International survey on growth indices and impacting factors in children with food allergies

Abstract

Background: Elimination diets required for the management of food allergies increase the risk for poor growth in children. Currently, no worldwide data exist on this topic and limited published data exist on the impact of atopic comorbidity, type of allergy and foods eliminated on growth. We therefore set out to perform a worldwide survey on growth and impacting factors in food allergic children. Methods: A prospective growth survey was performed of children (aged 0-16 years) on an elimination diet with confirmed immunoglobulin (Ig)E and non-IgE mediated food allergies. Data collected included: weight-for-age, weight-for-height, height-for-age, head circumference, body mass index, type of food allergy and eliminated foods, allergic comorbidities and replacement milk/breast milk. Multivariable regression analysis was used to establish factors that affected growth. Results: Data from 430 patients from twelve allergy centres were analysed: median age at diagnosis and data collection was 8 months and 23 months, respectively. Pooled data indicated that 6% were underweight, 9% were stunted, 5% were undernourished and 8% were overweight. Cow's milk elimination lead to a lower weight-for-height Z-scores than other food eliminations and mixed IgE and non-IgE mediated allergy had lower height-forage Z-scores than IgE mediated allergy. Children with only non-IgE mediated allergies had lower weight-for-height and body mass index. Atopic comorbidities did not impact on growth. Conclusions: Stunting is more common in children with food allergies than low weight. Children particularly at risk of poor growth are those with non-175

Food protein‐induced enterocolitis syndrome

“…In addition, patients with CV-and/ or soya-FPIES have an increased risk of reacting to solid food(s) 82,83 ( The impact on paediatric growth as a result of dietary elimination for food allergies has been well documented. [86][87][88][89][90][91] A recent international survey on growth indices in children with food allergies (n = 430) found that children with non-IgE-mediated allergies or mixed IgE-and non-IgE-mediated food allergy had lowered heightfor-age Z scores than those with IgE-mediated food allergy alone, confirming findings from other studies. 86,87,92,93 Children with FPIES should have their growth closely monitored including measurements of both weight and length.…”

“…The impact on paediatric growth as a result of dietary elimination for food allergies has been well documented . A recent international survey on growth indices in children with food allergies (n = 430) found that children with non‐IgE‐mediated allergies or mixed IgE‐ and non‐IgE‐mediated food allergy had lowered height‐for‐age Z scores than those with IgE‐mediated food allergy alone, confirming findings from other studies .…”

Non-IgE-Mediated Gastrointestinal Food Allergies in Children: An Update

“…Children with non-IgE-GI-FA can experience poor growth, which may be attributed to increased losses due to intestinal malabsorption and/or to limited food intake due to feeding difficulties, which are found in up to 30% of these patients [ 64 , 168 ]. Consequently, both weight [ 64 , 168 , 169 ] and height [ 169 ] may be affected. Deficient intake of indispensable micronutrients, including vitamin D, calcium, zinc, selenium [ 170 , 171 , 172 , 173 ], has also been reported, negatively impacting bone health [ 173 ].…”

Tutorial: Nutrition Therapy in Eosinophilic Esophagitis—Outcomes and Deficiencies

“…In children with food allergy, allergy to cow's milk is a risk factor for poor growth, and the presence of 2 or more food allergies has been associated with reduced height for age compared with controls. 28,[32][33][34] In addition, children with allergy to cow's milk consume less calcium than is recommended compared…”