Feng Hua, Chen Yan, Chen Hongbing, Liu Chengwei, Zhou Wei, Wang Lianglu, Wu Yongning
State Key Laboratory of Food Science and Technology, Nanchang University, Nanchang City, Jiangxi Province, China.
School of Public Health, Nanchang University, Nanchang City, Jiangxi Province, China.
China CDC Wkly. 2022 Aug 26;4(34):749-755. doi: 10.46234/ccdcw2022.159.
Adverse reactions to food (ARF) are a major worldwide public health and food safety problem. Among the various causes of ARF, food allergies (FA) are particularly serious as the immune response that is triggered can be fatal even at very low doses. However, the prevalence of ARF and FA in the general population in China is presently unclear. This study aims to determine the epidemiological characteristics and risk factors for ARF and FA, which can be a basis for estimating thresholds for major food allergens.
This is a multicenter, cross-sectional, epidemiologic survey with a case-control study nested among a selected population in China. Random individuals were recruited using stratified cluster random sampling; ARF and FA were comprehensively assessed using modified EuroPrevall FA Project questionnaires as well as structured interviews, sensitization testing, and double-blind placebo-controlled food challenges (DBPCFC).
This method of epidemiologic study on ARF and FA was a pilot application in Jiangxi Province from January 2020; among the total 21,273 children and adults that completed the questionnaire, 5.8% reported ARF and 4.3% reported FA. ARF were determined to be associated with age, gender, and region. Animal-derived foods were the dominant offending foods, especially shrimp, and skin symptoms were the most commonly reported ARF.
This is the first multi-center, large-scale, epidemiologic study on ARF and FA using standardized methods, including DBPCFC, in the Chinese general population. This study presents an important approach to assessing ARF and FA, provides significant insights about the prevalence of ARF and FA, and facilitates support for updating the list of allergenic food labels: which will be essential for improving ARF prevention and management in China.
食物不良反应（ARF）是一个全球性的重大公共卫生和食品安全问题。在ARF的各种病因中，食物过敏（FA）尤为严重，因为即使在极低剂量下引发的免疫反应也可能是致命的。然而，目前中国普通人群中ARF和FA的患病率尚不清楚。本研究旨在确定ARF和FA的流行病学特征及危险因素，为估计主要食物过敏原的阈值提供依据。
这是一项在中国选定人群中进行的多中心、横断面流行病学调查，并嵌套了病例对照研究。采用分层整群随机抽样招募随机个体；使用改良的欧洲食物过敏流行率（EuroPrevall）食物过敏项目问卷以及结构化访谈、致敏检测和双盲安慰剂对照食物激发试验（DBPCFC）对ARF和FA进行综合评估。
这种关于ARF和FA的流行病学研究方法于2020年1月在江西省进行了试点应用；在完成问卷的总共21273名儿童和成人中，5.8%报告有ARF，4.3%报告有FA。确定ARF与年龄、性别和地区有关。动物性食物是主要的致过敏食物，尤其是虾，皮肤症状是最常报告的ARF。
这是首次在中国普通人群中使用包括DBPCFC在内的标准化方法对ARF和FA进行的多中心、大规模流行病学研究。本研究提出了评估ARF和FA的重要方法，提供了关于ARF和FA患病率的重要见解，并有助于支持更新致敏食物标签清单：这对于改善中国ARF的预防和管理至关重要。
