Prevalence of tree nut allergy in Europe: A systematic review and meta-analysis

Giulia C I Spolidoro, Daniil Lisik, Sungkutu Nyassi, Athina Ioannidou, Mohamed Mustafa Ali, Yohannes Tesfaye Amera, Graciela Rovner, Ekaterina Khaleva, Carina Venter, Ronald van Ree, Margitta Worm, Berber Vlieg-Boerstra, Aziz Sheikh, Antonella Muraro, Graham Roberts, Bright I Nwaru*

*Corresponding author for this work

Research output: Contribution to journalReview articlepeer-review

Abstract / Description of output

In 2014, the European Academy of Allergy and Clinical Immunology (EAACI) published the first systematic review that summarized the prevalence of food allergy (FA) and food sensitization in Europe for studies published 2000-2012. However, only summary estimates for tree nut allergy (TNA) were feasible in that work. In the current update of that systematic review, we summarized the prevalence of tree nut allergy/sensitization to individual tree nuts. Six databases were searched for relevant papers published 2012-2021 and 17 eligible studies were added to the 15 studies already identified between 2000 and 2012, giving a total of 32 studies. Of the investigated tree nuts, meta-analysis was possible for hazelnut, walnut, almond, and in few cases, for cashew, and Brazil nut. The lifetime self-reported prevalence was 0.8% (95% CI 0.5-1.1) for hazelnut and 0.4% (0.2-0.9) for walnut. The point self-reported prevalence was 4.0% (2.9-5.2) for hazelnut, 3.4% (2.0-4.9) for Brazil nut, 2.0% (1.1-2.9) for almond, and 1.8% (1.1-2.5) for walnut. Point prevalence of food challenge-confirmed TNA was 0.04% (0.0-0.1) for hazelnut and 0.02% (0.01-0.1) for walnut. Due to paucity of data, we could not identify any meaningful and consistent differences across age groups and European regions.

Original languageEnglish
Number of pages22
Early online date4 Oct 2023
Publication statusE-pub ahead of print - 4 Oct 2023

Keywords / Materials (for Non-textual outputs)

  • epidemiology
  • Europe
  • food allergy
  • sensitization
  • systematic review


Dive into the research topics of 'Prevalence of tree nut allergy in Europe: A systematic review and meta-analysis'. Together they form a unique fingerprint.

Cite this