Modifying the infant's diet to prevent food allergy

Abstract

Recommendations and guidelines on the prevention of food allergy have changed in recent decades. The aim of this review of the current evidence and ongoing studies is to provide a comprehensive and up to date picture of prevention of food allergy for healthcare professionals. The review was undertaken as part of the European Union funded Integrated Approaches to Food Allergy and Allergen Management (iFAAM) study. This is a wide ranging project bringing together expertise across the breadth of food allergy research. Specifically, the review discusses dietary manipulation in food allergy prevention, and covers the possible preventive strategies of allergen avoidance, early allergen introduction, general nutrition and supplements, as well as other strategies, such as prebiotics and probiotics. The review concludes that despite agreement that allergen avoidance strategies should not be undertaken for allergy prevention, there is currently no consensus regarding what actions should be recommended beyond exclusive breastfeeding for the first 4–6 months of life. Recent and upcoming trial results, which are detailed in this review, should help inform the debate and add clarity to the topic.

The Role of Vitamin D in the Immune System as a Pro-survival Molecule

“…164 Food allergy, as a risk factor from diet or environmental issues associated with pediatrics, is still a matter of debate. [165][166][167][168] The so-called hypothesis of "five Ds" has been suggested, in which vitamin D cannot yet be translated into a clinical recommendation for food allergy. 169 This conclusion may come from the current concern regarding our ability to fully comprehend the role of this hormone-like vitamin in immunity and allergy, although literature suggesting a role for vitamin D deficiency in allergy has been also reported.…”

The Australasian Society of Clinical Immunology and Allergy infant feeding for allergy prevention guidelines

“…There is controversy surrounding the overall benefits of exclusive breastfeeding for 6 months compared with 4 months in Australia, with relatively low incidence of infectious disease and high prevalence of allergic disease. Breastfeeding when solid foods are first introduced may help reduce the risk of infant allergies, although evidence for this is weak …”

Immunoglobulin E (IgE)-Mediated Food Allergy in Children: Epidemiology, Pathogenesis, Diagnosis, Prevention, and Management

“…All of this has led to abandoning the strategy of allergenic avoidance and, in fact, has induced several groups to carry out prospective intervention studies according to the hypothesis that the onset of food allergies in the general population, or in children with a high, medium, or low risk of developing food allergies (familiarity and/or atopic dermatitis and/or sensitization to food) could be prevented by the early introduction of common allergenic food [51][52][53][54][55][56][57][58][59].…”