Development and Application of an Evaluation-Based, Student-Led Obesity Program

This study evaluated the effectiveness of an obesity program developed to solve ‘obesity’, which was selected as the top priority for urgent improvement among the dietary problems of elementary school students in Busan. The program aimed to practice four health rules every day (sleep early, eat two vegetables with each meal, reduce sugary snacks, and exercise for 30 minutes every day). The participants were trained to practice the four rules online in real time every day for three weeks, and their performance in nutrition education tasks was monitored using Padlet. The anthropometric measurements showed no change in the overall average weight before and after participating in the program, but all students grew in height (z=–6.978, P＜0.001), and the number of obese students decreased significantly (z=–3.317, P＜0.001). This obesity program was effective in improving height growth and obesity in elementary school students. In terms of dietary changes, after participating in the program, the frequency of vegetable consumption increased significantly (z= –4.849, P＜0.001), the frequency of sweet snack consumption decreased significantly (z=–4.298, P＜0.001), and the bedtime improved (z=–1.000). Therefore, the non-face-to-face, self-directed obesity program developed in this study is expected to reduce the workload of nutrition teachers carrying a heavy workload such as meal service and nutrition classes, and can be used as an efficient nutrition counseling program.

Dietary Behavior of Students in the Busan Area as Determined Using the Nutritional and Dietary Diagnostic System

In this study, the authors surveyed the dietary habits of all elementary school students registered with the Busan Metropolitan City Office of Education using an online questionnaire called the Dietary Screening Test (DST). The DST consists of 36 items, and these were divided into 5 factors: life rhythm, meal quality, eating development, eating temperament characteristics, and eating habit characteristics. Data were collected from 153,017 students attending 304 schools in Busan, and the responses of 4,020 were included in the analysis.The study was undertaken to document growth and development and diagnose nutrition and dietary problems to provide basic data for the development of customized nutrition education and counseling programs. Results showed that 13.5% and 14.3% of participants were classified as overweight or required weight management for obesity, respectively; 6.7% were underweight. Additionally, 37.0% and 9.5% of children required parental attention at bedtime and sleeping hours, and 14.2% ate too quickly or too slowly. Furthermore, food group consumptions were unbalanced, 25.0% and 64.4% of participants ate grains and protein less than twice a day, respectively, and 72.3% and 74.5% ate kimchi and vegetables less than twice a day, respectively. In contrast, 28.8% of respondents consumed sweet snacks daily or 5∼6 times weekly. These findings highlight the need for a standardized school nutrition counseling manual and individually customized nutrition counseling programs to address the nutrition and dietary problems of elementary school students in Busan.

Analysis of the diet of obese elementary school students using various dietary intake survey methods / 한국영양학회지

Purpose@#Childhood obesity has become a social problem due to the social distancing necessitated by the coronavirus disease 2019 pandemic. This study aimed to identify the dietary problems of obese children through various dietary assessment methods and to confirm the usefulness of each method. @*Methods@#The subjects were 88 students in the 4th to 6th grade of elementary school who participated in the nutrition camp organised by the Busan Metropolitan Office of Education, 2020. To evaluate dietary problems and assess diet quality, 24-hour meal records, monthly food intake frequency, and Dietary Screening Test (DST) data were analyzed. @*Results@#Of the subjects, 15.7%, 30.3%, and 53.9% were normal weight, overweight, and obese, respectively. The average age was 11.77 ± 0.77 years and the average body mass index was 23.96 ± 3.01 kg/m 2 . It was observed from the 24-hour meal record method that the overweight and obese subject groups consumed fewer green vegetables (p < 0.001) and white vegetables (p < 0.01) than the normal weight group. In the monthly food intake frequency method, the consumption of ramen (p < 0.01), snacks (p < 0.05), and sausages (p < 0.05) were high in the obese group, and that of anchovies, broccoli, and sweet pumpkin was high in the normal group (p < 0.05). The comparative data from the DST revealed that the overweight and obese groups had less vegetable intake than the normal weight group (p < 0.01) and had higher intakes of dairy products, fast food, and sweet snacks (p < 0.05). @*Conclusion@#The usefulness of each method in the dietary evaluation of obese children was confirmed. To address the problem of obesity, it is necessary to evaluate the dietary problem and approach it with a customized solution tailor-made for the individual subject.

Examining Nutritional and Dietary Risk Factors Across Weight Classes in Elementary School Students using Busan Office of Nutrition Education Center's Dietary Diagnosis System

This study was undertaken to analyze the growth, nutritional, and dietary risk factors of elementary school students belonging to the Busan Metropolitan City Office of Education and provide the basic data needed to develop an underweight and obesity prevention program. In 2021, BMI and Dietary Screening Test (DST) data of 4,046 children surveyed by the Nutrition Education Experience Center’s “Diagnosis System” of the Busan Regional Office of Education were analyzed. The DST consists of 36 questions about lifestyle habits, meal quality, meal regularity, snack quality, and eating behavior. Of the children included, 6.8% were underweight, 65.4% were normal weight, 13.4% were overweight, and 14.4% were obese. Children in the obesity group had shorter sleep and meal times (P＜0.001), lower vegetable and fruit consumption frequencies (P＜0.001), higher fast food consumption frequencies (P＜0.001), higher rates of skipping meals (P＜0.01) and breakfast (P＜0.001), and more frequently used smartphones and watched TV during meals (P＜0.001). The underweight group had the highest scores for all eating development factors but more frequently had chewing and swallowing difficulties (P＜0.001). The study confirms underweightedness and obesity are present different problems and indicates that nutrition teachers should conduct accurate studies on the eating habits and behaviors of obese and underweight students and provide individually tailored nutritional counseling.

The effect of the mother's modeling and feeding practices on the eating behavior of young children / 한국영양학회지

Purpose@#To investigate the effect of a mother's modeling and feeding practices on the eating behavior of the children. @*Methods@#From April to June 2018, 1,036 young children aged 2 to 6 years and their mothers in Gyeongsan, Gyeongsangbuk-do, were examined for their eating behavior and feeding practices using a verified dietary behavior test (DBT). The children's dietary behavior was classified into four categories: “access evasiveness”, “sensory acuity”, “hyperactivity”, and “irregularity”. The mother's eating behavior was classified into three categories: “pickiness”, “negligence”, and “irregularity”, and feeding practice types were classified into two categories: “responsibility/monitoring”, and “restriction/pressure”. The differences between the groups were tested using the t-test, ANOVA, and Duncan's multiple range test. The influence of feeding practices on the children's eating behavior was analyzed by hierarchical regression analysis while controlling for the mother’s modeling. @*Results@#The problem rates of irregularity, negligence and pickiness in the mother's modeling were 33.7%, 22.8%, and 20.7%, respectively. An analysis of the mother's feeding practices revealed that responsibility/monitoring had a middle, high and low significance in 74.2%, 17.3%, and 8.5% of respondents, respectively and the risk rate of restriction/pressure when guiding children to eat was 15.3%. The problem rates for sensory acuity, access evasiveness, irregularity, and hyperactivity in children were 27.9%, 26.1%, 24.8%, and 22.0%, respectively. Among the four eating behavior characteristics of children, the child's access evasiveness and sensory acuity were more affected by their pickiness rather than the mother's feeding practices, and the child's hyperactivity was more influenced by feeding practices than the mother's eating behavior. The child's irregularity was similarly affected by the mother's eating behavior and feeding practices. @*Conclusion@#Since the mother's eating behavior and feeding practices affect the children's eating behavior, a diet improvement program for children should consider not only the nutrition education of children but also the mother's eating behavior and provide the necessary intervention for feeding practices.

Analysis of the types of eating behavior affecting the nutrition of preschool children: using the Dietary Behavior Test (DBT) and the Nutrition Quotient (NQ) / 한국영양학회지

PURPOSE: To investigate the effect of eating behavior on nutritional status according to temperament type.METHODS: One thousand one hundred three preschool children aged 2 to 6 years in Gyeongsan, Gyeongsangbuk-do from April to June 2018 were surveyed about their eating behavior and nutritional status using DBT (Dietary Behavior Test) and NQ (Nutrition Quotient) which are proven tests. The dietary behaviors of the children were classified into four categories: approach avoidance, sensory sensitivity, hyperactivity, and irregularity. NQ scores were divided into five categories: balance, diversity, moderation, regularity, and practice.RESULTS: The mean of the children's age was 3.42 ± 1.4 (596 boys and 507 girls). The percentage distribution of the NQ grade was as follows: 5.5% (highest), 12.5% (high), 47.1% (medium), 22.2% (low), and 12.6% (lowest). The risk group of approach avoidance and sensory sensitivity had significantly (p < 0.001) lower scores than the normal group in balance factor (51.9 ± 12.0 vs. 57.8 ± 15.9 in approach avoidance type, 52.6 ± 17.6 vs. 57.7 ± 15.9 in sensory sensitivity type) and diversity factor (32.5 ± 24.4 vs. 50.1 ± 22.4 in approach avoidance type, and 32.5 ± 24.0 vs. 50.7 ± 22.2 in sensory sensitivity type). The scores of the hyperactivity risk group were significantly lower in moderation factor (78.2 ± 12.1 vs. 81.2 ± 11.9), and those of the irregular risk group were significantly lower in variety (35.9 ± 24.5 vs. 48.8 ± 23.2), regularity (57.6 ± 37.1 vs. 66.1 ± 17.6), and practice (57.1 ± 19.4 vs. 65.1 ± 22.5) factors than the normal group (p < 0.001). Especially, the risk group of approach avoidance and sensitivity type had significantly (p < 0.001) lower intakes of whole grain, fruit, bean and bean products, vegetables, and Kimchi.CONCLUSION: This present study suggested that the eating behavior based on temperament of demanding preschool children affected food choice resulting in food consumption diversity of children. Therefore, it is important to provide customized nutrition education programs based on temperament type.

Perception of food allergy among parents and school health instructors: A nationwide survey in 2015

PURPOSE: This study aimed to examine the perception of food allergy among parents and school health instructors in Korea. METHODS: A nationwide epidemiological survey in Korea was conducted in September 2015. From 17 cities and provinces, a total of 1,000 elementary, middle and high schools were selected by stratified random sampling. Parents and school health instructors were surveyed using a questionnaire on the perception of food allergy. RESULTS: The prevalence of food-induced anaphylaxis was 22.3%. Of 252 children with anaphylaxis, 47.6% were prescribed epinephrine auto-injector (EAI). Forty-three parents (37.7%) were educated about the use of EAI. Parents carrying their own EAI at all times or keeping them at schools were 5.6% and 3.8%, respectively. For the food allergen-labeling system, 42.1% of parents read food labels, and 32.1% were satisfied with the system. Only 35.2% of school health instructors received education on food allergy and anaphylaxis, and 42.5% of them knew how to use EAI. There were 70 children (9.4%) with anaphylaxis in school, and 75.9% of schools had the emergency management system. CONCLUSION: The awareness of Korean parents and school health instructors on food allergy is still low, and many parents are dissatisfied with the food allergen labeling system. Many school health instructors have difficulty in using EAI in case of anaphylaxis and are insufficiently educated about food allergy. Therefore, it is necessary to establish more systematic food allergy management plans by providing high-quality education to parents and school health instructors and by utilizing legal systems.

Prevalence of Immediate-Type Food Allergy in Korean Schoolchildren in 2015: A Nationwide, Population-based Study

PURPOSE: This study aimed to determine the prevalence of immediate-type food allergy (FA) among schoolchildren in Korea. METHODS: A nationwide, cross-sectional study was performed in September 2015. A stratified random sample of 50,000 participants was selected from children and adolescents aged 6-7 years (n=17,500), 9-10 years (n=17,500), 12-13 years (n=7,500), and 15-16 years (n=7,500). Parents were asked to complete a questionnaire on the detailed history of immediate-type FA. RESULTS: A total of 32,001 (64.0%) responded to the questionnaire survey, and 29,842 children (59.7%) were analyzed after adjusting for missing data. The number of the cases in each age group was 9,671 (6-7 years), 9,756 (9-10 years), 5,169 (12-13 years), and 5,246 (15-16 years). The prevalence of lifetime perceived FA was 15.82%. The prevalence of current immediate-type FA was 4.06% in total, with 3.15% in 6- to 7-year-olds, 4.51% in 9- to 10-year-olds, 4.01% in 12- to 13-year-olds, and 4.49% in 15- to 16-year-olds. Among individual food items, peanut (0.22%) was the most frequent causative food, followed by hen's egg (0.21%), cow's milk (0.18%), and buckwheat (0.13%). Among the food groups, fruits (1.41%), crustaceans (0.84%), tree nuts (0.32%), and fish (0.32%) were the most common offending foods. The prevalence of food-induced anaphylaxis was 0.97%. The most frequent causative food of anaphylaxis was peanut (0.08%), followed by cow's milk (0.07%), buckwheat (0.06%), and hen's egg (0.06%), while fruits (0.28%), crustaceans (0.18%), tree nuts (0.12%), and fish (0.09%) were the most commonly responsible food groups. CONCLUSIONS: The prevalence of current immediate-type FA and food-induced anaphylaxis in Korean schoolchildren in 2015 was 4.06% and 0.97%, respectively. Peanuts, cow's milk, hen's egg, fruits, crustaceans, and tree nuts are common allergens.

Diagnostic Value of Specific IgE to Peanut and Ara h 2 in Korean Children with Peanut Allergy

PURPOSE: The purpose of this study was to establish the diagnostic decision point (DDP) of peanut specific IgE (sIgE) for predicting the outcome of oral food challenge (OFC). We also evaluated the usefulness of sIgE to peanut components (Ara h 1, 2, 3, 8, and 9) in diagnosing peanut allergy. METHODS: Korean children aged over 12 months with a suspected peanut allergy were enrolled. Diagnosis of peanut allergy was confirmed by an open OFC or through the convincing history of anaphylaxis. Cutoff levels of sIgE to peanut and peanut components were determined by analyzing receiver operating characteristic curves. RESULTS: Forty-eight children (22 boys and 26 girls) with a suspected peanut allergy were enrolled. The previously established DDP for peanut-sIgE antibodies (14 kU/L) showed a sensitivity of 22.7%, specificity of 100%, positive predictive value (PPV) of 100%, and negative predictive value of 60.4% in our study population. The median levels of peanut-sIgE (5.4 kU/L vs 1.1 kU/L, P<0.001) and Ara h 2-sIgE (0.8 kU/L vs 0 kU/L, P<0.001) were significantly higher in the peanut allergy group than in the peanut tolerance group. The peanut-sIgE concentration indicating a PPV of 100% was 10.3 kU/L. The Ara h 2-sIgE level of 4.0 kU/L had a PPV of 100%. CONCLUSIONS: Our results showed that the cutoff levels for peanut (10.3 kU/L) and Ara h 2 (4.0 kU/L) established in this study is useful for the diagnosis of peanut allergy in Korean children.

Diagnostic Decision Points of Specific IgE Concentrations in Korean Children With Egg and Cow's Milk Allergies

PURPOSE: The purpose of this study was to evaluate the utility of specific IgE (sIgE) concentrations for the diagnosis of immediate-type egg and cow's milk (CM) allergies in Korean children and to determine the optimal cutoff levels. METHODS: In this prospective study, children > or =12 months of age with suspected egg or CM allergy were enrolled. Food allergy was diagnosed by an open oral food challenge (OFC) or through the presence of a convincing history after ingestion of egg or CM. The cutoff levels of sIgE for egg white (EW) and CM were determined by analyzing the receiver operating characteristic curves. RESULTS: Out of 273 children, 52 (19.0%) were confirmed to have egg allergy. CM allergy was found in 52 (23.1%) of 225 children. The EW-sIgE concentration indicating a positive predictive value (PPV) of >90% was 28.1 kU/L in children or =24 months of age. For CM-sIgE, the concentration of 31.4 kU/L in children or =24 months of age indicated a >90% PPV. EW-sIgE levels of 3.45 kU/L presented a negative predictive value (NPV) of 93.6% in children or =24 months of age presented a NPV of 99.2%. The CM-sIgE levels of 0.59 kU/L in children or =24 months of age showed NPVs of 100% and 96.9%. CONCLUSIONS: Our results indicate that different diagnostic decision points (DDPs) of sIgE levels should be used for the diagnosis of egg or CM allergy in Korean children. The data also suggest that DDPs with high PPV and high NPV are useful for determining whether OFC is required in children with suspected egg or CM allergy.

Mixed plant extract-dependent exercise-induced anaphylaxis

Food-dependent exercise-induced anaphylaxis (FDEIA) is a potentially life-threatening clinical reaction in which anaphylaxis develops when physical activity occurs within a few hours after ingesting a specific food. An 18-year-old girl experienced generalized urticaria, periorbital swelling, and dyspnea repeatedly by exercise after intake of a red ginseng health supplement. A confirmed diagnosis was established in this case by using an exercise challenge test after ingesting mixed-plant extract containing red ginseng health supplement. To the best of our knowledge, this is the first case of FDEIA caused by components in a red ginseng health supplement.

Nutrient intakes of infants with atopic dermatitis and relationship with feeding type

BACKGROUND/OBJECTIVES: The prevalence of atopic dermatitis in infants is increasing worldwide. However, the nutrient intake status of infants with atopic dermatitis has not been studied properly. This study was conducted to compare the nutrient intake status of infants in the weaning period with atopic dermatitis by feeding type. MATERIALS/METHODS: Feeding types, nutrient intake status and growth status of 98 infants with atopic dermatitis from age 6 to 12 months were investigated. Feeding types were surveyed using questionnaires, and daily intakes were recorded by mothers using the 24-hour recall method. Growth and iron status were also measured. RESULTS: The result showed that breastfed infants consumed less energy and 13 nutrients compared to formula-fed or mixed-fed infants (p < 0.001). The breastfed group showed a significantly lower intake rate to the Dietary Reference Intakes for Koreans than the other two groups (p < 0.001). In addition, they consumed less than 75% of the recommended intakes in all nutrients, except for protein and vitamin A, and in particular, iron intake was very low, showing just 18.7% of the recommended intake. There was no significant difference in growth by feeding type, but breastfed infants showed a significantly higher rate of iron deficiency anemia (p < 0.001). CONCLUSIONS: Continuous management programs should be prepared for breastfed infants with atopic dermatitis, who are in a period when rapid growth takes place and proper nutrient intake is essential.

Erratum: Nutrient intakes of infants with atopic dermatitis and relationship with feeding type

We made a mistake in presenting author affiliations.

Erratum: Nutrient intakes of infants with atopic dermatitis and relationship with feeding type

We made a mistake in presenting author affiliations.

The Development and Validation of Eating Behavior Test Form for Infants and Young Children / 대한지역사회영양학회지

OBJECTIVES: This study was conducted to develop and validate Eating Behaviors Test form (EBT) for infants and young children, including eating behaviors of their parents and parental feeding practices. METHODS: Draft version of EBT form was developed after a pretest on 83 mothers. It was consisted of 42 questions including 3 components; eating behavior of children, eating behavior of parents, and parental feeding practices. Using these questionnaires, the first survey was conducted on 320 infants and children, 1 to 6 year old, for exploratory factor analysis, and the second survey was collected on 731 infants and children for confirmatory factor analysis. RESULTS: Exploratory factor analysis on 42 questions of EBT form resulted in 3 factor model for children's eating behavior, 3 factor model for parents' eating behavior, and 1 factor model for parental feeding practices. Three factors for children's eating behavior could be explained as follows; factor 1, pickiness (reliability alpha=0.89; explanation of variance=27.79), factor 2, over activity (alpha=0.80, explanation of variance=16.51), and factor 3, irregularity (alpha=0.59, explanation of variance=10.01). Three factors for mother's eating behavior could be explained as follows; factor 1,irregularities (alpha=0.73, explanation of variance=21.73), factor 2, pickiness (alpha=0.65, explanation of variance= 20.16), and factor 3, permissiveness (alpha=0.60, explanation of variance=19.13). Confirmatory factor analysis confirmed an acceptance fit for these models. Internal consistencies for these factors were above 0.6. CONCLUSIONS: Our results indicated that EBT form is a valid tool to measure comprehensive eating and feeding behaviors for infants and young children.

Significance of 40-, 45-, and 48-kDa Proteins in the Moderate-to-Severe Clinical Symptoms of Buckwheat Allergy

PURPOSE: This study was aimed to investigate the relationship between the allergen components and moderate-to-severe allergic reactions in patients with buckwheat allergy. METHODS: Fifteen patients with a history of buckwheat ingestion and a buckwheat specific IgE level> or =0.35 kU/L were enrolled. They were divided into 2 groups according to clinical severity scores, with 0-1 being asymptomatic-to-mild and 2-4 being moderate-to-severe symptoms. Immunoblotting was performed to investigate IgE reactivity toward buckwheat allergens and to measure intensity of each component by using a reflective densitometer. RESULTS: The proportions of positive band to the 16 kDa (62.5% vs 0%, P=0.026) and 40-50 kDa (87.5% vs 28.6%, P=0.041) buckwheat allergens in the grade 2-4 group were higher than those in grade 0-1 group. The level of buckwheat specific IgE of grade 2-4 group was higher than that of grade 0-1 group (41.3 kU/L vs 5.5 kU/L, P=0.037). The median optical densities (ODs) of IgE antibody binding to 40-50 kDa protein were higher in the grade 2-4 group, compared with those in the grade 0-1 group (130% OD vs 60.8% OD, P=0.037). CONCLUSIONS: The 40-50 kDa protein is implicated as an important allergen to predict moderate-to-severe clinical symptoms in Korean children with buckwheat allergy.

Effects of enzymatic hydrolysis of buckwheat protein on antigenicity and allergenicity

BACKGROUND/OBJECTIVES: Due to its beneficial health effects, use of buckwheat has shown a continuous increase, and concerns regarding the allergic property of buckwheat have also increased. This study was conducted for evaluation of the hydrolytic effects of seven commercial proteases on buckwheat allergens and its allergenicity. MATERIALS/METHODS: Extracted buckwheat protein was hydrolyzed by seven proteolytic enzymes at individual optimum temperature and pH for four hours. Analysis was then performed using SDS-PAGE, immunoblotting, and competitive inhibition ELISA (ciELISA) with rabbit antiserum to buckwheat protein, and direct ELISA with pooled serum of 21 buckwheat-sensitive patients. RESULTS: Alkaline protease, classified as serine peptidase, was most effective in reducing allergenicity of buckwheat protein. It caused decomposition of the whole buckwheat protein, as shown on SDS-PAGE, and results of immunoblotting showed that the rabbit antiserum to buckwheat protein no longer recognized it as an antigen. Allergenicity showed a decrease of more than 50% when pooled serum of patients was used in ELISA. Two proteolytic enzymes from Aspergillus sp. could not hydrolyze buckwheat allergens effectively, and the allergenicity even appeared to increase. CONCLUSIONS: Serine-type peptidases appeared to show a relatively effective reduction of buckwheat allergenicity. However, the antigenicity measured using rabbit antiserum did not correspond to the allergenicity measured using sera from human patients. Production of less allergenic buckwheat protein may be possible using enzymatic hydrolysis.

Erratum: Effects of enzymatic hydrolysis of buckwheat protein on antigenicity and allergenicity

We made a mistake in presenting author affiliations.

Relationship Between Indoor Air Pollutant Levels and Residential Environment in Children With Atopic Dermatitis

PURPOSE: This study was aimed to investigate the relationship between indoor air pollutant levels and residential environment in children with atopic dermatitis (AD) living in Seoul. METHODS: A total of 150 children with AD were included. Residential environment was assessed by questionnaires which were completed by their parents. To evaluate the level of exposure to the indoor air pollutants, concentrations of the indoor air pollutants including particulate matter with diameter less than 10 microm (PM10), formaldehyde, carbon dioxide (CO2), carbon monoxide (CO), nitrogen dioxide (NO2), Total Volatile Organic Compound (TVOC), benzene, toluene, ethyl-benzene, xylene, styrene, bacterial aerosols, and airborne fungi were measured. RESULTS: A significant difference was exhibited in the levels of PM10 in case of visible fungus on the walls (P=0.047). There was relationship between the construction year of the house, moving to a newly constructed building within 1 year and formaldehyde level. With the use of artificial air freshener, the differences were found in the concentrations of TVOC (P=0.003), benzene (P=0.015), toluene (P=0.012) and ethyl-benzene (P=0.027). The concentration of xylene was significantly high when oil was used as heating fuel (P=0.015). Styrene exhibited differences depending on building type and its concentrations were significantly high in a residential and commercial complex building (P=0.005). The indoor concentration of bacterial aerosols was significantly low with the use of air cleaner (P=0.045). High NO2, benzene concentrations were present in case of almost no ventilation (P=0.028 and P=0.028, respectively). CONCLUSIONS: Individual residential environments are closely related with the levels of the indoor air pollutants. To alleviate AD symptoms, simple questions about residential environments such as visible fungus on the walls and the use of artificial air freshener are helpful to assess the possibility of increased indoor air pollutant levels when direct measurement is not available.

Prevalence of Immediate-Type Food Allergy in Early Childhood in Seoul

PURPOSE: There are scanty epidemiologic data on the prevalence of food allergy (FA) among preschool children in Asia. We performed this study to determine the prevalence and causative foods of immediate-type FA in early childhood in Korea. METHODS: A questionnaire-based, cross-sectional study was performed between September and October 2011. Children aged 0-6 years were recruited from 301 public child care centers in Seoul. Parents were asked to complete a questionnaire on FA. Children with FA were classified into "perceived FA, ever," "immediate-type FA, ever," and "immediate-type FA, current" according to the algorithm. RESULTS: A total of 16,749 children were included in this study. The prevalence of "perceived FA, ever," "immediate-type FA, ever," and "immediate-type FA, current" was 15.1%, 7.0%, and 3.7%, respectively. "Immediate-type FA, current" was reported by 182 (4.9%) out of 3,738 children aged < or =2 years, 262 (3.4%) of 7,648 children aged 3-4 years, and 177 (3.3%) of 5,363 children aged 5-6 years. Hen's egg (126/621) was the most frequent cause as the individual food item, followed by cow's milk (82/621) and peanut (58/621). Among the food groups, fruits (114/621), tree nuts (90/621) and crustaceans (85/621) were the most common offending foods. The three leading causes of food-induced anaphylaxis were hen's egg (22/47), cow's milk (15/47), and peanut (14/47). CONCLUSIONS: The prevalence of immediate-type FA in early childhood is 3.7%, and is higher in younger children. The most common offending foods differed with age.