House CallDec/Jan 2015 Issue

Research Roundup: Food Allergy Slows Growth & More!

The latest medical news for people with allergies and food sensitivities

 

Photo of boy being measured

Photo by Thinkstock/valueline

Food Allergy Slows Growth

Studies show that food-allergic tots tend to lag behind their non-allergic peers in height and weight. Milk-allergic children are particularly vulnerable to growth impairments.

Now a large study published last July in the Journal of Pediatrics has found food-allergic kids with commercial insurance are more likely to fall behind on growth charts than those with state health insurance. It’s unclear why.

Food-allergic children should have their height and weight checked regularly, say researchers. Other studies have also recommended dietary counseling to ensure adequate caloric and nutrient intake.

Inner-City Kids Have More Allergies

One in ten inner-city youngsters has a food allergy, according to a new NIH-funded study. This latest estimate is a stunner because researchers used a strict definition of food allergy, not a self-report which tends to over-estimate allergy’s true occurrence. What’s more, the high prevalence included just three food allergens—peanuts, eggs and milk.

Overall, the American College of Allergy, Asthma and Immunology says about 5 percent of U.S. kids under age 5 has a food allergy. Findings call for more research with inner-city children to help identify modifiable risk factors (like breastfeeding) to curb the skyrocketing incidence of food allergies.

Auto-Injector Size Matters

Epinephrine auto-injectors (EAIs) deliver potentially lifesaving medication during anaphylaxis. However, recent research raises concerns that EAIs may be too short to reach the muscle—where epinephrine is rapidly absorbed—in obese children. The medicine may be injected just under the skin where it’s less effective.

Concerns have also been expressed that EAIs may not work as well on very small children for the opposite reason; the injectors are too long. Canadian researchers found children weighing less than 15 kg (about 33 pounds) were at risk of having the medication injected into bone, not muscle. This risk was especially high in children weighing less than 10 kg (about 22 pounds).

In the study, published last August in Allergy, Asthma & Clinical Immunology, researchers tested two popular EAIs, Epipen® Jr and Allerject® 0.15 mg. Although these EAIs are indicated for larger children (weighing 15 to 30 kg), EAIs with a shorter needle length aren’t currently available and so these products may be prescribed to smaller children.

EoE and Gut Health

Researchers now think gut bacteria may be tied to eosinophilic esophagitis (EoE) risk. EoE is an allergic disease of the esophagus that’s on the rise in children, as well as adults. Symptoms include heartburn, swallowing difficulties and persistent burping.

According to the new study, the rate of EoE was three times higher in children born via C-section and in those given antibiotics early in life. Both events significantly alter the developing gut microbiota, the alphabet soup of bacteria and other organisms that help regulate digestive health and immunity. Breastfeeding didn’t make a difference in EoE risk. Neither did the age at which a baby started eating solid foods.

The research was published in August in the Journal of Allergy and Clinical Immunology: In Practice.

Celiac and Healthy Pregnancy

Having celiac disease doesn’t put you at high risk for pregnancy complications, according to a large study published in August in the American Journal of Gastroenterology. The study showed celiac disease—whether diagnosed or undiagnosed—was not a major source of pregnancy complications like pre-eclampsia, hemorrhage or assisted delivery. Similarly, stillbirth, preterm and low birth weight babies weren’t more common in celiac women.

In related research, published in August in Gastroenterology, investigators found celiac women overall were not more likely to experience infertility. (However, a somewhat higher rate of infertility was seen in younger celiac women, those ages 25 to 29.)

Both study findings are surprising. Over the years, a number of studies have implicated celiac disease, especially undiagnosed (untreated) celiac disease, with infertility, miscarriage, stillbirth, preterm birth and low birth weight deliveries.

Researchers contend that many of these studies were small and focused on special patient populations, like women attending infertility clinics. The two new studies pulled records from huge UK databases (i.e., the general population).

Support for Celiac Screening

It can be difficult to persuade those at risk for celiac disease, like relatives, to get tested. A study published last August in Gastroenterology strengthens the case for screening.

In the study, which was conducted in Finland, celiac relatives were screened for the autoimmune disease and if test results were positive, they were randomly assigned to a gluten-free or regular gluten-containing diet. After one year, the gluten-free group reported improved gastrointestinal symptoms, reduced anxiety and better health than the regular diet group. Importantly, no one in the gluten-free group considered their experience to be negative and most reported that they expected to remain on the gluten-free diet.

For ethical reasons, only those who said they were symptom-free at the study start were able to participate. However, the findings suggest that many may have had subtle symptoms that were only recognized in hindsight.

Individuals at risk for celiac disease include relatives of celiacs, type-1 diabetics, those with certain other autoimmune disorders and those with Down syndrome.

Allergic to Farm Spray

It’s possible to have an allergic reaction to the antibiotic residue used to keep pests off fruits and veggies. This new finding was published in September in the Annals of Allergy, Asthma and Immunology.

According to the report, a ten-year-old girl suffered anaphylaxis after eating blueberry pie, even though she wasn’t allergic to any ingredients in the pie. (She had severe allergies to cow’s milk and penicillin, as well as seasonal allergies and asthma.) After extensive testing, doctors determined the cause of the reaction was streptomycin-contaminated blueberries. Streptomycin is an antibiotic drug also used as a pesticide in fruits and vegetables to combat the growth of bacteria, fungi and algae.

Study authors say this is the first report of this type of allergy, calling it very rare. They add that new FDA regulations may help reduce antibiotic contaminants in food, which could help curb this type of allergy, as well as help reduce antibiotic resistance.

Supplement Use in Celiac

Nearly one in four celiacs takes a dietary supplement to treat persistent celiac symptoms, according to a new U.S. survey. Probiotics were the most frequently used diet supplement.

Although supplement use didn’t seem to help with stubborn symptoms, supplement users rated their quality of life higher than non-users. Researchers don’t know why.

The survey was published in September in the Journal of Clinical Gastroenterology.

Senior medical correspondent Christine Boyd lives in Baltimore.

 

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