Summary:
This study, a cross-sectional analysis conducted from 2017 to 2024, investigated how the number of food allergies in children relates to diet quality. Participants aged 2-19 years were recruited from pediatric allergy and general clinics in New York. Children with a confirmed food allergy and children without any reported food allergies were included. Dietary intake was assessed using a 168-item food frequency questionnaire adapted to include common allergen-free alternatives. Nutrient intake was calculated based on portion sizes and nutritional data. Statistical analyses examined the association between the number of food allergies and diet quality, adjusting for age, sex, race, and socioeconomic status. The study included 195 participants, 60% of whom had at least one food allergy, with an average of 1.7 allergies per child. Tree nuts, peanuts, and sesame were the most common allergens. Analysis revealed that a higher number of food allergies was associated with lower dietary variety, meaning children with more allergies consumed fewer servings across different food groups. Conversely, more food allergies were linked to greater dietary moderation, indicating lower intake of foods high in fats, cholesterol, and sodium. These findings suggest that while children with multiple food allergies tend to eat a less varied diet, they may also make healthier food choices, potentially due to allergen-related label reading and substitution of lower-fat alternatives. Importantly, overall nutrient intake and diet quality were comparable to children without food allergies, indicating that children with multiple allergies can maintain adequate and balanced diets despite restrictions. This paper is currently published as a journal pre-proof, which means it contains the full study data and findings but may undergo minor changes before the final version appears in a journal.
Abstract:
Background: Over 30% of food allergic children in the US have multiple food allergies. Food restrictions due to food allergies can affect children’s diet and growth. We hypothesized that a higher number of food allergies would be associated with poorer diet quality. Objective: To assess the relationship between number of food allergies and diet quality. Methods: 195 participants age 2-19 years were recruited from pediatric clinics within the Mount Sinai Health System in New York, NY. Participants completed food frequency questionnaires. Diet quality was scored using the Diet Quality Index-International (DQI-I). Multivariable regression models were built to assess for associations between number of food allergies and DQI scores for overall diet quality, variety, adequacy, moderation, and balance while controlling for age, race, sex, and socioeconomic status. Results: The mean age of the cohort was 7.4 years (SD=4.8) and 49.7% were female. 117 (60%) of the 195 participants were food allergic. Participants had between zero to nine food allergies (mean=1.7, SD=1.9). Covariate-adjusted models showed that number of food allergies was negatively associated with dietary variety (β = -0.51, p = 0.036) and positively associated with dietary moderation (β = 0.22, p = 0.002). There were no associations between number of food allergies and overall diet quality, adequacy, or balance. Conclusion: Number of food allergies positively correlates with dietary moderation and negatively correlates with dietary variety. While children with food allergies had an overall diet quality comparable to that of their non-allergic peers, they would still benefit from awareness to increase dietary variety.
Article Publication Date: 15/09/2025
DOI: 10.1016/j.jacig.2025.100610.
