Future asthma risk flagged for babies with food allergy

Having a food allergy in early childhood may be linked with a four-fold increased risk of developing asthma and reduced lung function by the time the child starts school, new research suggests.
 
The Murdoch Children’s Research Institute (MCRI) study is the first to examine this relationship between food allergy in infancy and lung function later in childhood, with the authors acknowledging GPs’ important role in monitoring the respiratory health of children with food allergies and tailoring care.
 
While food allergy is considered an indicator of developing asthma – in the setting of an allergic disease developing over the course of infancy and childhood, or the ‘atopic march’ – the authors of the study, published in The Lancet Child and Adolescent Health, emphasise the relationship between infant food allergy phenotypes and lung function and asthma in childhood ‘is unclear’.
 
Nonetheless, lead author, MCRI Associate Professor Rachel Peters, said the link is ‘concerning’ given reduced lung growth in childhood is also associated with issues in adulthood, including respiratory and heart conditions, and early-life food allergies should be more closely monitored.
 
‘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.’
 
The research presents results from the HealthNuts cohort study in Melbourne, which recruited 5276 one-year-olds who had skin prick testing to four common food allergens (egg, peanut, sesame, and either shrimp or cow’s milk) and an oral food challenge to test for allergy. The children were then followed up at six years with further food allergy and lung function assessments, finding that 13.7% reported a diagnosis of asthma.
 
Babies with a food allergy were almost four times more likely to develop asthma at six years of age, compared to those without a food allergy.
 
Whether resolved or not, food allergy in infancy is associated with ‘lung function deficits’ and asthma at six years of age, with the most significant risk noted in children whose food allergy persisted to age six compared to those who had outgrown their allergy.
 
The authors recommend that healthcare providers and parents should be aware of any asthma symptoms in children with food allergy, given that ‘poorly controlled asthma’ was also shown as a risk factor for ‘severe food-induced allergic reactions’ and anaphylaxis.
 
They note that often parents may be unaware of the link between food allergy and asthma prior to any diagnosis and may only focus on the food allergy, with asthma not on their radar.
 
Associate Professor Peters told newsGP she hopes her team’s findings ‘create greater awareness’ among families and clinicians alike.
 
‘GPs 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 conclude that follow-up studies of interventions to prevent food allergy are an opportunity to further examine whether preventing these food allergies improves respiratory health.
 
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asthma children’s health food allergy lung function respiratory health