Association of Food Allergy and Other Allergic Conditions with Autism Spectrum Disorder in Children
Open accessAbstract
Importance: The prevalence of autism spectrum disorder (ASD) in US children has increased during the past decades. Immunologic dysfunction has recently emerged as a factor associated with ASD. Although children with ASD are more likely to have gastrointestinal disorders, little is known about the association between food allergy and ASD. Objective: To examine the association of food allergy and other allergic conditions with ASD in US children. Design, Setting, and Participants: This population-based, cross-sectional study used data from the National Health Interview Survey collected between 1997 and 2016. The data analysis was performed in 2018. All eligible children aged 3 to 17 years were included. Food allergy, respiratory allergy, and skin allergy were defined based on an affirmative response in the questionnaire by a parent or guardian. Main Outcomes and Measures: Reported ASD diagnosed by a physician or other health professional. Results: This analysis included 199 520 children (unweighted mean [SD] age, 10.21 [4.41] years; 102 690 boys [51.47%]; 55 476 Hispanic [27.80%], 97 200 non-Hispanic white [48.72%], 30 760 non-Hispanic black [15.42%], and 16 084 non-Hispanic other race [8.06%]). Among them, 8734 (weighted prevalence, 4.31%) had food allergy, 24 555 (12.15%) had respiratory allergy, and 19 399 (9.91%) had skin allergy. A diagnosis of ASD was reported in 1868 children (0.95%). The weighted prevalence of reported food, respiratory, and skin allergies was higher in children with ASD (11.25%, 18.73%, and 16.81%, respectively) compared with children without ASD (4.25%, 12.08%, and 9.84%, respectively). In analyses adjusting for age, sex, race/ethnicity, family highest education level, family income level, geographical region, and mutual adjustment for other allergic conditions, the associations between allergic conditions and ASD remained significant. The odds ratio (OR) of ASD increased in association with food allergy (OR, 2.29; 95% CI, 1.87-2.81), respiratory allergy (OR, 1.28; 95% CI, 1.10-1.50), and skin allergy (OR, 1.50; 95% CI, 1.28-1.77) when comparing children with these conditions and those without. Conclusions and Relevance: In a nationally representative sample of US children, a significant and positive association of common allergic conditions, in particular food allergy, with ASD was found. Further investigation is warranted to elucidate the causality and underlying mechanisms.
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Food allergies are more frequently found in children with ASD, with a rate of 20-25% compared to 5-8% in children without ASD.
“Moreover, food allergies are more frequently found in children with ASD, with a rate of 20–25% compared to only 5–8% in children without ASD [72].”
From Unraveling the Connections: Eating Issues, Microbiome, and Gastrointestinal Symptoms in Autism Spectrum Disorder (2025) · cites this paper as [72]
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- Authors
- Xu, G., Snetselaar, L. G., Jing, J., Liu, B., Strathearn, L., & Bao, W.
- Affiliations
- University of Iowa (US)
- Department of Maternal and Child Health, School of Public Health, Sun Yat-Sen University, Guangzhou, China
- Corresponding author
- Bao, Wei
- Venue
- JAMA Network Open
- Publisher
- American Medical Association (AMA)
- Published
- 2018-06-08
- Volume
- 1
- Issue
- 2
- Pages
- e180279
- ISSN
- 2574-3805 (ISSN-L)
- PMC
- PMC6324407
- OpenAlex
- W2806927106
- Cited by
- 159
- References
- 56
- Citations by year
- 2026: 10 · 2025: 29 · 2024: 23 · 2023: 17 · 2022: 36 · 2021: 17 · 2020: 15 · 2019: 10 · 2018: 2
- FWCI
- 6.54
- Type
- journal article
- Language
- en
- Open access
- gold
- doi.org
- Locations
- JAMA Network Open (publishedVersion)
- Europe PMC (PubMed Central) (publishedVersion, cc-by)
- PubMed Central (publishedVersion, cc-by)
- PubMed (publishedVersion)
- Iowa Research Online (The University of Iowa) (submittedVersion)
- Topics
- Life Sciences › Neuroscience › Cognitive Neuroscience › Autism Spectrum Disorder Research
- Health Sciences › Medicine › Immunology and Allergy › Food Allergy and Anaphylaxis Research
- Health Sciences › Medicine › Psychiatry and Mental health › Child Nutrition and Feeding Issues
- Keywords
- autism spectrum disorder, food allergy, allergic diseases, respiratory allergy, skin allergy, children, prevalence, immune dysfunction, gastrointestinal diseases, comorbidities, National Health Interview Survey, racial and ethnic disparities, socioeconomic factors, parental education, household income, regional variation, physician diagnosis
- MeSH terms
- Autism Spectrum Disorder, Adolescent, Child, Child, Preschool, Cross-Sectional Studies, Female, Food Hypersensitivity, Health Surveys, Humans, Hypersensitivity, Male, United States
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