Atopic conditions are associated with food addiction in US women

Abstract

Atopic conditions, particularly atopic dermatitis (AD) and asthma, are associated with obesity. In epidemiologic studies, obesity is associated with a higher risk of developing AD and asthma. It is possible, though, that the association is bidirectional. A possible mediator between obesity and atopy that has not been explored is obesogenic eating behavior. The psychological burden of atopic conditions, including decreased quality of life and increased rates of depression, may lead to overeating and promote obesity. Food addiction is a form of obesogenic eating behavior analogous to substance dependence and is associated with depression and obesity. In this study, we examined the association between atopic conditions (AD, food allergy, hay fever, and asthma) and food addiction in the Nurses’ Health Study 2, a cohort of US female nurses. Nurses’ Health Study 2 began in 1989 with 116,609 participants. Race/ethnicity was reported at cohort baseline. Information on body weight, physical activity, alcohol intake, and smoking status was comprehensively collected and updated during the cohort follow-up and data from 2009 were used in this analysis. History of AD, food allergy, and hay fever was assessed in 2009 and history of asthma was assessed biennially from 1989, with data up to 2009 included in this analysis; questions used to define cases of atopic conditions are presented in Table E1 in this article’s Online Repository at www.jaci-inpractice.org. Food addiction was assessed in 2009 using a modified version of the Yale Food Addiction Scale. The modified version of the Yale Food Addiction Scale shows good construct validity and sensitivity (79%), providing a conservative assessment of food addiction. Participants’ completion and return of the selfadministered questionnaire is considered informed consent. The study was approved by the institutional review board of Brigham and Women’s Hospital. A total of 90,482 participants had valid questionnaire data for 2009. We excluded participants who did not answer the question regarding a diagnosis of eczema, food allergy, and hay fever (n 1⁄4 10,391) or who did not sufficiently answer the food