Scientific Study

Introduction: While much attention has been devoted to food allergy in children, little is known about the prevalence and characteristics of food allergy in adults. Moreover, recent research has shown that increasing numbers of individuals are developing food allergy in adulthood. This population-based study was conducted to examine the prevalence, severity, and distribution of adult-onset food allergy. Methods: A survey was administered to 40,443 adult United States residents between 2015 and 2016. Population-level prevalence was estimated using complex survey weighting. Demographics, history of reactions and diagnosis for each allergen, and comorbid conditions were analyzed. Self-reported food allergies were considered convincing if symptoms were consistent with IgE-mediated reactions. Results: Among all adults with food allergy, 45.3% reported developing at least one food allergy after 18 years of age. Of these, 24.9% only experienced onset of food allergy in adulthood, and 54.7% only experienced onset of food allergy in childhood. The five most prevalent adult-onset food allergies included shellfish (13.3% of adults), milk (6.0%), wheat (5.6%), tree nut (4.8%), and soy (3.9%). More than half of individuals with adult-onset allergy to peanut, tree nut, fin fish, or shellfish reported a prior severe reaction to the allergen. Factors associated with development of adult-onset food allergy include female sex, increasing age, and a history of multiple food allergies, allergic rhinitis, or medication allergy. Conclusions: One in four adults with food allergy develop a food allergy for the first time as an adult. Further study is necessary to understand potential predictors of adult-onset food allergy.