Prevalence of Fruit and Vegetable Allergies in Children in Taiwan

Young boy with a packed lunch takes out his anaphylaxis auto injector.
A nationwide study in Taiwan characterized the prevalence of pediatric fruit and vegetable allergies, as well as foods causing the most problems and typical presentations.

Fruit and vegetables allergies are present in almost 10% of Taiwanese children, especially common in children with atopic diseases, and most commonly present in mucocutaneous tissue. These were among study findings recently published in Pediatrics and Neonatology.

Studies show that the prevalence of food allergy is increasing globally, study authors noted. The researchers, who were based in Taiwan, therefore sought to investigate the prevalence and presentation of fruit and vegetable allergies as well as the relationship between food allergies and atopic diseases among children in Taiwan.

The current retrospective review was based on a 2012 nationwide, cross-sectional survey of children in elementary school in Taiwan. The researchers ultimately examined questionnaires completed by 9982 children (with the help of their parents; mean age of children 10.1 years [range 6 to 13 years]; 51% female).

The investigators found fruit allergies in 560 children (5.6%) and vegetable allergies in 304 children (3.0%). Mango and kiwifruit were the most common fruit allergen; the most common vegetable allergens were taro and bamboo shoot. Researchers noted that common food allergens would vary significantly in Taiwan with the diversity of dietary habits between cold, mild, and tropical locales.

Allergic symptoms most commonly appeared in mucocutaneous tissue (skin itching, skin rash, eye itching), and less frequently in the upper airway and gastrointestinal tract. For most children, avoidance managed the condition. A greater percentage of comorbid atopic dermatitis, allergic rhinitis, and asthma was found in the children with allergies vs those without. Moreover, the proportion of children with fruit and vegetable allergies who had comorbid atopic diseases was similar to the proportion of children with allergies to shellfish (the most common allergen) who had comorbid atopic diseases. Vegetable allergies were equally distributed between boys and girls. Fruit allergies were significantly greater among girls (6.1%) than boys (5.1%; P <.05).

 “Fruits and vegetables are common food allergens in Taiwanese children who present with diverse and potentially severe symptoms,” the researchers concluded. “If a child has symptoms of atopic diseases, but no specific allergen is identified among common allergic foods, vegetable or fruit allergy should be considered and evaluated,” the investigators added.

Study limitations were related to use of questionnaire rather than a double-blind, placebo-controlled food challenge test; the retrospective nature of the study; and possible selection bias and response bias.


Li S-K, Liu Z, Huang C-K, Wu T-C, Huang C-F. Prevalence, clinical presentation, and associated atopic diseases of pediatric fruit and vegetable allergy: a population-based study. Pediatr Neonatol. Published online June 22, 2022. doi:10.1016/j.pedneo.2022.03.019