Food Allergies May Increase Risk for Asthma in Children

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After a skin prick test, participants were observed for 15 minutes, wheal size was measured, and identified as positive if wheal ≥1mm.
After a skin prick test, participants were observed for 15 minutes, wheal size was measured, and identified as positive if wheal ≥1mm.

Children with 2 or more food allergies may have a higher risk of developing asthma at age 4 regardless of whether the food allergy resolves, according to a study published in the Journal of Allergy and Clinical Immunology.

In a prospective longitudinal study from Melbourne, Australia, 5276 12-month-old children underwent a skin prick test to identify the presence of an allergic reaction to egg, peanut, and sesame. Children who exhibited a positive result underwent a subsequent oral food challenge. Follow-up at age 4 was completed via questionnaire or phone call to the children's parents.

The purpose of the study was to determine the “relationship between the presence and number of food allergies at age 1 year and asthma at age 4 years.” The study also investigated if the identified associations were also influenced by early life wheeze, eczema, or food allergy persistence versus complete resolution.

Study results found that children with 1 food allergy had an increased risk of developing asthma by age 4 (relative risk [RR] 1.69; 95% CI, 1.29-2.21), with children with 2 or more food allergies at 12 months at a significantly higher risk (RR 2.76; 95% CI 1.94-3.92) compared with children with 1 food allergy (P =.016). Children with an egg allergy had a high risk of developing asthma (RR 2.00; 95% CI, 1.52-2.59); there was no risk with peanut allergy, and the highest risk for asthma was in children with a combination of peanut and egg allergy (RR 2.99; 95% CI, 1.98-4.17).

In addition, study results showed that both a persistent and transient allergy to egg was associated with a high risk of developing asthma when compared to children who had never had an allergy to egg, regardless of whether it resolved by age 4 (P =.18) or not. Both food and eczema allergies were independently associated with asthma at age 4, with an observed additive effect when combined as children with eczema and a food allergy had a higher risk compared with children with eczema alone (P <.001) or a food allergy alone (P =.018). 

Researchers concluded that food allergies in children age 1 is associated with an increased risk of developing asthma at age 4 regardless of whether the food allergies resolved, with multiple food allergies associated with an even higher risk. Therefore, clinicians can identify children with food allergies at high risk for asthma in order to closely monitor and screen them early to provide early management in the event that they develop asthma. 

Reference

Vermeulen EM, Koplin JJ, Dharmage SC, et al. Food allergy is an important risk factor for childhood asthma, irrespective of whether it resolves [published online November 15, 2017]. J Allergy Clin Immunol. doi:10.1016/j.jaip, 2017.10.019

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