TOPLINE:

Children with food hypersensitivity experienced elevated perceived stress and fatigue symptoms, with the highest levels observed in those with mixed pathology (both food allergy and intolerance). Adolescents showed the highest stress and fatigue scores, and a moderate positive correlation existed between stress and fatigue (r = 0.49).

METHODOLOGY:

• Researchers conducted an observational, cross-sectional study over 13 months (September 2024 to October 2025) involving 339 children aged 1-18 years in Romania with specialist-confirmed food allergy, food intolerance, or mixed pathology.
• Data were collected through structured, parent-reported interviews incorporating the Perceived Stress Questionnaire (PSQ) and the Fatigue Assessment Scale (FAS), with parents acting as proxy respondents due to the wide age range of the participants.
• Participants were recruited from allergology and clinical immunology outpatient settings, with a participation rate of 75.3% (339 of 450 eligible families approached).
• Diagnoses were rigorously established by specialist physicians using national and international protocols, including skin prick tests, serum-specific immunoglobulin E levels, hydrogen breath tests, and elimination-reintroduction diets conducted under medical supervision.
• Multivariable linear regression models were constructed to identify independent predictors of perceived stress and fatigue, adjusting for age, sex, and weight-for-length or BMI-for-age percentiles as covariates.

TAKEAWAY:

• Children with food allergies had significantly higher perceived stress and fatigue scores than those with food intolerance (P < .05), with the highest levels observed in the mixed pathology group (PSQ: P = .0248; FAS: P < .001).
• Both perceived stress and fatigue scores increased with age, and a moderate positive correlation was identified between stress and fatigue (r = 0.49, P < .0001).
• In multivariable analyses, age emerged as a dominant independent predictor of perceived stress levels (beta = 0.406, P = .0002), whereas mixed pathology maintained a significantly higher stress burden (beta = 3.318, P = .0144) after adjustment for age and sex.
• For fatigue, both age (beta = 0.404, P < .0001) and weight-for-length or BMI-for-age percentiles (beta = 0.0248, P = .0170) were identified as significant positive predictors, whereas a single food allergy was associated with lower fatigue scores (beta = -2.830, P = .0010) than in the intolerance group.

IN PRACTICE:

“Food hypersensitivity in children is associated with a significant psychological burden characterized by elevated perceived stress and fatigue, particularly in adolescents and in those with more complex diagnostic profiles. These findings highlight the importance of multidisciplinary management strategies integrating accurate diagnosis, nutritional counseling, and psychosocial support in order to address the broader impact of pediatric food hypersensitivity,” wrote the authors of the study.

SOURCE:

The study was led by Roxana Maria Martin-Hadmas, Department of Community Nutrition and Food Safety, George Emil Palade University of Medicine, Pharmacy, Science, and Technology of Târgu Mureș, Târgu Mureș, Romania. It was published online on April 27 in Nutrients.

LIMITATIONS:

The cross-sectional design precludes the establishment of causal relationships and limits the ability to assess symptom progression or the long-term impact of food hypersensitivity. The broad age range (1-18 years) represents a limitation because it includes markedly different developmental stages that may influence both perceived stress and fatigue, particularly when responses are obtained through parent proxy reports rather than direct self-report. The multivariable models explained a modest proportion of the variance in stress (R² = 0.0728) and fatigue (R² = 0.1548), and other potentially important confounders such as socioeconomic status, parental psychological distress, duration of diagnosis, and severity of allergic reactions were not available in the dataset. Recruitment from a tertiary center and urban predominance may limit generalizability, and the absence of a healthy control group restricts direct comparisons with the general population.

DISCLOSURES:

The study received no external funding. The authors declared having no conflicts of interest.

This article was created using several editorial tools, including AI, as part of the process. Human editors reviewed this content before publication.