Correction: Quake et al. Early Introduction of Multi-Allergen Mixture for Prevention of Food Allergy: Pilot Study. Nutrients 2022, 14, 737

Quake, Antonia Zoe; Liu, Taryn Audrey; D’Souza, Rachel; Jackson, Katherine G.; Woch, Margaret; Tetteh, Afua O.; Sampath, Vanitha; Nadeau, Kari; Sindher, Sayantani; Chinthrajah, R. Sharon; Cao, Shu

doi:10.3390/nu15010135

Cited by 3 publications

(6 citation statements)

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“…This review included 12 RCTs which involved a total of 6583 participants, with 53% male and the mean age of participants was 4 months. Of the included RCTs, three were based in the UK,9 22 23 three in Australia,24–26 two in Japan,27 28 two in Norway and Sweden,29 30 one in Germany31 and USA 32…”

Section: Resultsmentioning

confidence: 99%

“…The intervention was early introduction of multiple allergic foods in four RCTs, egg in nine RCTs, peanut and wheat in four RCTs, milk in three RCTs, fish in two RCTs, and soy and sesame in one RCT each. Most of the included RCTs introduced the allergic food before the age of 6 months 9 23–26 28 29 31–33. All included RCTs followed infants for a minimum duration of 12 months with a median follow-up duration of 1.5 years (IQR 1–2.5 years).…”

Section: Resultsmentioning

confidence: 99%

“…All included RCTs followed infants for a minimum duration of 12 months with a median follow-up duration of 1.5 years (IQR 1–2.5 years). Eleven RCTs9 23–33 investigated risk of food allergy, five RCTs investigated risk of autoimmune and allergic conditions22 25 26 29 32 and ten studies investigated the risk of allergic sensitisation 9 23–29 31 33. Detailed characteristics of the included studies are shown in table 1.…”

Section: Resultsmentioning

confidence: 99%

“…Half of the included studies (n=6)24 25 27–29 33 were rated as low risk of bias, one-third (n=4)9 23 31 32 had some concerns and two (16%)22 26 as high risk (online supplemental eTable 3). Missing outcome data and selection of the reported result were the main issues across the studies.…”

Section: Resultsmentioning

confidence: 99%

“…Studies that focused on the concurrent introduction of multiple allergenic foods and food allergy risk showed high heterogeneity. In these studies, different methods of allergy assessment were used, such as specific IgE and skin prick tests 23 28 29 32. Despite showing favour towards early introduction, intervention of multiple foods simultaneously, and their impact on food allergy, requires stronger evidence to support this finding.…”

Section: Discussionmentioning

confidence: 99%

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Introduction of allergenic food to infants and allergic and autoimmune conditions: a systematic review and meta-analysis

Tuballa,

Connell,

Smith

et al. 2023

BMJ EBM

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ObjectivesTo evaluate the effects of early introduction to allergenic foods compared with late introduction and its impact on food allergy, food sensitisation and autoimmune disease risk.Design and settingThe systematic review was reported in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses 2020 guidelines. Four electronic databases (MEDLINE, CENTRAL, EMBASE and CINAHL) were searched from inception till 24 October 2022 using keywords and MeSH without limitations on publication’s language or date. A forward and backwards citation analysis was also conducted. Risk of bias was assessed by three authors independently, in pairs using the Cochrane Risk of Bias Tool 2. Findings were narratively and quantitatively synthesised. Certainty of evidence was assessed using the Grading of Recommendations Assessment, Development and Evaluation approach.ParticipantsRandomised controlled trials (RCTs) on allergenic food introduction prior to 12 months of age that evaluated its effect on the development of allergic and autoimmune conditions.InterventionEarly introduction to allergenic foods to infants diet.Main outcome measures(1) Food allergy and sensitisation with main measures including oral food challenge, specific-IgE, skin prick testing, physician assessment and parental reporting. (2) Allergic and autoimmune conditions such as asthma and eczema.ResultsOf the 9060 identified records, we included 12 RCTs. We found high to moderate certainty evidence suggested that early introduction of allergen-containing foods reduces the risk of multiple food allergies (4 RCTs, 3854 participants, RR 0.49, 95% CI 0.33 to 0.74), egg (8 RCTs, 5193 participants, RR 0.58, 95% CI 0.44 to 0.78), peanut (3 RCTs, 4183 participants, RR 0.31, 95% CI 0.17 to 0.54) and atopic dermatitis or eczema (4 RCTs, 3579 participants, RR 0.88, 95% CI 0.78 to 1.00). Effects on other food allergies including milk, wheat, fish; autoimmune conditions, and food sensitisation are very uncertain and informed by low and very-low certainty evidence. No important subgroup differences were observed related to baseline risk of allergy and age at introduction. Sensitivity analyses limited to low risk of bias RCTs showed similar results.ConclusionsThis systematic review and meta-analysis shows that early introduction of allergen-containing food from 4 to 12 months of age, was associated with lower risk of multiple food allergy and eczema. Further research on other allergenic foods, and their long-term impact on food allergy and autoimmune risk is essential for enhancing our understanding on development of these conditions and guiding future clinical recommendations.PROSPERO registration numberCRD42022375679.

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