Diet Diversity Through the Life-Course as an Opportunity Toward Food Allergy Prevention

Abstract

The prevalence of food allergies (FA) is increasing worldwide. Generally, the onset of allergies, including FA, begins in early childhood and may persist and/or develop through the life-course. Even though epidemiological studies have focused mainly on children, allergies can also occur for the first-time during adulthood. Within the prolongation of life, it is expected that allergies will be encountered more often even in older people. Recent findings suggest that an early exposure to diverse food antigens may promote the development of immune tolerance. Accordingly, diet diversity during the first year of life or even earlier may have a positive impact on the prevention of allergies. The anti-inflammatory properties of some dietary nutrients may positively contribute to a tolerogenic immune environment too. Diet diversity is associated with a more favorable microbiome, and increasing evidence suggests a promising role of gut microbiota manipulation in inducing immune tolerance. Unjustified avoidance of allergenic foods may expose to intakes of some nutrients below recommended levels through the life-course, even more in cases of self-diagnosis and treatment of presumed forms of food intolerance. Nutritional strategies including the early exposure to a variety of food antigens are a promising area of research for preventive purposes through the life-course possibly extending positive outcomes to older stages. The aim of this paper is to highlight the role of diet diversity in preventing the development of FA starting in early life, as well as to provide an overview of the main strategies to prevent related nutritional issues throughout the life-course.

The immune‐supportive diet in allergy management: A narrative review and proposal

“…Given the effects of processing and the immunomodulatory properties of specific foods, dietary advice and support should enable individuals with a food allergy change to more healthy dietary patterns in addition to excluding the trigger food(s). Such advice may be especially important in adults as aging is associated with progressive alteration of intestinal permeability, chronic low‐grade inflammation, gastritis and a decreased ability to digest food, which often results in nutritional deficiencies including low levels vitamin D, zinc, and iron 149 . More emphasis should also be on achieving an immune‐supportive diet, especially since it may support immune function to maintain or even achieve tolerance 150 .…”

“…Such advice may be especially important in adults as aging is associated with progressive alteration of intestinal permeability, chronic low-grade inflammation, gastritis and a decreased ability to digest food, which often results in nutritional deficiencies including low levels vitamin D, zinc, and iron. 149 More emphasis should also be on achieving an immune-supportive diet, especially since it may support immune function to maintain or even achieve tolerance. 150 This active management is also warranted to counteract the unnecessary avoidance of foods, especially wheat and milk, which is an increasingly worldwide phenomenon, 151 and highly prevalent in individuals with allergic diseases, especially atopic dermatitis and/or food allergy.…”

Nurturing Infants to Prevent Atopic Dermatitis and Food Allergies: A Longitudinal Study

“…This delay contributed to a decrease in dietary diversity. Fruits and pulses are known for their high dietary fiber and antioxidant content, which can have a notable anti-inflammatory impact, promoting immune tolerance [ 22 ]. These foods enhance the diversity and maturation of gut microbiota by acting as prebiotics and providing nourishment to tolerogenic microbes [ 23 ].…”

EAACI guidelines on the diagnosis of IgE‐mediated food allergy

“…However, new food allergies may develop in adults and older children and need to be investigated. Older adults have not been studied as much as younger adults, but they can still develop food allergy 2,46 . The same tests used to confirm the diagnosis of food allergy can be used to determine the probability of spontaneous resolution and the right time to reintroduce the avoided food to the diet.…”

“…Older adults have not been studied as much as younger adults, but they can still develop food allergy. 2,46 The same tests used to confirm the diagnosis of food allergy can be used to determine the probability of spontaneous resolution and the right time to reintroduce the avoided food to the diet. However, it should be noted that the diagnostic characteristics of the tests are not necessarily the same as for the original diagnosis.…”