Journal List > J Nutr Health > v.48(6) > 1081424

J Nutr Health. 2015 Dec;48(6):530-541. Korean.
Published online December 31, 2015.
© 2015 The Korean Nutrition Society
Perception on food allergy labelling and management of nutritional education among higher grade elementary school students in Jeju area
Yunkyoung Lee, Hyun-Hee Kim and Yang-Sook Ko
Department of Food Science and Nutrition, Jeju National University, Jeju 63243, Korea.

To whom correspondence should be addressed. tel: +82-64-754-3553, Email:
Received October 08, 2015; Revised October 28, 2015; Accepted December 17, 2015.

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License ( which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.



This study was conducted to examine the prevalence of food allergy, food allergy knowledge, and perception on food allergen labelling along with management of substitute meals in school foodservice in elementary school students in Jeju, South Korea.


Six elementary schools in Jeju-si were randomly selected, and the higher grade elementary school students (n=1,500), from fourth graders to sixth graders, were surveyed using a questionnaire in July 2014. A total of 1,000 responses were used for data analysis.


The percentage of students who had experienced food allergy was 16.7%; 26.4% had been diagnosed as having a food allergy by doctors. Milk, crabs, and shrimps were the most frequent allergenic foods with common symptoms including urticaria followed by itching, and vomiting. As the student's grade went up, the knowledge scores on food allergy showed a significant increase. Although students with and without food allergy experience had a similar level of knowledge on food allergy and perception on food allergen labelling, students with food allergy experience had a significantly lower level of healthy dietary practices. Last, only 20.4% of students with food allergies were offered substitute meals by school foodservices, and 30.8% of students received food allergy education.


For prevention and management of food allergies in school foodservice, schools should provide an individualized substitute meal plan and food allergy education to students, parents, and teachers.

Keywords: elementary school students; food allergies; food allergen labelling; school meal; nutritional education


Table 1
Prevalence of food allergy and its diagnosis
Click for larger image

Table 2
Primary food allergy symptoms that students experienced1)
Click for larger image

Table 3
Sources of food allergies1)
Click for larger image

Table 4
Rate of correct answers on food allergy knowledge and knowledge score
Click for larger image

Table 5
Perception of food allergy labelling on school menus1)
Click for larger image

Table 6
Levels of healthy dietary practices by gender, grade and food allergy experience1)
Click for larger image

Table 7
Status of managing substitute meals to students with food allergies in schools lunches 1)
Click for larger image

Table 8
Comparison of methods and contents of nutritional education by gender, grade and food allergy experience1)
Click for larger image


This work was supported by the 2015 scientific promotion program funded by Jeju National University.

1. Sicherer SH, Sampson HA. Food allergy. J Allergy Clin Immunol 2010;125 2 Suppl 2:S116–S125.
2. Moneret-Vautrin DA, Kanny G, Morisset M, Flabbee J, Guénard L, Beaudouin E, Parisot L. Food anaphylaxis in schools: evaluation of the management plan and the efficiency of the emergency kit. Allergy 2001;56(11):1071–1076.
3. Branum AM, Lukacs SL. Food allergy among children in the United States. Pediatrics 2009;124(6):1549–1555.
4. Hong SJ, Ahn KM, Lee SY, Kim KE. The prevalences of asthma and allergic diseases in Korean children. Korean J Pediatr 2008;51(4):343–350.
5. Gupta RS, Springston EE, Warrier MR, Smith B, Kumar R, Pongracic J, Holl JL. The prevalence, severity, and distribution of childhood food allergy in the United States. Pediatrics 2011;128(1):e9–e17.
6. Sicherer SH, Sampson HA. Food allergy: epidemiology, pathogenesis, diagnosis, and treatment. J Allergy Clin Immunol 2014;133(2):291–307.
7. Kim WK. Diagnosis and treatment of food allergy in children. Pediatr Allergy Respir Dis 2006;16(4):274–283.
8. Lim DH. Epidemiology of anaphylaxis in Korean children. Korean J Pediatr 2008;51(4):351–354.
9. Lim DH. Food anaphylaxis. Korean J Asthma Allergy Clin Immunol 2010;30(2):91–92.
10. Sampson HA. Food allergy. Part 1: immunopathogenesis and clinical disorders. J Allergy Clin Immunol 1999;103(5 Pt 1):717–728.
11. Lee AH, Kim KE, Lee KE, Kim SH, Wang TW, Kim KW, Kwak TK. Prevalence of food allergy and perceptions on food allergen labeling in school foodservice among Korean students. Allergy Asthma Respir Dis 2013;1(3):227–234.
12. Sampson MA, Muñoz-Furlong A, Sicherer SH. Risk-taking and coping strategies of adolescents and young adults with food allergy. J Allergy Clin Immunol 2006;117(6):1440–1445.
13. Gendel SM. Comparison of international food allergen labeling regulations. Regul Toxicol Pharmacol 2012;63(2):279–285.
14. Ministry of Education (KR). Statistics on school foodservice. Seoul: Ministry of Education; 2011.
15. Ahn K. Food allergy: diagnosis and management. Korean J Asthma Allergy Clin Immunol 2011;31(3):163–169.
16. Seo WH, Jang EY, Han YS, Ahn KM, Jung JT. Management of food allergies in young children at a child care center and hospital in Korean. Pediatr Allergy Respir Dis 2011;21(1):32–38.
17. Kim S, Yoon J, Kwon S, Kim J, Han Y. Current status of managing food allergies in schools in Seoul, Korea. J Child Health Care 2012;16(4):406–416.
18. Ministry of Education, Science and Technology (KR). Perception of allergenic school food manual. Seoul: Ministry of Education, Science and Technology; 2012.
19. Ministry of Food and Drug Safety (KR). Allergenic food labeling act 2013-132. Cheongju: Ministry of Food and Drug Safety; 2013.
20. Lee SY, Kim KW, Ahn K, Kim HH, Pyun BY, Park YM, Kim KE. Consumer's use and satisfaction of allergic food labels. Pediatr Allergy Respir Dis 2011;21(4):294–301.
21. Kim YG, Yu KH, Ly SY. Perception of elementary school parents in Gyeongbuk area on allergenic food labeling system and children's food allergy status. Korean J Hum Ecol 2013;22(5):491–506.
22. Choi Y, Ju S, Chang H. Food allergy knowledge, perception of food allergy labeling, and level of dietary practice: a comparison between children with and without food allergy experience. Nutr Res Pract 2015;9(1):92–98.
23. Jeong KJ, Ly SY. Current status and food allergy related-dietary behaviors of atopy and asthma-friendly elementary school students in the Chungnam area. Korean J Hum Ecol 2015;24(1):123–135.
24. Chung SJ, Han YS, Chung SW, Ahn KM, Park HY, Lee SI, Cho YY, Choi HM. Marasmus and kwashiorkor by nutritional ignorance related to vegetarian diet and infants with atopic dermatitis in South Korea. Korean J Nutr 2004;37(7):540–549.
25. Park JY, Park GY, Han YS, Shin MY. Survey of food allergy in elementary school children in Bucheon-city and relationship between food allergy and other allergic diseases. Allergy Asthma Respir Dis 2013;1(3):266–273.
26. Oh JW, Pyun BY, Choung JT, Ahn KM, Kim CH, Song SW, Son JA, Lee SY, Lee SI. Epidemiological change of atopic dermatitis and food allergy in school-aged children in Korea between 1995 and 2000. J Korean Med Sci 2004;19(5):716–723.
27. Hong S. Korean ISAAC Study Group of Korean Association of Allergy and Respiratory Diseases. Report of Korean ISAAC epidemiologic study for asthma and allergic diseases in children. Pediatr Allergy Respir Dis 2007;17 Suppl 1:55–66.
28. Chen W, Mempel M, Schober W, Behrendt H, Ring J. Gender difference, sex hormones, and immediate type hypersensitivity reactions. Allergy 2008;63(11):1418–1427.
29. Schäfer T, Böhler E, Ruhdorfer S, Weigl L, Wessner D, Heinrich J, Filipiak B, Wichmann HE, Ring J. Epidemiology of food allergy/food intolerance in adults: associations with other manifestations of atopy. Allergy 2001;56(12):1172–1179.
30. Rancé F, Kanny G, Dutau G, Moneret-Vautrin DA. Food hypersensitivity in children: clinical aspects and distribution of allergens. Pediatr Allergy Immunol 1999;10(1):33–38.
31. Lee AJ, Thalayasingam M, Lee BW. Food allergy in Asia: how does it compare? Asia Pac Allergy 2013;3(1):3–14.
32. Yang SH, Kim EJ, Kim YN, Seong KS, Kim SS, Han CK, Lee BH. Comparison of eating habits and dietary intake patterns between people with and without allergy. Korean J Nutr 2009;42(6):523–535.
33. Barth GA, Weigl L, Boeing H, Disch R, Borelli S. Food intake of patients with atopic dermatitis. Eur J Dermatol 2001;11(3):199–202.
34. Flammarion S, Santos C, Guimber D, Jouannic L, Thumerelle C, Gottrand F, Deschildre A. Diet and nutritional status of children with food allergies. Pediatr Allergy Immunol 2011;22(2):161–165.
35. Min S, Cho M, Park K. Risk factors for allergic diseases in schoolaged children. J Korean Soc Food Sci Nutr 2013;42(9):1387–1394.
36. Lee K, Myung C, Nam H, Hong CS, Lee YC. A study on nutritional status of allergic patients and food allergens in Korea. Korean J Diet Cult 1996;11(1):123–130.
37. Yu JW, Kagan R, Verreault N, Nicolas N, Joseph L, St Pierre Y, Clarke A. Accidental ingestions in children with peanut allergy. J Allergy Clin Immunol 2006;118(2):466–472.
38. Park SJ, Lee JS, Ahn K, Chung SJ. The comparison of growth and nutrient intakes in children with and without atopic dermatitis. Korean J Community Nutr 2012;17(3):271–279.
39. Cheong HS, Lee JS. Study on nutrition education and perception of nutrition teachers and dietitians in Gyeongnam area. Korean J Food Cookery Sci 2012;28(3):229–240.
40. Rona RJ, Keil T, Summers C, Gislason D, Zuidmeer L, Sodergren E, Sigurdardottir ST, Lindner T, Goldhahn K, Dahlstrom J, McBride D, Madsen C. The prevalence of food allergy: a metaanalysis. J Allergy Clin Immunol 2007;120(3):638–646.
41. Burks AW, Tang M, Sicherer S, Muraro A, Eigenmann PA, Ebisawa M, Fiocchi A, Chiang W, Beyer K, Wood R, Hourihane J, Jones SM, Lack G, Sampson HA. ICON: food allergy. J Allergy Clin Immunol 2012;129(4):906–920.