Effect of combined maternal and infant food-allergen avoidance on development of atopy in early infancy: A randomized study

Zeiger, Robert S.; Heller, Susan; Mellon, Michael; Forsythe, Alan B.; O’Connor, Richard D.; Hamburger, Robert N.; Schatz, Michael

doi:10.1016/0091-6749(89)90181-4

Cited by 448 publications

(267 citation statements)

References 51 publications

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“…Peanut is ubiquitous within the US food supply, with virtually 100% of US children being exposed by the age of 2 years (8). The sensitization rate to peanut in a birth cohort of children on the Isle of Wight, UK, followed to the age of 4 years, was 1%, with half having experienced a clinical reaction to peanut (9).…”

Section: Prevalencementioning

confidence: 99%

Peanut and soy allergy: a clinical and therapeutic dilemma

Sicherer¹,

Sampson²,

Burks

2000

Allergy

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Peanut and soy share several characteristics that are relevant to allergy. First, as legumes, they are phylogenetically and antigenically (1, 2) similar to each other and to other beans. Second, they are common sources of protein in the food supply; therefore, exposure to them is widespread. Third, they are an exceedingly common cause of food allergy (3±7). While these two food allergens have much in common, the clinical manifestations of allergy to peanut and soy are generally quite distinct. This paper will explore the similarities and differences in the clinical manifestations of peanut and soy allergy, summarize the current understanding of the molecular-immunologic aspects of these allergies, and discuss recent concerns regarding the development of severe allergy to soy in peanutallergic individuals. Characteristics of peanut allergy PrevalenceRecent surveys of the general population found the prevalence of peanut allergy to be 0.48% in the UK (7) and 0.6% in the USA (3). Peanut is ubiquitous within the US food supply, with virtually 100% of US children being exposed by the age of 2 years (8). The sensitization rate to peanut in a birth cohort of children on the Isle of Wight, UK, followed to the age of 4 years, was 1%, with half having experienced a clinical reaction to peanut (9). In children with atopic dermatitis undergoing evaluation for food hypersensitivity, 20/113 (18%) (5) and 27/165 (16%) (4) were allergic to peanut. Clinical manifestationsThe clinical characteristics of peanut allergy have been explored from a variety of vantage points. Studies of peanut-allergic individuals have highlighted the acute and severe nature of the allergy. In our study of 101 children (median age 7.6 years) with acute reactions to peanut (10), reactions occurred soon after ingestion, with 91% experiencing skin symptoms, 45% respiratory symptoms, and 36% gastrointestinal symptoms. In this group, 47% had involvement of two or more organ systems and 20% required treatment with epinephrine for their ®rst reaction. A study of 622 peanut-allergic individuals in the UK (11) also highlighted the severity of reactions because over 50% had moderate to severe reactions with breathing dif®culties or cardiovascular collapse. Severe symptoms were more common in adults than young children.

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Section: Prevalencementioning

confidence: 99%

Peanut and soy allergy: a clinical and therapeutic dilemma

Sicherer¹,

Sampson²,

Burks

2000

Allergy

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“…In the five RCTs [27,32,34,36,39], there was no significant difference overall in the prevalence of childhood eczema (RR 0.76 95% CI 0.50 to 1.16, total of 682 children, random effects). These trials showed statistical (I 2 = 44%) and clinical heterogeneity with different dietary restrictions and eczema assessed at different ages.…”

Section: Intervention Studiesmentioning

confidence: 99%

“…As described in section 1.1, one intervention required avoiding cow's milk and egg during pregnancy [32]and two trials continued this restriction while the mother was breast feeding [27,34]. Zeiger et al also restricted peanut and limited soy and wheat intake during pregnancy and lactation.…”

Section: Intervention Studiesmentioning

confidence: 99%

“…Zeiger [34] restricted cow's milk, egg and peanut and limited intake of soy and wheat during pregnancy and lactation in the intervention group. Children were followed up until 7 years of age and reported any atopic disorder (asthma; food allergy; allergic rhinitis; eczema and aeroallergen sensitization).…”

Section: Intervention Studiesmentioning

confidence: 99%

“…Four RCTs assessed the effects of maternal dietary restriction on asthma in children (Falth Magnusson et al [27], Zeiger et al [34], Arshad et al [36] and Lilja [32] (Table 1). As described in section 1.1, one intervention required avoiding cow's milk and egg during pregnancy [32]and two trials continued this restriction while the mother was breast feeding [27,34].…”

Section: Intervention Studiesmentioning

confidence: 99%

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Does maternal diet during pregnancy and lactation affect outcomes in offspring? A systematic review of food-based approaches

2014

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Abstract:Objectives: To investigate the relationship between maternal diet during pregnancy and lactation and development of atopic disorders in childhood. Methods:We included studies published up to August 2011 which either assessed food-based maternal dietary interventions or examined associations between maternal dietary intake during pregnancy and/or lactation and allergic outcomes (eczema, asthma, hay fever and sensitization) in their children. Results:We included 43 studies (over 40 000 children): 11 intervention studies (including seven RCTs), 27 prospective cohort studies, four retrospective cohort studies and one case-control study.In the RCTs, no significant difference was noted overall in the prevalence of eczema and asthma in the offspring of women on diets free from common food allergens during pregnancy. The prospective cohorts investigated a large number of potential associations, but reported few significant associations between maternal dietary intake and development of allergy. Maternal diets rich in fruits and vegetables, fish and foods containing vitamin D and 'Mediterranean' dietary patterns were among the few consistent associations with lower risk of allergic disease in their children. Foods associated with higher risk included vegetable oils and margarine, nuts and fast food. Conclusion:This review did not find widespread or consistent links between mother's dietary intake and atopic outcomes in their children. However, maternal consumption of 'Mediterranean' dietary patterns, diets rich in fruits and vegetables, fish and vitamin D containing foods were suggestive of benefit, requiring further evaluation.

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