The role of dietary interventions in the prevention of IgE-mediated food allergy in children
George Du Toit
Division of Asthma, Allergy and Lung Biology, Department of Paediatric Allergy, King's College London, Guy's and St. Thomas’ NHS Foundation Trust, London, UK
Equal contribution from these authorsSearch for more papers by this authorRu-Xin Foong
Division of Asthma, Allergy and Lung Biology, Department of Paediatric Allergy, King's College London, Guy's and St. Thomas’ NHS Foundation Trust, London, UK
Institute of Child Health, University College of London, London, UK
Equal contribution from these authorsSearch for more papers by this authorCorresponding Author
Gideon Lack
Division of Asthma, Allergy and Lung Biology, Department of Paediatric Allergy, King's College London, Guy's and St. Thomas’ NHS Foundation Trust, London, UK
Correspondence
Gideon Lack, Division of Asthma, Allergy and Lung Biology, Department of Paediatric Allergy, King's College London and Guy's and St. Thomas’ NHS Foundation Trust, London, UK
Tel.: +44 (0)20 7188 9730
Fax: +44 (0)20 7188 9782
E-mail: [email protected]
Search for more papers by this authorGeorge Du Toit
Division of Asthma, Allergy and Lung Biology, Department of Paediatric Allergy, King's College London, Guy's and St. Thomas’ NHS Foundation Trust, London, UK
Equal contribution from these authorsSearch for more papers by this authorRu-Xin Foong
Division of Asthma, Allergy and Lung Biology, Department of Paediatric Allergy, King's College London, Guy's and St. Thomas’ NHS Foundation Trust, London, UK
Institute of Child Health, University College of London, London, UK
Equal contribution from these authorsSearch for more papers by this authorCorresponding Author
Gideon Lack
Division of Asthma, Allergy and Lung Biology, Department of Paediatric Allergy, King's College London, Guy's and St. Thomas’ NHS Foundation Trust, London, UK
Correspondence
Gideon Lack, Division of Asthma, Allergy and Lung Biology, Department of Paediatric Allergy, King's College London and Guy's and St. Thomas’ NHS Foundation Trust, London, UK
Tel.: +44 (0)20 7188 9730
Fax: +44 (0)20 7188 9782
E-mail: [email protected]
Search for more papers by this authorAbstract
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.
References
- 1Du Toit G, Foong RM, Lack G. Prevention of food allergy - early dietary interventions. Allergol Int 2016: 65: 370–7.
- 2Anagnostou K, Meyer R, Fox A, Shah N. The rapidly changing world of food allergy in children. F1000Prime Rep 2015: 7: 35.
- 3Sampson HA. Update on food allergy. J Allergy Clin Immunol 2004: 113: 805–19; quiz 20.
- 4Prescott SL, Pawankar R, Allen KJ, et al. A global survey of changing patterns of food allergy burden in children. World Allergy Organ J 2013: 6: 21.
- 5Johansson SG, Bieber T, Dahl R, et al. Revised nomenclature for allergy for global use: report of the Nomenclature Review Committee of the World Allergy Organization, October 2003. J Allergy Clin Immunol 2004: 113: 832–6.
- 6Antolin-Amerigo D, Manso L, Caminati M, et al. Quality of life in patients with food allergy. Clin Mol Allergy 2016: 14: 4.
- 7Bollinger ME, Dahlquist LM, Mudd K, Sonntag C, Dillinger L, McKenna K. The impact of food allergy on the daily activities of children and their families. Ann Allergy Asthma Immunol 2006: 96: 415–21.
- 8Gupta R, Holdford D, Bilaver L, Dyer A, Holl JL, Meltzer D. The economic impact of childhood food allergy in the United States. JAMA Pediatr 2013: 167: 1026–31.
- 9Longo G, Berti I, Burks AW, Krauss B, Barbi E. IgE-mediated food allergy in children. Lancet 2013: 382: 1656–64.
- 10Katz Y, Goldberg MR, Stein M, Levy M. Oral immunotherapy: ready for prime time? J Allergy Clin Immunol 2011: 127: 289–90; author reply 91–2.
- 11Koplin JJ, Allen KJ. Optimal timing for solids introduction - why are the guidelines always changing? Clin Exp Allergy 2013: 43: 826–34.
- 12Challacombe DN. The incidence of coeliac disease and early weaning. Arch Dis Child 1983: 58: 326.
- 13Prescott SL, Smith P, Tang M, et al. The importance of early complementary feeding in the development of oral tolerance: concerns and controversies. Pediatr Allergy Immun 2008: 19: 375–80.
- 14Woods H. Peanut Allergy. Committee on Toxicity of Chemicals in Food, Consumer Products and the Environment [Internet]. 1998. Available from: http://cot.food.gov.uk/sites/default/files/cot/cotpeanutall.pdf
- 15Fox AT, Sasieni P, du Toit G, Syed H, Lack G. Household peanut consumption as a risk factor for the development of peanut allergy. J Allergy Clin Immunol 2009: 123: 417–23.
- 16Saadeh RJ. The Baby-Friendly Hospital Initiative 20 years on: facts, progress, and the way forward. J Hum Lact 2012: 28: 272–5.
- 17Ip S, Chung M, Raman G, et al. Breastfeeding and maternal and infant health outcomes in developed countries. Evid Rep Technol Assess (Full Rep) 2007: 153: 1–186.
- 18Fleischer DM, Spergel JM, Assa'ad AH, Pongracic JA. Primary prevention of allergic disease through nutritional interventions. J Allergy Clin Immunol Pract 2013: 1: 29–36.
- 19Kramer MKR. The optimal duration of exclusive breastfeeding - a systematic review 2002. Available from: http://apps.who.int/iris/bitstream/10665/67208/1/WHO_NHD_01.08.pdf?ua=1
- 20Fiocchi A, Assa'ad A, Bahna S, Adverse Reactions to Foods C, American College of Allergy A, Immunology. Food allergy and the introduction of solid foods to infants: a consensus document. Adverse Reactions to Foods Committee, American College of Allergy, Asthma and Immunology. Ann Allergy Asthma Immun 2006: 97: 10–20; quiz 1, 77.
- 21du Toit G, Tsakok T, Lack S, Lack G. Prevention of food allergy. J Allergy Clin Immunol 2016: 137: 998–1010.
- 22Liu AH. Revisiting the hygiene hypothesis for allergy and asthma. J Allergy Clin Immunol 2015: 136: 860–5.
- 23Allen KJ, Koplin JJ. Why does Australia appear to have the highest rates of food allergy? Pediatr Clin North Am 2015: 62: 1441–51.
- 24Marrs T, Bruce KD, Logan K, et al. Is there an association between microbial exposure and food allergy? A systematic review. Pediatr Allergy Immunol 2013: 24: 311–20 e8.
- 25Metsala J, Lundqvist A, Kaila M, Gissler M, Klaukka T, Virtanen SM. Maternal and perinatal characteristics and the risk of cow's milk allergy in infants up to 2 years of age: a case-control study nested in the Finnish population. Am J Epidemiol 2010: 171: 1310–6.
- 26Savage J, Johns CB. Food allergy: epidemiology and natural history. Immunol Allergy Clin North Am 2015: 35: 45–59.
- 27Strachan DP. Hay fever, hygiene, and household size. BMJ 1989: 299: 1259–60.
- 28Rudders SA, Camargo CA Jr. Sunlight, vitamin D and food allergy. Curr Opin Allergy Clin Immunol 2015: 15: 350–7.
- 29Allen KJ, Koplin JJ, Ponsonby AL, et al. Vitamin D insufficiency is associated with challenge-proven food allergy in infants. J Allergy Clin Immunol 2013: 131: 1109–16, 16 e1–6.
- 30Koplin JJ, Suaini NH, Vuillermin P, et al. Polymorphisms affecting vitamin D-binding protein modify the relationship between serum vitamin D (25[OH]D3) and food allergy. J Allergy Clin Immunol 2016: 137: 500–6 e4.
- 31Kelleher MM, Dunn-Galvin A, Gray C, et al. Skin barrier impairment at birth predicts food allergy at 2 years of age. J Allergy Clin Immunol 2016: 137: 1111–6 e8.
- 32Horimukai K, Morita K, Narita M, et al. Application of moisturizer to neonates prevents development of atopic dermatitis. J Allergy Clin Immunol 2014: 134: 824–30 e6.
- 33Lack G, Fox D, Northstone K, Golding J, Avon Longitudinal Study of P, Children Study T. Factors associated with the development of peanut allergy in childhood. N Engl J Med 2003: 348: 977–85.
- 34Venkataraman D, Soto-Ramirez N, Kurukulaaratchy RJ, et al. Filaggrin loss-of-function mutations are associated with food allergy in childhood and adolescence. J Allergy Clin Immunol 2014: 134: 876–82 e4.
- 35Brough HA, Simpson A, Makinson K, et al. Peanut allergy: effect of environmental peanut exposure in children with filaggrin loss-of-function mutations. J Allergy Clin Immunol 2014: 134: 867–75 e1.
- 36Simpson EL, Chalmers JR, Hanifin JM, et al. Emollient enhancement of the skin barrier from birth offers effective atopic dermatitis prevention. J Allergy Clin Immunol 2014: 134: 818–23.
- 37Kramer MS, Kakuma R. Maternal dietary antigen avoidance during pregnancy or lactation, or both, for preventing or treating atopic disease in the child. Cochrane Database Syst Rev 2012: (9): CD000133.
- 38Sicherer SH, Wood RA, Stablein D, et al. Maternal consumption of peanut during pregnancy is associated with peanut sensitization in atopic infants. J Allergy Clin Immunol 2010: 126: 1191–7.
- 39Khakoo A, Lack G. Preventing food allergy. Curr Allergy Asthma Rep 2004: 4: 36–42.
- 40Lack G. Update on risk factors for food allergy. J Allergy Clin Immunol 2012: 129: 1187–97.
- 41Palmer DJ, Metcalfe J, Makrides M, et al. Early regular egg exposure in infants with eczema: a randomized controlled trial. J Allergy Clin Immunol 2013: 132: 387–92 e1.
- 42Lack G. The concept of oral tolerance induction to foods. Clin Biochem 2014: 47: 715.
- 43Leonard SA. Debates in allergy medicine: baked milk and egg ingestion accelerates resolution of milk and egg allergy. World Allergy Organ J 2016: 9: 1.
- 44Ramesh S. Food allergy overview in children. Clin Rev Allergy Immunol 2008: 34: 217–30.
- 45Koletzko S, Niggemann B, Arato A, et al. Diagnostic approach and management of cow's-milk protein allergy in infants and children: ESPGHAN GI Committee practical guidelines. J Pediatr Gastroenterol Nutr 2012: 55: 221–9.
- 46Snijders BE, Thijs C, van Ree R, van den Brandt PA. Age at first introduction of cow milk products and other food products in relation to infant atopic manifestations in the first 2 years of life: the KOALA Birth Cohort Study. Pediatrics 2008: 122: e115–22.
- 47Katz Y, Rajuan N, Goldberg MR, et al. Early exposure to cow's milk protein is protective against IgE-mediated cow's milk protein allergy. J Allergy Clin Immunol 2010: 126: 77–82 e1.
- 48Boyle RJ, Tang ML, Chiang WC, et al. Prebiotic-supplemented partially hydrolysed cow's milk formula for the prevention of eczema in high-risk infants: a randomized controlled trial. Allergy 2016: 71: 701–10.
- 49Nwaru BI, Sheikh A. Risk factors for the development of egg allergy: progress to date and future directions. Allergy 2012: 67: 1325–6.
- 50Koplin JJ, Osborne NJ, Wake M, et al. Can early introduction of egg prevent egg allergy in infants? A population-based study. J Allergy Clin Immunol 2010: 126: 807–13.
- 51Palmer DJ, Sullivan TR, Gold MS, Prescott SL, Makrides M. Randomized controlled trial of early regular egg intake to prevent egg allergy. J Allergy Clin Immunol 2016: pii: S0091-6749(16)30793-X.
- 52Perkin MR, Logan K, Marrs T, et al. Enquiring About Tolerance (EAT) study: feasibility of an early allergenic food introduction regimen. J Allergy Clin Immunol 2016: 137: 1477–86.
- 53Perkin MR, Logan K, Tseng A, et al. Randomized trial of introduction of allergenic foods in breast-fed infants. N Engl J Med 2016: 374: 1733–43.
- 54Bellach J SV, Ahrens B, Trendelenburg V, Keil T, Niggemann B, Beyer K. Early introduction of hen's egg during weaning results in frequent allergic reactions: first results from a randomized placebo-controlled trial on hen's egg allergy prevention. EAACI Online Library. 2015: 2015: 104806.
- 55Wei-Liang Tan J, Valerio C, Barnes EH, et al. A randomized trial of egg introduction from 4 months of age in infants at risk for egg allergy. J Allergy Clin Immunol 2016: pii: S0091-6749(16)31118-6.
- 56Leonard SA, Sampson HA, Sicherer SH, et al. Dietary baked egg accelerates resolution of egg allergy in children. J Allergy Clin Immunol 2012: 130: 473–80 e1.
- 57Du Toit G, Katz Y, Sasieni P, et al. Early consumption of peanuts in infancy is associated with a low prevalence of peanut allergy. J Allergy Clin Immunol 2008: 122: 984–91.
- 58Du Toit G, Roberts G, Sayre PH, et al. Identifying infants at high risk of peanut allergy: the Learning Early About Peanut Allergy (LEAP) screening study. J Allergy Clin Immunol 2013: 131: 135–43 e1–12.
- 59Du Toit G, Roberts G, Sayre PH, et al. Randomized trial of peanut consumption in infants at risk for peanut allergy. N Engl J Med 2015: 372: 803–13.
- 60Feeney M, Du Toit G, Roberts G, et al. Impact of peanut consumption in the LEAP Study: feasibility, growth, and nutrition. J Allergy Clin Immunol 2016: 138: 1108–18.
- 61Du Toit G, Sayre PH, Roberts G, et al. Effect of avoidance on peanut allergy after early peanut consumption. N Engl J Med 2016: 374: 1435–43.
- 62Togias A, Cooper SF, Acebal ML, et al. Addendum guidelines for the prevention of peanut allergy in the United States: report of the national institute of allergy and infectious diseases-sponsored expert panel. Pediatr Dermatol 2017: 34: e1–21.
- 63Kull I, Bergstrom A, Lilja G, Pershagen G, Wickman M. Fish consumption during the first year of life and development of allergic diseases during childhood. Allergy 2006: 61: 1009–15.
- 64Muraro A, Dubois AE, DunnGalvin A, et al. EAACI Food Allergy and Anaphylaxis Guidelines. Food allergy health-related quality of life measures. Allergy 2014: 69: 845–53.
- 65Poole JA, Barriga K, Leung DY, et al. Timing of initial exposure to cereal grains and the risk of wheat allergy. Pediatrics 2006: 117: 2175–82.
- 66Fleischer DM, Sicherer S, Greenhawt M, et al. Consensus communication on early peanut introduction and prevention of peanut allergy in high-risk infants. Pediatr Dermatol 2016: 33: 103–6.
- 67Primary c, Fleischer DM, Sicherer S, et al. Consensus communication on early peanut introduction and the prevention of peanut allergy in high-risk infants. Pediatrics 2015: pii: peds.2015-2394.
- 68Fleischer DM, Sicherer S, Greenhawt M, et al. Consensus communication on early peanut introduction and the prevention of peanut allergy in high-risk infants. J Allergy Clin Immunol 2015: 136: 258–61.
- 69Fleischer DM, Sicherer S, Greenhawt M, et al. Consensus communication on early peanut introduction and the prevention of peanut allergy in high-risk infants. World Allergy Organ J 2015: 8: 27.
- 70 ASCIA. Guidelines on Infant feeding and allergy prevention: Australasian Society of Clinical Immunology and Allergy; 2016 [Available from: http://www.allergy.org.au/images/pcc/ASCIA_guidelines_infant_feeding_and_allergy_prevention.pdf