Household Food Allergen Exclusion Practices and Food Allergy–Related Psychosocial Functioning
Year: 2025
Type: article
Study design: Observational Study
Abstract: To determine the proportion of households of children with food allergy that exclude the allergen from the house and the association of this practice with food allergy–related psychosocial functioning and to compare the results based on the individual food allergy.Families of children with health care clinician–diagnosed food allergy from Boston Children’s Hospital from April 2022 to November 2023 were sent a survey to complete and return. A total of 919 surveys were completed by parents of a child with food allergy.This was a cross-sectional study approved by Boston Children’s Hospital Institutional Review Board (IRB). IRB-approved validated surveys were collected anonymously. Food allergy–related psychosocial functioning was determined by 5 questionnaires: the Food Allergy Independent Measure for child and parent, the Food Allergy Quality of Life Questionnaire for child and parent, the Food Allergy Independent Measure for child and parent, the Screen for Anxiety Related Disorders for child and parent, and the Food Allergy Self-Efficacy Scale for parents only. The authors used logistic regression with generalized estimating equations to account for individual clustering to compare household food allergy exclusion practices by specific food allergy.The median (IQR) parent age was 39 years and median child age 6 years. A total of 881 (96.6%) of the parents were mothers; 775 (88.5%) were white and 23 (2.5%) were Black. Among the children, 521 (57.6%) were male, 704 (78.6%) were white, and 29 (3.2%) were Black. The most common food allergies were peanut (67.8%), tree nut (65.5%), and egg (44%). A total of 586 (63.8%) of the parents excluded at least 1 food their child was allergic to from the household. Based on a priori analysis, the foods most excluded from homes with food allergy were peanut (62.4%), tree nut (54.7%), and sesame (51.3%), followed in descending order by shellfish, fish, cow milk, egg, soy, and wheat. Parents who excluded food from the home because of their child’s food allergy reported worse food allergy–related quality-of-life scores for worry, anxiety, and self-efficacy compared with parents who did not (P < .001). These findings were consistent in age subgroups. The parent-proxy screener for child anxiety disorders indicated that children aged 8 to 17 years living in homes that excluded food allergens were more likely to have elevated generalized anxiety scores than children from homes that did not exclude food allergens (P = .03)In this study, a majority of families chose to exclude food allergens from their household, and families who did engage in this practice reported more food allergy–related psychosocial concerns than families who did not. These findings suggest that insight into the psychosocial well-being of a family could be obtained by asking how food allergies were managed in the home and whether any foods were excluded.This study is limited by its cross-sectional design and small cohort. The results may seem counterintuitive to some. The causality between psychosocial well-being and excluding allergens from the home cannot be determined from this study and may not represent the broader food allergy population. Further studies are needed to determine the causes of psychosocial distress in families that exclude food allergens from the home and how this can be improved.
Source: PEDIATRICS
Author: Alan Goldsobel
Language: English
Subfield: Immunology and Allergy
Field: Medicine
Domain: Health Sciences
Open Access status: bronze
OpenAlex ID: W4416832564
FWCI:
Cites:
Cited by:
Related to: