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12-08-2013 | Respiratory | Article

Asthma–food allergy combination linked to poor outcomes


Free abstract

medwireNews: US research in a group of inner-city school children with asthma shows that those with food allergies experience greater asthma-related morbidity, use more healthcare resources, and have greater lung function impairment than those without.

“These independent associations remained when adjusting for other atopic disease, including physician-diagnosed eczema, which suggests that concurrent food allergy diagnosis is an independent risk factor for increased asthma morbidity,” comment the authors, who say that increased surveillance may be needed in those children with both asthma and food allergies.

The study, reported in the Journal of Allergy & Clinical Immunology In Practice, involved 300 children with physician-diagnosed asthma, aged 5–13 years, recruited from urban schools. Most of the children were non-White (>95%), and nearly half came from households with an annual income of less than US$ 25,000 (€18,700).

Overall, 73 (24.3%) had physician-diagnosed food allergy, of whom 36 (49.3%) had multiple food allergies.

Authors Wanda Phipatanakul (Harvard Medical School, Boston, Massachusetts) and colleagues found that children with both conditions were around two times more likely to experience daytime coughing and wheezing, to have ever been hospitalized, or to be currently using asthma controller medication than those with asthma alone (hazard ratios=1.95, 2.35, and 1.99, respectively).

These children also had significantly poorer lung function, with a mean % predicted forced expiratory volume in 1 second (FEV1) of 98.1 compared with 103.0 in those with no food allergy, while FEV1/forced vital capacity ratio was 0.855 compared with 0.870.

These effects were even more pronounced in children with multiple food allergies, who had visited their health provider significantly more often in the past year than those without allergies, at a median of 4.5 versus 3.0 times.

Their healthcare resource use was particularly high, being 4.1 times more likely to have been hospitalized in the previous 12 months, and 3.5 times more likely to have been hospitalized for asthma in the same time period, than patients with asthma alone.

The team says that their results add to those of previous studies reporting an increased prevalence of food allergies among children with asthma, as well as a heightened risk for food-induced anaphylaxis and death among those with both conditions.

“Based upon these findings, it is reasonable that children with asthma and food allergies may require increased surveillance by their physicians and caretakers to optimize asthma control,” they conclude.

medwireNews ( is an independent clinical news service provided by Springer Healthcare Limited. © Springer Healthcare Ltd; 2013

By Kirsty Oswald, medwireNews Reporter

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