Prevalence estimates of eight big food allergies in Europe: Updated systematic review and meta-analysis

In 2014, the European Academy of Allergy and Clinical Immunology published prevalence estimates for food allergy (FA) and food sensitization (FS) to the so-called eight big food allergens (i.e. cow's milk, egg, wheat, soy, peanut, tree nuts, fish and shellfish) in Europe for studies published between 2000 and 2012. The current work provides 10-year updated prevalence estimates for these food allergens. A protocol was registered on PROSPERO before starting the research (reference number CRD42021266657). Six databases were searched for studies published 2012–2021, added to studies published up to 2012, resulting in a total of 93 studies. Most studies were graded as at moderate risk of bias. The overall pooled estimates for all age groups of self-reported lifetime prevalence were as follows: cow's milk (5.7%, 95% confidence interval 4.4–6.9), egg (2.4%, 1.8–3.0), wheat (1.6%, 0.9–2.3), soy (0.5%, 0.3–0.7), peanut (1.5%, 1.0–2.1), tree nuts (0.9%, 0.6–1.2), fish (1.4%, 0.8–2.0) and shellfish (0.4%, 0.3–0.6). The point prevalence of food challenge-verified allergy were as follows: cow's milk (0.3%, 0.1–0.5), egg (0.8%, 0.5–1.2), wheat (0.1%, 0.01–0.2), soy (0.3%, 0.1–0.4), peanut (0.1%, 0.0–0.2), tree nuts (0.04%, 0.02–0.1), fish (0.02%, 0.0–0.1) and shellfish (0.1%, 0.0–0.2). With some exceptions, the prevalence of allergy to common foods did not substantially change during the last decade; variations by European regions were observed.