Dietary variety and food group consumption in children consuming a cows' milk exclusion diet

Abstract

Background Dietary variety is defined as the number of different foods or food groups consumed over a given reference period, the consensus being that dietary variety and dietary quality are positively correlated. Recently there has been considerable interest in the association between infant dietary variety and atopic disease. Methods This was a cross‐sectional study of 8‐ to 27‐month‐old children from the Isle of Wight, UK, including two groups: a group of children consuming a cows' milk exclusion (CME) diet and a control group of children consuming an unrestricted diet. Parents completed a validated food frequency questionnaire, from which dietary variety and consumption of food groups were calculated. Growth measurements were recorded. Results A total of 126 participants of mean age 13.0 months were recruited. In addition to the expected differences in dairy and soya consumption, the CME group consumed sweet foods 1.6 times less frequently, non‐water drinks seven times less frequently (p < 0.05) and ready‐made baby foods 15 times more frequently (p < 0.01) than the control group. Overall dietary variety was significantly lower in the CME group (p < 0.01) as was variety of meat and sweet foods consumed. There was a greater concern with healthy eating in the CME group (p < 0.05). Conclusions Children consuming an exclusion diet for cows' milk allergy have an overall less varied diet, including a less varied consumption of meat and sweet foods. Efforts should be made to ensure exclusion diets are as varied as possible to optimize nutritional intake.

Eliminating cows’ milk, but not wheat, barley or rye, increases the risk of growth deceleration and nutritional inadequacies

“…On the downside, advancing to more textured food was slower in the children on food elimination diets and they ate more pureed food, such as fruit or berry purees and porridge than the controls. Previous studies have reported that children with CMA consumed a less varied diet than children without CMA, and food preferences changed slowly even after the food allergy had been resolved .…”

Different Measures of Diet Diversity During Infancy and the Association with Childhood Food Allergy in a UK Birth Cohort Study

“…Furthermore, the microbial content is known to vary, with homemade infant meals having a higher aerobic colony count, but lower pesticide count that those made commercially 22 , which potentially could influence gut microbiota. Research from our group has recently reported that commercially prepared infant food is consumed 15 times more frequently in young children consuming an exclusion diet for milk allergy 23 . Furthermore, data from a UK birth cohort suggest that a diet high in fruit, vegetables and home prepared foods, with only occasional use of commercially produced infant food, is associated with less FA at age 2 years 24 .…”

Food allergy in EAACI journals (2016)

“…Nutritional adequacy of a cows' milk exclusion diet in infancy is a matter of concern. In the cross‐sectional study of 8‐ to 27‐month‐old children from the Isle of Wight, children consuming an exclusion diet for cows' milk allergy have an overall less varied diet, including a less varied consumption of meat and sweet foods . Efforts should be made to ensure exclusion diets are as varied as possible to optimize nutritional intake.…”

“…In the cross-sectional study of 8-to 27-month-old children from the Isle of Wight, children consuming an exclusion diet for cows' milk allergy have an overall less varied diet, including a less varied consumption of meat and sweet foods. 22 Efforts should be made to ensure exclusion diets are as varied as possible to optimize nutritional intake. A study assessed the nutritional adequacy of a cows' milk exclusion diet in a group of UK infants (subgroup of the Prevalence of Infant Food Allergy study) over 6 months.…”