Table S1: FOOD ALLERGY PREVALENCE BY REGION Unselected population: FA confirmed by food challenges Unselected population: FA confirmed by sensitization Unselected population: questionnaire / self-reporting only Selected population study (descriptive data) No data OCEANIA and ASIA PACIFIC Region Country Prevalence of clinical food allergy in last 10 years (%) Method of determining prevalence, population size (and reference to support response if available) Change in in last 10 years? Age group most affected by any change? All ages < 5 year olds > 5 year olds Oceania Australia (6%) 10% 3.8% (nuts only) Population-based sample of 2,848 infants at 1 year using predetermined SPT and OFC criteria to measure outcomes. Other percentages (in brackets) estimates only based on other data sets. Increased , < 5years New Zealand - - - Recognized lack of data ** Increased* < 5years * Asia China 2.4 3.8% 6.2% 7.7% - 497 consecutive infants attending well-baby checks. Food allergy history, SPT and OFC. Study across 3 cities, based on food allergy history, SPT and OFC (0-2 year olds). Same methodology 10 years apart showed increase from 3.5% 1999 to 7.7% in 2009 in in Chongqing, China Indirect evidence of increasing food allergy comparing higher rates of food allergy in Chinese born in Hong Kong (4.8%) versus Mainland China (2.4%). Increased -
AMERICAS Region Country Prevalence of clinical food allergy in last 10 years (%) Method of determining prevalence, population size (and reference to support response if available) Change in prevalence in last 10 years? Age group most affected by any change? All ages < 5 year olds > 5 year olds North America Canada 7.1% (8%) (5%) Self reporting telephone interviews in 10 provinces (9,667 individuals including 2,198 children). Other percentages (in brackets) estimates only based on other data sets. Stable , - USA 3.4% – 8%28 (6%) (3%) Physician diagnosis review of electronic medical records (9,184 low-income, minority children years). Randomized, cross-sectional electronic survey (40,104 children 0-18 years). Other percentages (in brackets) estimates only based on other data sets. Increased < 5years Central and South America Colombia 10.1-12.6% 12.6% Cross-sectional population survey of 3099 (aged 1-83 years) in Cartagena. 10% self reporting of food allergy for 1-8 year olds, 12% for 9-16 year olds - -
Czech R - - - **No population prevalence data reported/found Stable* - Russia - - - **No population prevalence data reported/found - - Bulgaria - - - **No population prevalence data reported/found Increased* >5 year olds* Albania - - - **No population prevalence data reported/found - - Ukraine - - - **No population prevalence data reported/found - - Moldova - - - **No population prevalence data reported/found - - Nordic regions Denmark 2.5 1.2% -3.6% 2.3% 1.2% 1% As above. DARC Cohort of 562 children, questionnaires, specific IgE and OFC (milk, egg, and peanut). DARC Cohort at 6 years. Cohorts of children <3 yr (n=111), 3 yr (n= 486 children), >3 yr (n=301) for questionnaires, SPT, specific IgE and OFC to the most common allergenic foods. - - Norway - 6.8% 53 - Birth cohort 512 children followed to 2.years, food allergy defined by history, SPT and DBPCFC. Previous prevalence assessed in birth cohort of 2803 (parental reporting of reactions to foods (egg, fish, or nuts) and egg allergy confirmed by DBPCFC or IgE at 2.5yrs. Increased , 1-5 years Iceland 2% 16.2% Prospective (n=1,341) birth cohort, children with possible food allergy had SPT and double-blind OFC. Second cohort (n=3000) also under analysis (published in Islandic) EuroPrevall as above: Parent-reported food hypersensitivity (from baseline data from siblings of 1341 Icelandic infants). Increased 1-5 years Sweden - 3.2% -11% 5.3% Questionnaires on 3694 children (90%) of the BAMSE birth cohort at 4 years. IgE measurements on 2563. Total perceived Increased* 1-5 years*
Japan Egg, Cows milk, wheat, peanut, fish, fruits Egg, cows milk, wheat, shellfish, fruits and peanut IgE mediated Rice, potatoes, vegetables, fruits, soy paste. 4-6 months 50-75% 25-50% Often Korea Egg, cows milk, peanut, wheat, (soy and fish*) Egg (6-7 years), shellfish and fruits (nuts and grains*) Mixed (IgE and non-IgE features) Rice soup, fruits, vegetables, beef, beans 4-6 months 25-50% 50-75% Often Hong Kong Shellfish , , egg, peanut , milk, fish, fruits - IgE mediated - - - - - Singapore Egg, milk, peanut, tree nut, shellfish Egg, Peanut, tree nut, shellfish, fish , cow milk IgE mediated Rice, fruits, vegetables, fish, tubers 4-6 months < 25% 25-50% Rarely Seafood, eggs, milk soy, peanut (no data) Shellfish, Peanut, fish (egg, cow milk, soy) Mixed (IgE and non-IgE features) Rice, banana, vegetables, orange, cereals, fish, meat 4-6 months < 25% 25-50% Rarely Indonesia Cows milk and egg (no data) Seafood, eggs, nuts Mixed IgE and symptoms Fruit, biscuit, porridge (wheat or rice) vegetables, meat 4-6 months < 25% 25-50% Rarely Malaysia Cows milk, egg, peanut, tree nuts, sea food (no data) Sea food, chicken, peanut, egg Mixed IgE and symptoms Potatoes, sweat potato, rice, carrot, fruits 4-6 months 50-75% 25-50% Sometimes Burma (no data) - - - - (no data) - Mixed IgE and - 4-6 months < 25% < 25% Sometimes
symptoms Sri Lanka (no data) - - - - - - - Vietnam (no data) - - - - Vietnam (no data) - - - - India (no data) - - - - < 25% < 25% Rarely Mongolia (no data) - - - - - - - 2) AMERICAS Region Country Most common food triggers < 5 years Most common symptoms (IgE, or mixed features) First weaning foods (other than formula milk) Age of starting foods (actual rather than recommended) Estimated perinatal use of formulas (by hospital or nursery staff) Estimated use of any formulas < 4 months (excluding the neonatal period) Is allergy prevention a common parental concern? < 5 years > 5 years North America Canada Cows milk Egg, peanut tree nuts, fish and soy Peanut, tree nuts, cows milk, egg, seafood, wheat IgE mediated Rice cereal, other cereal grains, bananas, other fruits, pureed vegetables 4-6 months <25% 25-50% Often USA Cows milk, peanut, eggs, , shellfish, tree nuts, fish (soy) Peanuts, , shellfish, , milk, tree nuts, , egg , IgE mediated Rice cereal, oat cereal, carrot, sweet potatoes other vegetables 4-6 months 25-50% >75% Often Central and South America Colombia Cows milk, egg, sea food, vegetables (limited data) Fruits and vegetables, seafood, meats, milk, egg (limited data). Mixed IgE and symptoms - - - - -
Mexico Cows milk, egg, fish, shrimp, soy (wheat) Egg, milk, wheat, soy, fish (others: beans, chili, mango,cacao, strawberry) IgE mediated Apple, pear, banana, potato, carrot 4-6 months >75% >75% Often Panama - - - - - - - - Honduras Cows milk, soy, egg, wheat, fruits (no data) Cows milk, soy, egg, wheat, fruits, peanuts (no data) Mixed IgE and symptoms Apple, banana, potato, sweet potato, pear 3-4 months 25-50% 25-50% Rarely Argentina Cows milk, egg, wheat, peanut, soy (no data) Cows milk, peanut, tree nuts, shellfish, fish (no data) IgE mediated Potatoes, carrots, apple, banana, pumpkin 4-6 months 25-50% <25% Rarely Uruguay Cows milk, egg, soy, wheat, shrimp, (no data) Cows milk, egg, wheat, soy, shrimp, fruits (no data) Non-IgE features Carrots, potatoes, banana, apple, chicken >6 months < 25% 25-50% Rarely Brazil Cows milk, egg, soy, wheat, corn, (no data) Fish, shellfish, tree nuts, peanuts, eggs (no data) IgE mediated Apple, orange, banana, cereals, egg yolk 4-6 months > 75% 25-50% Sometimes Chile Cows milk, egg, soy, legumes, corn, vegetables (no data) Egg, soy, wheat, fruits, vegetables (no data) Non-IgE features Potatoes, pumpkin, chard, beef, apple 4-6 months 25-50% < 25% Sometimes
Croatia Egg, Cows milk, peanuts, wheat, soy (based on clinical practice) Peanuts, fiah, soy, chicken, potato (based on clinical practice) Mixed IgE and symptoms Apple, pear, banana, carrot, potato 4-6 months >75% 25-50% Sometimes Romania Cows milk, egg, wheat, chicken, carrot (based on clinical practice) Egg, meats wheat, nuts, fruits (based on clinical practice) IgE mediated Apple, potato, carrots, wheat, chicken 4-6 months 25-50% 25-50% Rarely Hungary - - - - - - - - Serbia - - - - - - - - Georgia - - IgE mediated Egg, milk, fish, fruit, tree nuts 3-4 months >75% 25-50% Sometimes Latvia Egg, milk, wheat, fish, carrot (based on clinical practice) Fish, hazelnut, soy, chicken, potato(based on clinical practice) Mixed IgE and symptoms Potato, rice, banana, apple, carrot 4-6 months 25-50% <25% Sometimes Belarus Milk, egg, soy, wheat, fish (based on clinical practice) Fish, hazelnuts, shrimps, egg, peanut (based on clinical practice) Non-IgE mediated Porridge (cereals), vegetable, meat, fruit, egg 4-6 months 25-50% <25% Sometimes Czech R Cows milk, egg, nuts, wheat, peanut (based on clinical practice) Fruits, vegetables, nuts, peanuts, poppy (based on clinical practice) IgE mediated Carrot, potato, apple, rice, vegetables 4-6 months >75% 25=50% Often
Russia (no data) - - - - - - - Bulgaria Cows milk. egg soy, kiwi, peach (based on clinical practice) Peanut, hazelnut, fish, shrimp, vegetables Non-IgE mediated Cereals, fruits, vegetables, meats 4-6 months >75% >75% Sometimes Albania (no data) - - - - - - - Ukraine (no data) - - - - - - - Moldova (no data) - - - - - - - Nordic regions Denmark Egg, cows milk, peanut (fish and soy) Vegetables, cows milk, fruits, nuts, legumes, seafood, nuts, wheat IgE mediated - - - - - Norway Cows milk, fruits, vegetables, egg, fish, nuts, cereals - IgE mediated - 4-6 months - - Often Iceland Egg, cows milk, fish, wheat, peanuts, soy - Mixed IgE and symptoms Rice, potato, carrot, apple banana 4-6 months <25% <25% Sometimes Sweden Cows milk egg, fish, wheat, tree nuts, soy , Peanut, tree nut, cows milk, egg, fish, soy , IgE mediated Fruit, carrot, potato, banana, pea 4-6 months <25% 25-50% Often Finland Cows milk, fruits, vegetales, fish, egg, nuts, Vegetables, nuts, fruits, milk, eggs and grains Mixed IgE and symptoms - - - - -
wheat 4) MIDDLE EAST AND AFRICA Region Country Most common food triggers < 5 years Most common symptoms (IgE, or mixed features) First weaning foods (other than formula milk) Age of starting foods (actual rather than recommended) Estimated perinatal use of formulas (by hospital or nursery staff) Estimated use of any formulas < 4 months (excluding the neonatal period) Is allergy prevention a common parental concern? < 5 years > 5 years Middle East Israel Milk, egg, sesame, peanut, fish Jews: milk, egg, peanut and sesame Arab: Egg, sesame, peanut milk, IgE mediated Vegetables, fruit, wheat, rice, potato, wheat 4-6 months 50-75% >75% Sometimes United Arab Emirates # - Eggs, fruits, fish, peanuts, tree nuts, cow milk, wheat, vegetables IgE mediated - - - - - Lebanon Cows milk, wheat, sesame, tree nuts, peanuts (based on clinical experience) Wheat, sesame, shellfish, fish, tree nuts peanuts IgE mediated Potato, squash, carrots, rice, wheat 4-6 months <25% 25-50% Rarely Iran cow's milk, cow's milk, IgE Rice, apple, 4-6 months <25% 25-50% Sometimes
hazelnuts, wheat flour, egg white (12.6%). {Farjadian, hazelnuts, wheat flour, egg white (12.6%) mediated potato, lamb, carrot Egypt Cows milk, egg, sea food, fruits, peanut (based on clinical experience) Sea food, egg, fruits, sesame, peanut (based on clinical experience) IgE mediated Rice, cereals vegetables, yogurt, egg yolk 3-4 months <25% 25-50% Sometimes Jordan Cows milk, egg, nuts, peanut, fruit (based on clinical experience) Cows milk, egg, nuts, peanuts, vegetables (based on clinical experience) IgE mediated - 3-4 months <25% 25-50% Sometimes Kuwait Cow's milk, eggs, peanuts, wheat, tree nuts (based on clinical experience) Peanuts, tree nuts, fish, shell fish (based on clinical IgE mediated Rice, cereals, vegetables, fruits, dairy products 3-4 months 50-75% 25-50% Rarely Azerbaijan (no data) - - - - - - - Afghanistan (no data) - - - - - - - Pakistan (no data) - - - - - - - Africa Ghana # (no data) Peanut, pineapple, pawpaw orange, mango, Mixed IgE and symptoms Fruits, vegetables, cereals, meat, egg yolk - - - -