Can dietary strategies in early life prevent childhood food allergy? A report from two iFAAM workshops

Abstract

Food allergy affects a small but significant number of children and adults. Food allergy is responsible for considerable morbidity and is the commonest cause of anaphylaxis in children. One of the aims of the European Union‐funded “Integrated Approaches to Food Allergen and Allergy Risk Management” (iFAAM) project was to improve our understanding of the best way to prevent the development of food allergy. Groups within the project worked on integrating the current prevention evidence base as well as generating new data to move our understanding forward. This paper from the iFAAM project is a unique addition to the literature on this topic as it not only outlines the recently published randomized controlled trials (as have previous reviews) but also summarizes two iFAAM‐associated project workshops. These workshops focused on how we may be able to use dietary strategies in early life to prevent the development of food allergy and summarized the range of opinions amongst experts in this controversial area.

Balancing laissez‐faire and paranoia in patients at risk of anaphylaxis

“…We need to wait a little longer for the food allergy results from the Preventall study. Please keep safe in the midst of the CORVID‐19 pandemic 8,9 …”

Why we should focus on adolescents and young adults

“…We know that heat can alter the allergenicity of food proteins 8 . Graversen et al look at whether the heat treatment of a whey‐based protein changes allergenicity, tolerogenicity and intestinal uptake in animal models 9 .…”

Developments allergy in 2019 through the eyes of Clinical and Experimental Allergy, Part II clinical allergy

“…The first from Roberts and colleagues summarized two iFAAM workshop, the large EU project that has done much to advance our management of food allergy. 12 The second is a systematic review from Burgess and colleagues. 35 Their synthesis of the randomized controlled trial data indicated that introducing egg from 4 to 6 months and peanut from 4 to 11 months reduced the risk of egg and peanut allergy, respectively.…”

“…Other important early life exposures that may have an impact on asthma and allergic disease include exposure to diet and microbiota. In a report from two iFAAM workshops, the role of dietary strategies to prevent childhood food allergy was summarized 12 and Mensink‐Bout reported on the association between maternal and neonatal 25‐hydroxyvitamin D concentrations and school‐age lung function, asthma and allergy from the Generation R Study 13 . Helminth exposure however does not seem to be important for the difference in allergy‐related outcomes between rural and urban communities 14 and the association between season of birth, childhood asthma and allergy to be mediated by lower respiratory infections 15 …”