Risk factors of adverse reactions to food in German adults


Prof Dr Margitta Worm, Department of Dermatology and Allergy, Allergy-Center-Charité, Universitätsmedizin Berlin, Charitéplatz 1, 10117 Berlin, Germany. E-mail: margitta.worm@charite.de


Background Allergic diseases have been increasing during the last decades. Previous studies suggest an impact of a variety of risk factors on the prevalence of food hypersensitivity.

Objective Data of a cross-sectional population-based survey were analysed to study the prevalence of food hypersensitivity in females and males adjusted for age and education.

Methods A population aged 18–79 years from a representative, randomly sampled survey studying 13 300 inhabitants from Germany (Berlin) was analysed. The Berlin study data were weighted with regard to age, sex, education and allergic diseases such as atopic dermatitis, rhinoconjunctivitis and asthma. Instruments for evaluation included mailed questionnaires, structured telephone interviews, physical examinations, detection of total IgE, skin prick tests and double-blind, placebo-controlled food challenge tests (DBPCFC).

Results Three thousand two hundred and twenty-seven questionnaires were evaluated. The data show a significantly higher risk of self-reported symptoms in the female group, among persons with higher education and in the age group of 18–39 years. Among individuals with clinical symptoms, females were at lower risk of having positive skin prick tests [aOR=0.32; 95% CI (0.21–0.50); P<0.01] and having a raised total IgE [aOR=0.37; 95% CI (0.24–0.56); P<0.01], but showed a higher risk of non-IgE and IgE-mediated food hypersensitivity [aOR=2.27; 95% CI (1.31–3.93); P<0.01] than males. Based on weighted data, the point prevalence of adverse reactions to food resulted in 3.3% [95% CI (2.4–4.5%)] for women and 1.8% [95% CI (1.2–2.7%)] for men after DBPCFC.

Conclusion From a general population survey conducted in Germany, we determined that women are at greater risk of having symptoms of food allergy and also at greater risk of having DBPCFC-confirmed symptomatic food allergy. However, among individuals with symptoms of food allergy, men have a higher prevalence of food-specific IgE-sensitization and of raised total IgE than women.