Quality Of Life In Food Hypersensitive Schoolchildren And Their Families
Quality Of Life In Food Hypersensitive Schoolchildren And Their Families
Background: About 20% of schoolchildren and adolescents in Sweden suffer from perceived food hypersensitivity (e.g. allergy or intolerance). Our knowledge of how child food hypersensitivity affects parents HRQL and what aspects of the hypersensitivity condition relate to HRQL deterioration in the family is limited. Thus the aim of this study was to investigate the parent-reported HRQL in families with a schoolchild considered to be food hypersensitive. The allergy-associated parameters we operated with were number of offending food items, adverse food reactions, additional hypersensitivity, allergic diseases and additional family members with food hypersensitivity. These parameters, along with age and gender were assessed in relation to child, parent and family HRQL.
Methods: In May 2004, a postal questionnaire was distributed to parents of 220 schoolchildren with parent-reported food hypersensitivity (response rate 74%). Two questionnaires were used: CHQ-PF28 and a study-specific questionnaire including questions on allergy-associated parameters. In order to find factors that predict impact on HRQL, stepwise multiple linear regression analyses were carried out.
Results: An important predictor of low HRQL was allergic disease (i.e. asthma, eczema, rhino conjunctivitis) in addition to food hypersensitivity. The higher the number of allergic diseases, the lower the physical HRQL for the child, the lower the parental HRQL and the more disruption in family activities. Male gender predicted lower physical HRQL than female gender. If the child had sibling(s) with food hypersensitivity this predicted lower psychosocial HRQL for the child and lower parental HRQL. Food-induced gastro-intestinal symptoms predicted lower parental HRQL while food-induced breathing difficulties predicted higher psychosocial HRQL for the child and enhanced HRQL with regards to the family's ability to get along.
Conclusion: The variance in the child's physical HRQL was to a considerable extent explained by the presence of allergic disease. However, food hypersensitivity by itself was associated with deterioration of child's psychosocial HRQL, regardless of additional allergic disease. The results suggest that it is rather the risk of food reactions and measures to avoid them that are associated with lower HRQL than the clinical reactivity induced by food intake. Therefore, food hypersensitivity must be considered to have a strong psychosocial impact.
About 20% of schoolchildren and adolescents in Sweden suffer from perceived hypersensitivity (e.g. allergy or intolerance) to defined food items. The way such allergy-associated condition is manifested varies extensively depending on the specific foods and the type of reactions and symptoms that the child has. Adverse reactions to food can result in either immediate or delayed problems depending on the mechanism underlying the reaction. Food reactions can range from mild (e.g. mild itching or redness around the mouth), unpleasant and scary (e.g. intense stomach pains or asthma) to systemic reactions severe enough to be fatal (i.e. anaphylaxis). As there is no satisfying treatment for most kinds of food hypersensitivity individuals have to manage their problems by themselves and, if possible, try to avoid the offending food.
It is not uncommon that individuals with food hypersensitivity have other hypersensitivities or allergy-associated problems as well. Food allergy is associated with other manifestations of atopy, such as urticaria, asthma, atopic eczema and hay fever. Our previous study showed that 78% of food hypersensitive Swedish schoolchildren may experience such symptoms that can be related to asthma, eczema and/or rhino conjunctivitis A number of studies describe deterioration of the health-related quality of life (HRQL) in children. and adults with the allergic diseases asthma, eczema and rhinitis. However, physical and organ-related measures and tests do not always correlate with HRQL scores. Thus there is no absolute coherence between the biomedical severity of the allergy-associated condition and quality of life.
In recent years there have been a number of studies that show that food hypersensitivity impair the HRQL of individuals and even their families. Our recent school survey showed that those young individuals who, in addition to their food related problems suffered from other allergy-associated conditions, reported a greater impact on the physical life quality dimension than those without such chronic problems. The psychosocial impact of food hypersensitivity was however reported equally low regardless of other allergy-associated conditions. Avery et al have shown that children with peanut allergy have a poorer HRQL, apparently related to anxiety, compared with children with diabetes. Studies from Sicherer et al and Primeau et al have demonstrated a psychosocial impact of food allergy on quality of life on both the child and its family. It has also been shown that the parents of food allergic children experience more distress and worry, and also more interruptions and limitations in usual family activities, compared with a US population sample. Furthermore, the parents of peanut-allergic children report significantly more disruption in the child's daily activities and in their familial-social interactions than parents of children with rheumatological diseases.
It is first and foremost the children's parents who are responsible for not exposing their children to potentially dangerous dietary products, and food hypersensitivity in a child often leads to the whole family having to adapt to new food and eating practices. Yet, little is known of how child food hypersensitivity affects parents' HRQL and what aspects of the hypersensitivity condition relate to HRQL deterioration in the family. Thus the aim of the study was to investigate the parent-reported HRQL in families with a schoolchild considered to be food hypersensitive. The following research questions were addressed:
Allergy-associated parameters in this study include number of offending food items, adverse food reactions, additional hypersensitivities, allergic diseases and additional family members with food hypersensitivity.
Background: About 20% of schoolchildren and adolescents in Sweden suffer from perceived food hypersensitivity (e.g. allergy or intolerance). Our knowledge of how child food hypersensitivity affects parents HRQL and what aspects of the hypersensitivity condition relate to HRQL deterioration in the family is limited. Thus the aim of this study was to investigate the parent-reported HRQL in families with a schoolchild considered to be food hypersensitive. The allergy-associated parameters we operated with were number of offending food items, adverse food reactions, additional hypersensitivity, allergic diseases and additional family members with food hypersensitivity. These parameters, along with age and gender were assessed in relation to child, parent and family HRQL.
Methods: In May 2004, a postal questionnaire was distributed to parents of 220 schoolchildren with parent-reported food hypersensitivity (response rate 74%). Two questionnaires were used: CHQ-PF28 and a study-specific questionnaire including questions on allergy-associated parameters. In order to find factors that predict impact on HRQL, stepwise multiple linear regression analyses were carried out.
Results: An important predictor of low HRQL was allergic disease (i.e. asthma, eczema, rhino conjunctivitis) in addition to food hypersensitivity. The higher the number of allergic diseases, the lower the physical HRQL for the child, the lower the parental HRQL and the more disruption in family activities. Male gender predicted lower physical HRQL than female gender. If the child had sibling(s) with food hypersensitivity this predicted lower psychosocial HRQL for the child and lower parental HRQL. Food-induced gastro-intestinal symptoms predicted lower parental HRQL while food-induced breathing difficulties predicted higher psychosocial HRQL for the child and enhanced HRQL with regards to the family's ability to get along.
Conclusion: The variance in the child's physical HRQL was to a considerable extent explained by the presence of allergic disease. However, food hypersensitivity by itself was associated with deterioration of child's psychosocial HRQL, regardless of additional allergic disease. The results suggest that it is rather the risk of food reactions and measures to avoid them that are associated with lower HRQL than the clinical reactivity induced by food intake. Therefore, food hypersensitivity must be considered to have a strong psychosocial impact.
About 20% of schoolchildren and adolescents in Sweden suffer from perceived hypersensitivity (e.g. allergy or intolerance) to defined food items. The way such allergy-associated condition is manifested varies extensively depending on the specific foods and the type of reactions and symptoms that the child has. Adverse reactions to food can result in either immediate or delayed problems depending on the mechanism underlying the reaction. Food reactions can range from mild (e.g. mild itching or redness around the mouth), unpleasant and scary (e.g. intense stomach pains or asthma) to systemic reactions severe enough to be fatal (i.e. anaphylaxis). As there is no satisfying treatment for most kinds of food hypersensitivity individuals have to manage their problems by themselves and, if possible, try to avoid the offending food.
It is not uncommon that individuals with food hypersensitivity have other hypersensitivities or allergy-associated problems as well. Food allergy is associated with other manifestations of atopy, such as urticaria, asthma, atopic eczema and hay fever. Our previous study showed that 78% of food hypersensitive Swedish schoolchildren may experience such symptoms that can be related to asthma, eczema and/or rhino conjunctivitis A number of studies describe deterioration of the health-related quality of life (HRQL) in children. and adults with the allergic diseases asthma, eczema and rhinitis. However, physical and organ-related measures and tests do not always correlate with HRQL scores. Thus there is no absolute coherence between the biomedical severity of the allergy-associated condition and quality of life.
In recent years there have been a number of studies that show that food hypersensitivity impair the HRQL of individuals and even their families. Our recent school survey showed that those young individuals who, in addition to their food related problems suffered from other allergy-associated conditions, reported a greater impact on the physical life quality dimension than those without such chronic problems. The psychosocial impact of food hypersensitivity was however reported equally low regardless of other allergy-associated conditions. Avery et al have shown that children with peanut allergy have a poorer HRQL, apparently related to anxiety, compared with children with diabetes. Studies from Sicherer et al and Primeau et al have demonstrated a psychosocial impact of food allergy on quality of life on both the child and its family. It has also been shown that the parents of food allergic children experience more distress and worry, and also more interruptions and limitations in usual family activities, compared with a US population sample. Furthermore, the parents of peanut-allergic children report significantly more disruption in the child's daily activities and in their familial-social interactions than parents of children with rheumatological diseases.
It is first and foremost the children's parents who are responsible for not exposing their children to potentially dangerous dietary products, and food hypersensitivity in a child often leads to the whole family having to adapt to new food and eating practices. Yet, little is known of how child food hypersensitivity affects parents' HRQL and what aspects of the hypersensitivity condition relate to HRQL deterioration in the family. Thus the aim of the study was to investigate the parent-reported HRQL in families with a schoolchild considered to be food hypersensitive. The following research questions were addressed:
How do parents of a food hypersensitive child perceive the child's, their own and the family's HRQL?
To what extent do allergy-associated parameters, age and gender relate to child, parent and family HRQL?
Allergy-associated parameters in this study include number of offending food items, adverse food reactions, additional hypersensitivities, allergic diseases and additional family members with food hypersensitivity.
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