PMID- 37625503 OWN - NLM STAT- MEDLINE DCOM- 20231106 LR - 20240116 IS - 1534-4436 (Electronic) IS - 1081-1206 (Print) IS - 1081-1206 (Linking) VI - 131 IP - 5 DP - 2023 Nov TI - Prevalence and burden of coconut allergy in the United States. PG - 645-654.e2 LID - S1081-1206(23)00594-X [pii] LID - 10.1016/j.anai.2023.08.017 [doi] AB - BACKGROUND: Epidemiologic data on coconut allergy remains sparse in the United States despite the labeling requirement by the Food Allergen Labeling and Consumer Protection Act for products containing coconut. OBJECTIVE: To provide current estimates of the prevalence, severity, determinants, and distribution of coconut allergy in the United States. METHODS: A comprehensive food allergy prevalence survey was administered to a nationally representative, probability-based sample of US households between October 1, 2015 and September 30, 2016. Eligible respondents included adults who were able to complete self- and parent-proxy report surveys in English or Spanish by means of web or phone. RESULTS: Using survey responses from 78,851 individuals, 0.39% (95% confidence interval [CI], 0.33-0.45) of the US general population were categorized as having convincing coconut allergy. Among children, 0.22% (95% CI, 0.16-0.30) were estimated to have coconut allergy compared with 0.43% (95% CI, 0.37-0.51) of adults, whereas only 0.12% (95% CI, 0.08-0.18) of these children and 0.20% (95% CI, 0.16-0.24) of adults with convincing immunoglobulin E (IgE)-mediated coconut allergy reported physician-confirmed diagnoses. A current epinephrine prescription was reported by 40.1% (95% CI, 33.3-47.4) of those with convincing coconut allergy. Reactions involving multiple organ systems were reported by 47.5% (95% CI, 40.1-54.9) of those with convincing coconut allergy. CONCLUSION: Roughly 1 in 260 Americans report symptoms consistent with an IgE-mediated allergy to coconut, although fewer than half of these individuals report receiving a physician diagnosis. Our data indicate that most individuals with reported coconut allergy meeting symptom-based criteria for convincingly IgE-mediated disease have comorbid FAs, and for many patients, clinical management seems to be suboptimal. CI - Copyright (c) 2023 The Authors. Published by Elsevier Inc. All rights reserved. FAU - Warren, Christopher M AU - Warren CM AD - Department of Preventive Medicine, Northwestern University Feinberg School of Medicine, Chicago, Illinois; Center for Food Allergy and Asthma Research, Institute for Public Health and Medicine, Northwestern University Feinberg School of Medicine, Chicago, Illinois. Electronic address: christopher.warren@northwestern.edu. FAU - Sehgal, Shruti AU - Sehgal S AD - Center for Food Allergy and Asthma Research, Institute for Public Health and Medicine, Northwestern University Feinberg School of Medicine, Chicago, Illinois. FAU - Nimmagadda, Sai R AU - Nimmagadda SR AD - Center for Food Allergy and Asthma Research, Institute for Public Health and Medicine, Northwestern University Feinberg School of Medicine, Chicago, Illinois; Department of Pediatrics, Northwestern University Feinberg School of Medicine, Chicago, Illinois; Division of Allergy and Immunology, Ann and Robert H. Lurie Children's Hospital of Chicago, Chicago, Illinois. FAU - Gupta, Ruchi AU - Gupta R AD - Center for Food Allergy and Asthma Research, Institute for Public Health and Medicine, Northwestern University Feinberg School of Medicine, Chicago, Illinois; Department of Pediatrics, Northwestern University Feinberg School of Medicine, Chicago, Illinois; Division of Allergy and Immunology, Ann and Robert H. Lurie Children's Hospital of Chicago, Chicago, Illinois. LA - eng GR - R21 AI135702/AI/NIAID NIH HHS/United States PT - Journal Article PT - Research Support, N.I.H., Extramural PT - Research Support, Non-U.S. Gov't DEP - 20230824 PL - United States TA - Ann Allergy Asthma Immunol JT - Annals of allergy, asthma & immunology : official publication of the American College of Allergy, Asthma, & Immunology JID - 9503580 RN - 0 (Allergens) RN - 37341-29-0 (Immunoglobulin E) SB - IM MH - Child MH - Adult MH - Humans MH - United States/epidemiology MH - *Cocos MH - Prevalence MH - *Food Hypersensitivity/epidemiology/diagnosis MH - Allergens MH - Immunoglobulin E PMC - PMC10789306 MID - NIHMS1926947 COIS- Christopher Warren receives research grant support from the National Institutes of Health (NIH), and Food Allergy Research and Education (FARE). Shruti Sehgal reports no competing interests, Sai R. Nimmagadda receives research grant support from the National Institutes of Health (NIH), and the Food Allergy Research and Education (FARE). Ruchi S. Gupta receives research grant support from the National Institutes of Health (NIH), Food Allergy Research and Education (FARE), Stanford Sean N. Parker Center for Allergy Research, UnitedHealth Group, Thermo Fisher Scientific, Genentech, and the National Confectioners Association (NCA); and has served as a medical consultant/advisor for Aimmune Therapeutics, Genentech, Before Brands, Kaleo, DBV Technologies, ICER, DOTS Technology, and FARE. The study protocol was reviewed and approved by the Northwestern University IRB STU#00202279. EDAT- 2023/08/26 05:42 MHDA- 2023/11/06 06:42 PMCR- 2024/11/01 CRDT- 2023/08/25 19:25 PHST- 2023/06/05 00:00 [received] PHST- 2023/08/05 00:00 [revised] PHST- 2023/08/11 00:00 [accepted] PHST- 2024/11/01 00:00 [pmc-release] PHST- 2023/11/06 06:42 [medline] PHST- 2023/08/26 05:42 [pubmed] PHST- 2023/08/25 19:25 [entrez] AID - S1081-1206(23)00594-X [pii] AID - 10.1016/j.anai.2023.08.017 [doi] PST - ppublish SO - Ann Allergy Asthma Immunol. 2023 Nov;131(5):645-654.e2. doi: 10.1016/j.anai.2023.08.017. Epub 2023 Aug 24.