Evidence map›Paper›PMID 41661638›Full record

SynthesisJAMA pediatrics2026

Risk Factors for the Development of Food Allergy in Infants and Children: A Systematic Review and Meta-Analysis.

Nazmul Islam, Alexandro W L Chu, Falana Sheriff, Farid Foroutan, Gordon H Guyatt, Romina Brignardello-Petersen, Paul Oykhman, Alfonso Iorio, Ariel Izcovich, Katherine M Morrison and 34 more

Abstract readSystematic ReviewMeta-Analysis
PubMed Full text at PMC Publisher
In one paragraph

Synthesis in JAMA pediatrics, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 7 papers.

0numbers the graph read from it
0cells of the map it votes in
7citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

7 citing papers in PubMed.

  1. Review
  2. Taste aversion and adverse events contribute equally to OIT discontinuation in children: A real-world multi-allergen analysis.Pediatric allergy and immunology : official publication of the European Society of Pediatric Allergy and Immunology · 2026
    Observational
  3. Review
  4. Review
  5. Review
  6. Article
  7. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

44 authors.

Nazmul IslamEvidence in Allergy Group, McMaster University, Hamilton, Ontario, Canada.
Alexandro W L ChuEvidence in Allergy Group, McMaster University, Hamilton, Ontario, Canada.
Falana SheriffEvidence in Allergy Group, McMaster University, Hamilton, Ontario, Canada.
Farid ForoutanDepartment of Health Research Methods, Evidence and Impact, McMaster University, Hamilton, Ontario, Canada.
Gordon H GuyattDepartment of Health Research Methods, Evidence and Impact, McMaster University, Hamilton, Ontario, Canada.
Romina Brignardello-PetersenDepartment of Health Research Methods, Evidence and Impact, McMaster University, Hamilton, Ontario, Canada.
Paul OykhmanDepartment of Medicine, McMaster University, Hamilton, Ontario, Canada.
Alfonso IorioDepartment of Health Research Methods, Evidence and Impact, McMaster University, Hamilton, Ontario, Canada.
Ariel IzcovichFaculty of Medicine, Universidad del Salvador, Buenos Aires, Argentina.
Katherine M MorrisonDepartment of Pediatrics, McMaster University, Hamilton, Ontario, Canada.
Yetiani Roldan BenitezEvidence in Allergy Group, McMaster University, Hamilton, Ontario, Canada.
Rachel J CoubanDepartment of Anesthesia, McMaster University, Hamilton, Ontario, Canada.
Dorota BorovskyDepartment of Medicine, McMaster University, Hamilton, Ontario, Canada.
Yiming ZhangMichael G. DeGroote School of Medicine, McMaster University, Hamilton, Ontario, Canada.
Leonardo OlogunduduMichael G. DeGroote School of Medicine, McMaster University, Hamilton, Ontario, Canada.
Keerthana PasumarthiDepartment of Medicine, University of Toronto, Toronto, Ontario, Canada.
Syed Fahad FarooqDepartment of Health Research Methods, Evidence and Impact, McMaster University, Hamilton, Ontario, Canada.
Kyle TongFaculty of Medicine, University of Ottawa, Ottawa, Ontario, Canada.
Wang-Choi TangDepartment of Health Research Methods, Evidence and Impact, McMaster University, Hamilton, Ontario, Canada.
Haseeb FaisalDepartment of Medicine, McMaster University, Hamilton, Ontario, Canada.
Muhammad Faran KhalidDepartment of Health Research Methods, Evidence and Impact, McMaster University, Hamilton, Ontario, Canada.
Mohammad Saad AsifDepartment of Health Research Methods, Evidence and Impact, McMaster University, Hamilton, Ontario, Canada.
Shannon FrenchDepartment of Medicine, McMaster University, Hamilton, Ontario, Canada.
Susan WasermanDepartment of Medicine, McMaster University, Hamilton, Ontario, Canada.
R Sharon ChinthrajahSean N. Parker Center for Allergy and Asthma Research, Stanford University, Palo Alto, California.
Hugh A SampsonJaffe Food Allergy Institute, Division of Pediatric Allergy and Immunology, Department of Pediatrics, Icahn School of Medicine at Mount Sinai, New York, New York.
S Shahzad MustafaDepartment of Medicine, Rochester Regional Health, Rochester, New York.
Jay A LiebermanDivision of Pulmonology, Allergy and Immunology, Department of Pediatrics, The University of Tennessee Health Science Center, Le Bonheur Children's Hospital, Memphis.
Kirsi M JärvinenCenter for Food Allergy, Division of Allergy and Immunology, Department of Pediatrics, University of Rochester Medical Center, Rochester, New York.
Sally BaileyDivision of Pediatric Allergy and Immunology, Department of Pediatrics, Georgetown University, Washington, DC.
Philippe BéginCentre Hospitalier Universitaire Sainte-Justine, Montréal, Québec, Canada.
Scott H SichererJaffe Food Allergy Institute, Serena and John Liew Division of Pediatric Allergy and Immunology, Icahn School of Medicine at Mount Sinai, New York, New York.
Jennifer GerdtsFood Allergy Canada, Toronto, Ontario, Canada.
Melanie CarverThe Asthma and Allergy Foundation of America, Arlington, Virginia.
Lynda MitchellAllergy and Asthma Network, Fairfax, Virginia.
Kelly ClearyFood Allergy Research and Education, McLean, Virginia.
Matthew J GreenhawtFood Allergy Research and Education, McLean, Virginia.
Julie WangJaffe Food Allergy Institute, Division of Pediatric Allergy and Immunology, Department of Pediatrics, Icahn School of Medicine at Mount Sinai, New York, New York.
Aikaterini AnagnostouDivision of Allergy and Immunology, Department of Pediatrics, Baylor College of Medicine, Houston, Texas.
Marcus S ShakerDepartment of Pediatrics and Department of Medicine, Geisel School of Medicine at Dartmouth, Lebanon, New Hampshire.
Anita Chandra-PuriDivision of Community-Based Primary Care, Department of Pediatrics, Northwestern University Feinberg School of Medicine, Chicago, Illinois.
Patricia C FulkersonUS National Institute of Allergy and Infectious Diseases, Bethesda, Maryland.
Robert A WoodDivision of Allergy and Immunology, Department of Pediatrics, Johns Hopkins University School of Medicine, Baltimore, Madison.
Derek K ChuEvidence in Allergy Group, McMaster University, Hamilton, Ontario, Canada.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

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.

Indexed as

Food HypersensitivityChildChild, PreschoolFilaggrin ProteinsHumansIncidenceInfantRisk FactorsFilaggrin ProteinsFLG protein, human

Identifiers

PMID41661638
PMCPMC12887841

What Socratic holds

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LicenceCC BY
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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.