Evaluating the Associations of Race, Ethnicity, and Food Allergens in the Development of Childhood Asthma: Re-analysis of Publicly Available Retrospective Cross-Sectional Cohort Data

Asthma is among the most prevalent chronic diseases affecting children worldwide. Sociodemographic factors, such as race and ethnicity, as well as food allergens and their association with asthma, have been extensively studied in an individual manner. Less is known about how food allergens can influence the effect of sociodemographic factors on childhood asthma prevalence. In this study, we re-analyzed a publicly available retrospective cross-sectional cohort dataset of childhood asthma. Multiple logistic regression of asthma by race and ethnicity, before and after adjustment by the most prevalent allergens, was implemented to the dataset. Hispanic individuals showed a higher odds risk (ORs; 1.30, CI 1.26 – 1.35) of asthma than Non-Hispanic individuals (0.24, CI 0.23 – 0.25), but after adjustment by most frequent food allergens reactivities (shellfish, peanut, and milk), the asthma odd risks were comparable (Hispanic, 3.62 [CI 3.49 – 3.76]; Non-Hispanic, 3.51 [3.47 – 3.52]). When considering race, Black individuals (1.90, CI 1.87 – 1.94) had higher ORs of asthma than White individuals (0.21, CI 0.20 – 0.22), Asian/Pacific Islander individuals (1.00, CI 0.95 – 1.05), and Other/Unknown races (1.14, CI 1.11 – 1.27). Although the ORs increased by three to four times for all races after adjusting for the most frequent food allergen reactivities, the same pattern of childhood asthma remained when considering races (in this order, Black, Other/Unknown, Asian/Pacific Islander, and White). In the dataset evaluated in this study, food allergens modified the association of race and ethnicity with the development of asthma. Therefore, public health interventions that gear towards the incidence of childhood asthma should contemplate the interplay and differences in nutrition among races and ethnicities.