Laparoscopic sleeve gastrectomy (LSG) is widely performed for severe obesity but is associated with postoperative gastroesophageal reflux disease (GERD) and esophageal motility disorders. Gastropexy has been proposed to preserve gastric anatomy and reduce complications. To evaluate the effect of gastropexy on esophageal manometric values following LSG. A randomized controlled study was conducted on 40 patients undergoing LSG at our Hospital, (20 with gastropexy, 20 without). Esophageal manometry was performed preoperatively and 6 months postoperatively. Postoperative symptoms, complications, and percentage of total body weight loss (%TBWL) were assessed. In the non-gastropexy group, there was a significant decrease in lower esophageal sphincter (LES) resting pressure and distal contractile integral (DCI) postoperatively (p = 0.002 and p = 0.01, respectively). The gastropexy group showed preserved LES pressure and DCI. Postoperative GERD symptoms, vomiting, and food intolerance were significantly less in the gastropexy group (p < 0.05). There was no significant difference in %TBWL between groups (p = 0.86). Operative time was longer in the gastropexy group (p < 0.001). Gastropexy step during LSG may play a role in preservation of the esophageal manometric values and reduces postoperative GERD and vomiting, although it increases operative time. Larger long-term trials are needed for confirmation.

Prenatal Air Pollution Exposure During Late Pregnancy Associates With Food Sensitization at 18 Months.

Introduction Adherence to post-bariatric supplement intake may be affected by tolerability issues. This study aimed to characterize nausea associated with supplement intake and explore the patient-reported symptom course following structured intake instructions in a real-world customer-support context. Methods This retrospective observational study with prospectively collected data consisted of two parts. Part one: a cross-sectional survey of 540 FitForMe customers after bariatric surgery who reported nausea, assessing the timing of supplement intake, the onset and triggers of nausea, and theimpact on daily functioning. Part two: a single-arm, uncontrolled follow-up of a separate sample of 75 French FitForMe customers experiencing nausea, who received structured intake instructions during standardized telephone interviews. Recommendations included switching from capsules to chewable tablets, taking supplements with meals, dividing doses, and allowing slower dissolution. The presence of nausea (yes/no) was reassessed by telephone one week later. Results Part one indicated that a large percentage of individuals did not take the supplement according to intake instructions; 256 (47.4%) took it on an empty stomach. Nausea occurred in 93 patients (17.2%) before the actual intake of the supplement. Overall, 365 patients (67.6%) reported a score of 5 or higher on a 0-10 scale measuring the impact on daily life, where 0 indicated no restriction, and 10 indicated being unable to do anything. In part two, at the one-week follow-up, 55 of 75 patients (73.3%) reported resolution of nausea (within-patient comparison, p<0.001). The recommendation most frequently endorsed by patients as perceived to have contributed to their symptom course was switching from capsule to chewable tablet, reported as helpful by 41 of 44 patients who made this switch (93.2%; 54.7% of the total follow-up cohort, n=75; p<0.001). Taking supplements with lunch or dinner was also commonly endorsed (n=42, 56.0%). Additional complaints were common, including potentially dumping-related symptoms (n=30, 40.0%), food intolerance (n=28, 37.3%), and altered taste or smell (n=31, 41.3%). Conclusion In a selected sample of bariatric patients who reported nausea during multivitamin use, incorrect intake practices and multifactorial symptom patterns were common. In a follow-up cohort, structured intake advice was associated with patient-reported resolution of nausea in many participants. While these observational findings do not establish causality, the recommendations are simple, low-cost, and easy to implement, and may be considered as a pragmatic first step in routine post-bariatric care.

BackgroundThe role of the autonomic nervous system in postprandial metabolic responses to ultra-processed foods (UPFs) in individuals with obesity remains uncertain.ObjectiveTo investigate how fasting autonomic function, assessed by heart rate variability (HRV), affects the thermogenic response and insulin sensitivity after meals with or without UPF in individuals with obesity.MethodsParticipants consumed one of two matched test meals differing only in UPF content. Fasting HRV was assessed, and associations with postprandial glucose, insulin, homeostatic model assessment of insulin resistance (HOMA-IR), and the thermic effect of food (TEF) were analyzed using mixed-ANCOVA and linear regression models, adjusted for age, sex, and group.Results40 individuals were analyzed. Considering the two groups together, there was a negative relationship between RMSSD and blood glucose variation (β = -7.95, CI95%: -13.05; -2.84) and a positive relationship between LF/HF and blood glucose variation (β = 12.05, CI95%: 2.35; 21.76), insulin (β = 16.90, CI95%: 1.90; 31.90) and HOMA-IR (β = 1.79, CI95%: 0.27; 3.23). When considering interaction with groups, RMSSD showed a positive relationship with TEF in the control meal and a negative relationship in the UPF meal (P-interaction = 0.04).ConclusionFasting autonomic function influences postprandial insulin sensitivity in individuals with obesity, regardless of the UPF content of the meal. The influence on TEF appears to depend on the meal's UPF content.Clinical trial registry (ReBEC)RBR-56nsh92: https://ensaiosclinicos.gov.br/rg/RBR-56nsh92.

Introduction: Food allergies and intolerances represent a growing pediatric health concern. While stress-related outcomes have received increasing attention, fatigue symptoms in children with food hypersensitivity remain insufficiently characterized. The aim of the study was to evaluate perceived stress and fatigue in children with food hypersensitivity. Material and Methods: We conducted an observational cross-sectional study including 339 children aged 1–18 years with specialist-confirmed food allergy, food intolerance, or mixed pathology. Data were collected through structured parent-reported interviews incorporating the Perceived Stress Questionnaire (PSQ) and the Fatigue Assessment Scale (FAS). Results: Children with food allergy had significantly higher perceived stress and fatigue scores compared to those with food intolerance (p < 0.05), with the highest levels observed in the mixed pathology group. Both perceived stress and fatigue scores increased with age, with adolescents showing the highest values. A moderate positive correlation was identified between stress and fatigue (r = 0.49, p < 0.0001). In multivariable analyses, higher stress and fatigue scores were significantly associated with age and diagnostic category, including mixed pathology, after adjustment for sex and anthropometric indicators. Higher scores were also associated with the presence of multiple clinical symptoms, such as sleep disturbances and concentration difficulties. Conclusions: Food hypersensitivity in children is associated with a significant psychological burden characterized by elevated perceived stress and fatigue, particularly in adolescents and in those with more complex diagnostic profiles. These findings highlight the importance of multidisciplinary management strategies integrating accurate diagnosis, nutritional counseling, and psychosocial support in order to address the broader impact of pediatric food hypersensitivity.

Sleeve gastrectomy (SG) is the most frequently performed metabolic and bariatric surgery (MBS) worldwide, but long-term suboptimal weight loss (SOWL) or recurrent weight gain (RWG) affects up to one third of patients and often necessitates revisional procedures. One-anastomosis gastric bypass (OAGB) is an effective revision, yet pouch dilation and late RWG remain concerns. Ring augmentation (RA) has been proposed to enhance restriction and sustain weight loss, but evidence in the revisional OAGB setting is limited. This retrospective comparative cohort study analyzed 94 adults who underwent revisional OAGB after SG at a high-volume tertiary MBS center. Patients were grouped into two categories: Ring Augmented OAGB (RaOAGB) (n = 45) and Non-Ring Augmented OAGB (NRa-OAGB) (n = 49). The primary outcomes were percentage excess weight loss (%EWL), percentage total weight loss (%TWL), and change in body mass index (BMI) at 3, 6, and 12 months. Secondary outcomes included improvement of obesity-related conditions, metabolic parameters (lipid profile, HbA1c), nutritional markers, operative time, hospital stay, and early/late complications. Both groups achieved significant weight reduction at 12 months (p < 0.001 within groups). RaOAGB yielded greater BMI reduction (27.6 vs. 32.2kg/m²), %EWL (81.7% vs. 61.3%), and %TWL (31.5% vs. 24.2%) compared with NRa-OAGB (all p < 0.001). Lipid profiles improved in both groups; LDL decreased, and total cholesterol equalized by 12 months. Glycemic control changes were modest and similar between cohorts. Operative time, length of stay, and early postoperative complications were comparable. Ring-related adverse events were infrequent (food intolerance 6.7% vs. 4.1%; no erosions were observed; one patient (2.2%) required ring removal at 10 months due to persistent vomiting and food intolerance). RaOAGB is a safe and effective revisional option for RWG and SOWL after SG, achieving significantly greater 1-year weight loss than standard OAGB, with uncommon ring-related adverse events, including one ring removal. These findings support the role of mechanical reinforcement to enhance the durability of revisional bypass but warrant confirmation through long-term, multicenter randomized trials.

The intestinal mucus layer constitutes an essential component of the gut barrier and plays a pivotal role in gastrointestinal health. Disruptions of this layer, particularly due to dietary fiber deficiency and mucus degrading bacteria, have been associated with various disorders including irritable bowel syndrome (IBS), inflammatory bowel disease (IBD), food intolerances, and other related conditions. While research on gastrointestinal microbiota has garnered significant attention, the knowledge of the mucus layer remains comparatively understudied. This review synthesizes current knowledge regarding the mucus layer and evaluates its clinical relevance for both the pathogenesis and therapeutic management of intestinal disorders, as well as their prevention. An intact mucus layer provides critical protection against pathogenic factors while promoting microbiota homeostasis and functionality. Conversely, fiber deficiency accelerates mucus layer degradation, increases intestinal permeability, and promotes inflammatory processes. Therapeutic interventions such as dietary fibers, prebiotics, and postbiotics (e.g., short-chain fatty acids, SCFAs) demonstrate potential to restore mucus layer integrity and reinforce intestinal barrier function. The intestinal mucus layer represents an underappreciated yet crucial factor in intestinal health and disease pathogenesis. Fiber supplementation and postbiotic administration emerge as key therapeutic strategies for mucus layer reinforcement and regeneration. Further research is warranted to develop disease- and symptom-specific mucus-targeted therapies, including refined post- and prebiotic based therapeutic approaches.

Comparison of dominant foodborne and inhalant allergies developing in the first 5 years of life.

To determine the prevalence of sensitization to food allergens in pediatric and adult patients with allergic diseases. A prospective, descriptive, observational, and cross-sectional study was conducted on pediatric and adult patients treated at the General Hospital of Mexico Dr. Eduardo Liceaga, between August 2024 and May 2025. Associated sociodemographic and clinical factors were identified, and prick skin tests were performed on patients with allergic diseases and suspected food allergies. A total of 90 patients were registered. The 26.6% presented sensitization to food allergens, and 22.2% met allergy criteria. Allergic rhinitis was the most common comorbidity. A statistically significant association was found between older age and the presence of food allergen sensitization (p = 0.021), but not with food allergy (p = 0.28). The main allergens involved were walnut, casein, peanut, and shrimp. Food allergy is common in patients with a history of allergies. The findings are consistent with previous studies and underscore the need for further research into this condition in the Mexican population.

Food intolerance in inflammatory bowel disease: From mechanism typing to precision management

'Breast Implant Illness' (BII) refers to non-specific constitutional, rheumatic, mental and cognitive symptoms experienced by women with silicone breast implants (SBIs). This potential late effect of SBIs challenges the safety of SBI-use in oncologic breast reconstruction (BR). Previous studies on BII mainly focused on women with cosmetic SBIs. It remains unclear whether symptoms reported in this population differ from those reported by breast cancer (BC) survivors with SBI-based BR. We conducted a cross-sectional survey in a Dutch cohort including 578 breast augmentation recipients and 2,884 BC survivors, of whom 1,039 had an SBI-based BR. Eighteen BII-related symptoms were assessed. Multivariable logistic regression was used to compare breast augmentation recipients with BC survivors with and without SBIs. Median follow-up time was 8.0 (IQR, 3.9) years. Overall, breast augmentation recipients had a higher risk of myalgia (Odds ratio (OR) 2.10, 95%CI [1.25-3.54]) and food intolerance (OR 1.77, 95%CI [1.01-3.09]) than BC survivors with SBIs, whereas the latter group did not report more BII-associated symptoms than BC survivors without SBIs. In a sensitivity analysis excluding BC patients treated with (neo)adjuvant systemic therapy, breast augmentation recipients reported more BII-related symptoms-headache, myalgia, hair loss, muscle weakness, sleep impairment, and morning stiffness (ORs 1.69-3.35; all p < 0.05) compared to BC survivors with SBIs. Breast augmentation recipients report more BII-related symptoms than BC survivors with or without SBIs. These findings do not support the hypothesis that BII is a distinct disease entity mediated by a generic SBI-related pathogenesis that exists across different populations.Trial registration: This study was preregistered at ClinicalTrials.gov on June 2 nd 2022 (NCT05400954).

Background: The Mediterranean diet (MedDiet) has been associated with anti-inflammatory effects and potential benefits in several chronic conditions. However, adherence to the MedDiet and its relationship with lifestyle factors and disease severity across different rheumatological diseases remain poorly characterized. Objectives: This study aimed to evaluate differences in MedDiet adherence among patients with rheumatoid arthritis (RA), psoriatic arthritis (PsA), and fibromyalgia (FM), and to explore its association with cardiovascular comorbidities, bowel habits, and disease-related outcomes. Methods: In this monocentric cross-sectional study, adherence to the MedDiet was assessed using the 14-item PREDIMED questionnaire. Self-reported data on sociodemographic characteristics, cardiovascular comorbidities, bowel habits, and dietary behaviors were collected through questionnaires. Disease activity and severity were assessed using validated disease-specific measures. Differences in MedDiet adherence across diagnostic groups were evaluated using non-parametric tests. Multivariable models were performed to examine associations between MedDiet adherence and cardiovascular comorbidities or disease outcomes, adjusting for potential confounders including age, sex, BMI, smoking status, and educational level. Results: A total of 422 participants were included (RA n = 165, PsA n = 85, FM n = 172). Significant differences in MedDiet adherence were observed across diagnostic groups (p < 0.001), with the highest adherence in RA, intermediate values in PsA, and the lowest in FM. Compared with the other groups, a higher proportion of FM participants reported food intolerances (46.5%) and restrictive diets, including lactose-free (34.9%) and gluten-free (15.1%) diets. In the FM group, high adherence to the MedDiet was significantly associated with lower FIQR scores (β = -16.9; 95% CI -32.1 to -1.7; p = 0.01) and lower PDS scores (β = -4.34; 95% CI -7.81 to -0.86; p = 0.01). Sensitivity analyses using the continuous PREDIMED score confirmed these associations. Conclusions: Adherence to the MedDiet differs across rheumatological diseases, with the lowest adherence observed in FM. Higher adherence was associated with lower disease severity and impact in FM. These findings highlight the potential relevance of nutritional counselling in rheumatological diseases and support the need for longitudinal and interventional studies evaluating the role of the MedDiet within multidisciplinary disease management.

BACKGROUNDFunctional abdominal pain syndrome (FAPS) is a subset of functional gastrointestinal disorder characterized by chronic recurrent abdominal pain condition that is not attributable to structural, organic, or metabolic diseases. The etiology and pathophysiology of FAPS remain poorly understood; however, brain-gut interactions and food intolerance, particularly to fermentable oligo-, di-, and monosaccharides and polyols, have been implicated.AIMTo determine the frequency of fructose malabsorption (FM) in patients with FAPS and to evaluate the occurrence of resultant symptoms.METHODSThis was a prospective, case-control study conducted over 22 months, from December 2016 to September 2018, at the Department of Gastroenterology, Govind Ballabh Pant Institute of Postgraduate Medical Education and Research, New Delhi, India. In this study, 61 patients with FAPS and 31 healthy controls underwent fructose hydrogen breath testing (FHBT) after excluding small intestinal bacterial overgrowth.RESULTSFM was detected in 26% of patients with FAPS vs 3% of controls (P = 0.009). Symptoms during the FHBT were significantly more prevalent in patients with FAPS (39.3%) than in the controls (12.9%) (P = 0.009). Among patients with FAPS, those with positive FHBT results had a higher prevalence of symptoms (62.5%) than those with negative results (31%) (P = 0.03). Multivariate analysis identified younger age (P = 0.012) and male sex (P = 0.049) as predictive of a positive FHBT result. Methane producers were present in 37% of patients with FAPS, with no difference between those with and without FM.CONCLUSIONThis study demonstrated a high prevalence of FM and intolerance in patients with FAPS, with younger age and male sex as predictors.

There has continued to be an increase in the production of gluten-free products, including beer. This interest is a combination of responses to both consumers addressing food sensitivities as well as personal preferences. Beer produced from gluten-free grains has a distinct flavor that differs greatly from traditional barley beer. Recently, the use of millet to produce gluten-free beer has increased with larger-scale malting of millet. It is the goal of this project to investigate the chemical composition of the millet beer aroma. The fermentation of millet-based beers was compared to sorghum and barley beers. Beyond this, the impact of common yeast strains on the fermentation of millet-based beers weas also investigated. All brews were regularly monitored for pH, gravity, total titratable acidity, total polyphenols, and free amino nitrogen. In addition, the aroma profile was sampled using Solid-Phase Microextraction (SPME) with chemical separation and identification and quantification using Gas Chromatography with Mass Spectroscopy (GC-MS). The analysis showed the production of acceptable beers; however, the fermentation there is obvious needed to optimize brewing conditions. In addition, the amount of total volatile compounds was found to be significantly different than beer produced using malted barley.

Background: Current recommendations for infant weaning suggest the early introduction of solid and diverse foods. Although homemade meals are advisable, there is a demand for commercially available complementary foods (CACFs), and the information present on their labeling influences caregivers’ choices. The aim of this study was to evaluate recommended-age-of-introduction labeling of CACFs in the Portuguese market, in light of current guidelines for complementary feeding. Methods: Between November and December 2025, labels of all CACFs found in infant feeding sections of 13 Portuguese grocery retailers were analyzed. Milk formulas, powders, products for children over 15 months, and those for children with food allergies or intolerances were excluded. Results: Of the 539 products analyzed, 458 showed a recommended age for introduction, ranging from 4 to 12 months, with significant variability being observed between food categories. Significant variability was also observed in the recommended age for introduction depending on whether major allergens were present. Conclusions: The results of our study identified an age-segmented approach to complementary feeding recommendations in CACF labeling, not reflecting current infant feeding guidelines that support complementary feeding. Our results reinforce the need for more support from scientific evidence and health guidelines in food availability and marketing.

BACKGROUNDCesarean section (C-section) delivery rates are rising globally, raising concern about their potential long-term health consequences on offspring. Emerging evidence suggests that C-section, by bypassing the physiological and microbial exposures of vaginal birth, may adversely affect neonatal gastrointestinal (GI) development and immune regulation.AIMTo evaluate the short- and long-term gastrointestinal outcomes in infants born via C-section, compared to those born vaginally.METHODSA systematic literature search was conducted across PubMed, Scopus, and Web of Science for studies published from inception to 2024. Studies were included if they reported gastrointestinal outcomes among C-section-born infants and included a vaginal delivery comparison group. Outcomes of interest included short-term disorders (infantile colic, gastroesophageal reflux, constipation, dyschezia, and functional gastrointestinal disorders) and long-term conditions (inflammatory bowel disease, food allergies including cow's milk protein allergy, celiac disease, and microbiota dysbiosis). Data extraction and synthesis were conducted in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines.RESULTSC-section -born infants demonstrated a higher risk of several short-term GI disturbances, including infantile colic, reflux, and constipation. These outcomes were consistently associated with early gut microbiota dysbiosis, characterized by reduced microbial diversity and delayed colonization by Bifidobacteria and Bacteroides. Long-term associations with C-section included a modest increase in the risk of Crohn’s disease, cow’s milk protein allergy, and food sensitization, while the links with ulcerative colitis and celiac disease were inconsistent. Breastfeeding, probiotic/synbiotic supplementation, and limited antibiotic exposure emerged as protective modifiable factors.CONCLUSIONC-section delivery is associated with a higher risk of adverse gastrointestinal outcomes in infancy and childhood, driven in part by early-life gut microbial disruption. Preventive strategies targeting microbial restoration and immune modulation, particularly breastfeeding and probiotic interventions, may help mitigate these risks. Clinicians should be aware of these associations to guide personalized care and parental counseling, particularly in elective C-section deliveries.

Background Allergic conditions, particularly food and environmental allergies, are increasingly recognized as important contributors to pediatric morbidity worldwide. However, data describing age-related and seasonal patterns of allergen sensitization in children from low- and middle-income countries remain limited. This retrospective, cross-sectional, laboratory-based study aimed to evaluate the frequency and seasonal variation of food and environmental allergen sensitization among children undergoing allergen-specific IgE testing. Methods A total of 2,796 pediatric patients (1,676 males and 1,120 females) under 18 years of age who underwent allergen-specific IgE testing between January 2013 and July 2023 were included. Participants were categorized into four age groups: <1, 2-5, 6-10, and 11-18 years. Six food allergens and eight environmental allergens were analyzed using the IMMULITE® 2000 system (Siemens Healthcare Diagnostics Inc., Deerfield, IL, USA) with 3gAllergy® kits. Specific IgE ≥0.35 kU/L was considered positive. Associations between allergen positivity, age, sex, and season were assessed using chi-square and Kruskal-Wallis tests. Results Dermatophagoides farinae (52.5%) and Dermatophagoides pteronyssinus (52.1%) were the most frequently detected environmental allergens, while egg white (30%) and shrimp (28.7%) were the most common food allergens. Environmental allergen positivity was higher in younger children, whereas food allergen positivity peaked in adolescents (11-18 years). Male participants demonstrated higher overall allergen positivity rates. Significant seasonal variation was observed, with increased sensitization during autumn and winter months. Conclusions This study characterizes patterns of allergen sensitization within a clinically tested pediatric cohort in Pakistan, demonstrating age- and season-related variation in allergen-specific IgE positivity. As a laboratory-based analysis, the findings reflect immunologic sensitization rather than confirmed clinical allergy and should not be interpreted as population-level prevalence. These data provide region-specific insights that may support clinical evaluation and patient counseling in similar settings.

The current study hypothesized that gastrointestinal symptoms would improve following a low-FODMAP diet in patients with irritable bowel syndrome (IBS) due to reduced load on enzyme systems and normalization of the activity of disaccharidases involved in the final assimilation of carbohydrates. To evaluate the effect of a low-FODMAP diet on the dynamics of disaccharidase activity in patients with IBS who have symptoms of food intolerance. The study included 20 patients with IBS aged 18 to 50 years: median 32.0 years, Q1 = 27.0, Q3 = 38.0, p-value (Shapiro-Wilk) < 0.05. Complaints were collected from patients, dietary history was analyzed with an emphasis on intolerance to FODMAP products and the occurrence/intensification of clinical symptoms when eating dairy products. All patients underwent esophagogastroduodenoscopy with a biopsy from the subbulb of the duodenum to determine the activity of four intestinal carbohydrates: lactase, sucrase, maltase and glucoamylase according to the Dahlquist method as modified by N.I. Belostotsky. The control group consisted of 30 apparently healthy people, comparable in age and gender to the examined IBS patients. Among them were 10 men and 20 women (average age - 31.2 ± 9.2 years). The activity of intestinal enzymes in this group was within the reference values. Statistical processing of data was carried out using the computer program Statistica 8.0 (StatSoft Inc, USA). The analysis of enzymatic activity showed that initially the level of intestinal carbohydrates in patients with IBS was reduced compared to the control group. 2 months after following the low-FODMAP diet, the activity of all enzymes studied increased, but a statistically significant increase was noted only for lactase and sucrase (p < 0.05). Clinical improvement was observed with adherence to the low-FODMAP diet, decrease in the number of patients with complaints of pain, bloating, rumbling in the abdomen, nausea and diarrhea syndrome, however, a statistical difference was found only for bloating and diarrhea (p < 0.05). Reducing the substrate load on the enzyme systems of the small intestinal mucosa can help improve clinical symptoms in patients with IBS with symptoms of intolerance to foods containing FODMAPs and have a positive effect on the activity of intestinal enzymes.

Background/Objectives: As an escalating global health challenge, food allergies impose substantial burdens on the physical and psychological well-being of pediatric populations, profoundly compromising their quality of life. Given the marked geographical heterogeneity in allergen distribution patterns, this epidemiological investigation systematically characterizes prevalent pediatric food allergens sensitization patterns in Southwest China, yielding critical region-specific data to inform targeted prevention strategies and clinical management protocols. Methods: A cohort of 36,399 pediatric participants (age <18 years) underwent hospital-based testing for allergen-specific immunoglobulin E (sIgE) reactivity against 10 regionally prevalent food allergens, utilizing a semi-quantitative, immunocapture-based, and enzyme-linked immunosorbent assay. Results: Of the 36,399 children whose food allergen sensitization profiles were analyzed, 48.12% (n = 17,514) demonstrated elevated sIgE reactivity in response to at least one tested allergen, with milk and eggs emerging as the predominant allergenic triggers. Age-stratified analyses identified preschool age (≤6 years) as the critical window for food sensitization, demonstrating peak IgE reactivity to major allergens, including milk, peanuts, soybeans, shrimp, eggs, wheat, and beef. Male subjects exhibited significantly higher sensitization rates to peanuts, soybeans, crustaceans and wheat compared to females (p < 0.05), underscoring the importance of sex-based considerations in allergy prevention strategies. Conclusions: Milk and eggs emerge as the dominant food allergens that cause sensitization in Chengdu's pediatric population. Age- and sex-dependent vulnerabilities were identified, with younger children and male participants demonstrating higher sensitization rates than their counterparts. These age-stratified and male-predominant sensitization patterns provide a scientific foundation for public health initiatives.

Food allergies are increasing worldwide, yet the early epithelial mechanisms that initiate allergic sensitization remain incompletely defined. As the intestinal epithelium governs both allergen translocation and epithelial-immune crosstalk, it constitutes a critical but underutilized model for predicting allergenicity. In this study, we used Caco-2 and T84 intestinal epithelial monolayers cultured on Transwell® inserts to compare barrier properties and responses to peanut protein extract. Phenotypic characterization included biomarker profiling, transepithelial electrical resistance (TEER) measurements, tight junction integrity assessment, and analysis of cytokine levels as well as oxidative and nitrosative stress. Peanut exposure caused moderate TEER reductions without overt tight junction disruption while allowing translocation of the major allergen, Arachis hypogaea allergen 1 (Ara h 1), likely via transcellular pathways. Peanut protein extracts also induced epithelial stress responses, characterized by increased reactive oxygen species and nitric oxide production, alongside time-dependent secretion of innate and type 2-associated mediators, including IL-1β, TSLP, IL-25, and IL-33, indicating epithelial activation in the absence of complete barrier breakdown. Notably, basolateral supernatants from peanut-exposed epithelial monolayers activated THP-1-derived macrophages and enhanced IL-6 secretion, demonstrating that limited allergen passage across an otherwise intact epithelial barrier is sufficient to elicit early innate immune responses. Collectively, these findings indicate that peanut extract induce subtle functional perturbations in the intestinal epithelium while promoting downstream immune activation, highlighting Caco-2 and T84 cells as complementary in vitro platforms for studying barrier-dependent mechanisms of allergic sensitization.