Epidemiology of food allergy/food intolerance in adults: associations with other manifestations of atopy

Allergy. 2001 Dec;56(12):1172-9. doi: 10.1034/j.1398-9995.2001.00196.x.


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.

Publication types

  • Comparative Study
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Aged
  • Allergens / adverse effects
  • Animals
  • Case-Control Studies
  • Female
  • Food Hypersensitivity / epidemiology*
  • Food Hypersensitivity / etiology
  • Fruit / adverse effects
  • Germany / epidemiology
  • Humans
  • Hypersensitivity, Immediate / epidemiology*
  • Hypersensitivity, Immediate / etiology
  • Male
  • Middle Aged
  • Milk / adverse effects
  • Nuts / adverse effects
  • Population Surveillance
  • Prevalence
  • Skin Tests
  • Surveys and Questionnaires


  • Allergens