The School of Nutritional Sciences, The Hebrew University of Jerusalem, Rehovot, Israel.
Institute of Allergy, Immunology, and Pediatric Pulmonology, Yitzhak Shamir Medical Center, Zerifin, Israel.
J Allergy Clin Immunol Pract. 2019 Feb;7(2):509-515. doi: 10.1016/j.jaip.2018.11.038. Epub 2018 Dec 7.
Growth impairment was previously described in milk-allergic children but was not examined in adults on reaching final height.
To investigate the dietary intake and final stature of young adults with IgE-mediated cow's milk allergy (IgE-CMA) as compared with nonallergic controls.
Eighty-seven patients with IgE-CMA, median age 19.5 years (interquartile range [IQR], 17.3-22.7), and 36 control participants without food allergies, median age 22.7 years (IQR, 18.9-26.1), were studied. Anthropometric and nutritional data were collected. Age and gender z-scores were determined according to the Centers for Disease Control and Prevention growth charts. Nutrient intake assessment was based on dietary records. Individuals with conditions or treatments affecting bone metabolism or growth, other than asthma, were excluded.
Mean values of height z-scores were significantly reduced in CMA subjects compared with controls (-0.64 ± 0.9 vs -0.04 ± 0.7, P = .001). In contrast, no differences were found between the 2 groups in weight and body mass index z-scores. Patients with CMA had significantly lower intake of protein, and several essential vitamins (A, B12, and riboflavin) and minerals (calcium, potassium, phosphorus, magnesium, and zinc) compared with controls (P < .05), but the intakes of calories, carbohydrate, and fat were not significantly different between the 2 groups. Differences between actual and expected (based on midparental height) height z-scores were comparable in CMA subjects with or without asthma and between those with and without additional food allergies.
Young adults who have CMA from infancy are at risk of not reaching their growth potential. Growth and nutritional monitoring and appropriate dietary intervention are of particular importance in these at-risk individuals.
先前有研究描述过牛奶过敏儿童的生长受损,但并未在成年后达到最终身高时对其进行研究。
与非过敏对照者相比,调查 IgE 介导的牛奶过敏(IgE-CMA)的年轻成年人的饮食摄入和最终身高。
研究了 87 名 IgE-CMA 患者(中位年龄 19.5 岁[四分位间距(IQR):17.3-22.7])和 36 名无食物过敏的对照者(中位年龄 22.7 岁[IQR:18.9-26.1])。收集了人体测量学和营养数据。根据疾病预防控制中心的生长图表,确定了年龄和性别 z 分数。根据饮食记录评估了营养素摄入量。排除了除哮喘以外,会影响骨骼代谢或生长的疾病或治疗的个体。
与对照组相比,CMA 患者的身高 z 分数平均值明显降低(-0.64 ± 0.9 与-0.04 ± 0.7,P =.001)。相比之下,两组在体重和体重指数 z 分数方面没有差异。与对照组相比,CMA 患者的蛋白质以及几种必需维生素(A、B12 和核黄素)和矿物质(钙、钾、磷、镁和锌)的摄入量明显较低(P <.05),但两组的热量、碳水化合物和脂肪摄入量没有明显差异。有或没有哮喘的 CMA 患者以及有或没有其他食物过敏的患者,实际身高 z 分数与预期身高 z 分数(基于中父母身高)的差异是可比的。
从婴儿期就患有 CMA 的年轻人有无法达到生长潜力的风险。在这些高危人群中,生长和营养监测以及适当的饮食干预尤为重要。