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Gender should be more widely considered when trying to understand people’s experiences of food allergies, say researchers after finding that these particularly impact on the well-being of girls and women.

Their systematic review of more than 30 studies showed that females with food allergies mediated by immunoglobulin(Ig)-E had poorer in health-related quality of life (HRQL) at baseline than males, regardless of age.

Mothers who were caregivers had poorer HRQL than fathers relating specifically to dietary, social, well-being and physical factors.

There also were potential gender differences in HRQL following food allergy interventions.

The findings “highlight that a tailoring of allergy management approaches to account for gender is needed,” say Mimi Tang, PhD, from the University of Melbourne, and colleagues.

“Understanding factors that impact HRQL is essential to inform personalized allergy management and identification of those most in need of intervention,” they maintain in the journal Clinical & Experimental Allergy.

Studies suggest that food allergies have the greatest impact on HRQL for individuals and their care givers.

Potential reasons for this include the need for rigorous dietary restrictions, lack of treatment options, and fear of accidental exposure.

To investigate the issue further, Tang and team searched the Medline and Embase databases for English-language studies on HRQL and Ig-E mediated food allergies.

Among the 34 studies included, one investigated HRQL across all age groups, five investigated only cross-sectional HRQL in adults with food allergies, and 28 focused on children with food allergies.

Caregiver HRQL was investigated in seven of the studies involving children with food allergies.

There were 10 interventional studies of children with food allergies, nine of which investigated the effects of immunotherapy on and one of which studied the impact of exclusion diets. No intervention studies in adult populations were identified.

The researchers found strong evidence for poorer baseline self-reported HRQL in female compared with male participants who had food allergies, regardless of age.

Women reported poorer baseline total or subscore HRQL than men across five of the six cross-sectional studies.

Girls also had worse baseline HRQL scores than boys when HRQL was self-reported in five of the eight relevant studies included.

There also appeared to be gender differences in the change of HRQL between baseline and follow-up among interventional studies involving children, though the researchers report that the direction of this was unclear.

The one study to investigate exclusion diets as a form of intervention found no gender differences in child HRQL.

“We identified similar gender differences across HRQL subdomains, with females with food allergy, especially children, reporting poorer outcomes across a range of physical, psychological and social HRQL subscores,” the authors report.

“The female predominance in anxiety, avoidant eating disorders and distorted body image symptoms may help explain some of the gender differences observed in these subscores.”

They conclude: “This study highlights the need for purposeful consideration of a diversity of gender identities, ages and allergens in future investigations of HRQL to establish whether psychosocial experience or biological factors drive differences in food allergy outcomes.”

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