Multi-Food Allergy Comorbidities Warrant Targeted Screening and Intervention for Children

High rates of comorbidity were found between specific tree nut allergies including cashew-pistachio allergies and walnut-pecan allergies

MILWAUKEE, Feb. 19, 2026 /PRNewswire/ -- Distinct phenotypes and comorbidities associated with multi-food allergy may require additional allergy screening for pediatric patients, according to new research being presented at the 2026 AAAAI Annual Meeting.

In this study, researchers leveraged data from a National Institute of Allergy and Infectious Diseases (NIAID)-supported multi-site longitudinal cohort, which recruited participants younger than 12 years old with allergist-confirmed food allergy (FA). Allergy status, demographics and clinical details were assessed at the annual clinical allergist visits, and researchers utilized quarterly surveys reported by children and their parents alongside ongoing electronic health record extraction. Researchers calculated conditional probabilities for all food allergies to understand comorbidity patterns and used latent class analytic methods to understand clinically relevant clusters of multi-food allergies, their distribution and their predictors via multilevel regression.

The analysis included data from 1382 children with FA, 75.5% of whom had multiple current food allergies, and an additional 49.2% of those with single FA were peanut-allergic. Multi-food allergy was predicted by race, ethnicity, age, socioeconomic status, comorbid atopy and Total IgE. Rates of comorbid FA varied tremendously by allergy, with very high probability of comorbidity observed between specific tree nut allergies including cashew-pistachio, walnut-pecan (>0.9 ), and the lowest rates observed between seafood and milk or egg allergies (<.2). Latent class analyses indicated 3 primary classes/clusters of multi-food allergy representing 55%, 30% and 15% of the sample respectively, each of which could be predicted by assessed factors including a dual peanut and tree nut allergy; a combined peanut, egg and milk allergy; and a broadly multi-food allergic class with allergy to many common foods.

Visit aaaai.org to learn more about food allergy. Research presented at the 2026 AAAAI Annual Meeting, February 27 – March 2 in Philadelphia, PA, is published in an online supplement to The Journal of Allergy and Clinical Immunology (JACI).

The American Academy of Allergy, Asthma & Immunology (AAAAI) is the leading membership organization of more than 7,100 allergists, asthma specialists, clinical immunologists and other professionals with a special interest in the research and treatment of allergic and immunologic diseases. Established in 1943, the AAAAI is the go-to resource for patients living with allergies, asthma and immune deficiency disorders.

SOURCE American Academy of Allergy, Asthma & Immunology (AAAAI)