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Journal Scan
Allergy & Clinical Immunology, August 2004
Posted 09/24/2004
Margaret A. Clark, BA, RN, RRT
The Allergy & Clinical Immunology Journal Scan is the clinician's guide to the latest clinical research findings in American Journal of Respiratory and Critical Care Medicine, Chest, European Respiratory Journal, JAMA, The New England Journal of Medicine, and other important journals. Short summaries of feature articles include links to the article abstracts. (Access to full-text articles usually requires registration at the specific journal's Web site.)
From
Pediatrics
July 2004 (Volume 114, Number 1)
Early Infant Multivitamin Supplementation Is Associated With Increased Risk for Food Allergy and Asthma
Milner JD, Stein DM, McCarter R, Moon RY
Pediatrics. 2004;114(1):27-32
Several studies have identified an association between asthma and the antioxidant properties of vitamin supplementation.[1-3] Most of the studies reviewed the patients' vitamin usage at the time of diagnosis. This study used data from the National Maternal and Infant Health Survey (NMIHS, 1988) and the Longitudinal Follow-up (LF, 1991) of the same patients. The researchers assessed whether early vitamin supplementation during infancy increased the risk for the development of asthma and food allergies during early childhood.
Methods
The NMIHS evaluated the prenatal, maternal, and infant data of approximately 8000 mothers with infants born in 1988. The LF evaluated the health status of these same infants in 1991. The researchers defined early vitamin supplementation as vitamin use within the first 6 months. It should be noted that African Americans with low socioeconomic status, breastfed babies, and premature infants were intentionally overrepresented in the survey data. This was done because these groups are more likely to have been instructed to include vitamin supplementation in the babies' diets.
Results
The surveyed participants included 51.2% African Americans, 46% whites, and 3% other ethnicities. Some 50.2% of those surveyed had a household income of < $20,000. Of the African American infants, 26.2% were premature, 20.9% of non-African American infants were premature, and 40% of the babies had been breastfed for some time. Overall, 32% of the infants had received supplementation before the age of 3 months, 41% before the age of 6 months, and 42% by the age of 3 years. Eight hundred fifty (10.5%) of total respondents reported having been professionally diagnosed with asthma. The researchers found that African American children who received vitamin supplementation before 6 months of age had an increased risk for developing asthma by the age of 3 years (odds ratio [OR] 1.27, 95% confidence interval [CI] 1.04-1.56; P = .022). They did not find this correlation to be true for non-African American infants (OR 0.91, 95% CI 0.70-1.18; P = .479). They also did not find that vitamin supplementation at 3 years of age increased the risk for asthma.
Food allergies were professionally diagnosed in 396 (4.9%) of the total respondents. When the infants were stratified by feeding status, formula-fed infants who had received vitamin supplementation within 3 months (OR 1.75, 95% CI 1.29-2.38; P = .001) and 6 months of age (OR 1.63, 95% CI 1.21-2.20; P = .001) were at increased risk for developing food allergies by 3 years of age. The children who had received supplementation by 3 years of age, regardless of feeding status, also showed an increased risk for food allergies. Breastfed and formula-fed babies did not show an increased risk for food allergies (OR 1.62, 95% CI 1.19-2.21; P = .002 and OR 1.39, 95% CI 1.03-1.88; P = .031, respectively).
Conclusion
The researchers concluded that vitamin supplementation before 3-6 months of age increases the risk for asthma in African American children. Supplementation also increases the risk for food allergies in formula-fed children.
References
1. Picado C, Deulofeu R, Llconart R, et al. Dietary micronutrients/ antioxidants and their relationship with bronchial asthma severity. Allergy. 2001;56:43-49.
2. Fogarty A, Lewis S, Weiss S, Britton J. Dietary vitamin E, IgE concentrations, and atopy. Lancet. 2000;356:1573-1574.
3. Baker JC, Ayres JG. Diet and asthma. Respir Med.
