Children of Asian ethnicity in Australia have higher risk of food allergy and early-onset eczema than those in Singapore

Noor H.A. Suaini, Evelyn Xiu Ling Loo, Rachel L. Peters, Gaik Chin Yap, Katrina J. Allen, Hugo Van Bever, David J. Martino, Anne Eng Neo Goh, Shyamali C. Dharmage, Marjorelee T. Colega, Mary Foong Fong Chong, Anne Louise Ponsonby, Kok Hian Tan, Mimi L.K. Tang, Keith M. Godfrey, Bee Wah Lee, Lynette Pei Chi Shek, Jennifer J. Koplin, Elizabeth Huiwen Tham

Research output: Contribution to journalArticlepeer-review

24 Citations (Web of Science)


Background: In Western countries, Asian children have higher food allergy risk than Caucasian children. The early-life environmental exposures for this discrepancy are unclear. We aimed to compare prevalence of food allergy and associated risk factors between Asian children in Singapore and Australia. Methods: We studied children in the Growing Up in Singapore Towards healthy Outcomes (GUSTO) birth cohort (n = 878) and children of Asian ancestry in the HealthNuts cohort (n = 314). Food allergy was defined as a positive SPT ≥3 mm to egg or peanut AND either a convincing history of IgE-mediated reaction at 18 months (GUSTO) or a positive oral food challenge at 14-18 months (HealthNuts). Eczema was defined as parent-reported doctor diagnosis. Results: Food allergy prevalence was 1.1% in Singapore and 15.0% in Australia (P<0.001). Egg introduction was more often delayed (>10 months) in Singapore (63.5%) than Australia (16.3%; P<0.001). Prevalence of early-onset eczema (<6 months) was lower in Singapore (8.4%) than Australia (30.5%) (P<0.001). Children with early-onset eczema were more likely to have food allergy than those without eczema in Australia [aOR 5.11 (2.34-11.14); P<0.001] and Singapore [aOR4.00 (0.62-25.8); P = 0.145]. Conclusions: Among Asian children, prevalence of early-onset eczema and food allergy was higher in Australia than Singapore. Further research with larger sample sizes and harmonized definitions of food allergy between cohorts is required to confirm and extend these findings. Research on environmental factors influencing eczema onset in Australia and Singapore may aid understanding of food allergy pathogenesis in different parts of the world.

Original languageEnglish
Pages (from-to)3171-3182
Number of pages12
JournalAllergy: European Journal of Allergy and Clinical Immunology
Issue number10
Early online date22 Mar 2021
Publication statusPublished - Oct 2021


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