Early Introduction of Food Allergens and Risk of Developing Food Allergy

Yakaboski, Elizabeth; Robinson, Lacey B.; Arroyo, Anna Chen; Espinola, Janice A.; Geller, Ruth J.; Sullivan, Ashley F.; Rudders, Susan A.; Camargo, Carlos A.

doi:10.3390/nu13072318

Cited by 19 publications

(29 citation statements)

References 50 publications

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“…Delayed introduction of the most common allergens by time of complementary food introduction for prevention of food allergy, including CMA, is strongly discouraged by EAACI, ASCIA, and AAAAI, as there is no evidences for its beneficial effect [ 81 , 83 , 84 ]. In fact, several studies have shown that early introduction of allergenic foods, such as peanuts [ 98 , 99 ], cow’s milk [ 100 , 101 ], or hen’s egg [ 99 ], can decrease the risk of developing food allergy against the particular allergens [ 102 ].…”

Section: Food Allergymentioning

confidence: 99%

Alternatives to Cow’s Milk-Based Infant Formulas in the Prevention and Management of Cow’s Milk Allergy

Maryniak

Sancho

Hansen

et al. 2022

Foods

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Cow’s milk-based infant formulas are the most common substitute to mother’s milk in infancy when breastfeeding is impossible or insufficient, as cow’s milk is a globally available source of mammalian proteins with high nutritional value. However, cow’s milk allergy (CMA) is the most prevalent type of food allergy among infants, affecting up to 3.8% of small children. Hypoallergenic infant formulas based on hydrolysed cow’s milk proteins are commercially available for the management of CMA. Yet, there is a growing demand for more options for infant feeding, both in general but especially for the prevention and management of CMA. Milk from other mammalian sources than the cow, such as goat, sheep, camel, donkey, and horse, has received some attention in the last decade due to the different protein composition profile and protein amino acid sequences, resulting in a potentially low cross-reactivity with cow’s milk proteins. Recently, proteins from plant sources, such as potato, lentil, chickpeas, quinoa, in addition to soy and rice, have gained increased interest due to their climate friendly and vegan status as well as potential lower allergenicity. In this review, we provide an overview of current and potential future infant formulas and their relevance in CMA prevention and management.

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Section: Food Allergymentioning

confidence: 99%

Alternatives to Cow’s Milk-Based Infant Formulas in the Prevention and Management of Cow’s Milk Allergy

Maryniak

Sancho

Hansen

et al. 2022

Foods

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“…Хоча з'являються нові докази того, що оптимізація догляду за екзематозною шкірою для підтримки здорового шкірного бар'єра і, отже, запобігання харчовій сенсибілізації (ХС), ймовірно, відіграє важливу роль у профілактиці харчової алергії [6, 7], підхід, підкріплений найбільш переконливими даними, стосується раннього введення в раціон алергенних продуктів, особливо яєць та арахісу [8][9][10].…”

Section: значення харчової алергії при атопічному дерматиті в дітейunclassified

Significance of food allergy in atopic dermatitis in children

Волосовец¹,

Kryvopustov

Mozyrska

et al. 2022

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Background. Atopic dermatitis is the most common inflammatory skin disease in childhood, affecting almost 20 % of children. Food allergies affect one of three children with atopic dermatitis, and allergies to peanuts, eggs and milk are the predominant food allergies in the world. The purpose was to assess the prevalence of food allergies in the group of patients with atopic dermatitis, to determine the association of food allergies with anamnestic and clinical parameters of atopic dermatitis. Materials and methods. Children with atopic dermatitis (n = 116) were included in the study from September 2020 to August 2021 in Kyiv, Ukraine. Food sensitization was established by determining specific immunoglobulin E (sIgE) to food allergens using immunochemiluminescent method on the ImmunoCAP 100 system (Thermo Fisher Scientific Inc., Phadia, Sweden). Results. The average age of children in the main group (59 boys and 57 girls) was 6.8 years. All 116 patients at the time of examination had manifestations of atopic dermatitis in the form of erythematous itchy rash. The number of children with food allergy was 23 (19.8 %). Among food allergens, positive sIgE were found: in 14 patients (12 %) — to milk, in 13 (11.2 %) — to eggs, in 5 (4.3 %) — to fish, and in 4 people (3.4 %) — to hazelnuts. Food sensitization was significantly more common in children with moderate-to-severe atopic dermatitis than in the group of patients with mild atopic dermatitis (χ2 = 7.555, p < 0.05). Children with food sensitization had an earlier onset of atopic dermatitis — the average age of manifestations onset was 8 months, and in the group of children without food allergy, it was 18 months. Children with a parental history of atopic diseases were significantly more likely to have concomitant food allergy (χ2 = 12.831, p < 0.05). Conclusions. Given the significant association between early onset as well as moderate-to-severe atopic dermatitis and food sensitization, it is likely that food sensitization occurs primarily through an inflamed skin barrier in eczematous skin, which could potentially lead to clinical food allergy.

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“…This led to the modern recommendation by medical experts to expose children to common allergenic foods early in life. 4 It is now thought that sensitization to food allergens may actually occur primarily due to dermal and/or inhalation exposure to food dust, whereas exposure to these same allergens in the gut favors tolerization against allergy (dual allergen exposure hypothesis). 5 , 6 …”

Section: Pediatric Recommendations On Exposure To Foodsmentioning

confidence: 99%

Slow alignment of GMO allergenicity regulations with science on protein digestibility

2022

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The current science on food allergy supports the dual allergen exposure hypothesis where sensitization to allergenic proteins is favored by dermal and inhalation exposure, and tolerization against allergy is favored by exposure in the gut. This hypothesis is bolstered by the epidemiological evidence showing that regions where children are exposed early in life to allergenic foods have lower rates of allergy. This led medical experts to replace the previous recommendation to exclude commonly allergenic foods from the diets of young children with the current recommendation that such foods be introduced to children early in life. Past beliefs that lowering gut exposure would reduce the likelihood that a protein would be allergenic led regulators and risk assessors to consider digestively stable proteins to be of greater allergenic risk. This resulted in international guidance and government regulations for newly expressed proteins in genetically engineered crops that aligned with this belief. Despite empirical results showing that allergens are no more digestively stable than non-allergens, and that gut exposure favors tolerization over sensitization, regulations have not come into alignment with the current science prompting developers to continue to engineer proteins for increased digestibility. In some rare cases, this could potentially increase sensitization risk.

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Early Introduction of Food Allergens and Risk of Developing Food Allergy

Cited by 19 publications

References 50 publications

Alternatives to Cow’s Milk-Based Infant Formulas in the Prevention and Management of Cow’s Milk Allergy

Alternatives to Cow’s Milk-Based Infant Formulas in the Prevention and Management of Cow’s Milk Allergy

Significance of food allergy in atopic dermatitis in children

Slow alignment of GMO allergenicity regulations with science on protein digestibility

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