Related Experiment Video
Updated: Jan 8, 2026
A Treatment Package without Escape Extinction to Address Food Selectivity
Published on: August 21, 2015
Timing of symptom onset during 60-min interval oral food challenges in children
Nana Kojima1, Makoto Nishino1, Ken-Ichi Nagakura1
1Department of Allergy, Clinical Research Center for Allergy and Rheumatology, NHO Sagamihara National Hospital, Kanagawa, Japan.
Insights
For oral food challenges (OFCs), longer intervals between doses are crucial for safety. This study found that symptom onset times, even with 60-minute intervals, indicate a need for >30 minutes between doses.
Area of Science:
- Allergy and Immunology
- Pediatric Gastroenterology
- Clinical Nutrition
Background:
- Oral food challenges (OFCs) are vital for diagnosing food allergies and assessing tolerance.
- Determining optimal dosing intervals for OFC safety and accuracy is critical but not well-established.
- This study addresses the need for clarity on symptom onset times in pediatric OFCs.
Purpose of the Study:
- To investigate symptom onset times in low-dose oral food challenges (OFCs) using 60-minute intervals.
- To evaluate the safety and accuracy of OFC dosing intervals in pediatric patients.
- To inform optimal OFC protocols for common food allergens.
Main Methods:
- Retrospective analysis of low-dose OFCs in children allergic to egg, milk, wheat, and peanut.
- Two doses were administered at 60-minute intervals.
- Symptom onset times were recorded, with OFCs considered positive upon observation of objective symptoms.
Main Results:
- Out of 1610 children, 552 (34%) had positive OFCs across the four allergens.
- Median symptom onset times ranged from 25-45 minutes after the first dose and 25-35 minutes after the second dose.
- Late-onset reactions (≥30 minutes) were observed in 64% of first doses and 54% of second doses.
Conclusions:
- Dosing intervals greater than 30 minutes are essential for safe and accurate oral food challenges.
- The findings support the need for extended intervals to capture potential late-onset reactions.
- Current 60-minute intervals in low-dose OFCs highlight the importance of sufficient spacing between doses.
Background:
Dosing intervals are important in determining oral food challenge (OFC) safety; however, the optimal interval remains unclear. This study aimed to investigate symptom onset time in low-dose OFCs, utilizing 60-min intervals, involving four common pediatric allergens.
Methods:
We retrospectively analyzed symptom onset time for low-dose OFCs involving two doses at 60-min intervals in children allergic to egg, milk, wheat, and peanut. Challenges were performed to diagnose allergies or confirm tolerance acquisition. Total challenge doses were 250, 102, 52, and 133 mg of egg, milk, wheat, and peanut proteins, respectively. OFCs were positive when objective symptoms were observed.
Results:
Of the 1610 children (379, 430, 431, and 370 had allergies to egg, milk, wheat, and peanut, respectively), 552 (34 %) were OFC-positive: 103 (27 %) with egg allergy, 210 (49 %) with milk allergy, 105 (24 %) with wheat allergy, and 134 (36 %) with peanut allergy. The median (interquartile range) onset times of symptom were 45 (29-60) min for egg allergy, 30 (15-45) min for milk allergy, 42 (30-55) min for wheat allergy, and 30 (14-45) min for peanut allergy after the first dose, and 35 (17-60) min for egg allergy, 30 (15-45) min for milk allergy, 35 (24-55) min for wheat allergy, and 25 (15-40) min peanut allergy after the second dose. Late-onset reactions (≥30 min) occurred in 64 % of first doses and 54 % of second doses across all allergens.
Conclusions:
OFC dose intervals at >30 min are necessary to ensure safety and accurate assessment.
More Related Videos
08:52Psychophysical Tracking Method to Assess Taste Detection Thresholds in Children, Adolescents, and Adults: The Taste Detection Threshold TDT Test
Published on: April 21, 2021
09:17Psychophysical Tracking Method to Measure Taste Preferences in Children and Adults
Published on: July 16, 2016
Related Concept Videos
01:20Taste Buds and Receptors
01:17Assessment of the Gastrointestinal System I: Subjective Data
Health History
The initial step in assessing the GI system is obtaining a comprehensive health history. This includes inquiring about the patient's history or presence of problems...
01:23Pharmacokinetics in Pediatric Patients: Overview and Drug Absorption