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Childhood obesity may be associated with more allergies
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Obesity may contribute to the increasing prevalence of allergic disease in children, according to data from the National Health and Nutrition Examination Survey 2005-2006.
Researchers examined data on 4,111 children aged 2 to 19 years, and looked at the total and allergen-specific immunoglobulin E or antibody levels to a large panel of indoor, outdoor and food allergens, body weight, and responses to a questionnaire about diagnoses of hay fever, eczema and allergies. Obesity was defined as ≥95th percentile of BMI for age; overweight was defined as ≥85th percentile to <95th percentile.
Obese or overweight children had higher immunoglobulin E levels, and obese children were about 26% more likely to have allergies than children of normal weight.
Food allergies were particularly more common among obese children — 59% higher compared with normal-weight children.
The researchers reported an increased OR for atopy (1.26) — any positive specific immunoglobulin E measurement — among obese children compared with normal-weight children, an association that “was driven largely by allergic sensitization to food.” Further, c-reactive protein levels were associated with total immunoglobulin E levels, food sensitization and atopy.
“While the results from this study are interesting, they do not prove that obesity causes allergies,” Darryl Zeldin, MD, acting clinical director at the National Institute of Environmental Health Sciences, said in a press release. “More research is needed to further investigate this potential link.” – by Jennifer Southall
Zeldin D. J Aller Clin Immun. 2009;123:1163-1169.
Although the precise pathogenetic mechanism connecting obesity to asthma is not known with certainty, recent scientific evidence demonstrating an activated innate immune state of adipose tissue may lead to a better understanding of the pathogenesis of a variety of diseases, including asthma where inflammation plays a central role. Adipose tissue is now known to be metabolically active and capable of releasing proinflammatory mediators such as interkeukin-6, tumor necrosis factor-alpha and c-reactive protein, as well as adipokines such as leptin, which are not only involved in innate immune pathways but also drive a neutrophilic pattern of airway inflammation that is increasingly recognized as a key element in asthma. In addition to strategies directed to reducing dietary intake, new therapeutic strategies aimed at addressing diet-induced innate immune activation associated with obesity may be developed which will have profound clinical implications.
– Joseph A. Bellanti, MD
Director of the International Immunology Center,
Georgetown University Medical Center