Abstract
BackgroundThe role of timing and diversity of allergenic food introduction in the development of childhood allergic sensitization and atopic diseases is controversial.ObjectiveTo examine whether timing and diversity of allergenic food introduction are associated with allergic sensitization, allergy and eczema in children until age 10 years.Materials and methodsThis study among 5,202 children was performed in a population-based prospective cohort. Timing (age ≤6 months vs. >6 months) and diversity (0, 1, 2 and ≥3 foods) of allergenic food (cow's milk, hen's egg, peanut, tree nuts, soy and gluten) introduction were assessed by questionnaires at ages 6 and 12 months. At age 10 years, inhalant and food allergic sensitization were measured by skin prick tests, and physician-diagnosed inhalant and food allergy by questionnaire. Data on parental-reported physician-diagnosed eczema were obtained from birth until age 10 years.ResultsChildren introduced to gluten at age ≤6 months had a decreased risk of eczema (aOR (95% CI): 0.84 (0.72, 0.99)), compared with children introduced to gluten at age >6 months. However, timing of allergenic food introduction was not associated with allergic sensitization or physician-diagnosed allergy. Children introduced to ≥3 allergenic foods at age ≤6 months had a decreased risk of physician-diagnosed inhalant allergy (0.64 (0.42, 0.98)), compared with children not introduced to any allergenic food at age ≤6 months. However, diversity of allergenic food introduction was not associated with allergic sensitization, physician-diagnosed food allergy or eczema.ConclusionNeither timing nor diversity of allergenic food introduction was consistently associated with childhood allergic sensitization, allergy or eczema.
Highlights
The role of timing and diversity of allergenic food introduction in the development of childhood allergic sensitization and atopic diseases, such as allergy and eczema, is controversial
Children introduced to gluten at age 6 months had a decreased risk of eczema (aOR: 0.84 (0.72, 0.99)), compared with children introduced to gluten at age >6 months
Timing of allergenic food introduction was not associated with allergic sensitization or physician-diagnosed allergy
Summary
The role of timing and diversity of allergenic food introduction in the development of childhood allergic sensitization and atopic diseases, such as allergy and eczema, is controversial. The LEAP and LEAP-On trials showed that peanut introduction in high-risk children aged 4–11 months was associated with a decreased frequency of peanut allergy at age 5 years that persisted after 12 months of peanut avoidance[6, 7] This resulted in addendum guidelines for the prevention of peanut allergy in high-risk children, recommending introduction of peanut as early as age 4–6 months in children with severe eczema, egg allergy or both[8]. Another trial did not show an effect of early introduction of six common allergenic foods on the frequency of food allergies between age 1 and 3 years among a selected group of exclusively breast-fed children from the general population[9]. The role of timing and diversity of allergenic food introduction in the development of childhood allergic sensitization and atopic diseases is controversial
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