Wheat allergy (WA)

Wheat allergy prevalence: limited and relatively unclear

Wheat is considered one of the most common and well-known triggers of food allergies. However, data on the global prevalence of wheat allergy is limited, and the available epidemiological studies provide an inconsistent and incomplete picture.

Wheat allergy ous prevalence and clinical relevance in children and adults

The prevalence of wheat allergy in the general population is relatively low. A European study reports a prevalence of probable wheat allergy - based on clinical symptoms and the detection of specific IgE antibodies - of up to 0.37% in adults. Overall, prevalence rates in the general population are usually below 1%.

In children in Europe, the prevalence is estimated at around 0.2% to 1.5%. In general, wheat allergy is more common in childhood than in adulthood. The prevalence decreases significantly with age. In many cases, wheat allergy disappears by the time children start school; in around 65% of affected children, it is no longer detectable by the age of 12.

Clinically diagnosed wheat allergies in adolescents and adults are rare. In these age groups, they are often secondary food allergies that can develop in the context of other atopic diseases. However, if a wheat allergy develops in adulthood, it usually persists throughout life. Clinically, two specific forms dominate in this context: wheat-dependent exercise-induced anaphylaxis (WDEIA) and inhalation-triggered baker's asthma. In Europe, wheat is also considered the most common trigger of anaphylactic reactions associated with food.

Technology and wheat allergy: How modern processes influence allergenicity

Compared to other food allergens, such as peanuts, wheat allergy is much less common in adults. One possible explanation for this is that various processing methods modify the allergenic potential of wheat. For example, thermal treatment such as cooking can reduce the allergenic potency of wheat proteins, while roasting processes can potentially increase it. Fermentation processes—such as the use of yeast or lactic acid bacteria—can also influence the allergen structure and thus the immune response. These processing-related factors could play a role in the comparatively low prevalence of clinically relevant wheat allergies in adults.

Wheat allergy prevalence depends on diagnostic method

Self-reported cases: 0.63%

Here, individuals themselves report having a wheat allergy based on their own experience of symptoms after consuming wheat.

Self-reported cases with medical diagnosis: 0.70%

Here, the self-reported allergy is supported by a medical assessment. However, the diagnosis is not always based on objective tests.

Skin prick testing: 0.22%

A standardized allergy test in which wheat extract is applied to the skin and the reaction (e.g., wheal formation) is observed.

Serological testing for specific immunoglobulin E (IgE): 0.97%

A blood test that measures the presence of IgE antibodies against wheat proteins. An elevated IgE concentration indicates sensitization, but not always a clinically relevant allergy.

Oral food challenge test: 0.04%

This is the so-called "gold-standard method" of allergy diagnosis. Under medical supervision, wheat is administered in a targeted manner to provoke a reaction. The allergy is only confirmed if symptoms clearly occur. This method shows the lowest prevalence, as it only detects clinically relevant cases and is infrequently employed in practice because it is often resource-intensive.

The choice of diagnostic method therefore has a decisive influence on the reported prevalence.

Sensitization ≠ clinical allergy: Many tests detect immunological reactions that do not always lead to symptoms. However, the true prevalence of clinically relevant wheat allergies is exceptionally low, as confirmed by provocation tests.

This discrepancy underscores the importance of differentiated medical diagnostics in order to avoid overdiagnosis and to provide targeted advice and treatment to those affected.

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