Clinical measures of allostatic load in children and adolescents with food allergy, depression, or anxiety

Purpose: Sustained high stress exposure results in chronic activation of the stress response system, dysregulated stress responses, high allostatic load, and poor later-life health. Children and adolescents with chronic health conditions face stressors related to their condition in addition to those typical of childhood and adolescence, placing them at risk of high allostatic load. The purpose of this secondary analysis was to examine whether youth with chronic health conditions differ from controls on clinical measures of allostatic load. Design and methods: A secondary analysis of two datasets, the electronic health record of a tertiary children's hospital and data from the Survey of the Health of Wisconsin, compared youth with chronic health conditions to controls on clinical measures of allostatic load. Additional analyses explored whether parental stress and mental health influenced these relationships. Results: Analyses identified differences in BMI, blood pressure, and waist circumference between youth with food allergy, anxiety, or depression, and controls. These relationships differed for males and females and for those with comorbid mental and physical conditions, and were influenced by parent stress and mental health. Conclusions: Results support future studies exploring whether high stress in youth with chronic health conditions leads to increased allostatic load. Incorporating biomarkers as well as genetic and epigenetic factors will provide critical insights. Practice implications: Youth with mental and physical CHCs may be at increased risk of high allostatic load, reflected in clinical measures of metabolism, and should have regular assessments of their metabolic health. (C) 2021 Elsevier Inc. All rights reserved.