Children with lower household income, lower parental health literacy, and greater neighborhood-level deprivation were significantly less likely to report resolution of food allergy, according to a FORWARD cohort study.¹
The factors linked to food allergy resolution in children have remained poorly defined despite rising prevalence and the substantial health, psychosocial, and financial burden the diagnosis places on families. According to Food Allergy, Research & Education (FARE), allergies to milk, egg, wheat, and soy often resolve in childhood, whereas allergies to peanuts, tree nuts, and shellfish are often lifelong.2
“Fewer than 20% of children will outgrow their peanut allergy,” said Kirsi Järvinen-Seppo, MD, chief of pediatric allergy and immunology at UR Medicine Golisano Children’s Hospital.3 “That is why peanut remains one of the most researched and carefully managed food allergies in pediatrics.”
Frequently Asked Questions
Which food allergies are most likely to resolve in children?
In the FORWARD cohort, milk (35%), soy (32%), and wheat (27%) allergies were resolved most often, while peanut (3.8%) and shellfish (3.5%) allergies rarely resolved.
Do racial disparities affect food allergy resolution?
Yes. White children reported resolution of food allergy more frequently than Black and Hispanic children across all common allergens, even after adjustment for socioeconomic covariates.
What social factors predict whether a child outgrows a food allergy?
Lower household income, lower parental health literacy scores, and higher area deprivation index were each associated with a lower likelihood of resolution across the 9 food allergens assessed.
The team, led by Mahboobeh Mahdavinia, MD, PhD, from McGovern Medical School at UT Health Houston, drew on caregiver surveys and electronic health record data from FORWARD (Food Allergy Outcomes Related to White and African American Racial Differences), a multicenter observational study, to identify demographic and clinical factors associated with resolution among children with ≥ 1 active food allergy.¹ Participants were allergic to either milk, soy, wheat, peanut, or shellfish.
Food Allergy Resolution Rates in the FORWARD Cohort
The analysis included 1359 participants younger than 12 years with physician-diagnosed IgE-mediated food allergy enrolled in FORWARD. Investigators compared demographic and clinical characteristics between children with and without caregiver-reported resolution of ≥ 1 food allergy at enrollment, then built multivariable logistic regression models evaluating associations between resolution and race/ethnicity, household income, health literacy scores, and area deprivation index (ADI).¹
Resolution rates varied widely by allergen. Milk allergy resolved most often (35%), followed by soy (32%) and wheat (27%). Peanut (3.8%) and shellfish (3.5%) allergies were resolved far less frequently, consistent with the more persistent natural history typically observed for these allergens relative to milk, egg, soy, and wheat.¹
Racial and Socioeconomic Predictors of Resolution
White children reported resolution of food allergy more frequently than Black and Hispanic children across all common food allergens evaluated in the cohort.¹ This pattern held in unadjusted comparisons and persisted after investigators accounted for clinical and demographic covariates in multivariable models.
