Food Allergy Group Research Articles

Dietary Intake, Diet Diversity, and Weight Status of Children With Food Allergy

BackgroundAdoption of allergen avoidance diets may increase the risk of nutritional deficiencies and affect growth in children with food allergy (FA). How these dietary restrictions have an impact on diet diversity, a health-promoting eating behavior, remains unclear. ObjectiveTo evaluate diet diversity, dietary intake, and weight status of children with FA. DesignObservational study. Participants/settingOne hundred children with immunoglobulin E (IgE)-mediated milk, egg, or nut FA or multiple FAs and 60 children with perennial respiratory allergies (RA) matched as controls, aged 3 to 18 years, were consecutively recruited into the study. Main outcome measuresDietary intake and diet diversity (number of different foods consumed/day) were assessed through 4 24-hour recalls. Weight status (underweight, healthy weight, overweight, or obesity) was also evaluated. Statistical analyses performedChi-squared test and 2-sample independent t test were used to test differences between groups. Adjustment for sex, age, and energy intake was made using linear regression. ResultsThe percentage of underweight was higher in children with FA (19.6%) compared with children in the control group (5.1%). Children with FA compared with children in the control group consumed more servings of meat (1.7, 95% CI, 1.6, 1.9 vs. 1.5, 95% CI, 1.3, 1.7 servings/day [Padj = 0.031]). No difference was observed in the diet diversity between the 2 groups (11–12 different foods/day). Within the FA group, children with allergy to milk proteins had lower energy intake from protein, lower intake of calcium, lower consumption of commercially prepared sweets, and higher consumption of eggs, compared with children with nut or egg allergy, but no difference in diet diversity was observed. ConclusionsDiet diversity did not differ between children with FA and children with no FA, despite some differences in the intake from specific food groups. However, the higher percentage of underweight in children with FA suggests the need for targeted nutrition intervention as early as possible after FA diagnosis.

The association of milk and multiple food avoidance with growth parameters in infants and children

BackgroundRecent studies reported that strict avoidance of milk products in cow's milk allergy (CMA) affects growth and bone turnover, causing negative calcium balance and changes in bone metabolism. ObjectiveTo investigate biochemical parameters to predict bone turnover and its relations with height and weight measurements and nutritional intake. MethodsHeight, weight, and body mass index z scores were plotted for age according to the World Health Organization. A 3-consecutive day food record was analyzed for nutritional values of foods. The blood levels of calcium, phosphorus, alkaline phosphatase, vitamin D, and parathyroid hormone (PTH) were determined. ResultsThe study included 69 controls, 66 children with isolated CMA, and 59 children with multiple food allergy (FA). The z scores for weight, height, and body mass index were lower in isolated CMA and multiple FA groups than controls (P < .001, P = .004, and P = .002, respectively). The nutritional intakes of protein, fat, carbohydrates, vitamins B2 and B12, niacin, calcium, and phosphorus were significantly lower in isolated CMA and multiple FA than controls. In infants (≤2 years of age), although blood calcium level was in normal range, it was significantly lower in isolated CMA and multiple FA than in controls (P < .001). In children older than 2 years, PTH level was significantly higher in isolated CMA and multiple FA groups than in controls (P = .003). ConclusionOur study revealed that children with isolated CMA and multiple FA had a high nutrition gap, growth deceleration, and unbalanced bone metabolism, as illustrated by low blood calcium and elevated PTH levels.

Factor associated with food allergy among preschool children with atopic dermatitis, and resolution of atopic dermatitis.

Food allergy (FA) has been reported in one-third of children with moderate-to-severe atopic dermatitis (AD). To identify factor associated with food allergy among preschool children with AD, and to compare AD resolution between preschool children with and without FA. A cross-sectional study using database registry and questionnaire interview was conducted at Siriraj Hospital(Bangkok, Thailand) during 2022, and physician-diagnosed AD children aged ≤ 6 years were enrolled. A total of 110 children (60.9% male, median age: 2.3 years) were included. Of those, 53 and 57 children had AD with and without FA, respectively. Very early-onset AD (≤ 3 months) and moderate-to-severe AD at onset were reported in 43.9% and 26.3% of AD without FA, and in 35.8% and 45.3% of AD with FA, respectively. The most commonly reported FAs were hen's egg, cow's milk, and wheat. Moderate-to-severe AD at onset was found significant associated with FA (aOR: 2.50; p = 0.037). Thirty-one (28.2%) patients experienced completed resolution of AD by 5 years of age. Of those, 19 had AD without FA, and 12 had AD with FA (p = 0.213). The median age at AD resolution was 18 months and 22.5 months in the without and with FA groups, respectively. AD with FA showed a strong trend toward a significantly longer duration to achieving AD resolution after adjusting for onset and severity of AD (aHR: 0.46, p = 0.050). Preschool AD children with FA were found to have significantly greater AD severity at AD onset and a longer duration to AD resolution compared to AD children without FA.

Nutritional Status of Children with Newly Diagnosed Food Allergies.

Most published pediatric guidelines on food allergy highlight the importance of nutritional counseling and dietary adequacy to avoid either growth retardation or nutritional deficiencies. The aim of the study was an assessment of the nutritional status of children with IgE-mediated food allergies. 45 patients with newly diagnosed food allergy (FA) and 33 healthy controls were analyzed (aged 6 to 72 months, 60.2% boys). The nutritional status was assessed using anthropometric measurements (body weight and length) and serum laboratory tests. The results were analyzed with the Statistica 12 software (Tulsa, OK, USA). 82%, 40%, 8.8%, and 6.6% of the studied children demonstrated allergy to hen's egg, cow's milk, pork meat, and wheat/rye, respectively. Z-score BMI < -2SD was more often found in the FA subjects under 30 months of age than in the controls (p = 0.04). As many as 77.8% of the FA subjects and 78.8% of the controls were of normal height (hSDS: -0.23 ± 1.74 and -0.31 ± 1.49, respectively, p = 0.8). Retinol binding protein four serum concentration was significantly lower in the FA group (17.01 ± 3.84 mg/L) than in the controls (20.47 ± 4.87 mg/L, p < 0.001). No statistically significant differences were observed between the FA group and the controls (either in the younger or the older age group) (p > 0.05) for the serum concentrations of total protein, total cholesterol, thyroxin-binding prealbumin (TBPA), 25(OH)D, hemoglobin level or white blood cells. In patients under 30 months of age, one of the symptoms of food allergy may be body weight deficiency, while short stature is less common at the time of diagnosis.

The alternative bile acid pathway can predict food allergy persistence in early childhood.

Mechanisms underlying persistent food allergy (FA) are not well elucidated. The intestinal mucosa is the primary exposure route of food allergens. However, no study has examined intestinal metabolites associated with FA persistence. The goal of this study was to investigate intestinal metabolites and associated microbiomes in early life that aid in determining the development and persistence of FA. We identified metabolomic alterations in the stool of infants according to FA by mass spectrometry-based untargeted metabolome profiling. The targeted metabolomic analysis of bile acid metabolites and stool microbiome was performed. Bile acid metabolite composition in infancy was evaluated by characterizing the subjects at the age of 3 into FA remission and persistent FA. In untargeted metabolomics, primary bile acid biosynthesis was significantly different between subjects with FA and healthy controls. In targeted metabolomics for bile acids, intestinal bile acid metabolites synthesized by the alternative pathway were reduced in infants with FA than those in healthy controls. Subjects with persistent FA were also distinguished from healthy controls and those with FA remission by bile acid metabolites of the alternative pathway. These metabolites were negatively correlated with specific IgE levels in egg white. The abundance of intestinal Clostridia was decreased in the FA group and was correlated with ursodeoxycholic acid. Intestinal bile acid metabolites of the alternative pathway could be predictive biomarkers for persistent FA in early childhood. These findings require replication in future studies.

Galectin-9 in synergy with NF-κB inhibition restores immune regulatory capability in dendritic cells of subjects with food allergy.

The pathogenesis of immune tolerance disruption is not fully understood. Galectin-9 (Gal9) has immune regulatory functions. The objective of the present study is to assess the role of Gal9 in maintaining immune tolerance. Blood and intestinal biopsies were taken from patients with food allergy (FA). The status of tolerogenic dendritic cells (tDC) and type 1 regulatory T cells (Tr1 cells) in the samples was evaluated and used as representative parameters of immune tolerance. An FA mouse model was established to assess the role of Gal9 in maintaining immune tolerance. We found that peripheral CD11c+ CD5+ CD1d+ tDC frequency was significantly lower in FA patients as compared to health control (HC) subjects. There was no significant change in CD11c+ DC frequency between the FA group and the HC group. The expression of IL-10 in peripheral tDCs was lower in the FA group than that in the HC group. A positive correlation was detected between the serum levels of IL-10 and Gal9. The expression of Gal9 was observed in intestinal biopsies, which was positively correlated with the serum levels of Gal9 as well as serum IL-10 levels. Peripheral Tr1 cells had lower frequencies in the FA group than in the non-FA (Con) group. tDCs demonstrated the ability to generate Tr1 cells, which was weaker in the FA group as compared with the Con group. Exposure of FA tDCs to Gal9 in culture restored the ability to generate Tr1 cells. In summary, the lower frequency of tDC and Tr1 cell of FA patients was associated with the levels of Gal9. The presence of Gal9 restored the capacity of tDC to generate Tr1 cells.

CD4+CD25+CD127loFOXP3+ cell in food allergy: Does it predict anaphylaxis?

Food allergy (FA), hence the incidence of food anaphylaxis, is a public health problem that has increased in recent years. There are still no biomarkers for patients with FA to predict severe allergic reactions such as anaphylaxis. There is limited information on whether regulatory T (Treg) cell levels are a biomarker that predicts clinical severity in cases presenting with FA, and which patients are at a greater risk for anaphylaxis. A total of 70 children were included in the study: 25 who had IgE-mediated cow's milk protein allergy (CMPA) and presented with non-anaphylactic symptoms (FA/A-), 16 who had IgE-mediated CMPA and presented with anaphylaxis (FA/A+) (a total of 41 FA cases), and a control group consisting of 29 children without FA. The study was conducted by performing CD4+CD25+CD127loFOXP3+ cell flow cytometric analysis during resting at least 2 weeks after the elimination diet to FA subjects. When the FA group was compared with healthy control subjects, CD4+CD25+CD127loFOXP3+ cell rates were found to be significantly lower in the FA group (p < 0.001). When the FA/A- and FA/A+ groups and the control group were compared in terms of CD4+CD25+CD127loFOXP3+ cell ratios, they were significantly lower in the FA/A- and FA/A+ groups compared to the control group (p < 0.001). Although there was no significant difference between the FA/A+ group and the FA/A- group in terms of CD4+CD25+CD127loFOXP3+ cells, our study is important, as it is the first pediatric study we know to investigate whether CD4+CD25+CD127loFOXP3+ cells in FA predict anaphylaxis.

Characteristics of tree nut, peanut, and seed consumption in the eastern Mediterranean region

Nuts and seeds are among the most common causes of food allergy (FA), and consumption differences across cultures and geographic regions are thought to account for the diversity of these allergies. Caregivers of infants (age 12-24 months) with or without FA were questioned in face-to-face interviews to identify the nut and seed consumption practices in the household, during pregnancy, breastfeeding, and early childhood. Of the 171 infants (median age: 17.3 months) included in the study, 75 were healthy and 96 had FA. More than two-thirds of the infants in the whole group started to be fed with walnuts, sesame/tahini, hazelnuts, almonds, and sunflower seeds. The percentages of healthy infants who were not fed with tree nuts, seeds, and peanuts were 4%, 4%, and 49.3%, respectively, for the healthy infants, and 11.8%, 11.8%, and 67.8% for those with FA. In the FA group, sesame and peanut consumption was initiated at a younger age, and walnut, hazelnut, and almond consumption at an older age compared to the healthy infants (p < 0.05 for each). Walnuts and sesame/tahini were the most consumed nuts at home, and peanuts and pumpkin seeds were the least consumed. Mothers reported that they increased tree nut consumption during pregnancy due to their positive effect on health and sesame/tahini consumption during breastfeeding to increase breast milk, respectively. The uniqueness of Turkish culinary culture is characterized by the frequent consumption of tree nuts and seeds, with further increases during pregnancy/lactation and early introduction to the diet of infants.

Trends in the contributions of atopic family history to pediatric food sensitization and allergy.

Family history of atopic diseases (FHA) contributes to food allergy (FA). But little is known whether FHA primarily increases IgE-mediated, non-IgE-mediated FA, or both. And the trends in the contributions of FHA to food sensitization (FS) and FA remain unclear. We aim to clarify the associations among FHA, FS and FA and to understand the trends in the contributions of FHA to FS and FA. We used chi-square test and mediating effect model to analyze the associations among FHA, FS and FA through comparisons between two cross-sectional investigations on FA in children under 2 years old in 2009 and 2019. In 2009 and 2019, the positive FHA proportion tended to be increasing without significance (28.9% to 31.6%, P = 0.39). Subgroup analysis showed the FS rate in FA group decreased significantly (37/39 to 44/62, P = 0.003). In 2009, the FS rate and FA prevalence were higher in FHA (+) group than in FHA (-) group (26% vs. 14.7%, P = 0.008 and 15% vs. 7.7%, P = 0.03), and FS had a complete mediating effect on the association between FHA and FA (Z = 2.54, P = 0.011), but the results lost significance in 2019. The association between FHA and FA was completely mediated by FS, which means FHA mainly increases IgE-mediated FA. And the contributions of FHA to FS and FA tended to be stabilized or even diminished, which means FHA alone could no longer be enough to screen high-risk children.

Exploring the Heterogeneity of IgE-Mediated Food Allergy through Latent Class Analysis

Introduction: Food allergy (FA) is a heterogeneous disease with multiple morbidities and a huge burden for patients and healthcare systems. Variable manifestations, comorbidities (atopic dermatitis [AD], asthma, and/or allergic rhinitis [AR]), severity (anaphylaxis), and outcomes suggest the existence of different endotypes that cluster analyses may reveal. In this study, we aimed to investigate distinct subgroups among patients with FAs using data from 524 children/adolescents. Methods: 524 patients with IgE-mediated FA (353 male [67%]; median age 4.4 years [IQR:3.0–6.8]), 354 (68%) had multiple FA. The history of AD, asthma, AR, and anaphylaxis was recorded in 59.4%, 35.5%, 24.2%, and 51.2% of the patients, respectively. Latent class analysis was carried out to distinguish clinical FA phenotypes using five potential markers of allergy severity (single/multiple FA, never/inactive/current asthma and AD, AR, and anaphylaxis). Results: Three distinct phenotypes were identified: (1) multiple FA with eczema and respiratory multimorbidity (42%), (2) multiple FA with persistent eczema (34%), and (3) single FA with respiratory multimorbidity without eczema (24%). Compared with the single FA cluster, the prevalence of AD was significantly higher in multiple FA groups. Cluster 1 had the highest frequency of AR and allergic asthma, and the lowest rate of total tolerance of FA. Discussion: We put forward the hypothesis of underlying pathogenesis according to the clinical phenotypes. While skin barrier defect may play a dominant role in the pathogenesis in Cluster 2, immune dysregulation may be dominant in Cluster 3. In Cluster 1, the most severe group, a combination of both skin barrier defects and immune dysregulation may be responsible for the clinical features.

The relationship between dietary elimination and maternal psychopathology in breastfeeding mothers of infants with food allergy.

There has been no study evaluating the psychopathology in breastfeeding mothers of infants with food allergy (FA). The aim of the study was to investigate the relationship between dietary elimination and maternal psychopathology, specifically anxiety, depression, and mother-to-infant bonding, in breastfeeding mothers of infants with food allergy. Breastfeeding mothers following an elimination diet due to FA in their children aged 1-to-12months were compared with the healthy controls. The physician-diagnosed FA group was divided into IgE-, non-IgE-mediated, and infants with some minor symptoms which were not enough to make the diagnosis of FA were classified as Indecisive symptoms for FA group. Mothers completed standardized questionnaires including Symptom Checklist 90R, Beck Depression/Anxiety Inventories (BDI/BAI), Postpartum Bonding Questionnaire (Bonding). Of 179mother and infants, 64 were healthy, 89 were FA, 16 were indecisive symptoms for FA. The mean age of the mothers and infants were 31.1±4.7years and 6.3±3.6months, respectively. The physician-diagnosed FA groups had higher scores for anxiety (p=.008), anger (p=.042), depression (p<.001), obsession (p=.002), phobia (p=.008), somatization (p=.002), general symptom index (GSI) (p=.001), BDI (p<.001), BAI (p=.008), and Bonding (attachment [p=.001], anger [p=.019], and total [p=.036]) than the healthy ones. The indecisive symptoms for FA group had a similar score pattern to physician-diagnosed FA, except interpersonal sensitivity, BDI, and attachment. Breastfeeding mothers of infants with FA were more anxious, with higher depression scores than controls, and had many psychopathologies which affected bonding. Interventions targeting negativity in caregivers' social relationships are urgently needed.

Nutrient intake in school-aged children with food allergies: a case-control study

Most studies assessed nutrient intake of young children with food allergy (FA) compared to healthy children. We aimed to compare macro- and micronutrient intake of school-aged children with FA to non-allergic children. This case-control study included 93 Italian children (52 with FA and 41 controls, median age 7.5 and 8.3 years, respectively). Macro- and micronutrient intake was assessed by a three-day food dietary record. Anthropometric measurements were also collected. The median height z-score was significantly lower in the FA group, despite a similar daily energy and protein intake. Calcium, iron and vitamin D intake was suboptimal in both groups, while protein intake was higher than recommended in both groups. Unexpectedly, children with FA consume more protein than controls, while having lower micronutrient intake, especially calcium. Our data suggest the importance of nutritional counseling for children with FA to ensure a balanced nutrient intake while on elimination diet.

Food allergy as an asthma comorbidity in children and adolescents: a practical approach through a real-world study.

Several studies have shown interactions between food allergy (FA) and asthma, but the influence of FA in asthma traits has been scarcely studied. A real-world retrospective observational study was conducted among patients between 3 and 18 years old referred to our Asthma Clinic from November 2014 to November 2017. Data were obtained from daily clinical practice. Only patients properly diagnosed with asthma and FA were included. 815 patients were included: 483 asthmatics and 332 non-asthmatics and 180 FA and 635 no FA. Food allergy was statistically more prevalent among asthma patients (p = 0.014). In a high pollen exposure area, Madrid, among subjects with asthma (121 FA, 362 no-FA), sensitization to lipid transfer protein (LTP) (p = 0.016, OR: 3.064, RR: 2.512) and pollen (p = 0.016, OR: 3.064, RR: 2.512) are risk factors to have a concomitant FA diagnosis, whereas sensitization to profilin is not. Peripheral blood eosinophils were higher in subjects with asthma and FA (≥450 eos/µL) than in asthmatics without FA (≤300 eos/µL) (p = 0.031). Blood eosinophilia, using a cut-off >300 eos/µL, was only present in the FA group. Therefore, this trait should be considered when phenotyping a patient as eosinophilic asthma. Sex had an impact on several variables: height, weight, BMI, blood eosinophils count, sensitization profile, and early-onset asthma. Asthma and FA are closely related and the presence of FA should be investigated in every asthma patient. This study shows an association between asthma with concomitant FA and sensitization to pollen and LTP, blood eosinophilia, and growth alterations. Differences between boys and girls were also described, so a sex-specific approach is recommended.

Microbial signature in IgE-mediated food allergies

BackgroundMultiple studies suggest a key role for gut microbiota in IgE-mediated food allergy (FA) development, but to date, none has studied it in the persistent state.MethodsTo characterize the gut microbiota composition and short-chain fatty acid (SCFAs) profiles associated with major food allergy groups, we recruited 233 patients with FA including milk (N = 66), sesame (N = 38), peanut (N = 71), and tree nuts (N = 58), and non-allergic controls (N = 58). DNA was isolated from fecal samples, and 16S rRNA gene sequences were analyzed. SCFAs in stool were analyzed from patients with a single allergy (N = 84) and controls (N = 31).ResultsThe gut microbiota composition of allergic patients was significantly different compared to age-matched controls both in α-diversity and β-diversity. Distinct microbial signatures were noted for FA to different foods. Prevotella copri (P. copri) was the most overrepresented species in non-allergic controls. SCFAs levels were significantly higher in the non-allergic compared to the FA groups, whereas P. copri significantly correlated with all three SCFAs. We used these microbial differences to distinguish between FA patients and non-allergic healthy controls with an area under the curve of 0.90, and for the classification of FA patients according to their FA types using a supervised learning algorithm. Bacteroides and P. copri were identified as taxa potentially contributing to KEGG acetate-related pathways enriched in non-allergic compared to FA. In addition, overall pathway dissimilarities were found among different FAs.ConclusionsOur results demonstrate a link between IgE-mediated FA and the composition and metabolic activity of the gut microbiota.

Immunoglobulin E-Mediated Food Allergies Differ in East Mediterranean Children Aged 0–2 Years

Objective: Precise diagnosis of allergy requires knowledge of the population’s food allergy (FA) spectrum and predictors. Methods: Medical charts of Turkish children aged 0–2 years with FA and/or atopic dermatitis (AD) were reviewed. Results: A total of 1,389 patients, 912 with FA and 1,140 with AD, were included. In the FA group, the most frequently diagnosed FAs were egg white (75.9%), cow’s milk (55.7%), tree nuts (31.5%) and sesame (20.6%). The detection of FA in 99% of children with any kind of FA necessitate testing with egg white, cow’s milk, hazelnut, sesame, walnut, cashew, and pistachio. In the FA group, 72.7 and 56.8% had AD and multiple FA respectively. Multiple FA (56.8 vs. 49.8%) and hen’s egg allergy (85.5 vs. 50.2%, p < 0.005) were more common and cow’s milk allergy (51.4 vs. 67.1%, p < 0.005) less common in the AD subgroup of the FA group than in the non-AD subgroup. Multiple FA likelihood increases parallel to the severity of AD (p < 0.05). In the AD group, 58.2% had an immunoglobulin E-mediated FA. The risk of concomitant FA increased as the age at symptom onset of AD decreased (OR 0.800 [95% CI 0.731–0.875]; p < 0.001) and the severity of AD increased (OR 2.350 [95% CI 1.898–2.911]; p < 0.001). Conclusion: Although severe and early-onset AD is a predictor of the presence and magnitude of FA in infancy, the spectrum of FA is a reflection of cultural characteristics. The clinical presentations of both AD and FA may in fact be an expression of the extent of the immune dysregulation underlying atopy and allergy.

Examining Differences in Parent Knowledge About Pediatric Food Allergies

Pediatric food allergy (FA) is a serious health condition that has become increasingly prevalent. Parents often play a primary role in assessing and managing risk for their child's FAs, making it critical that they remain informed of the most recent guidelines for FA management. This study aimed to examine if diagnostic source (i.e., pediatrician vs. allergist) and child- and parent-level variables predicted parental FA knowledge using a comprehensive measure. The Food Allergy Knowledge Test (FAKT) was administered to parents (N = 518) of children aged 3-17 years with (n = 349) and without (n = 169; i.e., control group) FAs using internet-sampling procedures. The sample was further partitioned into parents of children diagnosed by an allergist or a pediatrician, and control group parents who did or did not endorse knowing someone with an FA. Significant group differences were found with respect to the overall FAKT score and diagnostic source. Among the FA group, parental relationship to child, income, identification with a minority status, parental anxiety, and child possession of an emergency action plan were significant predictors of FAKT scores. Knowledge of FA was poor across all groups. Education for caregivers both with and without food-allergic children is important to ensure FA safety in multiple settings. Future directions and limitations are discussed.

A Web-based Survey for the Association Between Food Allergy and Depression/psychological Distress in 11,876 Japanese (P18-019-19)

ObjectivesThe aim of this study is to examine whether food allergy (FA) is associated with depression/psychological distress in a large Japanese sample. MethodsThis web-based survey was conducted on a platform of “Yahoo! JAPAN -HealthData Lab” and the Genequest Inc. (Tokyo, Japan). Participants were 1000 individuals with self-reported history of depression (mean age: 41.4 years, 501 men and 499 women) and the remaining 10,876 controls (mean age: 45.1 years, 5691 men and 5185 women). Six-item Kessler scale (K6) test cut-off score ≥13 was used to estimate severe psychological distress. We gained self-reported information on FA and 27 specific food allergens. ResultsThe proportion of individuals with FA, 2 or more, 3 or more, and 4 or more allergens was higher in the depression group compared to the control group (odds ratio [OR] = 1.64, 1.75, 2.02, and 2.27, respectively; P < 0.001). Allergen analyses revealed that allergies for shrimp, egg, mackerel, crab, kiwi fruit, milk, banana, and squid were more common in the depression group compared to the control group (P < 0.05). Individuals who had severe psychological distress was more common in the FA group than in the non-FA group, in the total participants (OR = 1.32, 1.62, 2.04 and 2.51; 1, 2, 3, and 4 or more allergens, respectively; P < 0.001). ConclusionsWe suggest that FA is likely to be a risk factor for depression and severe psychological distress, which is dependent on the number of food allergens. Funding SourcesThis work was supported by an Intramural Research Grant for Neurological and Psychiatric Disorders of National Center of Neurology and Psychiatry.

Food allergy is associated with depression and psychological distress: A web-based study in 11,876 Japanese

BackgroundAlthough some studies suggest a possible association between food allergy (FA) and depression/psychological distress, empirical data are still scarce. We aimed to examine whether this association exists in a large sample of the Japanese population. MethodsThis web-based cross-sectional survey included 1000 individuals with self-reported lifetime history of clinical depression (mean age: 41.4 years, 501 men), and the remaining 10,876 subjects served as controls (mean age: 45.1 years, 5691 men). A six-item Kessler scale (K6) test was used to evaluate severe psychological distress. Information on FA was obtained by a self-report checking for 27 specific allergens. ResultsParticipants with FA, 2 or more, 3 or more, and 4 or more allergens were more common in the depression group than in the control group (odds ratio [OR] = 1.64, 1.75, 2.02, and 2.27, respectively; p < 0.001). In the allergen analyses, allergies for shrimp, egg, mackerel, crab, kiwi fruit, milk, banana, and squid (nominal, p < 0.05) were more common in the depression group than in the controls. The proportion of individuals who had a K6 test cut-off score ≥ 13 was higher in the FA group than in the non-FA group, in the total sample (OR = 1.32, 1.62, 2.04 and 2.51; 1, 2, 3, and 4 or more allergens, respectively; p < 0.001). LimitationsThe identification of FA and depression was based on self-reports. ConclusionsOur data suggest that FA is a risk factor for depression and severe psychological distress, which depends on the number of allergens.

Kinetic changes of intestinal microbiota in the course of intestinal sensitization.

Food allergy (FA) is an adverse immune response to certain innocent food. It is estimated about 2% to 6% of the general population suffer from FA. Symptoms of a food allergic reaction may involve the gastrointestinal tract or/and other organs. The gut microbiota plays a critical role in diet-induced health problems. Whether the changes in the composition of the intestinal microbiota regulate allergic responses to food remains poorly understood. Thus, we created an FA animal model, sequenced the V4-V5 regions of 16S rRNA genes to characterize the genera abundance of gut microbiota. The results showed that mice under FA condition showed different gut bacterial structures. Diverse distribution of the bacterial species was identified between FA and control groups. FA altered the components of intestinal Microbiota in mice. The dysbiosis of the gut metagenome correlated with the development of the FA.

Food Allergy Awareness and Nutritional Management by the Parents of Preschool Children

Objectives: This study was performed to measure the food allergy (FA) awareness and management by the parents of preschool children. Methods: A questionnaire survey was conducted with the parents of preschool children. The questionnaire was designed to identify the prevalence of food allergies, requirements of food allergy support and differences in food management according to the presence or absence allergic diseases, using a modified International Study of Asthma and Allergies in Childhood (ISAAC) questionnaire. After excluding incomplete responses, the data of 158 parents of preschool children (90.3%) was used for statistical analysis. Results: The rate of the preschool children who had experienced food allergy (FA, ever) was 38.6% while diagnosed for food allergy by doctor (Diagnosis of FA, ever) was 17.7%. Forty nine preschool children (80.3%) had food restriction, and twenty three of them (37.7%) had self-restriction without diagnosis. The consumption frequencies of allergenic foods in FA group, such as ramyeon, noodles, bread, eggs, yogurt and ice cream were significantly (p Conclusions: This study identified a lack of food allergy training for the parents of preschool children and the necessity for food allergy education. Food allergy-related supports, such as menus without allergenic ingredients, guidelines for managing food allergy & anaphylaxis emergency care plan etc, should be provided to the parents in order to avoid events related to food allergies.