Food allergy outside the eight big foods in Europe: A systematic review and meta-analysis

The 2014 estimates of prevalence of food allergy (FA) in Europe published by the European Academy of Allergy and Clinical Immunology included only the eight so-called big foods (cow's milk/egg/wheat/soy/peanut/tree nuts/fish/shellfish). Those estimates have recently been updated. Complementing this, we sought to identify and estimate the prevalence of allergy to other foods that have been reported during the last decade.

Six databases were searched for studies published 2012-2021. Random-effects meta-analysis was performed to derive pooled prevalence of allergy to each food.

Twenty-seven studies were included, containing a total of 66 FAs. Among the most frequently reported FAs, the lifetime and point prevalence range of self-reported kiwi allergy was 0.1%-1.0% and 0.2%-8.1%, respectively, while the food challenge (FC)-verified kiwi allergy point prevalence range was 0.01%-0.10%. The point prevalence range for self-reported peach allergy was 0.2%-3.2%, while the range for FC-verified peach allergy was 0.02%-0.05%. The lifetime and point prevalence range for self-reported tomato allergy was 0.01%-1.8% and 0.2%-2.1%, respectively.

Allergy to some foods traditionally not considered important are now emerging as relevant FAs. The focus on FA in Europe should not be limited to the so-called eight big FA, but extended to other types of foods which need to be considered both for clinical purposes and population risk assessment.