Asthma affects more than 6.2 million children in the United States and is a major source of chronic disease burden. Concurrent food allergy may be a risk factor for worse asthma outcomes.
To estimate the prevalence of food allergy among a cohort of adolescents with persistent asthma and assess whether food allergy is an independent risk factor for asthma morbidity.
We included 342 adolescents aged 12 – 16 years with persistent asthma from the Rochester City School District, who were participants in the School Based Asthma Care for Teens (SB-ACT) trial between 2014 and 2018. Multivariable models were used to estimate the association between food allergy and asthma morbidity.
Overall, 29% of asthmatic adolescents reported having food allergy. While there were no statistically significant differences in daytime asthma symptoms, teens with food allergy had higher FeNO (47.5 vs 33.9 p=0.002) and reported more days with activity limitation due to asthma (3.1 vs 2.3 days/2 weeks, p=0.032) compared to teens without food allergy. Less than half (42%) of adolescents with food allergy had an epinephrine auto-injector.
Food allergy is common among this cohort of asthmatic adolescents. While food allergy was not related to asthma symptom severity, food allergic adolescents had higher FeNo and more activity limitation, and the majority did not have epinephrine auto-injectors. A history of food allergy and lack of epinephrine autoinjector may increase near fatal outcomes in adolescents with asthma. Preventive measures in addition to standard asthma treatments are warranted for these teens.

Copyright © 2020. Published by Elsevier Inc.