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Although some prevalence rates are greatly reduced, the rank order of the food allergens changes relatively little, peach, hazelnut, shrimp and wheat remaining the most common four. Countries also tended to be ranked in a similar order by different allergens (Kendall��s coefficient of concordance 0.45, P?ALK and France and low in the Nordic countries, particularly Iceland, and also in the Pazopanib molecular weight United Kingdom and Spain. Table?3 and Fig.?2 show the ecological association of sensitization to foods with (i) the geometric mean total IgE and (ii) sensitization to aeroallergens. Countries ranking highly on food sensitization had a high geometric mean total IgE (Spearman correlation 0.71, P?=?0.015), but there was no obvious relation with sensitization to aeroallergens (Spearman correlation 0.35, P?=?0.28). This is the first study that has looked at a large multicountry sample to determine the prevalence of food sensitization. It has demonstrated a relatively high prevalence of sensitization to hazelnut, apple, peach and shrimp but a low prevalence of sensitization to fish, egg and milk in this young adult sample. Despite local variations in consumption Regorafenib chemical structure of foods that people are sensitized to, there is more consistency in the prevalence of sensitization to different foods in each country than would be expected. Unexpectedly, countries with a high prevalence of sensitization to foods are not those with a high prevalence of sensitization to aeroallergens, but they do tend to have a higher total IgE. There are challenges in interpreting data from samples that are incomplete for a variety of reasons; however, our assessment of the effects of differential testing shows that there is relatively little evidence of bias in the results reported from this source. Interpretation of the results is complicated by the known cross-reactions between food allergens and aeroallergens from other sources. There is little evidence that such cross-reactions can explain these results. The commonest cross-reaction is that reported between birch pollen and foods such as hazelnut, peach and apple. Undoubtedly, this has some effect on the results reported here. Sweden and Norway, for instance, which have high prevalence of sensitization to birch, have a higher prevalence of sensitization to hazelnut and apple than would be predicted from their overall prevalence of sensitization to foods (Table?2).