Food Allergy Prevalence and Symptomatology in Inner City African Americans: A Retrospective Study

Background: The incidence of food allergy and severe allergic reactions to food has increased in the United States, where 6% of children and 3.7% of adults have food allergy (Sicherer, 2006). However, studies focusing on food allergies among African Americans are rare. Food allergies to fish, shelfish or any seafood have been reported more frequently in African Americans than whites (Sicherer, 2004). Peanut allergy is the most common food allergy to cause fatal anaphylaxis. Although prevalence of peanut allergy in American children has doubled, that of African American children and adults is not well documented.

Methods: Retrospective chart analysis of inner city African American pediatric (n = 102) and adult (n = 173) allergy outpatients was performed, focusing on epicutaneous skin tests (SPT), serum IgE levels (IgE ImmunoCAP, Pharmacia), and respiratory and dermatologic allergy history. Criteria for food allergy included a clinical reaction after ingestion and a positive SPT or presence of food specific IgE in serum.

Results: We found that 1/3 of our African American patients had food allergies (32.7%), with food allergy more common in children than adults (1.5 fold). The three most common food allergies in our population were fruits/vegetables (12%), shellfish (9.4%) and peanut (9.1%). In adults, ranking of food allergy prevalence (fruits/vegetables (14.5%), shellfish (13.9%) and peanut peanut (5.2%)) was similar to that of the general United States adult population. However, peanut allergy prevailed in African American allergic children (15.7%), followed by dairy products and eggs (13.7, 11.8%, respectively). The total peanut-allergic study population (n = 27) was comprised of 60% children and 40% adults. In contrast to the general population, in which respiratory symptoms predominate, peanut allergy most commonly manifested as hives in both children (37.5%) and adults (45.5%).

Conclusions: African American children in our center have an 8-fold increase in prevalence of peanut allergy, compared with the general US pediatric population. Hives is the most common manifestation of peanut allergy in inner city African American adults and children. Peanut allergy prevalence and symptomatology in the inner city African American population needs further research.