According to the researchers, this is the first time that IgE antibodies to common meals have been associated with an elevated risk of cardiovascular mortality. The findings do not establish convincingly that food antibodies cause the higher risk, but they do expand on earlier research linking allergic inflammation and heart disease.
“People who had an antibody called IgE to foods that they regularly eat seemed to be at increased risk for dying from heart disease,” said Keet, who is the corresponding author of the paper. “We were surprised by these findings because it is very common to have IgE in foods (about 15% of American adults have IgE to common food allergens), and most people don’t have any symptoms when they eat the food. As allergists, our thinking has been that it is not important if people have IgE to foods, as long as they don’t have symptoms when they eat the food,” she said.
This study, which was supported by the National Institute of Allergy and Infectious Diseases and a AAAAI Faculty Development Award to her coauthor Jeff Wilson at the University of Virginia, used two methodologies to investigate the relationship between IgE sensitization to foods and cardiovascular mortality. The researchers analyzed data from 4,414 adults who took part in the National Health and Examination Survey (NHANES) and 960 people who took part in the Multi-Ethnic Study of Atherosclerosis (MESA) cohort at the Wake Forest location. MESA participants were enrolled from 2000 to 2002 and monitored for up to 19 years. Participants were enrolled in the NHANES from 2005 to 2006, and data on mortality was collected for up to 14 years.
Food Sensitivity Linked to Heart Disease
For the NHANES group, total and specific IgE was tested on cow’s milk, egg, peanut, shrimp, and a panel of aeroallergens. The MESA group tested positive for IgE in cow’s milk, alpha-gal, peanut, dust mite, and timothy grass. In the NHANES, 229 cardiovascular fatalities were recorded, as well as 960 MESA deaths. Milk sensitivity was shown to be notably common in both the NHANES and the MESA. Food hypersensitivity to shrimp and peanut were also revealed to be a significant risk factors for heart disease. For the NHANES group, total and specific IgE levels were evaluated in response to cow’s milk, egg, peanut, shrimp, and a panel of aeroallergens. In the MESA group, IgE antibodies to cow’s milk, alpha-gal, peanut, dust mite, and timothy grass were measured. NHANES recorded 229 cardiovascular deaths and 960 MESA deaths. Milk sensitivity was shown to be notably common in both NHANES and MESA. Researchers also discovered that dietary sensitivity to shrimp and peanuts were both risk factors for heart disease.
It is also worth noting that the findings show links with food sensitivity rather than clinical allergy. Although researchers did not have access to clinical food allergy information in each cohort, they assumed that individuals who reported regularly eating a food allergen on food frequency questionnaires did not have food allergy symptoms. As a result, the data demonstrating how connections were increased when researchers eliminated people who avoided the meal suggest that these findings are most applicable to those who have not been diagnosed with food allergy. According to Keet, the findings raise concerns about whether these non-allergic people may suffer long-term repercussions from eating foods to which they are sensitized.
According to the study, cardiovascular illness had not previously been recognized as a long-term effect of food sensitization, despite two recent publications associating IgE with the unique carbohydrate allergen alpha-gal with coronary artery disease. However, there is now strong evidence that allergic-type immune pathways are important in normal cardiac physiology and heart disease. Because the link between milk sensitization and cardiovascular mortality was discovered recently, Keet believes there is still much more to learn about the role of food sensitization and nutrition in the development of cardiovascular disease.
“More research needs to be done about how sensitization to common food allergens is related to cardiovascular disease,” she said. “While this study provides good evidence of an association between sensitization to these allergens and death from cardiovascular disease, there is much work to be done to understand if this is a causal relationship.”
- IgE to common food allergens is associated with cardiovascular mortality in the National Health and Examination Survey and the Multi-Ethnic Study of Atherosclerosis – (https:www.jacionline.org/article/S0091-6749(23)01251-4/fulltext)