title: Decreased bone mineral density in young adult IgE-mediated cow's milk-allergic patients.
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.
authors.affiliation: Allergy and Immunology Institute, "Assaf-Harofeh" Medical Center, Zerifin, Israel.
authors.forename: Liat
authors.initials: L
authors.lastname: Nachshon
authors.affiliation: Allergy and Immunology Institute, "Assaf-Harofeh" Medical Center, Zerifin, Israel.
authors.forename: Michael R
authors.initials: MR
authors.lastname: Goldberg
authors.affiliation: School of Public Health, University of Haifa, Haifa, Israel.
authors.forename: Naama
authors.initials: N
authors.lastname: Schwartz
authors.affiliation: School of Nutritional Sciences, The Hebrew University of Jerusalem, Rehovot, Israel.
authors.forename: Tali
authors.initials: T
authors.lastname: Sinai
authors.affiliation: Allergy and Immunology Institute, "Assaf-Harofeh" Medical Center, Zerifin, Israel; School of Nutritional Sciences, The Hebrew University of Jerusalem, Rehovot, Israel.
authors.forename: Roni
authors.initials: R
authors.lastname: Amitzur-Levy
authors.affiliation: Allergy and Immunology Institute, "Assaf-Harofeh" Medical Center, Zerifin, Israel; Department of Pediatrics, Sackler Faculty of Medicine, Tel Aviv, Israel.
authors.forename: Arnon
authors.initials: A
authors.lastname: Elizur
authors.affiliation: Raymond and Beverly Sackler School of Physics and Astronomy, Tel Aviv University, Tel Aviv, Israel.
authors.forename: Eli
authors.initials: E
authors.lastname: Eisenberg
authors.affiliation: 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.
authors.forename: Yitzhak
authors.initials: Y
authors.lastname: Katz
mesh_terms: D000293:Adolescent; D000328:Adult; D015519:Bone Density / Q000276:immunology*; D002118:Calcium / Q000276:immunology* / Q000378:metabolism; D003888:Desensitization, Immunologic / Q000379:methods; D006801:Humans; D007073:Immunoglobulin E / Q000097:blood / Q000276:immunology*; D016269:Milk Hypersensitivity / Q000097:blood / Q000150:complications / Q000276:immunology* / Q000628:therapy; D010024:Osteoporosis / Q000097:blood / Q000209:etiology / Q000276:immunology* / Q000628:therapy; D011446:Prospective Studies; D012307:Risk Factors; D055815:Young Adult
chemical_list: D007073:Immunoglobulin E; D002118:Calcium
keywords: Bone mineral density; cow's milk allergy; osteoporosis