Milk allergy is associated with decreased growth in US Children


Published Online: October 10, 2014

Food allergy has the potential to affect nutrition and growth, yet population-wide studies investigating these issues are limited. Avoidance of a culprit food allergen is the mainstay of treatment for food allergy, but many of these foods are nutritionally rich and important parts of the Western diet. Some studies have suggested that food allergy, and specifically milk allergy, may be risk factors for decreased growth. In a recently published study in The Journal of Allergy and Clinical Immunology, K. Robbins et al utilize the National Health and Nutrition Examination Survey (NHANES) to publish the first description of growth and nutrition in a nationally representative sample of American children with food allergy.

NHANES is a continuously obtained, representative cross-sectional survey of the non-institutionalized US population, and includes questionnaire, dietary, physical examination, and laboratory data collected with the purpose of assessing the health and nutritional status of the American population. In the 2007-2008 and 2009-2010 NHANES datasets, respondents were questioned about presence of food allergy. Children were classified based on reported allergy and triggering foods, and for cow’s milk allergy, lack of recent cow’s milk consumption by report. Age-adjusted height, weight, and BMI percentiles were generated for all children, and comparisons were made between those with and without reported food allergy. Finally, nutrient intake based on 24-hour recall was compared in allergic versus non-allergic children, to investigate whether differences in daily calorie, protein, fat, calcium, or vitamin D exist.

Of the 6,189 children aged 2-17 years who were included, 6.3% were classified as food allergic, and 1.1% cow’s milk allergic. Children with cow’s milk allergy, but not other food allergies, had significantly decreased weight-, height-, and BMI-for age percentiles compared to non-allergic peers, and these differences persisted after controlling for differences in daily nutrient intake (calories, protein, fat, calcium, vitamin D). While milk avoidance itself was associated with a trend towards lower growth measurements, children with milk allergy appeared smaller than those without allergy who also did not drink milk. In addition, children with milk allergy had lower calcium intakes, and trended towards lower consumption of total calories and vitamin D. The authors’ findings were consistent with smaller studies that have suggested that children with cow’s milk allergy are at risk for decreased growth and nutrient intake, and highlight the need for close monitoring in this at-risk population.

The Journal of Allergy and Clinical Immunology (JACI) is an official scientific journal of the AAAAI, and is the most-cited journal in the field of allergy and clinical immunology.

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