The influence of cultural attitudes to nut exposure on reported nut allergy: A pilot cross sectional study.

Food allergies in children have become a common management and diagnostic concern and have a significant influence on general health-related quality of life. We investigated the prevalence of reported nut allergy between populations with different cultural attitudes to nuts during pregnancy and infancy. We conducted a survey to investigate the relationship between cultural differences in the consumption of nuts during pregnancy, breastfeeding and exposure to nuts in early childhood against the reported prevalence of nut allergy between three populations: Libyan, UK Libyan and a general UK population. The survey was administered to a representative sample of UK and Libyan parents with children aged between 3 and 16 years who were asked to report prevalence of nut allergy and to describe the factors that might affect this such as cultural behaviours and diet. A total of 1,123 parents responded. Nut allergy was defined as an allergic reaction that required medical treatment. The reported rates of nut allergy showed a significant difference in nut allergy between the Libyan populations and the general UK population with an increased odds ratio of nut allergy of ~10 when comparing the Native Libyan population to the UK population. The UK Libyan population reported the same low rate of allergic reactions as the Libyan population which were both significantly lower than the UK population (p < .0001). The Libyan populations showed significant differences from the UK population in exposure to nuts during pregnancy, breastfeeding and early infancy. The development of peanut and almond allergy through tolerance induction could be prevented by frequent and early ingestion of a moderate quantity of nuts during infancy and by maternal ingestion during pregnancy or lactation.