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Background and Objectives: About 65–80% of children with IgE-mediated cow’s milk allergy (CMA) can tolerate extensively heated milk. We have invested in the mass fabrication of a test product containing milk protein baked at 180°C for 30 min (SUTMEK-milk) and a milk-free placebo (SUTMEK-placebo) to carry out a standardised double-blind placebo-controlled food challenge (DBPCFC) test in patients with CMA. Methods: We studied children with IgE-mediated CMA between 13 and 48 months of age. Specific IgEs (spIgE) to milk proteins were quantified. A DBPCFC with our bakery products was performed, and factors determining reactivity to extensively heated milk were evaluated. We also tested the applicability of SUTMEK products in baked-milk oral immunotherapy in a pilot assessment. Results: We studied 15 children (8 girls, 7 boys) with a median age of 26 months (range: 13–48 months). Nine (60%) patients tolerated a challenge with extensively heated milk, while 6 (40%) were found reactive (anaphylaxis: 2, wheezing: 2, urticaria: 2). spIgE to milk, α-lactalbumin, and casein, and the wheal diameter on skin prick testing were higher in the reactive group than the tolerant groups (p = 0.001, p = 0.001, p = 0.002, and p = 0.048, respectively). Receiver-operating characteristic curve analyses yielded the following cut-off values for spIgEs that would predict a reactivity to extensively heated milk; milk: 25 kU/L (area under curve, AUC: 0.981), casein: 32 kU/L (AUC: 0.983), and α-lactalbumin: 17 kU/L (AUC: 0.981). Nine patients have tolerated well a continued daily consumption of SUTMEK-milk or -placebo for 6 months at the desired doses. Conclusions: Our bakery products were successfully used in DBPCFC studies and qualified as an acceptable tool for use in the research of interventional tolerance induction. Although spIgE appears useful in determining children at high risk of reacting to extensively heated milk, the predictive cut-off values are still far from being perfect.

Dietary intake of 117 male adolescents (aged 12 to 18 years, residing in Istanbul, Turkey) with autism spectrum disorder (ASD) and classified as normal (n=39), overweight (n=39) and obese (n=39) according to BMI-for-age were assessed. Anthropometric measurements were taken and participants were asked to complete a general questionnaire, feeding assessment survey and three-day food records. Daily intakes of energy and nutrients were calculated using food records. The EAR-cut point method was used to investigate the prevalence of inadequacy and potential risk of excess. Dietary fibre, calcium, zinc and folate intake of many participants were below the DRI value. Prevalence of inadequacy for iron, vitamin A, B6 and C were lower than these nutrients. Daily consumption of sodium and cholesterol was higher than the recommendations. Percent DRI value for energy differed significantly in each BMI-for-age group (p<0.05) and was highest in the obese category. This category also had higher %DRI values for most vitamins and minerals. Percent energy values provided by macronutrients (AMDR) were not significantly different from each other across BMI-for-age categories and remained within the reference values.

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