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Children of Asian ethnicity in Australia have higher risk of food allergy and early onset eczema than those in Singapore

Children of Asian ethnicity in Australia have higher risk of food allergy and early onset eczema than those in Singapore
Children of Asian ethnicity in Australia have higher risk of food allergy and early onset eczema than those in Singapore
Background: in Western countries, Asian children have higher food allergy risk than Caucasian children. The early life environmental exposures for this discrepancy are unclear. We aimed to compare prevalence of food allergy and associated risk factors between Asian children in Singapore and Australia. Methods: we studied children in the Growing Up in Singapore Towards healthy Outcomes (GUSTO) birth cohort (n=878) and children of Asian ancestry in the HealthNuts cohort (n=314). Food allergy was defined as a positive SPT ≥ 3 mm to egg or peanut AND either a convincing history of IgE-mediated reaction at 18 months (GUSTO) or a positive oral food challenge at 14-18 months (HealthNuts). Eczema was defined as parent-reported doctor diagnosis. Results: food allergy prevalence was 1.1% in Singapore and 15.0% in Australia (p<0.001). Egg introduction was more often delayed (>10 months) in Singapore (63.5%) than Australia (16.3%; p<0.001). Prevalence of early onset eczema (<6 months) was lower in Singapore (8.4%) than Australia (30.5%) (p<0.001). Children with early onset eczema were more likely to have food allergy than those without eczema in Australia [aOR 5.11 (2.34-11.14); p<0.001] and Singapore [aOR 4.00 (0.62-25.8); p=0.145]. Conclusions: among Asian children, prevalence of early onset eczema and food allergy was higher in Australia than Singapore. Further research with larger sample sizes and harmonized definitions of food allergy between cohorts is required to confirm and extend these findings. Research on environmental factors influencing eczema onset in Australia and Singapore may aid understanding of food allergy pathogenesis in different parts of the world.
Asian children, GUSTO, eczema, food allergy, healthnuts
0105-4538
3171-3182
Suaini, Noor H. A.
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Loo, Evelyn Xiu-Ling
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Peters, Rachel L.
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Yap, Gaik Chin
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Allen, Katrina J.
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van Bever, Hugo
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Martino, David J.
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Goh, Anne Eng Neo
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Dharmage, Shyamali C.
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Colega, Marjorelee T.
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Chong, Mary Foong-Fong
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Ponsonby, Anne-Louise
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Tan, Kok Hian
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Tang, Mimi L. K.
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Godfrey, Keith
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Lee, Bee Wah
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Shek, Lynette Pei-Chi
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Koplin, Jennifer J.
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Tham, Elizabeth Huiwen
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Suaini, Noor H. A.
8ddd1497-88c3-4840-8733-473947bbe5f9
Loo, Evelyn Xiu-Ling
229ed4b9-220f-4d95-a384-eb6529f6d2d6
Peters, Rachel L.
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Yap, Gaik Chin
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Allen, Katrina J.
1b75b2a8-551b-49af-8ab4-4f7b593eca98
van Bever, Hugo
967ee912-3ad6-4c7b-ab6c-bb50914ea687
Martino, David J.
d483381d-4912-4b75-a457-6b5f49900936
Goh, Anne Eng Neo
9d869111-5368-420f-97dc-336f052bef41
Dharmage, Shyamali C.
3cb055af-0503-432b-a380-8af7fca017a4
Colega, Marjorelee T.
75c5e6c9-9b67-46b9-90e6-e63632163ed8
Chong, Mary Foong-Fong
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Ponsonby, Anne-Louise
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Tan, Kok Hian
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Tang, Mimi L. K.
ceca5bb5-7a30-4716-83fc-94ef38789017
Godfrey, Keith
0931701e-fe2c-44b5-8f0d-ec5c7477a6fd
Lee, Bee Wah
81ec0089-b824-4835-b908-1fc8e9f62249
Shek, Lynette Pei-Chi
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Koplin, Jennifer J.
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Tham, Elizabeth Huiwen
e22014ec-8242-478a-aafc-e4177164f814

Suaini, Noor H. A., Loo, Evelyn Xiu-Ling, Peters, Rachel L., Yap, Gaik Chin, Allen, Katrina J., van Bever, Hugo, Martino, David J., Goh, Anne Eng Neo, Dharmage, Shyamali C., Colega, Marjorelee T., Chong, Mary Foong-Fong, Ponsonby, Anne-Louise, Tan, Kok Hian, Tang, Mimi L. K., Godfrey, Keith, Lee, Bee Wah, Shek, Lynette Pei-Chi, Koplin, Jennifer J. and Tham, Elizabeth Huiwen (2021) Children of Asian ethnicity in Australia have higher risk of food allergy and early onset eczema than those in Singapore. Allergy: European Journal of Allergy and Clinical Immunology, 76 (10), 3171-3182. (doi:10.1111/all.14823).

Record type: Article

Abstract

Background: in Western countries, Asian children have higher food allergy risk than Caucasian children. The early life environmental exposures for this discrepancy are unclear. We aimed to compare prevalence of food allergy and associated risk factors between Asian children in Singapore and Australia. Methods: we studied children in the Growing Up in Singapore Towards healthy Outcomes (GUSTO) birth cohort (n=878) and children of Asian ancestry in the HealthNuts cohort (n=314). Food allergy was defined as a positive SPT ≥ 3 mm to egg or peanut AND either a convincing history of IgE-mediated reaction at 18 months (GUSTO) or a positive oral food challenge at 14-18 months (HealthNuts). Eczema was defined as parent-reported doctor diagnosis. Results: food allergy prevalence was 1.1% in Singapore and 15.0% in Australia (p<0.001). Egg introduction was more often delayed (>10 months) in Singapore (63.5%) than Australia (16.3%; p<0.001). Prevalence of early onset eczema (<6 months) was lower in Singapore (8.4%) than Australia (30.5%) (p<0.001). Children with early onset eczema were more likely to have food allergy than those without eczema in Australia [aOR 5.11 (2.34-11.14); p<0.001] and Singapore [aOR 4.00 (0.62-25.8); p=0.145]. Conclusions: among Asian children, prevalence of early onset eczema and food allergy was higher in Australia than Singapore. Further research with larger sample sizes and harmonized definitions of food allergy between cohorts is required to confirm and extend these findings. Research on environmental factors influencing eczema onset in Australia and Singapore may aid understanding of food allergy pathogenesis in different parts of the world.

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2017-0186 NUS-Murdoch 20170223 Final_V7.1_unmarked_unlinked - Accepted Manuscript
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Highlights_Suaini_ALL-2020-01265.R1
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Online_repository_GUSTO_HN_Jan2021
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More information

Accepted/In Press date: 14 February 2021
e-pub ahead of print date: 22 March 2021
Keywords: Asian children, GUSTO, eczema, food allergy, healthnuts

Identifiers

Local EPrints ID: 447237
URI: http://eprints.soton.ac.uk/id/eprint/447237
ISSN: 0105-4538
PURE UUID: 60b940ee-01ef-4110-9510-b5373dceee73
ORCID for Keith Godfrey: ORCID iD orcid.org/0000-0002-4643-0618

Catalogue record

Date deposited: 05 Mar 2021 17:31
Last modified: 26 Nov 2021 02:35

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Contributors

Author: Noor H. A. Suaini
Author: Evelyn Xiu-Ling Loo
Author: Rachel L. Peters
Author: Gaik Chin Yap
Author: Katrina J. Allen
Author: Hugo van Bever
Author: David J. Martino
Author: Anne Eng Neo Goh
Author: Shyamali C. Dharmage
Author: Marjorelee T. Colega
Author: Mary Foong-Fong Chong
Author: Anne-Louise Ponsonby
Author: Kok Hian Tan
Author: Mimi L. K. Tang
Author: Keith Godfrey ORCID iD
Author: Bee Wah Lee
Author: Lynette Pei-Chi Shek
Author: Jennifer J. Koplin
Author: Elizabeth Huiwen Tham

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