Nutrition Publication

Annales 75.1 - Nutrition Intervention in Allergy Prevention

Editor(s): H. Szajewska, W. Raanan Shamir, P. Tikva/Tel Aviv. 75 / 1

Food allergy is defined as an immune-mediated adverse reaction to specific foods. This problem is becoming more widespread and affects up to 8% of children and 5% of adults in Western countries. Currently, there are no effective strategies to induce permanent tolerance: management of food allergies consists of recognizing the adverse reactions and treating the symptoms.

Because early infections are a major risk factor for asthma and allergic disease, protection through breastfeeding may be a pathway that shields against it. Pediatric asthma, eczema, food allergy and allergic rhinitis incur significant costs to the healthcare system, resulting in missed days of work and school, and affect the quality of life of parents and children.

Worldwide, the most common food allergies in children are allergies to cow’s milk, hen’s egg, soy, peanut, tree nuts, wheat, fish, and seafood.

In the past, food allergy prevention strategies focused on the avoidance of allergenic foods in infancy. The current paradigm, however, is shifting from avoidance to controlled exposure. Recent evidence from randomized controlled trials suggests that the early introduction of allergenic foods such as peanuts may reduce the prevalence of food allergies in high-risk infants.

 

Related Articles

Mechanisms of Tolerance Induction

Author(s): A. Nowak-Węgrzyn, P. Chatchatee

Food allergy is defined as an immune-mediated adverse reaction to specific foods. This problem is becoming more widespread and affects up to 8% of children and 5% of adults in Western countries. Currently, there are no effective strategies to induce permanent tolerance: management of food allergies consists of recognizing the adverse reactions and treating the symptoms. Food allergy arises when oral tolerance fails to develop in early life or is breached at an older age.
The initial exposure to food allergens occurs predominantly via the gastrointestinal tract or the skin, and can occur at different pre-and postnatal stages. Exposure to food allergens such as peanut and hen’s egg via an inflamed and disrupted epithelial barrier in the absence of oral feeding is an important pathway of allergic IgE sensitization in infants with severe atopic dermatitis. An additional route of allergic sensitization to food could be via the airway tissue.  

Breastfeeding, Childhood Asthma, and Allergic Disease

Author(s): W.H. Oddy

Exclusive breastfeeding for the first 6 months of life, and up to 2 years or longer is encouraged as the “gold” standard for infant feeding because breastfeeding has health benefits for mother and child. Human maternal milk is uniquely suited to the human baby with nutritional composition as well as bioactive and immunological factors that promote healthy development.
Breastfeeding is critical for optimum immune development of the infant through bioactivity in milk and through impact of healthy establishment of microbiota. Because early infections are a major risk factor for asthma and allergic disease, protection through breastfeeding may be a pathway that shields against it.

The Role of Hydrolyzed Formula in Allergy Prevention

Author(s): M.D. Cabana

Pediatric asthma, eczema, food allergy and allergic rhinitis incur significant costs to the healthcare system, resulting in missed days of work and school, and affect the quality of life of parents and children.
Although breastfeeding is accepted as the optimal way to feed all infants regardless of underlying allergy risk, a large proportion of infants are exposed to infant formula. Initial findings from clinical studies suggest that the use of hydrolyzed formulas may have beneficial effects in reducing the risk of certain allergic diseases, particularly against a background of atopic disease. 

Introduction of Complementary Foods to Infants

Author(s): C. West

Worldwide, the most common food allergies in children are allergies to cow’s milk, hen’s egg, soy, peanut, tree nuts, wheat, fish, and seafood. Although a large proportion of those with milk or egg allergies will develop tolerance as they age, certain subgroups remain allergic and are at risk of developing other disorders such as respiratory allergic disease. In the past, food allergy prevention strategies focused on the avoidance of allergenic foods in infancy.
The current paradigm, however, is shifting from avoidance to controlled exposure. Recent evidence from randomized controlled trials suggests that the early introduction of allergenic foods such as peanuts may reduce the prevalence of food allergies in high-risk infants. In countries where peanut allergy is prevalent, healthcare professionals should recommend the introduction of peanut-containing products into the diets of “high-risk” infants early in life (between 4 and 11 months of age).