Food allergy epidemic - is it only a western phenomenon?

The incidence and prevalence of allergic disease such as asthma, eczema and allergic rhinitis is widely reported to have increased over the past few decades, particularly in the developed world. Patient and public awareness of food allergy is also increasing. While most of the medical literature around food allergy focuses on the western world, there is also an increasing amount of evidence that food allergy (FA) is prevalent outside of the developed world. The true prevalence and morbidity of FA in the developing world is largely unknown. A literature review of the worldwide incidence of FA was undertaken with emphasis on the paediatric age group, for developing areas in Asia, Latin America and Africa to assess whether or not the 'food allergy epidemic' is a western phenomenon. We found that there are too few data using food challenges, the accepted gold standard, for the diagnosis of true FA to come to any conclusions either about the current prevalence of FA or whether it is rising. Robust, population-based studies are needed to establish the true burden of disease.