Prevalence of food allergy and its association with atopic dermatitis in Iran: Results from the PERSIAN birth cohort.

Background: The incidence of food allergy (FA) has been increasing worldwide, causing growing concern on a global scale. Objective: This birth cohort study analyzes the incidence of reported FA and other atopic comorbidities in children from birth to age 2 years who were living in 4 urban and semiurban areas in Iran. Methods: Children were followed from birth until age 24 months, with follow-up questionnaires administered through parent or guardian interviews conducted when the children were aged 2, 4, 6, 12, and 24 months. Results: The rate of physician-diagnosed FA reported by parents or guardians was higher than expected, with a cumulative incidence of 7.7% in children younger than 24 months. The highest prevalence of FA was found in Yazd, the most urban of the 4 cities studied. Breast-feeding was associated with a decreased cumulative risk of FA at age 12 months, with only 5% of breast-fed children developing parent-reported pediatrician-diagnosed FA compared with 13% of infants who never received breast milk after birth. Conclusion: This study provides valuable insight into the incidence of FA in the Middle East, which has previously not been reported on, and it is crucial in our understanding of global FA prevalence. The study demonstrates a high incidence of FA in an area with historically lower rates and confirms that breast-feeding does prevent FA during infancy in this population.