Food allergy in at-risk adolescents with asthma: A key area for focus

Asthma affects more than 6.2 million children in the United States and is a major source of chronic disease burden. Concurrent food allergy (FA) may be a risk factor for worse asthma outcomes.

To estimate the prevalence of FA among a cohort of adolescents with persistent asthma and assess whether FA is an independent risk factor for asthma morbidity.

We included 342 adolescents aged 12 to 16 years with persistent asthma from the Rochester city school district who participated in the School-Based Asthma Care for Teens trial between 2014 and 2018. Multivariable models were used to estimate the association between FA and asthma morbidity.

Overall, 29% of adolescents with asthma reported having a FA. Although there were no statistically significant differences in daytime asthma symptoms, teens with FA had higher fractional exhaled nitric oxide (47.5 vs 33.9 P = .002) and reported more days with activity limitation owing to asthma (3.1 vs 2.3 days/2 weeks, P = .03) compared with teens without FA. Less than half (42%) of adolescents with FA had an epinephrine autoinjector.

This study found FA to be common among this cohort of adolescents with asthma. Although FA was not related to asthma symptom severity, adolescents with FA had higher fractional exhaled nitric oxide and more activity limitation, and most did not have epinephrine autoinjectors. A history of FA 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.