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Background: Food allergy and food intolerance (FA/FI) are believed to be frequent medical problems; however, information from epidemiologic studies in adults is scarce. The objective was to determine the frequency of FA/FI and allergic sensitization to food in a large adult sample. Furthermore, the associations between FA/FI and other outcomes of atopy were studied. Methods: Within a population-based, nested, case-control study, a standardized interview was performed to obtain detailed information on FA/FI and the history of atopic diseases. In addition, a skin prick test with 10 common food and nine aeroallergens was performed. Results: Overall, 20.8% of the 1537 studied subjects (50.4% female, age median 50 years) reported FA/FI (women 27.5%, men 14.0%; OR 2.35, CI 1.80–3.08). Nuts, fruits, and milk most frequently led to adverse effects, and the sites of manifestation were oral (42.9%), skin (28.7%), gastrointestinal (13.0%), systemic (3.2%), and multiple (12.2%). One-quarter of the subjects (25.1%) were sensitized to at least one food allergen in the prick test, with hazelnut (17.8%), celery (14.6%), and peanut (11.1%) accounting for most of the positive reactions. The corresponding frequency estimates for the representative study base (n=4178) were 15.5% for reported adverse reactions and 16.8% for allergic sensitization. Relevant concomitant sensitization to food and aeroallergens was observed. Food-allergic subjects (positive history and sensitization to corresponding allergen) suffered significantly more often from urticaria, asthma, atopic eczema, and especially hay fever (73.1%) than controls (3.0%). Furthermore, hay fever was treated significantly more often in subjects who suffered from concomitant food allergy. Conclusions: FA/FI in adults is frequently reported and associated with other manifestations of atopy. Hay fever in conjunction with FA/FI tends to be clinically more severe since therapeutic needs are enhanced. [ABSTRACT FROM AUTHOR]

Background: There is evidence of an association between socioeconomic status (SES) and atopy mainly from studies in children which investigated atopic diseases and parental SES. We determined the association of allergic sensitization, as measured by skin prick test (SPT) and allergen-specific IgE (RAST), and SES in a population-based study in adults. Methods: Within a population-based, nested, case-control study, a standardized interview was performed and allergic sensitization to common aeroallergens was determined by SPT and RAST. Results: A total of 1537 adults (50.4% female, age: median 50.0, range 28-78 years) were investigated, half of whom (50.2%) exhibited at least one positive RAST result according to the study design. SPT reactivity was 37.3% in this group and was estimated to be 26.1% in the representative study base of 4178 adults. Within increasing categories of school graduation (none; after 8, 10, 13, and >13 years), the prevalence of SPT (20.5%, 31.3%, 44.0%, 44.2%, 48.1%; P trend <0.0001) and RAST reactivity (35.0%, 48.0%, 52.3%, 48.4%, 58.4%; P trend=0.004) increased continuously. Similar results were obtained when testing this association on the level of single allergens. After control for age, sex, and parental history of atopic diseases, all but the first odds ratios for SPT remained significant (first category=reference, 2.06, 3.21, 3.88, 3.96). The same model for RAST reactivity revealed a similar result with effect estimate for the last category being significant (first category=reference, 1.89, 2.08, 2.10, 2.81). Conclusions: Allergic sensitization (SPT and RAST) to common aeroallergens in adults follows a significant and linear association with school education. [ABSTRACT FROM AUTHOR]