Racial, Ethnic, and Socioeconomic Differences in Childhood Diet and Teenage Food Allergy
Sunday, March 4, 2018
South Hall A2 (Convention Center)
Elise Coulson, MD, Sheryl Rifas-Shiman, MPH, Joanne Sordillo, ScD, Supinda Bunyavanich, MD MPH FAAAAI, Carlos A. Camargo, MD DrPH FAAAAI, Thomas A.E. Platts-Mills, MD PhD FAAAAI, Brent Coull, Ph.D, Heiki Gibson, Ph.D, Mathew Gillman, MD, SM, Emily Oken, MD, MPH, Diane Gold, MD, MPH, Mary Rice, MD, MPH
RATIONALE: The prevalence of food allergy is increasing and may disproportionally affect disadvantaged or racial/ethnic minority youth.

METHODS: We studied 1,471 children in Project Viva, a Boston-area pre-birth cohort, and evaluated associations of maternal socioeconomic status (SES) during pregnancy and child race/ethnicity with food allergy in 11-16 year-olds, defined by IgE≥ 0.35 kUA/L to milk, egg, peanut, soy, or wheat, and by report of allergic-type symptoms upon ingestion of these allergens. SES measures included maternal education and, household and census tract income. We also examined associations of SES and race/ethnicity with diet at age 3-5 years, ascertained by food frequency questionnaire. Logistic and linear regression models were adjusted for child age, sex, and parental history of atopy.

RESULTS: Compared with non-Hispanic whites, black teens had higher odds of allergen sensitization and symptoms to all 5 foods; Hispanic teens had higher sensitization to milk and egg. For peanuts, black teens had an OR of 2.76 (95% CI 1.62, 4.71) for sensitization and 2.41 (95% CI 1.12, 5.18) for an allergic-type reaction. Odds of sensitization to peanuts and milk was higher among teens from lower income or less educated families, but not accompanied by differences in symptoms. In early childhood, dietary intake of nuts and milk was lower among minority children and those from lower income households.

CONCLUSIONS: Black teens were at higher risk for food allergy. Though we found differences in childhood food allergen intake by race, ethnicity and income, further research is needed to determine if the observed racial/ethnic disparities are explained by diet.