Food Insecurity in Food Allergic Children During the COVID-19 Pandemic in North America: Findings from A Scoping Review (Abstract)

Rationale
Food insecurity (FI) is a rising phenomenon compounded by higher costs of living, especially allergen-free food which is essential to food allergy management. Evidence on the multi-faceted burden of food allergy is well-documented, but FI burden is emerging. A scoping review was conducted to understand the evidence on FI in children living with food allergy.
Methods
Following Joanna Briggs Institute methodology, the search criteria considered children aged 0-18 years living in high-income countries, with any type of food allergy and FI. Published and unpublished sources, in English, within 10 years were included from electronic databases using a comprehensive search strategy. Articles were assessed for eligibility by 2 reviewers independently. Data was extracted, and subject to basic numerical and qualitative content analysis.
Results
Overall, 37 articles were included from North America, where the majority were published since the COVID-19 pandemic (n=29). Rates of FI and severity worsened post pandemic in food allergic children (+7.7-51.5% and +10% respectively) when compared to those without food allergies. Families with food allergic children reported greater difficulties accessing allergen-free foods during the pandemic than families without food allergies having access to food (18.2% vs. 8.8-11%). Caregivers reported pandemic-related unemployment (25.5%) and loss of income (41.8%). Most allergy clinicians (56.9%) believed that the pandemic increased FI in their patients.
Conclusions
Children living with food allergy are likely to have experienced greater FI or worsening of FI since the COVID-19 pandemic, heightened by difficulties in access to and affordability of allergen-free food. Further research and multi-agency support are urgently needed.