Association Between Folate Metabolites and the Development of Food Allergy in Children

Emily C. McGowan, Xiumei Hong, J. Selhub, Ligi Paul, Robert A. Wood, Elizabeth C. Matsui, Corinne A. Keet, Xiaobin Wang

Research output: Contribution to journalArticle

Abstract

Background: Studies on the association between folate/folic acid exposure and the development of allergic disease have yielded inconsistent results, which may be due, in part, to lack of data distinguishing folate from folic acid exposure. Objective: To examine the association between total folate, 5-methyltetrahydrofolate (5-MTHF), and unmetabolized folic acid (UMFA) concentrations at birth and in early childhood and the development of food sensitization (FS) and food allergy (FA). Methods: A nested case control study was performed in the Boston Birth Cohort (BBC). Total folate, 5-MTHF, and UMFA were measured at birth and in early childhood. Based on food-specific IgE (sIgE) levels, diet, and clinical history, children were classified as FS (sIgE ≥0.35 kU/L), FA, or non-FS/FA (controls). Folate concentrations were divided into quartiles, and multiple logistic regression was used to estimate odds ratios (ORs) and 95% confidence intervals (CIs). Results: Of a total of 1394 children, 507 children with FS and 78 with FA were identified. Although mean total folate concentrations at birth were lower among those who developed FA (30.2 vs 35.3 nmol/L; P = .02), mean concentrations of the synthetic folic acid derivative, UMFA, were higher (1.7 vs 1.3 nmol/L, P = .001). Higher quartiles of UMFA at birth were associated more strongly with FA (OR 8.50; 95% CI 1.7-42.8; test for trend P = .001). Neither early childhood concentrations of 5-MTHF nor UMFA were associated with the development of FS or FA. Conclusion: Among children in the BBC, higher concentrations of UMFA at birth were associated with the development of FA, which may be due to increased exposure to synthetic folic acid in utero or underlying genetic differences in synthetic folic acid metabolism.

Original languageEnglish (US)
JournalJournal of Allergy and Clinical Immunology: In Practice
DOIs
StatePublished - Jan 1 2019

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Food Hypersensitivity
Folic Acid
Parturition
Food
Immunoglobulin E
Odds Ratio
Confidence Intervals

Keywords

  • 5-Methyltetrahydrofolate
  • Folate
  • Folic acid
  • Food allergy
  • Unmetabolized folic acid

ASJC Scopus subject areas

  • Immunology and Allergy

Cite this

@article{f1debe5a28c54ad0905dee534a0c97fb,
title = "Association Between Folate Metabolites and the Development of Food Allergy in Children",
abstract = "Background: Studies on the association between folate/folic acid exposure and the development of allergic disease have yielded inconsistent results, which may be due, in part, to lack of data distinguishing folate from folic acid exposure. Objective: To examine the association between total folate, 5-methyltetrahydrofolate (5-MTHF), and unmetabolized folic acid (UMFA) concentrations at birth and in early childhood and the development of food sensitization (FS) and food allergy (FA). Methods: A nested case control study was performed in the Boston Birth Cohort (BBC). Total folate, 5-MTHF, and UMFA were measured at birth and in early childhood. Based on food-specific IgE (sIgE) levels, diet, and clinical history, children were classified as FS (sIgE ≥0.35 kU/L), FA, or non-FS/FA (controls). Folate concentrations were divided into quartiles, and multiple logistic regression was used to estimate odds ratios (ORs) and 95{\%} confidence intervals (CIs). Results: Of a total of 1394 children, 507 children with FS and 78 with FA were identified. Although mean total folate concentrations at birth were lower among those who developed FA (30.2 vs 35.3 nmol/L; P = .02), mean concentrations of the synthetic folic acid derivative, UMFA, were higher (1.7 vs 1.3 nmol/L, P = .001). Higher quartiles of UMFA at birth were associated more strongly with FA (OR 8.50; 95{\%} CI 1.7-42.8; test for trend P = .001). Neither early childhood concentrations of 5-MTHF nor UMFA were associated with the development of FS or FA. Conclusion: Among children in the BBC, higher concentrations of UMFA at birth were associated with the development of FA, which may be due to increased exposure to synthetic folic acid in utero or underlying genetic differences in synthetic folic acid metabolism.",
keywords = "5-Methyltetrahydrofolate, Folate, Folic acid, Food allergy, Unmetabolized folic acid",
author = "McGowan, {Emily C.} and Xiumei Hong and J. Selhub and Ligi Paul and Wood, {Robert A.} and Matsui, {Elizabeth C.} and Keet, {Corinne A.} and Xiaobin Wang",
year = "2019",
month = "1",
day = "1",
doi = "10.1016/j.jaip.2019.06.017",
language = "English (US)",
journal = "Journal of Allergy and Clinical Immunology: In Practice",
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TY - JOUR

T1 - Association Between Folate Metabolites and the Development of Food Allergy in Children

AU - McGowan, Emily C.

AU - Hong, Xiumei

AU - Selhub, J.

AU - Paul, Ligi

AU - Wood, Robert A.

AU - Matsui, Elizabeth C.

AU - Keet, Corinne A.

AU - Wang, Xiaobin

PY - 2019/1/1

Y1 - 2019/1/1

N2 - Background: Studies on the association between folate/folic acid exposure and the development of allergic disease have yielded inconsistent results, which may be due, in part, to lack of data distinguishing folate from folic acid exposure. Objective: To examine the association between total folate, 5-methyltetrahydrofolate (5-MTHF), and unmetabolized folic acid (UMFA) concentrations at birth and in early childhood and the development of food sensitization (FS) and food allergy (FA). Methods: A nested case control study was performed in the Boston Birth Cohort (BBC). Total folate, 5-MTHF, and UMFA were measured at birth and in early childhood. Based on food-specific IgE (sIgE) levels, diet, and clinical history, children were classified as FS (sIgE ≥0.35 kU/L), FA, or non-FS/FA (controls). Folate concentrations were divided into quartiles, and multiple logistic regression was used to estimate odds ratios (ORs) and 95% confidence intervals (CIs). Results: Of a total of 1394 children, 507 children with FS and 78 with FA were identified. Although mean total folate concentrations at birth were lower among those who developed FA (30.2 vs 35.3 nmol/L; P = .02), mean concentrations of the synthetic folic acid derivative, UMFA, were higher (1.7 vs 1.3 nmol/L, P = .001). Higher quartiles of UMFA at birth were associated more strongly with FA (OR 8.50; 95% CI 1.7-42.8; test for trend P = .001). Neither early childhood concentrations of 5-MTHF nor UMFA were associated with the development of FS or FA. Conclusion: Among children in the BBC, higher concentrations of UMFA at birth were associated with the development of FA, which may be due to increased exposure to synthetic folic acid in utero or underlying genetic differences in synthetic folic acid metabolism.

AB - Background: Studies on the association between folate/folic acid exposure and the development of allergic disease have yielded inconsistent results, which may be due, in part, to lack of data distinguishing folate from folic acid exposure. Objective: To examine the association between total folate, 5-methyltetrahydrofolate (5-MTHF), and unmetabolized folic acid (UMFA) concentrations at birth and in early childhood and the development of food sensitization (FS) and food allergy (FA). Methods: A nested case control study was performed in the Boston Birth Cohort (BBC). Total folate, 5-MTHF, and UMFA were measured at birth and in early childhood. Based on food-specific IgE (sIgE) levels, diet, and clinical history, children were classified as FS (sIgE ≥0.35 kU/L), FA, or non-FS/FA (controls). Folate concentrations were divided into quartiles, and multiple logistic regression was used to estimate odds ratios (ORs) and 95% confidence intervals (CIs). Results: Of a total of 1394 children, 507 children with FS and 78 with FA were identified. Although mean total folate concentrations at birth were lower among those who developed FA (30.2 vs 35.3 nmol/L; P = .02), mean concentrations of the synthetic folic acid derivative, UMFA, were higher (1.7 vs 1.3 nmol/L, P = .001). Higher quartiles of UMFA at birth were associated more strongly with FA (OR 8.50; 95% CI 1.7-42.8; test for trend P = .001). Neither early childhood concentrations of 5-MTHF nor UMFA were associated with the development of FS or FA. Conclusion: Among children in the BBC, higher concentrations of UMFA at birth were associated with the development of FA, which may be due to increased exposure to synthetic folic acid in utero or underlying genetic differences in synthetic folic acid metabolism.

KW - 5-Methyltetrahydrofolate

KW - Folate

KW - Folic acid

KW - Food allergy

KW - Unmetabolized folic acid

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