The role of dietary interventions in the prevention of IgE‐mediated food allergy in children

Abstract

Over the last 30 years, the prevalence of food allergy has been on the rise and remains a disease that can have a significant impact on the quality of life of children and their families. There are several hypotheses that have been suggested to account for the increasing prevalence, but this review will focus on the impact that dietary factors have on food allergy development. In the past food allergy, prevalence has largely focused on allergen avoidance; however, there is increasing evidence from interventional studies that have shown that early introduction to potential food allergens may have a beneficial role in allergy prevention. This review aims to look at the evidence in support of early introduction of allergens into infant diets to prevent against the development of food allergy.

Introduction of Complementary Foods and Food Allergies: New Studies and Modern Clinical Guidelines

“…Однако, учитывая устойчивую тенденцию к росту заболеваемости данной формой патологии, можно предполагать наличие других механизмов, способствую-щих извращению иммунного ответа на пищевые продук-ты. В последнее время придается все большее значение эпигенетическим факторам, например возможному воз-действию факторов окружающей среды [10]. Существует «гигиеническая» гипотеза, согласно которой вероятность развития аллергии уменьшается при естественных родах (физиологическая контаминация микрофлорой).…”

Weaning and complementary feeding in preterm infants: management, timing and health outcome

“…34 A recent study also showed that avoidance of cow milk by use of an extensively hydrolysed whey formula instead did not have a protective effect in infants in developing atopy (primarily eczema) at 12 months of age. 35,36 …”

“…Over the last few years, there is an increasing amount of interest and evidence to support the early introduction of potential allergenic foods to aid in the development of oral tolerance 36 …”

“…40 The Starting Time of Egg Protein study was performed on infants aged 4-6 months with no eczema symptoms who were randomized and double-blinded to receive daily pasteurized raw whole-egg powder or a colour-matched rice powder. 36 All the infants followed an egg-free diet until 10 months at which time cooked egg was introduced to both groups. In the data analysis, there was no difference between the two groups with regards to the development of IgE-mediated egg allergy at 12 months of age, 7% egg group vs 10.3% in the control group (95% CI: 0.48-1.17, P=0.20).…”

Nut allergy guideline

“…However with peanuts being almost ubiquitous, complete avoidance is impossible. The combined effect of no oral ingestion with ongoing environmental exposure to peanuts via the skin (especially in presence of eczema) probably fuelled the peanut allergy epidemic in the United Kingdom [2]. This BSACI peanut and tree nut guideline rectifies this advising that infants who do not have eczema, asthma or other food allergies can have peanut butter cautiously introduced into their diet at home [1].…”