Food Allergies May Increase Risk for Asthma Attacks

Laurie Barclay, MD

October 04, 2010

October 4, 2010 — Food allergies (FAs) may increase the risk for asthma attacks, according to the results of a study reported in the November issue of the Journal of Allergy and Clinical Immunology.

"Our study suggests that food allergies may be an important factor, and even an under-recognized trigger for severe asthma exacerbations," lead study author Andrew H. Liu, MD, from National Jewish Health and University of Colorado Denver School of Medicine, said in a news release. "People with a food allergy and asthma should closely monitor both conditions and be aware that they might be related."

The study goals were to obtain nationally representative estimates of the prevalence of FAs and to identify demographic risk factors and to evaluate associations of FAs with asthma, hay fever, and eczema.

As part of the National Health and Nutrition Examination Survey 2005-2006, 8203 participants underwent measurement of serum IgE specific for peanut, cow's milk, egg white, and shrimp. Likely FAs (LFAs), possible FAs, and unlikely FAs were determined from food-specific IgE and age-based criteria, allowing estimates of clinical FAs. Demographic risk factors and associations with asthma and related conditions were determined from self-reported data.

"This study is very comprehensive in its scope," said senior study author Darryl Zeldin, MD, acting clinical director at the National Institute of Environmental Health Sciences (NIEHS). "It is the first study to use specific blood serum levels and look at food allergies across the whole life spectrum, from young children aged 1 to 5 to adults 60 and older."

Estimated US prevalence of clinical FAs was 2.5%, including peanut, 1.3%; milk, 0.4%; egg, 0.2%; and/or shrimp, 1.0%. Groups at increased risk of possible FAs or LFAs were non-Hispanic blacks (odds ratio [OR], 3.06; 95% confidence interval [CI], 2.14 – 4.36), males (OR, 1.87; 95% CI, 1.32 – 2.66), and children (OR, 2.04; 95% CI, 1.42 – 2.93).

Compared with study participants without asthma, those with physician-diagnosed asthma had greater risk of all measures of food sensitization. Participants with LFAs had substantially increased adjusted ORs for current asthma (3.8; 95% CI, 0.5 – 10.7) and for an emergency department visit for asthma in the past year (6.9; 95% CI, 2.4 – 19.7).

Limitations of this study include possible overestimation of FA prevalence and inability to determine whether food allergies actually cause asthma attacks or whether asthma and food allergies are both manifestations of a severe allergic profile.

"Population-based serologic data on 4 foods indicate an estimated 2.5% of the US population has FA, and increased risk was found for black subjects, male subjects, and children," the study authors conclude. "In addition, FA could be an under-recognized risk factor for problematic asthma."

The Intramural Research Program of the National Institutes of Health (NIH), NIEHS, supported this study. Some of the study authors report various financial relationships with the Food Allergy Initiative, NIH/National Institute of Allergy and Infectious Diseases, Food Allergy and the Anaphylaxis Network, National Jewish Health, ActoGeniX NV, Intelliject, McNeil Nutritionals, Novartis, Allertein, MastCell Inc, Dannon CO Probiotics, Nutricia, the Wallace Research Foundation, American College of Allergy, Asthma & Immunology, NIH/Human-Animal Interaction Research Program, the Journal of Allergy and Clinical Immunology, and/or the US Food and Drug Administration.

J Allergy Clin Immunol. 2010;126:798-806.


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