A large-scale analysis has revealed that the risk of food allergies in children is rarely due to a single cause, but rather a combination of factors present very early in life, often within the first year. The research identifies several key early-life influences on the development of these allergies.
The study, conducted by researchers at McMaster University in Canada, analyzed data from approximately 2.8 million children worldwide. It found that around 5% of children develop a food allergy by the age of six. The findings were published in , in JAMA Pediatrics.
Researchers systematically reviewed and performed a meta-analysis of 190 studies on childhood food allergy, including those that confirmed allergy using gold-standard food challenge testing. They evaluated over 340 potential factors that could influence allergy risk. A central conclusion is that genetic predisposition alone cannot fully explain the rising trends in food allergies; instead, they arise from the interplay of genetics, skin health, the microbiome, and environmental exposures.
Among the factors identified as being associated with an increased risk is eczema appearing in the first year of life. Infants with eczema are three to four times more likely to develop a food allergy. The presence of wheezing or nasal allergies was also linked to a higher risk.
Family history is another important factor. Children with parents or siblings who have allergies are more likely to develop food allergies themselves, particularly when both parents are allergic.
The timing of introducing potentially allergenic foods into a child’s diet also plays a significant role. The study suggests that delaying the introduction of foods like peanuts, tree nuts, or eggs can increase the risk of allergy. Children who were exposed to peanuts after the age of 12 months had a risk more than two times higher of developing a peanut allergy.
Antibiotic use in early infancy was identified as another factor associated with increased risk. Administration of antibiotics in the first month of life was correlated with a higher probability of food allergies. Antibiotic use later in childhood or during pregnancy was associated with an increased risk, though to a lesser extent than exposure within the first month after birth.
What Doesn’t Appear to Influence Food Allergy Risk
Interestingly, the analysis did not find an association between food allergies and several commonly cited factors. These include low birth weight, post-term birth, partial breastfeeding (mixed feeding), the mother’s diet, or stress during pregnancy. This suggests these factors, while important for overall child health, do not appear to directly contribute to the development of food allergies.
“Our study highlights that genetics alone cannot fully explain food allergy trends, pointing to interactions – or a ‘perfect storm’ – between genes, skin health, the microbiome, and environmental exposures,” says Derek Chu, senior author of the study and assistant professor with McMaster’s Departments of Medicine and Health Research Methods, Evidence, and Impact.
The findings underscore the complexity of food allergy development. While a family history of allergies can increase a child’s susceptibility, it is not a guarantee they will develop an allergy. Similarly, the absence of a family history does not eliminate the risk. The interplay of these early-life factors creates a nuanced picture that requires further investigation.
This research provides valuable insights for healthcare professionals and parents alike. While it doesn’t offer a simple preventative solution, it highlights the importance of maintaining skin health in infancy, considering the timing of food introduction, and being mindful of antibiotic use in the first months of life. Further research is needed to fully understand these interactions and develop targeted strategies to reduce the incidence of food allergies in children.
It’s important to remember that this study identifies associations, not necessarily causation. More research is needed to determine whether modifying these early-life factors can directly prevent the development of food allergies. Parents should always consult with their pediatrician regarding the best approach to introducing solid foods and managing potential allergy risks for their child.
