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ANAHEIM, Calif. -- Patients and their caregivers believe that a wide array of causes are responsible for the development of their food allergies, according to findings from a national cross-sectional survey.

The factors that survey respondents most often reported as associated with development of food allergies was having eaten too much of the food in question (19.1%), genetics and family history (13.1%), antibiotic use (7.8%), not eating enough of the food in question (7.6%), and antacid use (6.7%), reported Rachelle Liu, BA, of Northwestern University Feinberg School of Medicine in Chicago, during the American College of Allergy, Asthma & Immunology annual meeting.

"We found that, nationwide, people have diverse attitudes around food allergy development, but that the associations people had also correlated with existing knowledge about factors that impact food allergy," Liu said. "While a portion of people associated food allergy with genetics, a higher percentage of people associated developing food allergy with behaviors and environment, aligning with the belief that people have agency over food allergy development."

A large proportion of responses indicated that many patients associate food allergy development with diet and eating behaviors, which Liu explained "emphasizes the impact that guidelines and patient education can have and gives insight into how people may perceive interventions such as oral immunotherapies."

In a , co-author Ruchi Gupta, MD, also of the Feinberg School of Medicine, said, "We now know that eating certain allergenic foods, like peanuts, if eaten starting in infancy, can prevent peanut allergy. Allergists and other healthcare professionals can help get the word out to parents of infants and others that it's preventative to introduce certain allergenic foods early in life."

"For new-onset adult allergies, understanding potential triggers that may be involved with the development of an allergy is critical," she added. "Factors like infections, changes in the environment, and hormonal changes may be factors contributing to developing an allergy later in life and need more exploration."

almost 6% of U.S. adults and children have a food allergy, with Black adults more likely to have food allergies compared with white, Hispanic, and Asian adults.

Liu told 番茄社区app that patient age, consistency in seeking healthcare, and changes to guidelines over the last few decades may play a role in the various perceptions and patient understanding of food allergy development.

"I feel like in terms of follow-up with physicians, I know it's a bit of a U-shaped curve -- with really good follow-up in the pediatric period, then throughout adolescence and early 20s or 30s, your health is pretty good and maybe you're not following up as often. If you're having symptoms, maybe it's not a big enough problem to bring it up," she noted. "Later in life, you get more of that contact again, so maybe there is a lack of patient-provider interaction [overall]."

For this study, an NIH-supported Food Allergy Prevalence Questionnaire was provided to patients both in English and Spanish either online or over the phone from 2015 to 2016. The questionnaire yielded a total of 78,851 responses -- patient-proxy data for 38,408 children and self-reported data for 40,443 adults.

Patient responses were categorized as self- or parent proxy-reported food allergy, convincing food allergy according to reported food-allergic reaction symptoms consistent with an IgE-mediated response, or convincing food allergy that was physician-diagnosed via skin prick testing, specific IgE blood testing, and/or oral food challenge.

Liu noted that follow-up surveys could be used in the future to better understand how patient perceptions may change with increased public awareness around the science of food allergies.

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