Liat Nachshon1, Michael R Goldberg1, Naama Schwartz2, Tali Sinai3, Roni Amitzur-Levy4, Arnon Elizur5, Eli Eisenberg6, Yitzhak Katz7. 1. Allergy and Immunology Institute, "Assaf-Harofeh" Medical Center, Zerifin, Israel. 2. School of Public Health, University of Haifa, Haifa, Israel. 3. School of Nutritional Sciences, The Hebrew University of Jerusalem, Rehovot, Israel. 4. Allergy and Immunology Institute, "Assaf-Harofeh" Medical Center, Zerifin, Israel; School of Nutritional Sciences, The Hebrew University of Jerusalem, Rehovot, Israel. 5. Allergy and Immunology Institute, "Assaf-Harofeh" Medical Center, Zerifin, Israel; Department of Pediatrics, Sackler Faculty of Medicine, Tel Aviv, Israel. 6. Raymond and Beverly Sackler School of Physics and Astronomy, Tel Aviv University, Tel Aviv, Israel. 7. Allergy and Immunology Institute, "Assaf-Harofeh" Medical Center, Zerifin, Israel; Department of Pediatrics, Sackler Faculty of Medicine, Tel Aviv, Israel. Electronic address: ykatz49@gmail.com.
Abstract
BACKGROUND: IgE-mediated cow's milk-allergic (IgE-CMA) patients provide a valuable model for studying the relationship between dairy intake and bone mineral density (BMD) because they are unable to consume even minor amounts of dairy foods. OBJECTIVE: To determine the effects of dairy restriction on BMD in young adult IgE-CMA patients. METHODS: A prospective observational study was conducted from July 2012 to June 2013 at the Allergy unit of the Assaf-Harofeh Medical Center. Densitometric measurements of postpubertal patients diagnosed with IgE-CMA (group I, n = 33) were compared with those of volunteers matched for age and sex without IgE-CMA (control group II, n = 24). In a second analysis, group I and II patients were compared with IgE-CMA patients who after desensitization consumed milk for 12 to 39 months before analysis (group III, n = 12). RESULTS: Densitometric measurements (average T scores and Z scores) of the hip, femoral neck, and lumbar spine of IgE-CMA patients were significantly lower than of those in the control group (P < .0001). A T score below -2.5 SD, identifying a risk for osteoporosis, was found in 27% of IgE-CMA patients but in none of the controls (P = .0071). Calcium intake was severely reduced in allergic patients than in controls (P < .0001). BMD measurements in group III were significantly greater than in group I (P < .0001) and unchanged from the control group. CONCLUSIONS: Patients with IgE-CMA have a significant risk of reduced BMD and early osteoporosis, which appears to be reversible on milk desensitization. Adequate calcium intake is not achieved while on a nondairy diet, requiring investigation into optimal nutritional protocols for these patients.
BACKGROUND: IgE-mediated cow's milk-allergic (IgE-CMA) patients provide a valuable model for studying the relationship between dairy intake and bone mineral density (BMD) because they are unable to consume even minor amounts of dairy foods. OBJECTIVE: To determine the effects of dairy restriction on BMD in young adult IgE-CMA patients. METHODS: A prospective observational study was conducted from July 2012 to June 2013 at the Allergy unit of the Assaf-Harofeh Medical Center. Densitometric measurements of postpubertal patients diagnosed with IgE-CMA (group I, n = 33) were compared with those of volunteers matched for age and sex without IgE-CMA (control group II, n = 24). In a second analysis, group I and II patients were compared with IgE-CMA patients who after desensitization consumed milk for 12 to 39 months before analysis (group III, n = 12). RESULTS: Densitometric measurements (average T scores and Z scores) of the hip, femoral neck, and lumbar spine of IgE-CMA patients were significantly lower than of those in the control group (P < .0001). A T score below -2.5 SD, identifying a risk for osteoporosis, was found in 27% of IgE-CMA patients but in none of the controls (P = .0071). Calcium intake was severely reduced in allergicpatients than in controls (P < .0001). BMD measurements in group III were significantly greater than in group I (P < .0001) and unchanged from the control group. CONCLUSIONS:Patients with IgE-CMA have a significant risk of reduced BMD and early osteoporosis, which appears to be reversible on milk desensitization. Adequate calcium intake is not achieved while on a nondairy diet, requiring investigation into optimal nutritional protocols for these patients.
Authors: P Bégin; E S Chan; H Kim; M Wagner; M S Cellier; C Favron-Godbout; E M Abrams; M Ben-Shoshan; S B Cameron; S Carr; D Fischer; A Haynes; S Kapur; M N Primeau; J Upton; T K Vander Leek; M M Goetghebeur Journal: Allergy Asthma Clin Immunol Date: 2020-03-18 Impact factor: 3.406
Authors: Nikola K Hamilton; Omorogieva Ojo; Amanda Rodrigues Amorim Adegboye Journal: Int J Environ Res Public Health Date: 2020-09-30 Impact factor: 3.390