Socializing practices of Irish children and adolescents with food allergy: A prospective study

J Allergy Clin Immunol Glob. 2023 Aug 14;2(4):100164. doi: 10.1016/j.jacig.2023.100164. eCollection 2023 Nov.

Abstract

Background: Food is an integral part of social activities; because of fear of accidental reaction, children with food allergy (FA) are at risk of exclusion or oversupervision at these events. The extent of adaptive exclusion behaviors is poorly defined. Families attending our service are encouraged to socialize and taught to minimize risk and avoid accidental reactions.

Objective: The aim of this study was to establish the social practices and eating-out habits of children and adolescents with FA who are already attending an allergy clinic.

Methods: Irish children, aged 2 to 16 years, with confirmed FA were recruited as part of a parallel prospective observational study titled Recording Accidental Allergic Reactions in Children and Teenagers (ReAACT). Information on social activities and eating out habits was collected prospectively.

Results: A total of 531 children were enrolled. The majority attended age-appropriate social activities; 97% of the 5- to 12-year-olds went to birthday parties and 85% visited friends' houses. More nonparticipators had previous anaphylaxis (relative risk [RR] = 1.44; 95% CI = 0.97-2.14; P = .06) and peanut allergy (RR = 1.19; 95% CI = 0.99-1.42; P = .06). Among adolescents, 94% visited friends' homes, but only 12% had been away from home alone. Overall, 523 participants (98.5 %) visited food establishments, whereas 4.6% did not eat out in any food establishment; these participants were significantly more likely to be adolescents (RR = 3.27; 95% CI = 1.65-7.48; P = .0001).

Conclusion: Overall, Irish children with FA are "living with allergy." There was a trend toward decreased participation among adolescents. Future interventions should target this group specifically.

Keywords: Activities; adolescents; anaphylaxis; children; eating out; egg allergy; food allergy; restaurants; social.