Food allergy, dermatologic diseases, and anaphylaxis
Serum nutrient markers and skin prick testing using data from the Third National Health and Nutrition Examination Survey

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Background

Diet nutrients and allergic sensitization both affect the development and severity of asthma, but the interrelationship between oral intake and allergic sensitization is not well characterized, although previous work suggests that a higher vitamin E intake may be protective against allergic sensitization.

Objective

To determine whether serum levels of dietary antioxidants, lipids, and other nutrients are associated with the presence of allergen skin sensitization.

Methods

Cross-sectional logistic regression analysis of 30 serum nutrient levels in relation to 10 skin test allergens in adults and children in the Third National Health and Nutrition Survey.

Results

In adults, allergic skin sensitization was less common in participants with higher serum levels of vitamin E: the adjusted odds ratio (OR) per SD difference in vitamin E level was 0.93 (95% CI, 0.87-0.99). Two of the carotenoids, β-cryptoxanthin and α-carotene, were also inversely associated with allergic skin sensitization (OR, 0.89; 95% CI, 0.83-0.95; and OR, 0.95; 95% CI, 0.91-0.99, respectively). Among adults, serum lycopene had a positive association with allergen sensitization. In youths, however, vitamin A was associated with an increased risk, and high-density lipoprotein cholesterol was associated with a decreased risk of allergic sensitization. The use of vitamin or mineral supplements had little effect on the magnitude of all reported associations.

Conclusion

Overall, there were no strong or consistent associations between serum levels of potentially antiallergic nutrients, and the occurrence of allergic skin sensitization in these data. However limited, findings suggest that increases in vitamin E, carotenoids, and high-density lipoprotein cholesterol may reduce the risk of allergic skin sensitization.

Section snippets

Methods

NHANES III is a survey designed to examine the health and nutrition of the noninstitutionalized US population and includes data for more than 30,000 participants. The cross-sectional survey was conducted between 1988 and 1994, and full details of the design and examination procedure have been published by the National Center for Health Statistics.12 All participants between the ages of 6 and 16 years and a randomly selected sample of 50% of the adults between 17 and 59 years old underwent

Results

Demographic details for eligible adults and children with serum nutrient data are presented in Table I. There were slightly more female subjects than male subjects in both groups, and the distribution of individuals by race and ethnicity was similar. Participants undergoing allergic sensitization testing were all youth and a randomly selected 50% sample of adults; thus, no selection bias is likely. Indeed, there were no notable differences between adults with and without allergic sensitization

Discussion

This study used an existing major data set to determine whether the risk of allergic skin sensitization was associated with blood levels of a range of nutrients. In addition to studying several vitamins and other antioxidants, lipids, and minerals that in previous studies have been directly linked with the expression of allergic skin sensitization, or indirectly linked through effects on asthma or other allergic disease, we also examined other serum nutrient data available in NHANES III. The

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Supported by the Wellcome Trust and National Institutes of Health grant R03HL6659 (Dr Cassano).

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