Multiple Food Allergies Associated with Worsened Pediatric Lung Function

December 17, 2018
Carisa D. Brewster

Children often develop food allergies prior to developing asthma, and the former condition is associated with a greater risk of the latter condition in later life.

Michael G. Sherenian, MD, MS

A new study suggests that asthmatic children with 2 or more food allergies are more likely to have poorer lung function compared to allergy-free children.

Study author Michael G. Sherenian, MD, MS, a research instructor with the Cincinnati Children’s Hospital Medical Center, explained that children often develop food allergies prior to developing asthma, and that having the former condition is associated with a greater risk of the latter condition in later life.

According to the American College of Allergy, Asthma & Immunology, more than 6 million children have some form of food allergy. In addition to asthma, other symptoms of allergies in general include skin rashes, sneezing, coughing or runny nose, and upset stomach.

The association between the 2 conditions and other early-onset inflammatory disease have been well-documented. A 130,000-plus participant cohort presented this year at the American Academy of Allergy, Asthma & Immunology (AAAAI) annual meeting in Orlando, FL showed associations between eosinophilic esophagitis, asthma, food allergy, atopic dermatitis, and allergic rhinitis.

In an interview with MD Magazine®, lead investigator Jonathan M. Spergel, MD, PhD argued the best approach to addressing the chain of allergic and inflammatory conditions may be proactive care.

“If you treat someone for their allergies over time, they’re a little bit less likely to develop other allergies,” Spergel said. “So maybe, right now, that may be the best prevention: if we treat people aggressively, then maybe that makes a difference.”

For this study, participants aged of 0-21 were recruited from Chicago area medical and allergy specialty clinics and enrolled in the Chicago Food Allergy Study. Food allergies were defined as having typical anaphylaxis symptoms within two hours of eating a food and food specific IgE antibodies. Asthma groups was divided into never asthma, current asthma, or outgrown asthma.

Forced expiratory volume 1 (FEV1), forced vital capacity (FVC), the Fev1/FVC ratio, and forced expiratory flow of 25% to 75% (FEF25%-75%) were used to evaluate pulmonary function.

Of the 1068 children, 417 had asthma, 402 had at least 1 food allergy, and 162 had 2 or more food allergies. For the children with asthma that had 2 or more food allergies, there were notable decreases in percent predicted FEF25%-75% compared to those with no food allergies (mean [SE] ß = -7.46% [3.67%]; P= .04).

When children with 1 food allergy were compared to those with none, there was no difference in percent predicted FEF25%-75%. However, after including aeroallergen sensitization status (using a statistical model) in the asthma group, FEV25%-75% remained lower in those with 2 or more food allergies compared to those none.

“Because we used a statistical model to predict missing values, we weren’t adequately able to assess environmental allergen sensitization in all children,” Sherenian said. “But our findings do suggest that children with multiple food allergies and asthma present a unique patient population that may be at greater risk for long-term airway complications.”

Sherenian added that further study should include investigating allergies to specific foods and their relationship with lung function, plus the effect of food allergy duration on lung function.

The study, “Association of food allergy and decreased lung function in children and young adults with asthma,” was published online in Annals of Allergy, Asthma and Immunology.


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