Food-allergic Children Research Articles

Evaluating the Food Allergy Passport: A Novel Food Allergy Clinical Support Tool

The prevalence of pediatric food allergy (FA) has increased in the past 2 decades. The previous literature suggests that FA presents burdens, both economically and psychosocially, to children and their caregivers, especially families in lower-income strata. Using data from a previously published needs assessment, the Food Allergy Management in Low-Income Youth study, the FA Passport and Workbook tools were developed to address identified needs. This study evaluated the utility of the FA Passport in helping families insured by Medicaid to manage FA better and improve quality of life. Families insured through Illinois Medicaid were recruited from two Chicago-based allergy clinics. Caregivers of children with FA completed a pretest evaluating knowledge, attitudes, beliefs, and practices regarding FA management. A clinician guided caregivers through the FA Passport. The caregivers then completed a posttest immediately afterward and again 3 months later. Changes were evaluated from baseline responses and direct feedback was elicited about the tool. The FA Passport successfully improved caregiver-reported confidence with epinephrine autoinjector use (from 69% to 93%), caregiver anaphylaxis recognition (from 66% to 73%), and reported quality of life, and it nearly doubled caregiver comfort regarding leaving the child in the care of others (from 40% to 75.7%). Caregivers rated the FA Passport tool as extremely helpful overall (9.4 out of 10). The FA Passport is a novel FA clinical support tool that addresses barriers to proper FA management described in previous studies. It proved effective at improving caregiver comfort with regarding leaving the food-allergic children with other caregivers, increasing FA knowledge, and improving the quality of life in families affected by FA.

Пищевая аллергия у детей с атопическим дерматитом (возможности лабораторной диагностики)

Objective - determination of the frequency of manifestation of allergic reactions of reaginic and cellular types in vitro to food allergens in children with atopic dermatitis (AD). Materials and methods. We examined 284 children aged 0 to 14 years: 200 children with AD in 4 age groups and 84 control children. Investigated total IgE, histamine and serotonin in the blood. A semi-quantitative method in ELISA identified specific IgE antibodies to 67 food allergens, and in leukocyte migration capillary tube technique (LMCT) the presence of delayed-type sensitization to 42 food allergens. Results. The levels of total Ig E, histamine and serotonin in children with AD were significantly higher than the control. The average value of positive results for the presence of specific IgE antibodies to any food allergens was 46.2±4.57%. Banana, goat's milk, tomatoes, egg protein and cow's milk casein topped the ranking. According to the results of LMCT, delayed sensitization of the cell type was determined on average in 40.38±4.81% of tests. The leaders were allergens of hake, black coffee, glucose, peas, rye flour, orange, corn flour and peanuts. Conclusions.AD develops in children already at an early age (up to 3 years), with an excess of control values of total serum IgE by 4.8 times (p<0.01), histamine - by 1.3 times (p<0.01), serotonin - 1.2 times (р<0.001). Reaginic and cellular reactions are involved in the occurrence of food sensitization. Methods of laboratory diagnosis of food allergy are preferable to skin tests and allow young children to simultaneously determine sensitization to a large number of allergens.

Human milk oligosaccharides in Chinese lactating mothers and relationship with allergy development in offspring.

The health benefits of breastfeeding are partly contributed by human milk oligosaccharides (HMOs), but there is limited data on breast milk (BM) HMO composition in Chinese. This study investigated the association between early-life HMO intake and allergy occurrence in Chinese children. 103 healthy Chinese pregnant women regardless of allergy history were recruited into this birth cohort. Their babies were followed until 24 months old. Concentrations of 2'-fucosyllactose (2'-FL), lacto-N-neotetraose (LNnT), -sialyllactose (3'-SL) and 6'-sialyllactose (6'-SL) in BM collected at 1-month postpartum were measured by liquid chromatography-mass spectrometry. The associations between these HMOs and allergy occurrence by 24 months were analyzed by multivariate regression analyses. Twenty-nine percent and 19% of participants had eczema at 12 and 24 months old respectively. Eighty BM samples were analyzed, with 2'-FL being the most abundant HMO (median 1447 ppm, interquartile range [IQR] 291-1906 ppm), and median (IQR) levels of LNnT, 6'-SL and 3'-SL in ppm were 738 (580-950), 20.5 (12.7-38.8) and 23.0 (17.8-27.6) respectively. Participants with eczema by 24 months consumed BM with higher 2'-FL concentration at 1-month (P = 0.008), and also lower 6'-SL concentration in exclusively breastfed infants (P = 0.012) but higher 6'-SL concentration for those with mixed feeding at 1 month (P = 0.043). Food allergic children at 12 months consumed BM with higher 2'-FL concentrations at 1 month (P = 0.048). BM 2'-FL concentration is higher in children who develops eczema by 24 months and food allergy during infancy. The relationship for 6'-SL is divergent depending on mode of feeding in infants.

Going on vacation increases risk of severe accidental allergic reaction in children and adolescents

Short holiday breaks with family, away from routine and familiar surroundings are an important part of childhood 1. To date, studies of the risks for allergic people, while on holiday, examine accidental allergic reactions (AARs) aboard airplanes or avoidance strategies of nut allergic adults 2-4. There is limited, published data, on the risk of vacation related accidental allergic reactions (VAARs), in food allergic children, who commonly have multiple allergies 5. Their use of restaurants versus self- catering has not been defined.

Health-related quality of life in food and venom induced anaphylaxis and role of influencing factors.

The impact on health-related quality of life (HRQL) plays a key role for patients suffering from allergies and anaphylaxis. In this narrative review we review the HRQL in allergic patients suffering from food and venom allergy, both being the most frequent elicitors of severe allergic, potential life-threatening reactions and provide an overview on the current knowledge and identified gaps. The data show that for food and venom allergy standardized assessment tools to measure HRQL are available and have been successfully applied. Our analysis shows that multiple factors can modulate HRQL in these patient groups. These include sociodemographic data like patients' age and sex, fear of accidental reactions but also external factors like the social environment and the appreciation of the seriousness of the condition by others. External factors may have a significant impact on HRQL and should be considered in patient-related outcome assessments to avoid biased measurements possibly affecting the results. The assessment of the quality of life in the context of specific immunotherapy should consider lifestyle factors and ideally, the individual change in HRQL should be measured. Although there are many data indicating a negative impact on HRQL in food allergic children and their caregivers, limited data are existing from adults with food allergy and venom allergic patients from all age groups. Also, the use of standardized questionnaires should be extended to allow for a better comparability of results between studies. Therefore, translation to additional languages is necessary. Taken together, the eliciting allergen, the severity of the allergic disease but moreover multiple external factors impact the outcome in HRQL and should be considered in HRQL assessment.

Clinical and Epidemiological Features of Allergies in Schoolchildren of the Chechen Republic: Results of an Epidemiological Study

Background. One of the topical issues of modern medicine is the widespread increase in the incidence of allergic pathology. Objective. The aim of the study is to investigate clinical and epidemiological features of allergies in schoolchildren of the Chechen Republic. Methods. We performed clinical and diagnostic verification of allergies according to clinical guidelines in patients who positively answered the ISAAC questionnaire (n = 80) — 46 first-grade and 34 eighth-grade pupils. The first diagnostic step on studying the clinical manifestations in observed children was the history taking, complaints, physical examination. Laboratory and instrumental diagnosis included: IgE total, detection of skin sensitivity to allergens via standard pollen, domestic, epidermal, and food allergens (produced by I.M. Mechnikov Research Institute of Vaccines and Sera, Stavropol Research Institute of Vaccines and Sera), revealing of allergen-specific antibodies, component-divided allergen diagnosis via indirect immunofluorescence with ImmunoCAP analyzer, respiratory function evaluation with CareFusion, nitric oxide level detection in exhaled air via portable NObreath analyzer. If needed, specialised medical consultation were performed. Results. Asthma was detected in 37 (46.3%) children, allergic rhinitis (AR) — in 37 (46.3%), atopic dermatitis (AD) — in 5 (6.3%) according to the results of our study. The most common combination of medical conditions in examined patients was combination of asthma and AR. There were no statistically significant differences in age groups. No gender differences were reported in the study. The highest incidence of asthma and AR was revealed in city residents (p < 0.05), while the AD incidence in the city and rural areas did not differ significantly. The sensibilization spectrum analysis in schoolchildren of the Chechen Republic revealed predominance of sensitivity to pollen (ragweed, herd grass) and domestic allergens (Dermatophagoides pteronyssinus, Dermatophagoides farinae). Sensitization to food allergens in children of the Chechen Republic did not have significant differences in the frequency of occurrence of individual allergens, that is, unlike pollen and household sensitization, a regional rating on the dominance of certain food allergens was not obtained. Sensibilization to epidermal allergens was also less common, the predominant one was the cat allergen. Conclusion. Thus, the first study on the territory of the Chechen Republic carried out according to the ISAAC program has revealed high prevalence of allergies in schoolchildren. Moreover, regional features of sensibilization structure have been identified. It will allow us to maintain economically optimal diagnosis of allergic diseases in children living in the Chechen Republic.

Exposure to ambient ultrafine particles and allergic sensitization in children up to 16 years

BackgroundFew epidemiological studies so far have investigated the role of long-term exposure to ultrafine particles (UFP) in inhalant and food allergy development. ObjectivesThe purpose of this study was to assess the association between UFP exposure and allergic sensitization to inhalant and food allergens in children up to 16 years old in the Netherlands. Methods2295 participants of a prospective birth cohort with IgE measurements to common inhalant and food allergens at ages 4, 8, 12 and/or 16 were included in the study. Annual average UFP concentrations were estimated for the home addresses at birth and at the time of the IgE measurements using land-use regression models. Generalized estimating equations were used for the assessment of overall and age-specific associations between UFP exposure and allergic sensitization. Additionally, single- and two-pollutant models with NO2, PM2.5, PM2.5 absorbance and PM10 were assessed. ResultsWe found no significant associations between UFP exposure and allergic sensitization to inhalant and food allergens (OR (95% CI) ranging from 1.02 (0.95–1.10) to 1.05 (0.98–1.12), per IQR increment). NO2, PM2.5, PM2.5 absorbance and PM10 showed significant associations with sensitization to food allergens (OR (95% CI) ranging from 1.09 (1.00–1.20) to 1.23 (1.06–1.43) per IQR increment). NO2, PM2.5, PM2.5 absorbance and PM10 were not associated with sensitization to inhalant allergens. For NO2, PM2.5 and PM2.5 absorbance, the associations with sensitization to food allergens persisted in two-pollutant models with UFP. ConclusionThis study found no association between annual average exposure to UFP and allergic sensitization in children up to 16 years of age. NO2, PM2.5, PM2.5 absorbance and PM10 were associated with sensitization to food allergens.

Vaccine Hesitation in Parents of Children with Food Allergy

Objective: The term vaccine hesitation means “rejection or delay of vaccines despite the availability of vaccine services”. Parents may delay the vaccination of their children when their children have a history of food allergies. The present study aims to evaluate the factors about vaccine hesitancy of parents with food allergic children.
 Methods: A cross-sectional survey research, created by the researchers, was conducted to the parents of children who were already followed up with food allergy by the pediatric allergy department.
 Results: The parents of 190 children with a median age of 24 (2-60) months who were followed up for food allergy were included in the study. The median follow-up period of the patients was 15.5 (4–160). Forty-four (23.1%) participants had delayed at least one vaccination of their children due to food allergy in the past. The most common vaccine hesitancy was toward the measles-mumps-rubella vaccine. The study also found that there were more delays in vaccination in children with egg allergy (100%) than in those without egg allergy (75.3%) (p = 0.01). As a result of our study, it was determined that the most frequent information about vaccination was obtained from doctors (89.5%)
 Conclusions: It was understood that a substantial proportion of parents with food allergic children had vaccine hesitancy in the past. Families obtaining complete and accurate information about food allergy and vaccine interactions, especially from the health system, will prevent unnecessary delay due to vaccine hesitations.

Narcolepsy-Like Sleepiness: A Symptom of Immediate-Type Reactions in Food-Allergic Children

It has been reported that sometimes children fall asleep and can barely be woken up during allergic reactions on food ingestion. Nevertheless, to date, there is scarce data on narcolepsy-like sleepiness as a symptom of allergic reactions. To investigate the frequency of narcolepsy-like sleepiness during oral food challenges and characterize this symptom regarding comorbidities, eliciting allergens, and severity of reactions. Children with immediate-type allergic reactions during oral food challenges (89% were double-blind, placebo-controlled) have been analyzed in this study. Narcolepsy-like sleepiness was defined as a somnolent condition during which patients could barely be woken up again, occurring within 2 hours of food intake and which was not due to drug side effects. Logistic generalized estimating equations were used to explore the effect of age, severity of reactions, and eliciting allergens on the occurrence of narcolepsy-like sleepiness. In 106 (12.5%) of all 848 food-allergic children, narcolepsy-like sleepiness was observed during oral food challenges. Children with eczema had a higher risk of developing narcolepsy-like sleepiness (P= .006). Narcolepsy-like sleepiness occurred most often due to an allergic reaction to hazelnut (P= .009) or other tree nuts (P= .003). Moderate to severe reactions occurred more often than mild reactions (P= .026; odds ratio, 1.521; 95% CI, 1.051-2.202) in children with narcolepsy-like sleepiness. We were able to show for the first time that narcolepsy-like sleepiness is a frequently occurring clinical manifestation of immediate-type allergic reactions on food ingestion in childhood. Further research is needed to unravel the underlying mechanisms to gain a deeper insight into this underestimated symptom.

EXPLORING PARENTAL INTEREST IN IDENTIFYING THE ELICITING DOSE OF PEANUT FOR THEIR PEANUT ALLERGIC CHILD

<h3>Introduction</h3> The eliciting dose (ED) of a food allergen, or minimum dose at which a patient is likely to react, is increasingly being used to inform precautionary allergen labeling (PAL), assess individual risk, and improve management of food allergies. However, conducting a low-dose oral food challenge to determine a patient's ED is not commonly done as part of the diagnostic work-up. Limited literature exists on parental desire to know their food-allergic child's ED. <h3>Methods</h3> We performed a prospective survey of parents with peanut-allergic children to determine their interest in performing a single-dose 10mg peanut challenge and explore variables that may be related to their interest. <h3>Results</h3> Parents of 51 peanut-allergic children were surveyed to date. Demographics of children are as follows: 62% male, 59% African American, median age of 7 years, 73% were insured by Medicaid, and 76% reported other food allergies. 69% reported avoiding foods with PAL for peanut allergy. Of all respondents, 69% reported interest in performing a one-time 10mg challenge to peanut (understanding peanut content in products with PAL likely contain less than 1mg of peanut). No variable correlated with interest in performing the challenge. <h3>Conclusion</h3> In this study to date, the majority of parents express interest in performing a low-dose challenge to peanut. Further research is needed to explore this area as it may have an impact on anxiety, social limitations, and desire to pursue therapy if parents know their child is at low risk of reaction to accidental ingestion of small amounts of peanut.

SOCIAL MEDIA USE AMONG PARENTS OF FOOD ALLERGIC CHILDREN

<h3>Introduction</h3> Social media influences medical decision making in various ways. This study aimed to characterize how parents of food-allergic children utilize online resources. <h3>Methods</h3> Caregivers of food allergic children answered an anonymous survey during a follow-up visit with their allergist. Identical surveys were distributed at two separate pediatric academic medical centers. <h3>Results</h3> Among 145 respondents, 74% use online searches at least weekly for food allergy information, but <25% use social media in this manner. The most common reasons for using social media were food allergy support groups and tips for school/travel. Convenience (80%), ease of information (77%), and quick answers (75%) were the most common reasons for online searches. Forty-five percent never, and 41% occasionally, follow recommendations found on social media. Professional organizations (65%) and allergist accounts (58%) were deemed more trustworthy than other parents (23%) and celebrities (6%). Forty-three percent of parents never discuss information found on social media with their child's allergist. Sixteen percent report increased anxiety directly from social media and 14% stopped their engagement. <h3>Conclusion</h3> Parents of food-allergic children are using online searches and social media to find information related to food allergies, but don't always discuss this with their child's allergist. Parents report variable trust of information found online. Allergists can assist caregivers of food- allergic children by proactively discussing social media and online searches during office visits.

SINGLE VERSUS MULTI-ALLERGEN ORAL IMMUNOTHERAPY FOR TREATMENT OF FOOD ALLERGY: A RETROSPECTIVE COHORT STUDY

<h3>Introduction</h3> With 40% of food-allergic children in the US being allergic to more than one food, more data on the safety and efficacy of multi-allergen oral immunotherapy (treating multiple allergens concurrently) will better inform clinician practice. <h3>Methods</h3> This retrospective study compares the safety and efficacy of multi-allergen versus single allergen oral immunotherapy (OIT) in two pediatric cohorts (single allergen n=169, multi-allergen n=147). Pearson Chi-square tests compared OIT completion rates (efficacy endpoint) and epinephrine use (safety endpoint). Multiple logistic regression models analyzed the difference between these endpoints while controlling for demographic differences between the cohorts. <h3>Results</h3> There was no statistical difference in OIT completion rates between the cohorts (85.2% single allergen vs 80.3% multi-allergen, p=0.245). There was a statistical difference in epinephrine use rates between cohorts (6.5% single vs 15.7% multi, p=0.009). More patients in the multi-allergen group had multiple food allergies (p=<0.001), asthma (p=0.043), allergic rhinitis (p=0.012), a prior reaction to the OIT treatment food (p=0.037), and a higher mean baseline allergen specific IgE (p=0.003). When analyzing OIT completion and epinephrine use endpoints while controlling for these differences using a multiple logistic regression model, neither OIT completion (odds ratio of 0.56, 95% confidence interval 0.23 – 1.37, p=0.205) nor epinephrine use (odds ratio of 1.63, 95% confidence interval 0.55 – 4.82, p=0.379) resulted in statistically significant differences between each group. <h3>Conclusion</h3> Multi-allergen OIT is as effective as single allergen OIT, however multi-allergen OIT may result in increased treatment-related epinephrine use, making it less safe than single allergen treatment.

Retail Food Equivalents for Post–Oral Immunotherapy Dosing in the Omalizumab as Monotherapy and as Adjunct Therapy to Multi-Allergen Oral Immunotherapy in Food-Allergic Children and Adults (OUtMATCH) Clinical Trial

Patients with food allergy may be advised to introduce specific foods into their diets, both to increase tolerance gradually and as next steps after completing oral immunotherapy or other therapeutic interventions. However, the safe use of retail foods depends on the ability to establish the specific allergen protein content of these foods. To develop a systematic approach to estimate the protein content of peanut, milk, egg, wheat, cashew, hazelnut, and walnut in a variety of retail food equivalents for each allergen and associated patient education materials. We created an algorithm that used a multistep process with information from product food labels, nutrient databases, independent weighing and measuring of foods, and information provided by manufacturers, including certificates of analysis, and e-mail communication to estimate the allergen protein content of multiple retail foods for each of seven allergens. Once a variety of retail food equivalents for each allergen and allergen serving size was determined, we developed participant education handouts, which were reviewed by study teams at 10 food allergy centers, the National Institute of Allergy and Infectious Diseases, and the Consortium for Food Allergy Research coordinating center. After 1 year of use, multiple queries were addressed and the retail food equivalents and educational materials were reviewed and edited. We identified a variety of retail food equivalents for seven allergens at six serving sizes, and created 48 unique patient education materials. Our results provide extensive guidance on a variety of retail equivalents for seven foods, and a method to estimate retail food protein equivalents systematically with ongoing reassessment.

Validation of the food allergy quality of life questionnaire series in Chinese families with food-allergic children.

Anxiety from accidental exposure and vigilant dietary monitoring impair the quality of life (QoL) of food-allergic patients. A comprehensive food allergy-specific questionnaire allows patients to accurately report their QoL. This study validated the Food Allergy Quality of Life Questionnaire (FAQLQ) series and assessed the QoL of Chinese food-allergic patients and their caregivers. FAQLQ series developed by EuroPrevall consists of four separate questionnaires for parents, children, adolescents and adults. All questionnaires were translated into traditional Chinese by standard forward and backward methods. A cross-sectional study was conducted on food-allergic patients and children's parents using an age-appropriate questionnaire. The performance indices of FAQLQ and their correlation with independent measures of food allergy were analyzed, and factor analysis was performed to confirm the factor structure of FAQLQ questionnaires. Cross-sectional validation was performed on 214 participants, with 40 reassessed for test-retest reliability. Overall scores for the FAQLQ series had good internal consistency with Cronbach's α ≥.90. Good construct validity was demonstrated by correlations between FAQLQ-Parent Form, FAQLQ-Child Form, FAQLQ-Teenager Form, FAQLQ-Adult Form and Food Allergy Independent Measure (FAIM) scores, except in 0- to 3-year-old children. Test-retest analyses revealed a significant correlation between total FAQLQ score, parent-reported FAIM and food anxiety domain in 4-6 years, and between total score and FAIM in 7-12 years. Exploratory factor analysis categorized items in the FAQLQ series into three to four domains. FAQLQ series provide a valid and reliable measure for QoL in Chinese food-allergic patients and caregivers, except for parents of children aged 0-3 years. Items for all FAQLQ questionnaires are categorized into different functional domains in our population.

Exposure to ambient ultrafine particles and allergic sensitization in children up to 16 years

Background and aim: Few epidemiological studies so far have investigated the role of long-term exposure to ultrafine particles (UFP) in allergy development. The purpose of this study was to assess the association between UFP exposure and allergic sensitization to inhalant and food allergens in children up to 16 years old in the Netherlands. Methods: 2295 participants of the prospective PIAMA birth cohort with specific IgE measurements to common inhalant and food allergens at ages 4, 8 or 12 or to common inhalant allergens at age 16 were included in the study. Annual average UFP concentrations were estimated for the home addresses at birth and at the time of the IgE measurements using land-use regression models. Generalized estimating equations were used for the assessment of overall and age-specific associations between UFP exposure and allergic sensitization. Additionally, single- and two-pollutant models with NO2, PM2.5, PM2.5 absorbance and PM10 were assessed. Results: We found no significant associations between UFP exposure and allergic sensitization to inhalant and food allergens (OR (95% CI) ranging from 1.02 (0.95 – 1.10) to 1.05 (0.98 – 1.12), per IQR increment). In contrast, NO2, PM2.5, PM2.5 absorbance and PM10 showed significant associations with sensitization to food allergens (OR (95% CI) ranging from 1.09 (1.00–1.20) to 1.23 (1.06–1.43) per IQR increment) but not with sensitization to inhalant allergens (OR (95% CI) ranging from 0.98 (0.90-1.07) to 1.08 (0.93-1.25) per IQR increment). For NO2, PM2.5 and PM2.5 absorbance, the associations with sensitization to food allergens persisted in two-pollutant models with UFP. Conclusion: This study found no association between annual average exposure to UFP and allergic sensitization in children up to 16 years of age. NO2, PM2.5, PM2.5 absorbance and PM10 were associated with sensitization to food allergens. Key words: ultrafine particles, IgE sensitization, inhalant and food allergens, children, air pollution, allergy

Characteristics and changes of sensitization patterns of major allergens in children from 2010 to 2020 in a hospital of pediatric in Beijing

Objective: To analyze the sensitization characteristics and change of major allergens in children from 2010 to 2020 in Beijing, so as to provide basis for diagnosis, treatment and prevention of allergic diseases in children. Methods: A retrospective study was conducted to analyze the children who were suspected of allergic diseases and tested for serum immunoglobulin E (total IgE and specific IgE) in the children's Hospital Affiliated to the Capital Institute of Pediatrics from January 2010 to December 2020. A total of 45 746 children aged 0-17 years in Beijing were enrolled with a median (interquartile range) of 3.8 (2.5, 5.3) years. There were 28 918 boys (63.2%) and 16 828 girls (36.8%) and 14 984 cases (32.8%) in the infant group (<3 years old), 22 049 cases (48.2%) in the preschool group (3-6 years old), and 8 713 cases (19.0%) in the school-age group (6 years old and above). Immunocap allergen detection system (fluorescence enzyme-linked immunosorbent assay) was used to detect and the characteristics and change trend of allergens during 11 years were statistically analyzed by Chi square test. Results: The top three positive rates of single food allergens sIgE were egg white 42.6% (2 788/6 577 tests), milk 38.4% (2 606/6 782 tests) and wheat 31.8% (1 417/4 449 tests), and the sequence of single inhaled allergens were Ragweed 42.6% (440/1 034 tests), Artemisia 38.4% (1 045/3 191 tests) and Alternaria alternata 31.3% (3 358/10 725 tests). The positive detection rates of egg white 47.0%(1 904/4 048 tests), milk 41.9%(1 769/4 226 tests) and wheat 33.9%(973/2 870 tests) in the infant group were the highest, and there have statistically significant(χ2=91.495, 73.907, 16.966, P<0.05). The positive rates of fx1 (22.5%, 121/537 tests), peanut (24.9%, 111/446 tests), soybean (20.0%, 74/370 tests) and shrimp (7.48%, 44/588 tests) were the highest in the school-age group(χ²=14.436, 10.751, 11.569, 13.703, P<0.05). The most common inhaled allergens were Alternaria alternata (14.8%, 422/2 859 tests) in the infant group, Ambrosia (34.5%, 143/415 tests) and Alternaria alternata (33.5%, 1 762/5 254 tests) in the preschool group, while in the school-age group were Ambrosia (56.4%, 282/500 tests) and Artemisia (48.2%, 573/1 189 tests). The positive rates of egg white, milk, wheat, sesame seed and peanut varied from 2010 to 2020, showing a trend of falling first and then rising(χ²=10.293,χ²=12.066,χ²=7.402,χ²=32.458,χ2=31.747,P<0.05).The positive detection rates of soybean showed a significant downward trend (21.4%, 173/809 tests in 2010, 15.4%, 70/455 tests in 2020, χ²=6.751,P=0.009), while that of shrimp and crab were at a stable low level(χ²=0.263, 1.346;P>0.05). From 2010 to 2020, mold (26.7%, 1 066/3 998 tests in 2010, 40.2% 1 705/4 243 tests in 2020), grass pollen (19.8%, 259/1 308 tests in 2010, 39.3%, 1 472/3 746 tests in 2020), tree pollen(17%, 180/1 058 tests in 2010, 29.8%, 916/3 075 tests in 2020) and animal dander (18.5%, 111/601 tests in 2010, 26.6%, 672/2 522 tests in 2020) were all showed significant upward trend (χ²=168.600, 163.601, 65.931 and 17.271 respectively, P<0.001) but dust mites (30.7%, 1 270/4 132 tests in 2010, 26.7%, 1 126/4 221 tests in 2020) showed a significant downward trend(χ²=16.822,P<0.001).In 2010, the most common inhaled allergen was dust mite 30.7% (1 270/4 132 tests), followed by mold 26.7% (1 066/3 998 tests), while they were mold 40.2% (1 705/1 243 tests), and grass pollen 39.3% (1 472/3 746 texts) respectively in 2020. Conclusion: In the past 11 years, the main food allergens in children were still egg white and milk, wheat, but the mold and pollen gradually replaced dust mite as the most common inhaled allergen.

Factors That Affect Food Parenting Practices of Children With Food Allergies

ObjectivesThe prevalence of food allergies continues to increase. Literature shows child diagnosis of a food allergy has implications for parents (e.g., higher levels of anxiety), which can influence food parenting practices (FPP). As such, the primary aim of the current study was to investigate whether FPP differ between parents of children with and without a food allergy. The secondary aim was to investigate whether secondary factors, such as historical severity of allergic reaction, will also affect FPP.MethodsParticipants were parents of children (N = 399) who completed online surveys about health history, including food allergy history, and FPP (Child Feeding Questionnaire, Structure and Control in Parent Feeding). About one-quarter (24.6%; n = 98) of children had at least one food allergy. A series of ANOVAs were conducted to assess differences in FPP between children with and without food allergies. Secondary analyses were conducted among parents of children with food allergies to examine how professional diagnosis, parental food allergy, reaction severity, hospitalization history, and presence of other chronic conditions affect FPP.ResultsParents of children with food allergies were more likely to report limit setting FPP (p = .035); there were no other significant differences in FPP between children with and without food allergies (ps > .133). Among families with food allergies, parents whose children were not professionally diagnosed with a food allergy reported greater use of restrictive feeding practices (p = .019). Compared to parents without a food allergy, when both parent and child have a food allergy, parents reported higher pressure to eat (p = .006, p = .046), use of control (p = .039), and structured feeding routines (p = .039).ConclusionsCurrent findings illustrate that FPP are similar between parents of children with and without food allergies, with parents of children with food allergies engaging in more limit setting. However, in families with a food allergic child, other factors, such as parental food allergy history, were associated with increased use of controlling FPP. Given that food parenting practices have implications for child health, it is critical to work with parents of children with food allergies to help reduce use of controlling food parenting practices.Funding SourcesUniversity at Buffalo Experiential Learning Network.

The Effect of an Elimination Diet on Early Childhood Growth in Children with Egg and/or Cow’s Milk Allergies

Objective: Eliminating egg and/or cow’s milk during early childhood may affect the growth of food-allergic children. The aim of this study was to determine the effects of elimination diets on anthropometric measurements and diet composition in children allergic to egg and/or cow’s milk. Materials and Methods: Anthropometric measurements and nutritional data were evaluated in children with cow’s milk and/or egg protein allergy during elimination diets. Their daily calorie, carbohydrate, fat, and protein intakes were analyzed based on a 3-day diet log. Z-scores for weight, height, weight-for-age, and weight-for-height were calculated. The data were compared with pre-elimination values and with those of healthy controls. Results: The study included 77 food-allergic children and a control group of 50 healthy children. In the patient group, the median age was 14 months and 57.1% (n=44) were male. Age, gender, and z-scores for weight-for-age and height-for-age were similar between the groups. Comparisons with pre-elimination measurements revealed that 18.2% of children with short stature at the time of diagnosis achieved normal height after elimination diets (p=0.001) and 37.4% of the children had increased height z-score. However, weight-forage z-score decreased significantly (p<0.01). Although caloric intake was the same in both groups, the patient group consumed relatively less protein and more fat and carbohydrates. Conclusion: In elimination diets, even if the calorie intake is adequate, eliminating allergenic food items may cause a decrease in weight without causing malnutrition. The height may improve. Growth should be monitored with age-corrected measurements and on an individual basis.

Evaluating the effects of a standardized polyphenol mixture extracted from poplar-type propolis on healthy and diseased human gut microbiota

IntroductionA large body of evidence suggests that propolis exerts antioxidant, anti-inflammatory, and antimicrobial activities, mostly ascribed to its polyphenol content. Growing evidence suggests that propolis could modulate gut microbiota exerting a positive impact on several pathological conditions. The aim of this study was to determine the in vitro impact of a poplar-type propolis extract with a standardized polyphenol content, on the composition and functionality of gut microbiota obtained from fecal material of five different donors (healthy adults, and healthy, obese, celiac, and food allergic children). MethodsThe standardized polyphenol mixture was submitted to a simulated in vitro digestion-fermentation process, designed to mimic natural digestion in the human oral, gastric, and intestinal chambers. The antioxidant profile of propolis before and after the digestion-fermentation process was determined. 16 S rRNA amplicon next-generation sequencing (NGS) was used to test the effects on the gut microbiota of propolis extract. The profile of the short-chain fatty acids (SCFA) produced by the microbiota was also investigated through a chromatographic method coupled with UV detection. ResultsIn vitro digestion and fermentation induced a decrease in the antioxidant profile of propolis (i.e., decrease of total polyphenol content, antiradical and reducing activities). Propolis fermentation exhibited a modulatory effect on gut microbiota composition and functionality of healthy and diseased subjects increasing the concentration of SCFA. ConclusionsOverall, these data suggest that propolis might contribute to gut health and could be a candidate for further studies in view of its use as a prebiotic ingredient.

The relationship between food allergy severity and experiencing harms from bullying victimization

Children with food allergies are a growing segment of the population who report high rates of bullying victimization. Yet, little is known about how bullying victimization experiences affect this population. Using data collected from an online survey administered to parents of children with food allergies (N = 621), this study examines if higher levels of food allergy severity are related to having higher odds of experiencing various harms from bullying victimization. Findings show that, according to parents, children with more severe food allergies have increased odds of experiencing emotional harms, social harms, psychological harms, and missed school from bullying victimization. Policy implications are discussed, such as allocating resources to build the emotional, social, and psychological resiliency among children with more severe food allergy conditions, as well as providing counseling services to food-allergic children and their families.