# Food Allergy Management and Outcomes Related to Racial/Ethnic Differences from Infancy through Adolescence: The FORWARD Study

> **NIH NIH R01** · NORTHWESTERN UNIVERSITY · 2024 · $865,762

## Abstract

PROJECT SUMMARY/ABSTRACT
Background: Food allergy (FA) is a potentially life-threatening condition that affects an estimated 8% of
children in the United States. Although differences between Black, White, and Latinx children in the
prevalence and severity of other atopic conditions such as asthma and eczema have been well described,
little is known about such differences in FA. Black children may have worse clinical outcomes, including
rates of FA-related fatal anaphylaxis and FA-related emergency department(ED) visits, than their White
peers. Phenotypic and endotypic differences, including rates of sensitization and co-morbidities, between
Black and White children are beginning to be examined. Data on racial differences in FA management
practices are incomplete; preliminary data suggest that Black families spend significantly less on allergen-
free foods and FA medications than do White families. Families caring for children with FA experience
significant impairments in psychosocial outcomes, including FA-related quality of life (FAQoL); however,
these data come primarily from White, privately insured families, and little is known about psychosocial
outcomes in Black families. There is limited data on these outcomes among the Latinx population of children
food allergy. Two recent reviews concluded that existing studies examining racial disparities in FA are far too
methodologically limited to draw definitive conclusions, primarily due to reliance on self-report of FA
diagnosis and cross-sectional designs.
Specific Aims and Methods: Our goal is to prospectively study a cohort of 1,450 Black, White, and Latinx
children with FA in order to:
 1) Determine the clinical and sociodemographic factors associated with differences in the development
 of clinical immune tolerance and the development of new food allergies;
 2) Determine differences in FA management and outcomes during pivotal developmental periods (i.e.
 middle childhood; adolescence) by expanding assessment of patient-reported outcomes to include
 dyadic assessment of the following caregiver-reported and patient self-reported constructs:
 Psychosocial Outcomes and Disease Management (e.g. epinephrine carriage and allergen exposure)
 and Eating behaviors and nutrition environments (e.g. in the home and community).
 3) Identify phenotypic and endotypic differences in FA by applying state-of-the-art precision medicine
 approaches for multidimensional phenotyping and endotyping of FA patients.
Hypotheses and Expected Results: We hypothesize that compared to White children, Black children are
less likely to develop clinical immune tolerance to foods and more likely to develop new-onset food allergy
during the study period. We also hypothesize that concordance between patient- and caregiver-report data
will decrease as children age and eating behaviors and nutrition environment will differ by child race/ethnicity.
Additionally, we hypothesize that White, Black, Mexican-American and Puerto-Rican c...

## Key facts

- **NIH application ID:** 10836346
- **Project number:** 5R01AI130348-08
- **Recipient organization:** NORTHWESTERN UNIVERSITY
- **Principal Investigator:** Ruchi S Gupta
- **Activity code:** R01 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2024
- **Award amount:** $865,762
- **Award type:** 5
- **Project period:** 2017-05-11 → 2027-04-30

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10836346

## Citation

> US National Institutes of Health, RePORTER application 10836346, Food Allergy Management and Outcomes Related to Racial/Ethnic Differences from Infancy through Adolescence: The FORWARD Study (5R01AI130348-08). Retrieved via AI Analytics 2026-05-22 from https://api.ai-analytics.org/grant/nih/10836346. Licensed CC0.

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