Prevalence of Immediate-Type Food Allergy and Food-Induced Anaphylaxis in Korean Schoolchildren

초록

Purpose: This study assessed the prevalence, major triggers, and risk factors of food allergy (FA) and food-induced anaphylaxis among Korean school-aged children. Methods: In 2022, a nationwide school-based survey was conducted using a structured questionnaire. Cluster sampling yielded a representative sample of 12,558 students aged 6–7, 9–10, and 12–13 years from 213 elementary and 103 middle schools in Korea. Results: The prevalence of self-reported perceived FA was 15.3%; recurrent immediate-type (< 4 hours) FA, 7.8%; and physician-diagnosed FA, 5.5%, with food-induced anaphylaxis in 0.7% of cases. The leading allergens for recurrent immediate-type FA were peach (1.13%), milk (0.82%), egg (0.79%), kiwi (0.65%), walnut (0.62%), peanut (0.62%), apple (0.61%), crab (0.59%), shrimp (0.54%), and pineapple (0.33%). By food group, fruits (3.67%) were most frequent, followed by crustaceans (1.20%), and tree nuts (1.18%). Major anaphylaxis triggers included egg (0.19%), milk (0.11%), walnut (0.10%), peanut (0.09%), and peach (0.06%). Fruit allergy was more common in older age groups, accompanied by increased oral allergy symptoms, suggesting a rising burden of pollen FA syndrome. In these groups, crustaceans were also major allergens. Among tree nuts, walnut was the most common. Perilla seed, a uniquely observed allergen in Korea, had prevalences of 0.11% for allergy and 0.02% for perilla seed-induced anaphylaxis. Multiple food allergies were reported by 29.9% of children with FA. Significant risk factors included paternal allergic disease, parental history of FA, delayed complementary food introduction (≥ 7 months), prolonged breastfeeding (≥ 7 months), and current allergic diseases, particularly atopic dermatitis. Conclusions: In Korean school-aged children, recurrent immediate-type FA and food-induced anaphylaxis affect 7.8% and 0.7%, respectively. Fruits, milk, egg, tree nuts, and peanuts are the most common triggers, with notable age-related differences. These findings underscore the need for continued surveillance, early identification of high-risk groups, and targeted prevention and management strategies. Copyright © 2026 The Korean Academy of Asthma, Allergy and Clinical Immunology · The Korean Academy of Pediatric Allergy and Respiratory Disease This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (https://creativecommons.org/licenses/by-nc/4.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

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