Folic acid concentrations at birth may be associated with food allergy in children

Folic acid exposure in utero may be associated with food allergy development in children, according to research presented at the American Academy of Allergy, Asthma & Immunology in Orlando.

“Interestingly, while the mean total folate levels at birth were lower among the children that developed a food allergy, mean levels of the synthetic folic acid derivative, unmetabolized folic acid, were higher,” Emily McGowan, MD, of the University of Virginia School of Medicine, said in a press release.

McGowan and colleagues noted that there is an unknown association between total folate, 5-methyltetrahydrofolate (5-MTHF) and unmetabolized folic acid (UMFA) at birth and early life and the development of food allergy. Folic acid, the synthetic form of folate, is often recommended to pregnant women to prevent neural tube defects, such as spina bifida, in children, according to the AAAAI release.

The researchers conducted a nested case control study in the Boston Birth Cohort. A chemiluminescent assay was used to measure total folate and liquid chromatography-tandem mass spectrometry was used to measure 5-MTHF and UMFA at birth and in early life. Other measurements taken in early life included diet, chemical history and specific IgE (sIgE) to common food allergies.

Children were classified as having food allergy or not based on sIgE results and clinical history.

Multiple logistic regression analysis was conducted.

The researchers studied 1,394 children, including 36% with food sensitization (sIgE ≥ 0.35 ku/L) and 5.6% with food allergy. A subset of patients included 502 children who had 5-MTHF and UMFA measured at birth and 362 children who had 5-MTHF and UMFA measured at early life.

Mean folate levels at birth were lower for children who developed food allergy (30.2 vs. 35.3 nmol/L; P = .02); however, mean levels of synthetic folic derivative, UMFA, were higher for that cohort (1.7 vs. 1.3 nmol/L, P = .0001).

There was a strong association between food allergy and higher quartiles of UMFA (OR = 0.94; 95% CI, 1.9-47.2; test for trend, P = .007).

Total folate, 5-HTMF or UMFA levels measured at early life were not associated with the development of food allergy.

The researchers report that the findings may be due to increased exposure to synthetic folic acid in utero or underlying genetic differences.

“More research is needed to conclude whether mothers should consider consuming different sources of folate, like leafy green vegetables, citrus fruits, beans or lentils instead of synthetic forms of folate,” researcher Corinne Keete, MD, MS, PhD, of the division of pediatric allergy/immunology at Johns Hopkins School of Medicine, said in the release. – by Bruce Thiel

Reference:

McGowan EC, et al. Abstract 275. Presented at: American Academy of Allergy, Asthma & Immunology Annual Meeting; March 2-5, 2017; Orlando.

Disclosure: Infectious Diseases in Children was unable to confirm relevant financial disclosures prior to publication.