Childhood Asthma: Are Infant Food Allergies the Missing Link?

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Highlights:

• A study found that children with early food allergies may face four times the risk of asthma and impaired lung function during school age
• Lung development in childhood can influence respiratory and cardiac health in adulthood, making monitoring of food allergies crucial
• Parents and physicians are urged to closely monitor food allergies in children to prevent poorly managed asthma and severe allergic responses

Early childhood food allergies may be associated with a fourfold greater risk of developing asthma and impaired lung function by the time the kid attends school.

The Murdoch Children's Research Institute (MCRI) study is the first to investigate the link between food allergy in infancy and lung function later in childhood, with the authors emphasizing the importance of general physicians (GPs) in monitoring and tailoring care for children with food allergies.

Food Allergy as a Risk Factor for Asthma and Lung Impairment

The authors of the study, which was published in The Lancet Child and Adolescent Health, stress that food allergy is thought to be a risk factor for developing asthma in the context of an allergic disease developing over the course of infancy and childhood, also known as the "atopic march". However, the relationship between infant food allergy phenotypes, lung function, and asthma in childhood is unclear (1^✔).

Lungs of Childhood Shape Lungs in Adulthood

Nonetheless, the main author, MCRI Associate Professor Rachel Peters, said that the association is concerning since lower lung growth in children is related with adult concerns such as respiratory and cardiac disorders, and early-life food allergies should be properly monitored.

‘Food allergies as a baby could increase the chances of lung impairment and asthma by the time the child goes to school, according to a new study. #Asthma #Allergy’

"Lung development is related to a child's height and weight, and children with a food allergy can be shorter and lighter compared to their peers without an allergy - this could explain the link between food allergy and lung function," she said.

"There are also similar immune responses involved in the development of both food allergy and asthma. The growth of infants with food allergy should be monitored."

"We encourage children who are avoiding foods because of their allergy to be under the care of a dietitian so that nutrition can be catered for to ensure healthy growth."

Babies with Food Allergies are at a Four-Fold Risk of Developing Asthma

The article includes findings from the HealthNuts cohort study, which enrolled 5276 one-year-olds for skin prick testing to four common food allergens (egg, peanut, sesame, and either shrimp or cow's milk) as well as an oral meal challenge to screen for allergy. Following a six-year follow-up with further food allergy and lung function evaluations, it was discovered that 13.7% of the children had asthma.

Babies with food allergies were nearly four times more likely to develop asthma at six years of age than those who did not have a food allergy.

Food allergy in infancy, whether cured or not, is linked to lung function impairments and asthma at six years of age, with the largest substantial risk shown in infants whose food allergy lasted to age six compared to those who had outgrown their allergy.

Urging Parents and Physicians to Closely Monitor Food Allergies

The authors advise healthcare practitioners and parents to be mindful of any asthma symptoms in children with food allergies, since poorly managed asthma' has been linked to severe food-induced allergic responses and anaphylaxis.

They emphasize that, prior to any diagnosis, parents may be ignorant of the relationship between food allergy and asthma and may only focus on the food allergy, with asthma remaining unnoticed.

Associate Professor Peters hopes that her team's results would raise awareness among both families and physicians.

"General practitioner can play an important role in monitoring the respiratory health of children with food allergies and ensuring that appropriate management strategies are in place," she said.

The authors suggest that follow-up studies of food allergy therapies provide a chance to further investigate whether avoiding certain food sensitivities improves respiratory health.

Reference:

1. Infant food allergy phenotypes and association with lung function deficits and asthma at age 6 years: a population-based, prospective cohort study in Australia - (https:www.thelancet.com/journals/lanchi/article/PIIS2352-4642(23)00133-5/fulltext)

Source: Medindia

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