Factors Associated with Outgrowing Food Allergies: Insights from a Large Food Allergy Cohort

Food allergy (FA) is increasing in prevalence among children worldwide, and this diagnosis creates substantial health, psychosocial, and financial burdens. Although some children may eventually achieve resolution of certain food allergies, the factors associated with resolution are poorly understood.

The objective of this study was to identify factors associated with FA resolution at baseline enrollment, focusing on children with at least one active FA and the determinants of resolution of their other allergies.

Children younger than 12 years old with physician-diagnosed IgE-mediated FA were enrolled in FORWARD, a multicenter observational study. Data from caregiver surveys completed at enrollment regarding resolution of other FA and electronic health records were analyzed. Unadjusted analyses compared demographic and clinical characteristics between children with and without reported resolution of at least one FA at enrollment. Multivariable logistic regression models then evaluated associations between resolution of FA and covariates, including race/ethnicity, household income, health literacy scores (HLS), and area deprivation index (ADI).

The study included 1,359 participants. Children most often experienced resolution of allergies to milk (35%), soy (32%), and wheat (27%), whereas resolution of peanut (3.8%) and shellfish (3.5%) allergies were less common. White children more frequently reported resolution of FA to all common food allergens when compared to Black and Hispanic children. Furthermore, lower family income, lower parental HLS and higher ADI were observed among children who did not report FA resolution for all 9 common food/food groups.

Socioeconomic disadvantage, parental health literacy, and racial/ethnic disparities were associated with a lower likelihood of FA resolution in this cohort.