic reality and culture. Tools aimed at assessing the impact of food allergy on HRQL should be always part of the diagnostic work up, in order to provide a complete basal assessment, to highlight target of intervention as well as to evaluate the effectiveness of interventions designed to cure food allergy. HRQL may be the only meaningful outcome measure available for food allergy measuring this continuous burden.
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