NUH is co-leading Singapore’s largest study on paediatric food allergies to shed light on their prevalence, health consequences and psychosocial burden — with the goal of improving safety, health and quality of life for children and families.
.jpg?sfvrsn=18c47316_3 "The Singapore Food Allergy Story: understanding the impact to shape safer futures")
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A sudden rash, swollen lips or gasping for breath. For children with food allergies, these are not minor inconveniences but medical emergencies that can sometimes be life-threatening. Around the world, such reactions seem to be occurring more frequently, raising concerns about whether food allergies are truly becoming more common.
The trend is also visible closer to home. At the National University Hospital (NUH), the number of allergy tests performed on children rose by 60 per cent between 2022 and 2024. In these tests, called food challenges, patients are carefully exposed to specific foods under medical supervision to confirm whether they are allergic. Doctors are also seeing more children with food allergies than in the past, when such cases were mostly seen in children who originated from countries where the condition was already common.
“The families told us they were struggling to cope with their food allergies on a day-to-day basis. We wanted to know if food allergies were really on the rise, and what its impact on local families was,” says Associate Professor Elizabeth Tham, Head and Senior Consultant, Division of Paediatric Allergy, Immunology & Rheumatology, Department of Paediatrics, Khoo Teck Puat – National University Children’s Medical Institute (KTP-NUCMI)1, NUH.
To answer this question, NUH is co-leading a landmark four-year initiative known as the Singapore Food Allergy Story. The study will provide the most comprehensive picture to date of how food allergies affect children in Singapore — from prevalence rates to their impact on nutrition, growth and mental health.
Food allergies occur when the immune system mistakes certain foods as harmful, triggering reactions that range from itchy skin and hives to swelling, breathing difficulties, or, in severe cases, cardiac arrest. “Fatal reactions to food allergies do happen, but are thankfully rare. Patients with food allergies have to constantly monitor what they eat, and carry emergency medications like an adrenaline autoinjector with them everywhere they go,” explains A/Prof Tham, who is also the study’s lead principal investigator.
For families, the challenges go beyond immediate health risks. Parents often live with constant anxiety, needing to monitor every meal and social activity to prevent accidental exposure. While there is no definitive cure apart from children naturally outgrowing their allergies over time, the reasons behind the rise remain unclear.
Reasons for the rise in food allergies are not clear, but possible explanations include a higher rate of eczema, and changes in dietary patterns and environmental factors like antibiotic use, reduced early exposure to microbes in increasingly clean environments.
“We see the impact of food allergies every day. But without accurate, up-to-date data on how widespread they are or how they affect children’s health, we are only seeing part of the bigger picture,” adds A/Prof Tham. “That is why it is important for us to study the issue systematically.”
Two families share their food allergy journey with A/Prof Elizabeth Tham
The Singapore Food Allergy Story will track how food allergies affect children’s nutrition, growth, metabolic health, and mental well-being, while also examining the broader social and economic toll on families.
The study has two phases. The first, which began in February 2025, has been surveying more than 2,000 parents and caregivers of toddlers during routine polyclinic visits. Those who report possible allergic reactions are referred to NUH for further evaluation. By September 2025, 900 participants had enrolled, with 119 reporting suspected allergies.
The second phase, launched in July 2025, focuses on about 400 children up to 18 years old who have confirmed allergies to milk, egg, peanut or shellfish. These children will undergo detailed growth and nutritional assessments, alongside blood and stool tests to better understand how allergies affect development.
Beyond medical data, the study is also designed to prioritise patientrelevant outcomes. Working with parent support groups such as the Singapore Parents of Eczema and Allergy Kids (SPEAK), the research team hopes to make an impact that matters most to families — from managing mealtimes to navigating schools, childcare and social life.
Findings from the study are expected to inform national dietary guidelines, shape allergen management policies in schools and food services, as well as guide healthcare professionals in supporting families more effectively. “With this research, we hope to deepen our understanding of food allergies and their broader impact,” says A/Prof Tham. “Our goal is to create a safer environment for children with food allergies, helping them reach their fullest potential while improving their mental health and well-being, especially for older children and adolescents.”
1 KTP-NUCMI is part of the National University Centre for Women and Children (NUWoC), a national university specialist centre that aims to empower women, children and their families to lead healthier lives
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