2f:I[703058,["/_next/static/immutable/chunks/3bhq_5eh1d760.js","/_next/static/immutable/chunks/1855-ogyi8eh4.js","/_next/static/immutable/chunks/2pfsjpn6k6zlg.js","/_next/static/immutable/chunks/26c7v3_3uwnwu.js","/_next/static/immutable/chunks/25a3ozcrvi1ff.js","/_next/static/immutable/chunks/2r4wx50nvjh_4.js","/_next/static/immutable/chunks/23fsw06hsi5b1.js","/_next/static/immutable/chunks/06_yt270h41rg.js","/_next/static/immutable/chunks/3ezsiz-7shkna.js","/_next/static/immutable/chunks/20x2y96ldu5wx.js","/_next/static/immutable/chunks/2lxntcm3pd1_h.js","/_next/static/immutable/chunks/00dgco8irq3jw.js","/_next/static/immutable/chunks/00nwe-kq0rboc.js","/_next/static/immutable/chunks/2051ffx3xzio9.js"],"PaperListPageClient"] 30:T737,A total of 190 studies involving 2.8 million participants across 40 countries were analyzed. Among studies using food challenge, overall food allergy incidence was likely 4.7% (moderate certainty). Among 176 studies identifying 342 risk factors with varying certainty, the strongest and most certain factors included prior allergic conditions (eg, atopic dermatitis [eczema] within the first year of life [OR, 3.88; risk difference [RD], 12.0%; 95% CI, 8.8%-15.7%], allergic rhinitis [OR, 3.39; RD, 10.1%; 95% CI, 6.7%-14.4%], and wheeze [OR, 2.11; RD, 5.0%; 95% CI, 2.1%-8.8%]), severity of atopic dermatitis (OR, 1.22; RD, 1.0%; 95% CI, 0.6%-1.6%), increased skin transepidermal water loss (OR, 3.36; RD, 10.0%; 95% CI, 6.3%-14.8%), filaggrin gene sequence variations (OR, 1.93; RD, 4.2%; 95% CI, 2.4%-6.4%), delayed solid food introduction (eg, peanut after age 12 months [OR, 2.55; RD, 6.8%; 95% CI, 1.9%-14.6%]), infant antibiotic use (first month [OR, 4.11; RD, 12.8%; 95% CI, 0.4%-40%], first year [OR, 1.39; RD, 1.8%; 95% CI, 0.8%-3.1%], during pregnancy [OR, 1.32; RD, 1.5%; 95% CI, 0.6%-2.5%]), male sex (OR, 1.24; RD, 1.1%; 95% CI, 0.7%-1.6%), firstborn child (OR, 1.13; RD, 0.6%; 95% CI, 0.3%-1.0%), family history of food allergy (eg, mother [OR, 1.98; RD, 4.4%; 95% CI, 2.5%-6.8%], father [OR, 1.69; RD, 3.2%; 95% CI, 1.3%-5.5%], both parents [OR, 2.07; RD, 4.8%; 95% CI, 1.3%-5.5%], siblings [OR, 2.36; RD, 6.0%; 95% CI, 4.4%-8.0%]), parental migration (OR, 3.28; RD, 9.7%; 95% CI, 4.9%-16.3%), self-identification as Black (vs White [OR, 3.93; RD, 12.1%; 95% CI, 5.2%-22.5%], vs non-Hispanic White [OR, 2.23; RD, 5.5%; 95% CI, 3.0%-8.7%]), and cesarean delivery (OR, 1.16; RD, 1.0%; 95% CI, 0.3%-1.2%). Factors like low birth weight, postterm birth, maternal diet, and stress during pregnancy showed no significant risk difference.31:Tbc5,The incidence and risk (predictive) factors for early life food allergy development remain uncertain. To estimate the incidence and quantify risk factors for food allergy development. MEDLINE and Embase were systematically searched to January 1, 2025. Data were analyzed from June 1, 2025, to November 25, 2025. Incidence estimates included studies confirming food allergy via food challenge. Risk factor analyses included cohort, case-control, and cross-sectional studies in any language assessing children younger than 6 years using multivariable analyses. Paired reviewers independently extracted data. Random-effects meta-analyses pooled incidence and adjusted odds ratios (ORs). Risk of bias was assessed using the QUIPS tool, and certainty of evidence assessed using GRADE. The primary outcome was food allergy to age 6 years. A total of 190 studies involving 2.8 million participants across 40 countries were analyzed. Among studies using food challenge, overall food allergy incidence was likely 4.7% (moderate certainty). Among 176 studies identifying 342 risk factors with varying certainty, the strongest and most certain factors included prior allergic conditions (eg, atopic dermatitis [eczema] within the first year of life [OR, 3.88; risk difference [RD], 12.0%; 95% CI, 8.8%-15.7%], allergic rhinitis [OR, 3.39; RD, 10.1%; 95% CI, 6.7%-14.4%], and wheeze [OR, 2.11; RD, 5.0%; 95% CI, 2.1%-8.8%]), severity of atopic dermatitis (OR, 1.22; RD, 1.0%; 95% CI, 0.6%-1.6%), increased skin transepidermal water loss (OR, 3.36; RD, 10.0%; 95% CI, 6.3%-14.8%), filaggrin gene sequence variations (OR, 1.93; RD, 4.2%; 95% CI, 2.4%-6.4%), delayed solid food introduction (eg, peanut after age 12 months [OR, 2.55; RD, 6.8%; 95% CI, 1.9%-14.6%]), infant antibiotic use (first month [OR, 4.11; RD, 12.8%; 95% CI, 0.4%-40%], first year [OR, 1.39; RD, 1.8%; 95% CI, 0.8%-3.1%], during pregnancy [OR, 1.32; RD, 1.5%; 95% CI, 0.6%-2.5%]), male sex (OR, 1.24; RD, 1.1%; 95% CI, 0.7%-1.6%), firstborn child (OR, 1.13; RD, 0.6%; 95% CI, 0.3%-1.0%), family history of food allergy (eg, mother [OR, 1.98; RD, 4.4%; 95% CI, 2.5%-6.8%], father [OR, 1.69; RD, 3.2%; 95% CI, 1.3%-5.5%], both parents [OR, 2.07; RD, 4.8%; 95% CI, 1.3%-5.5%], siblings [OR, 2.36; RD, 6.0%; 95% CI, 4.4%-8.0%]), parental migration (OR, 3.28; RD, 9.7%; 95% CI, 4.9%-16.3%), self-identification as Black (vs White [OR, 3.93; RD, 12.1%; 95% CI, 5.2%-22.5%], vs non-Hispanic White [OR, 2.23; RD, 5.5%; 95% CI, 3.0%-8.7%]), and cesarean delivery (OR, 1.16; RD, 1.0%; 95% CI, 0.3%-1.2%). Factors like low birth weight, postterm birth, maternal diet, and stress during pregnancy showed no significant risk difference. In this meta-analysis, the most credible risk factors associated with development of childhood food allergy are a combination of major and minor risk factors, including early allergic conditions (atopic march/diathesis), delayed allergen introduction, genetics, antibiotic exposure, demographic factors, and birth-related variables.32:T1148, Importance The incidence and risk (predictive) factors for early life food allergy development remain uncertain. Objective To estimate the incidence and quantify risk factors for food allergy development. Data Sources MEDLINE and Embase were systematically searched to January 1, 2025. Data were analyzed from June 1, 2025, to November 25, 2025. Study Selection Incidence estimates included studies confirming food allergy via food challenge. Risk factor analyses included cohort, case-control, and cross-sectional studies in any language assessing children younger than 6 years using multivariable analyses. Data Extraction and Synthesis Paired reviewers independently extracted data. Random-effects meta-analyses pooled incidence and adjusted odds ratios (ORs). Risk of bias was assessed using the QUIPS tool, and certainty of evidence assessed using GRADE. Main Outcome and Measure The primary outcome was food allergy to age 6 years. Results A total of 190 studies involving 2.8 million participants across 40 countries were analyzed. Among studies using food challenge, overall food allergy incidence was likely 4.7% (moderate certainty). Among 176 studies identifying 342 risk factors with varying certainty, the strongest and most certain factors included prior allergic conditions (eg, atopic dermatitis [eczema] within the first year of life [OR, 3.88; risk difference [RD], 12.0%; 95% CI, 8.8%-15.7%], allergic rhinitis [OR, 3.39; RD, 10.1%; 95% CI, 6.7%-14.4%], and wheeze [OR, 2.11; RD, 5.0%; 95% CI, 2.1%-8.8%]), severity of atopic dermatitis (OR, 1.22; RD, 1.0%; 95% CI, 0.6%-1.6%), increased skin transepidermal water loss (OR, 3.36; RD, 10.0%; 95% CI, 6.3%-14.8%), filaggrin gene sequence variations (OR, 1.93; RD, 4.2%; 95% CI, 2.4%-6.4%), delayed solid food introduction (eg, peanut after age 12 months [OR, 2.55; RD, 6.8%; 95% CI, 1.9%-14.6%]), infant antibiotic use (first month [OR, 4.11; RD, 12.8%; 95% CI, 0.4%-40%], first year [OR, 1.39; RD, 1.8%; 95% CI, 0.8%-3.1%], during pregnancy [OR, 1.32; RD, 1.5%; 95% CI, 0.6%-2.5%]), male sex (OR, 1.24; RD, 1.1%; 95% CI, 0.7%-1.6%), firstborn child (OR, 1.13; RD, 0.6%; 95% CI, 0.3%-1.0%), family history of food allergy (eg, mother [OR, 1.98; RD, 4.4%; 95% CI, 2.5%-6.8%], father [OR, 1.69; RD, 3.2%; 95% CI, 1.3%-5.5%], both parents [OR, 2.07; RD, 4.8%; 95% CI, 1.3%-5.5%], siblings [OR, 2.36; RD, 6.0%; 95% CI, 4.4%-8.0%]), parental migration (OR, 3.28; RD, 9.7%; 95% CI, 4.9%-16.3%), self-identification as Black (vs White [OR, 3.93; RD, 12.1%; 95% CI, 5.2%-22.5%], vs non-Hispanic White [OR, 2.23; RD, 5.5%; 95% CI, 3.0%-8.7%]), and cesarean delivery (OR, 1.16; RD, 1.0%; 95% CI, 0.3%-1.2%). Factors like low birth weight, postterm birth, maternal diet, and stress during pregnancy showed no significant risk difference. Conclusions and Relevance In this meta-analysis, the most credible risk factors associated with development of childhood food allergy are a combination of major and minor risk factors, including early allergic conditions (atopic march/diathesis), delayed allergen introduction, genetics, antibiotic exposure, demographic factors, and birth-related variables. 25:[[["$","script","0",{"type":"application/ld+json","dangerouslySetInnerHTML":{"__html":"{\"@context\":\"https://schema.org\",\"@type\":\"CollectionPage\",\"name\":\"Allergen Introduction Timing: modality Research & Clinical Takeaways\",\"description\":\"Explore peer-reviewed papers on Allergen Introduction Timing (modality). Clinician-written summaries and actionable practice insights. 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DeGroote School of Medicine, McMaster University, Hamilton, Ontario, Canada"}]},{"given":"Leonardo","family":"Ologundudu","sequence":"additional","affiliation":[{"name":"Michael G. DeGroote School of Medicine, McMaster University, Hamilton, Ontario, Canada"}]},{"given":"Keerthana","family":"Pasumarthi","sequence":"additional","affiliation":[{"name":"Department of Medicine, University of Toronto, Toronto, Ontario, Canada"}]},{"given":"Syed Fahad","family":"Farooq","sequence":"additional","affiliation":[{"name":"Department of Health Research Methods, Evidence and Impact, McMaster University, Hamilton, Ontario, Canada"}]},{"given":"Kyle","family":"Tong","sequence":"additional","affiliation":[{"name":"Faculty of Medicine, University of Ottawa, Ottawa, Ontario, Canada"}]},{"given":"Wang-Choi","family":"Tang","sequence":"additional","affiliation":[{"name":"Department of Health Research Methods, Evidence and Impact, McMaster University, Hamilton, Ontario, Canada"}]},{"given":"Haseeb","family":"Faisal","sequence":"additional","affiliation":[{"name":"Department of Medicine, McMaster University, Hamilton, Ontario, Canada"}]},{"given":"Muhammad Faran","family":"Khalid","sequence":"additional","affiliation":[{"name":"Department of Health Research Methods, Evidence and Impact, McMaster University, Hamilton, Ontario, Canada"}]},{"given":"Mohammad Saad","family":"Asif","sequence":"additional","affiliation":[{"name":"Department of Health Research Methods, Evidence and Impact, McMaster University, Hamilton, Ontario, Canada"}]},{"given":"Shannon","family":"French","sequence":"additional","affiliation":[{"name":"Department of Medicine, McMaster University, Hamilton, Ontario, Canada"},{"name":"Department of Pediatrics, McMaster University, Hamilton, Ontario, Canada"}]},{"given":"Susan","family":"Waserman","sequence":"additional","affiliation":[{"name":"Department of Medicine, McMaster University, Hamilton, Ontario, Canada"}]},{"given":"R. Sharon","family":"Chinthrajah","sequence":"additional","affiliation":[{"name":"Sean N. Parker Center for Allergy and Asthma Research, Stanford University, Palo Alto, California"}]},{"given":"Hugh A.","family":"Sampson","sequence":"additional","affiliation":[{"name":"Jaffe Food Allergy Institute, Division of Pediatric Allergy and Immunology, Department of Pediatrics, Icahn School of Medicine at Mount Sinai, New York, New York"}]},{"given":"S. Shahzad","family":"Mustafa","sequence":"additional","affiliation":[{"name":"Department of Medicine, Rochester Regional Health, Rochester, New York"},{"name":"Division of Allergy, Immunology, and Rheumatology, University of Rochester School of Medicine and Dentistry, Rochester, New York"}]},{"given":"Jay A.","family":"Lieberman","sequence":"additional","affiliation":[{"name":"Division of Pulmonology, Allergy and Immunology, Department of Pediatrics, The University of Tennessee Health Science Center, Le Bonheur Children’s Hospital, Memphis"}]},{"given":"Kirsi M.","family":"Järvinen","sequence":"additional","affiliation":[{"name":"Center for Food Allergy, Division of Allergy and Immunology, Department of Pediatrics, University of Rochester Medical Center, Rochester, New York"}]},{"given":"Sally","family":"Bailey","sequence":"additional","affiliation":[{"name":"Division of Pediatric Allergy and Immunology, Department of Pediatrics, Georgetown University, Washington, 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Accessed August 27, 2024. https://foodallergycanada.ca/wp-content/uploads/FAC-NationalStrategy-ENG-Online-July2019.pdf","article-title":null,"journal-title":null,"doi-asserted-by":null}],"short-title":[],"journal-issue":{"issue":"5","published-print":{"date-parts":[[2026,5,1]]}},"content-domain":{"domain":[],"crossmark-restriction":false},"original-title":[],"container-title":["JAMA Pediatrics"],"published-print":{"date-parts":[[2026,5,1]]},"reference-count":232,"published-online":null,"references-count":232,"short-container-title":["JAMA Pediatr"],"is-referenced-by-count":2},"unpaywall":{"doi":"10.1001/jamapediatrics.2025.6105","is_oa":true,"title":"Risk Factors for the Development of Food Allergy in Infants and Children","updated":"2026-02-13T15:49:00+00:00","published_date":"2026-02-09","best_oa_location":{"url":"https://jamanetwork.com/journals/jamapediatrics/articlepdf/2844828/jamapediatrics_islam_2026_oi_250086_1770061299.49692.pdf","pmh_id":null,"url_for_pdf":"https://jamanetwork.com/journals/jamapediatrics/articlepdf/2844828/jamapediatrics_islam_2026_oi_250086_1770061299.49692.pdf","url_for_landing_page":"https://doi.org/10.1001/jamapediatrics.2025.6105"}}},"created_at":"2026-05-07T22:49:16.880Z","updated_at":"2026-05-14T15:13:26.918Z","tags":[{"paper_doi":"10.1001/jamapediatrics.2025.6105","tag_type":"age_group","value":"infant","value_numeric":null},{"paper_doi":"10.1001/jamapediatrics.2025.6105","tag_type":"age_group","value":"pediatric","value_numeric":null},{"paper_doi":"10.1001/jamapediatrics.2025.6105","tag_type":"category","value":"Pediatrics","value_numeric":null},{"paper_doi":"10.1001/jamapediatrics.2025.6105","tag_type":"condition","value":"Allergic Rhinitis","value_numeric":null},{"paper_doi":"10.1001/jamapediatrics.2025.6105","tag_type":"condition","value":"Atopic Dermatitis","value_numeric":null},{"paper_doi":"10.1001/jamapediatrics.2025.6105","tag_type":"condition","value":"Food Allergy","value_numeric":null},{"paper_doi":"10.1001/jamapediatrics.2025.6105","tag_type":"impact_flag","value":"practice_changing","value_numeric":null},{"paper_doi":"10.1001/jamapediatrics.2025.6105","tag_type":"level_of_evidence","value":"1","value_numeric":null},{"paper_doi":"10.1001/jamapediatrics.2025.6105","tag_type":"modality","value":"Allergen Introduction Timing","value_numeric":null},{"paper_doi":"10.1001/jamapediatrics.2025.6105","tag_type":"modality","value":"Antibiotic Exposure","value_numeric":null},{"paper_doi":"10.1001/jamapediatrics.2025.6105","tag_type":"sample_size","value":"n=2,800,000","value_numeric":2800000},{"paper_doi":"10.1001/jamapediatrics.2025.6105","tag_type":"sex","value":"mixed","value_numeric":null},{"paper_doi":"10.1001/jamapediatrics.2025.6105","tag_type":"study_design","value":"Systematic Review and Meta-Analysis","value_numeric":null},{"paper_doi":"10.1001/jamapediatrics.2025.6105","tag_type":"warning","value":"Race/ethnicity risk estimates (e.g., Black vs. White) reflect self-identification categories and may carry unmeasured confounding related to environmental or healthcare access factors.","value_numeric":null},{"paper_doi":"10.1001/jamapediatrics.2025.6105","tag_type":"warning","value":"Sample size of 2.8 million is an aggregate across 190 heterogeneous studies, not a single cohort — individual study designs varied (cohort, case-control, cross-sectional).","value_numeric":null},{"paper_doi":"10.1001/jamapediatrics.2025.6105","tag_type":"warning","value":"The first-month antibiotic use risk difference has an extremely wide CI (0.4%–40%), meaning that estimate should be interpreted cautiously.","value_numeric":null},{"paper_doi":"10.1001/jamapediatrics.2025.6105","tag_type":"warning","value":"The paper was published February 9, 2026, with data analysis through November 2025 — this is a future date relative to typical indexing; no content anomalies were identified, but the timeline is noted.","value_numeric":null}],"summaries":{"what_studied":"This systematic review and meta-analysis estimated the incidence of and risk factors for food allergy development in children under 6 years, pooling data from 190 studies (2.8 million participants across 40 countries) up to January 2025.","key_result":"Food allergy incidence was ~4.7% (moderate certainty, challenge-confirmed). The strongest risk factors included early atopic dermatitis (OR 3.88; RD 12.0%), self-identification as Black vs. White (OR 3.93; RD 12.1%), antibiotic use in the first month of life (OR 4.11; RD 12.8%), parental migration (OR 3.28; RD 9.7%), and delayed peanut introduction after 12 months (OR 2.55; RD 6.8%). Factors like low birth weight, maternal diet, and prenatal stress showed no significant risk difference.","limitations":"- Wide CIs on several key estimates (e.g., first-month antibiotic use RD 0.4%–40%) reflect substantial heterogeneity and limit precision.\n- Most risk factor studies were observational (cohort, case-control, cross-sectional), limiting causal inference.\n- Certainty of evidence varied widely across the 342 risk factors identified.","practice_takeaway":"Introduce allergenic solids (e.g., peanut) before 12 months and avoid unnecessary early-life antibiotics to reduce food allergy risk. Infants with eczema, especially severe or early-onset, need prompt attention given a 3–4× higher odds of food allergy."}}],"initialOffset":1,"fetchConfig":{"kind":"tags","tags":[{"tag_type":"modality","value":"Allergen Introduction Timing"}]},"breadcrumbItems":[{"name":"Home","href":"/"},{"name":"Research Hub","href":"/hub"},{"name":"Modalities","href":"/hub/tag/modality"},{"name":"Allergen Introduction Timing"}],"hrefConfig":{"basePath":"/hub/papers","webViewQueryParams":{"hub_ctx":"tag","hub_tag_type":"modality","hub_tag_value":"Allergen Introduction Timing"}}}]]

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