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Food allergies common in children with autism

Food allergies were the most common of allergic conditions found in children with autism, according to findings recently published in JAMA Network Open.

“A few previous studies have examined the association between allergic conditions and [autism spectrum disorder]. However, their results have been inconsistent and inconclusive, and most of those studies focused on respiratory allergy and skin allergy,” Guifeng Xu, MD, of the department of epidemiology at the University of Iowa and colleagues wrote.

“Although gastrointestinal disorders are more common in children with [autism spectrum disorder than those with typical development, epidemiologic evidence for the association between food allergy and [autism spectrum disorder] is sparse. Limited and suggestive evidence indicates that food allergy is related to increased irritability and poorer functional outcomes in [autism spectrum disorder] and that exclusion of hyperallergenic foods might improve behavior in children with [autism spectrum disorder],” they added.

Researchers analyzed National Health Interview Survey data from 199,520 children aged 3 to 17 years. Of this total, 51.47% were boys; 48.72% were non-Hispanic white, 27.8% were Hispanic, 15.42% were non-Hispanic black and 8.06% were another ethnicity.

Researchers added that the associations between autism and food allergy remained significant even after the data were adjusted for age, family highest education level, family income level, geographical region, mutual adjustment for other allergic conditions, race and sex. Autism spectrum disorder increased in association with food allergy (OR = 2.29; 95% CI, 1.87-2.81), skin allergy (OR = 1.5; 95% CI, 1.28-1.77) and respiratory allergy (OR = 1.28; 95% CI, 1.1-1.5), when comparing children with these conditions and those without.

“Experimental evidence supports the notion that food allergy may increase the risk of [autism spectrum disorder],” Xu and colleagues wrote. “Large prospective cohort studies starting from birth or early life are needed to confirm our findings.”

In a related editorial, Christopher J. McDougle, MD, of the Lurie Center for Autism at Massachusetts General Hospital, addressed the novelty of the study’s findings despite the increasing amount of evidence supporting an immune-mediated subtype of autism spectrum disorder.

Food allergies were the most common of allergic conditions found in children with autism, according to findings recently published in JAMA Network Open.

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“To my knowledge, Xu et al are the first to document the association of food allergy with [autism spectrum disorder] with confidence, in part based on the large sample size they accessed,” he wrote.

McDougle also cautioned clinicians not to make hasty decisions in treating children with autism spectrum disorder who have allergies.

“Patients with [autism spectrum disorder] who are minimally verbal to nonverbal may be unable to describe the pain and discomfort they experience secondary to food allergy and subsequent inflammation in the gastrointestinal tract. Instead, their physical distress may manifest as irritability, aggression, and/or self-injury,” he wrote.

“It is important to underscore the need for health care professionals to conduct a thorough history and physical examination to rule out identifiable medical causes of aberrant behavior, including food allergy and secondary [gastrointestinal] inflammation, before proceeding with treatments designed to reduce behavior problems,” McDougle added. – by Janel Miller

Disclosures : The authors report no relevant financial disclosures.