Work

FoodAllergenSensitization in a Five-Year Allergy Clinic Cohort and Food Allergy Knowledge, Attitudes and Behaviours in Romanian Adults: Two Observational Studies

Year: 2026

Type: article

Abstract: Background/Objectives: Food allergy is reported far more often than it is confirmed by testing. Both ends of that gap matter nutritionally: dietary restriction adopted without confirmation, and unpreparedness for severe reactions. We characterized each end in two cohorts from one source population. Methods: Study 1 retrospectively analyzed 4404 patients assessed in a single allergy service over 2020–2024, with food sensitization being a positive skin prick test and/or specific IgE to at least one food allergen. Study 2 surveyed 500 adults by convenience sampling, using a 27-item questionnaire with a 10-point knowledge score. In Study 1, testing was indication-driven, and the food-tested subset could not be identified, so all Study 1 figures are proportions among patients assessed, not prevalence estimates. Analyses reported effect sizes with confidence intervals throughout, applied Holm–Bonferroni adjustment to the confirmatory comparisons, and used multivariable regression. Results: Food sensitization was documented in 185 of 4404 patients (4.2%; 95% CI 3.6–4.8) and concentrated in early childhood (13.05% at 0–5 years), age being the only independent demographic predictor (adjusted OR for 0–5 vs. 18–30 years: 4.61; 95% CI 2.87–7.41)—an association confounded with the indication to test. Of food-sensitized patients with a recorded severity score, one third (34.1%) had no active symptoms at assessment. In the community cohort, 17.6% (95% CI 14.5–21.2) self-reported a food allergy, but only 6.6% (95% CI 4.7–9.1) reported one as test-confirmed—a gap of 11.0 percentage points (95% CI 8.5–14.0). The mean knowledge score was 5.08/10: 70.2% knew anaphylaxis can be fatal, yet only 47.8% named adrenaline as first-line treatment, 33.4% had never heard of an auto-injector, and 15.4% always read allergen labels. Educational level and health-sector training were the strongest predictors of knowledge. Conclusions: Food allergy is labelled more readily than it is verified, while preparedness for severe reactions is thin. Better access to diagnostic confirmation and public information stratified by educational attainment are needed. The two cohorts share a source population but are differently selected and measure different constructs, so their proportions are complementary rather than interchangeable.

Source: Nutrients

DOI: 10.3390/nu18203324