Food Intolerance Research Articles

Prediction of Food Sensitization in Children with Atopic Dermatitis Based on Disease Severity and Epidermal Layer Impairment

Plain Language SummaryThe study has revealed notable associations between food sensitizations (FSs) and the disease severity as well as epidermal barrier impairment in children with atopic dermatitis (AD). Specifically, the findings indicate that children with AD who were sensitized to higher numbers of food allergens (FAs) had higher SCORAD scores and greater epidermal barrier impairment. In addition, SCORAD score and stratum corneum hydration (SCH) levels at lesional skin could be predictive factors for FS in children with AD. The findings of this study suggest that clinicians should consider screening for food sensitization in children with moderate-severe AD and/or low SCH levels at lesional skins.

Immünoglobulin G Antikorlarına Dayalı Gıda Eliminasyonu Gerilim Tipi Baş Ağrısını Azaltır Mı? – Longitudinal Çapraz Çalışma

The aim was to evaluate if foods, against which patient has IgG antibodies, trigger tension type headache (TTH). 22 patients (8 male, 14 female; 8 chronic TTH, 14 frequent episodic TTH) were recruited. The study had four periods: cooperation, provocation, free diet month and elimination were determined. At the cooperation perido patients’ cooperation abilities were checked. All patients were screened for 271 different antibodies against foods using Imupro300. Thus a list of food sensitivity was described for each patient. In provocation period,those detected foods were added to diet. In elimination period, those foods were eliminated from the diet with false foods added. In free diet month, there were no restrictions. Patients recorded the number of the days with headache as well as headache frequency, severity and duration and analgesic intake. These headache features in cooperation, provocation and elimination periods were compared. In the elimination period there was a significant decrease in the number of days with headache, headache frequency and duration in all patients. A significant increase in these three features were observed in the provocation period. In chronic TTH patients, only the number of the days with headache significantly increased in provocation period. IgG antibodies against foods may have a role in TTH. Number of days with headache, headache frequency and duration can be decreased by eliminating related foods from the diet, and this can be a part of the treatment. IgG antibodies against foods may be one of the pathophysiological mechanisms triggering TTH.

Eosinophilic esophagitis and duodenal food challenge - evaluation through endoscopic confocal laser endomicroscopy.

Endoscopic confocal laser endomicroscopy (eCLE) is an established technique that allows clinical evaluation of mucosal integrity by fluorescein leaking through the mucosa upon duodenal food challenge (DFC). Analysis of eCLE with DFC in eosinophilic esophagitis (EoE) would be interesting to evaluate epithelial barrier dysfunction also in other regions of the gastrointestinal tract and to characterize potential individual food allergens that trigger the esophageal inflammation. In an observational and proof of concept study we evaluated 9 patients with histologically proven EoE by eCLE and DFC. Severity of symptoms were graduated according to the validated symptom-based EoE activity index. The endoscopic appearance of the esophagus was described according to the Endoscopic Reference Score System (ERERS). Spontaneous and food induced transfer of fluorescein into duodenal lumen were detected 10 minutes following intravenously application of fluorescein and 10 minutes after DFC. Food allergens were yeast, egg, soy, milk, and wheat, respectively. Local application of sodium chloride solution 10 % to the duodenal mucosa before DFC served as a control. Patients responding to DFC received a dietary exclusion therapy according to the results of DFC. We investigated 9 patients with EoE (8 men, 49.7±13.8, 36-76 years). Symptom-based EoE activity index was 79±27.4, 33-100. In all patients EoE was confirmed by histology with number of esophageal mucosal eosinophilic granulocytes > 15/HPF, (91.4±77.4, 42-263). Mean ERERS score was 4.5±1.3, 3-7. None of the patients was aware of any food intolerance. eCLE revealed one patient with spontaneous transfer of i. v. fluorescein into duodenal lumen before DFC ("leaky gut"). 40 DFC were performed in the remaining 8 patients of whom 5 patients (61 %) responded to DFC. Rank order of fluorescein leakage upon DFC was wheat and milk in 37.5 % each, soy in 25 %, and egg in 12.5 %. The patients were treated by PPI (n=9), esophageal bouginage (n=5) and/or local corticoid therapy (n=3). The 5 patients responding to DFC received an additional food exclusion dietary advice focussed on the results of DFC. All patients reported a reduction of their symptoms. EoE activity indexes of patients with positive DFC were 73.7+28.6, 33-100 before and 22.7+37.9, 0-79 four weeks after food exclusion. The findings of our proof of concept study suggest that eCLE with DFC may be an interesting tool to further evaluate patients with EoE. This technique has the potential to identify patients who may benefit from an additional individual dietary therapy.

Self-reported food intolerances in an Indian population: Need for individualization rather than a universal low-FODMAP diet.

Low-fermentable oligo-, di-, and monosaccharides and polyol (FODMAP) diets have been recommended for individuals with food intolerance and irritable bowel syndrome (IBS). Individual food intolerances may, however, not correspond to the FODMAP content alone. We conducted a survey on self-reported intolerance to articles of food commonly identified as high FODMAP in 400 healthy Indian subjects (median age 40 years; 69% men) and 204 consecutive consenting patients with IBS (median age 36 years; 58% men). One-hundred seventy-nine (44.8%) healthy subjects and 147 (72.1%) patients with IBS reported some food intolerance (P < 0.00001); the latter reported intolerance to all items (except nuts) more frequently than healthy subjects. The prevalence, however, varied from 2.5 to 32%. Milk intolerance was reported equally commonly by healthy subjects and patients (23% vs 29.9%). Twenty-three (11.3%) patients and no healthy subjects reported wheat sensitivity. The IBS diarrhea subgroup reported intolerance to milk, pulses, capsicum, cauliflower, leafy vegetables, and dry fruits more frequently than the constipation subgroup. From among a list of high-FODMAP items, individuals' intolerance varied widely, suggesting that individuals should be the final judge in deciding their elimination diets rather than devise them based on the FODMAP content alone. As in the West, food intolerance was reported more commonly by patients with IBS, especially those with diarrhea, than by healthy individuals. Also noteworthy is the low prevalence of milk intolerance in a subcontinent labeled as high in lactose intolerance. Unlike in the West, wheat intolerance was not reported by any healthy individual.

Irritable Bowel Syndrome. Is it a Psychogenic or Organic Disease?

Irritable bowel syndrome (IBS) is a very common medical condition amongst the Mexican adult population, this chronic syndrome is characterized by abdominal pain and changes in bowel habits. The ability to identify a definitive etiology of this disease would not only help us to improve the treatment, it would also enable the possibility to prevent it. This is why the main objective of this article is just that, finding the cause and linking it with dietetic management and nutritional intervention. There is a bidirectional communication between the central nervous system and the gastro-intestinal tract (brain-intestine axis), this axis is made up from afferent fibers to integrate impulses in the central nervous system and efferent fibers to control smooth muscle, as well as glands and neuroendocrine cells. This communication permits the brain to have direct influence over the intestine, and therefore change bowel habits based on alterations in the brain chemistry such as stress or other strong emotions. Describing a single cause for IBS would be incorrect since there are multiple causes that might be happening simultaneously. Some of them are: infection, immune response, food intolerance, genetics and the psychological factors that were previously mentioned. It is not possible to talk about IBS without considering diet. Most patients with IBS report an intolerance to certain food from the mexican diet, such as lactose, legumes, oligosaccharides, monosaccharides and polioles this group is known as FODMAP, and they share three main characteristics that are associated with developing symptoms: they have osmotic activity, are poorly absorbed and also are fermented by the microbiome.In conclusion the are multiple etiologies for irritable bowel syndrome, that may or may not be simultaneously happening in a single person.

CLINICAL AND PARACLINICAL FEATURES AND PATHOPHYSIOLOGICAL MECHANISMS OF DIGESTIVE SYSTEM DISORDERS IN PREMATURE INFANTS WITH PERINATAL PATHOLOGY

CLINICAL AND PARACLINICAL FEATURES AND PATHOPHYSIOLOGICAL MECHANISMS OF DIGESTIVE SYSTEM DISORDERS IN PREMATURE INFANTS WITH PERINATAL PATHOLOGY

Prevalence of tree nut allergy in Europe: A systematic review and meta-analysis.

In 2014, the European Academy of Allergy and Clinical Immunology (EAACI) published the first systematic review that summarized the prevalence of food allergy (FA) and food sensitization in Europe for studies published 2000-2012. However, only summary estimates for tree nut allergy (TNA) were feasible in that work. In the current update of that systematic review, we summarized the prevalence of tree nut allergy/sensitization to individual tree nuts. Six databases were searched for relevant papers published 2012-2021 and 17 eligible studies were added to the 15 studies already identified between 2000 and 2012, giving a total of 32 studies. Of the investigated tree nuts, meta-analysis was possible for hazelnut, walnut, almond, and in few cases, for cashew, and Brazil nut. The lifetime self-reported prevalence was 0.8% (95% CI 0.5-1.1) for hazelnut and 0.4% (0.2-0.9) for walnut. The point self-reported prevalence was 4.0% (2.9-5.2) for hazelnut, 3.4% (2.0-4.9) for Brazil nut, 2.0% (1.1-2.9) for almond, and 1.8% (1.1-2.5) for walnut. Point prevalence of food challenge-confirmed TNA was 0.04% (0.0-0.1) for hazelnut and 0.02% (0.01-0.1) for walnut. Due to paucity of data, we could not identify any meaningful and consistent differences across age groups and European regions.

S634 Prevalence of Food Intolerance and Associations with Global Health and Psychological Symptoms in Adults with Ehlers-Danlos Syndrome (EDS) or Hypermobile EDS in the United States

S634 Prevalence of Food Intolerance and Associations with Global Health and Psychological Symptoms in Adults with Ehlers-Danlos Syndrome (EDS) or Hypermobile EDS in the United States

Nonallergic Diseases Associated With Foods

Clinicians are faced with evaluating real and alleged reactions to foods that may be allergic or nonallergic. Pathogenesis, diagnosis, and treatment of various non-IgE-mediated diseases are discussed in this review. These food-related conditions range from mild to severe. Referral for an allergy workup may be pursued despite the lack of IgE-mediated symptoms. Diagnostic testing is available for defined non-IgE-mediated food diseases that are either immunologic or nonimmunologic. These include celiac disease and related disorders, carbohydrate maldigestion, pancreatic insufficiency, and histamine intolerance. In contrast, there is a paucity of definitive studies to prove food intolerance diseases. There are no definitive diagnostic criteria or testing for nonceliac gluten sensitivity. Functional gastrointestinal disorders, such as irritable bowel syndrome, are better stratified diagnostically but still lack reliable testing. Both nonceliac gluten sensitivity and irritable bowel syndrome are linked to dietary triggers including fermentable oligosaccharides, disaccharides, monosaccharides, and polyols. Therefore, dietary alteration alone may be diagnostic and therapeutic when all other conditions are ruled out. These conditions are important considerations when evaluating a patient with history of a food reaction. There is little evidence that foods are causative in other ailments such as acne, migraines, and nasal congestion and hypersecretion.

Associations of exposure to metals with total and allergen-specific IgE: An NHANES analysis (2005–2006)

BackgroundImmunoglobulin E (IgE) is a diagnostic biomarker for allergic diseases. While some metal exposure has been found to be associated with allergic diseases, there are still a lot of knowledge gaps regarding the relationship between metal exposure and allergen-specific IgE antibodies, particularly in adults. MethodsWe included a total of 1433 adult participants from the 2005–2006 National Health and Nutrition Examination Survey (NHANES), all of whom had concentrations of 10 metals (including Barium (Ba), Cadmium (Cd), Cobalt (Co), Cesium (Cs), Molybdenum (Mo), Lead (Pb), Antimony (Sb), Thallium (Tl), Tungsten (Tu), and Uranium (Ur)) in urine, as well as measurements of 19 allergen-specific IgE and total IgE antibodies. Linear regression, logistic regression, weighted quantile sum (WQS) regression, and Bayesian kernel machine regression (BKMR) were used to estimate associations between metals and total and allergen-specific IgE. ResultsLinear regression models revealed a positive correlation between Pb and Cd levels and the total IgE levels. Furthermore, the WQS and BKMR models suggested a positive association between mixed metals and total IgE levels, with the WQS model highlighting Pb and Cd as the major contributors. Logistic regression models showed positive correlations between Pb and food sensitization, Ur and plant sensitization, negative correlations between Cs and plant sensitization, Co and dust mite and pet sensitization, Mo and dust mite and cockroach sensitization, and Tl and mold sensitization. Moreover, the BKMR results indicated a statistically significant negative correlation between mixed metals and mold sensitization. ConclusionAccording to the research findings, exposure to metals is associated with total and allergen-specific IgE in American adults. Further assessment of these relationships is necessary in representative populations of other countries.

Food intolerance related to gastrointestinal symptoms amongst adults living with bile acid diarrhoea: A cross-sectional study.

The role of food in managing bile acid diarrhoea (BAD) is poorly understood. The present study explored the prevalence of food intolerance amongst adults with BAD. The study comprised a cross-sectional survey of adults with BAD determined by the 75 selenium homotaurocholic acid test (SeHCAT) living in the UK. Participants anonymously completed an online questionnaire on 39 food items. Frequency of food in general affecting BAD symptoms, as well as frequencies of diarrhoea, abdominal pain, bloating, flatulence and consequential food avoidance after food item ingestion, were assessed. Food group avoidance was also assessed. There were 434 participants who completed the questionnaire between April and May 2021 of whom 80% reported moderate to severe chronic diarrhoea. Food intolerances were reported by 88.0% (95% confidence interval [CI] = 84.6-90.9) of participants. Diarrhoea was reported most frequently after take-away food, fish and chips, creamy sauces, cream and large quantities of fruit (range 41.0%-33.6%). Lowest frequencies were for potato, avocado, mango, watermelon and pear (range 3.7%-7.4%) for the foods listed in the questionnaire. Similar trends were found for abdominal pain, bloating, flatulence and consequential food avoidance. Symptom-triggering within 30 min of ingestion was more prevalence than after 30 min for almost all foods. Food group avoidance was highest for fatty foods (81.2%; 95% CI = 77.8-85.3) followed by dairy (53.9%; 95% CI = 49.1-58.7). Perceived food intolerance amongst adults with BAD and persisting diarrhoeal symptoms is high. Important triggers were meals with a higher fat content and higher-fat dairy products. Diets amongst those with persisting diarrhoeal symptoms may be overly restrictive.

First Clinical Nutrition Outpatient Consultation: A Review of Basic Principles in Nutritional Care of Adults with Hematologic Disease.

A bibliographic survey was carried out between 2020 and 2022 using two databases: PubMed/MEDLINE and Scientific Electronic Library Online (SciELO) and the information source Academic Google, irrespective of language or geography. In the first nutrition consultation (FNC), there should be an investigative direction focused on nutritional interventions in the short, medium, and long term. The record in the patient's medical record is relevant for carrying out the consultation, according to the recommendations of the normative councils of medicine and nutrition. The main steps to be followed are the investigation of the presence of food allergies and intolerances; the drugs/nutritional supplements in use; changes in the digestive tract; the presence or absence of picamalacia; and socioeconomic and lifestyle data. In addition, it is necessary to carry out laboratory evaluations, semiological assessment, anthropometric assessment, and assessment of food consumption. In the end, the nutritional approach should be composed of calculation of energy and macronutrient and micronutrient needs, intervention in nutritional status deviations, nutritional guidelines, and nutritional therapeutic planning of return, focusing on adherence to treatment. The first nutrition consultation may represent investigative steps that help the clinical nutritionist in the management, allowing a longitudinal and specific nutritional therapeutic planning for patients assisted in large reference centers for hematological disease.

Chiisanoside Mediates the Parkin/ZNF746/PGC-1α Axis by Downregulating MiR-181a to Improve Mitochondrial Biogenesis in 6-OHDA-Caused Neurotoxicity Models In Vitro and In Vivo: Suggestions for Prevention of Parkinson's Disease.

The degeneration of dopamine (DA) neurons is known to be associated with defects in mitochondrial biogenesis caused by aging, environmental factors, or mutations in genes, leading to Parkinson's disease (PD). As PD has not yet been successfully cured, the strategy of using small molecule drugs to protect and restore mitochondrial biogenesis is a promising direction. This study evaluated the efficacy of synthetic chiisanoside (CSS) identified in the leaves of Acanthopanax sessiliflorus to prevent PD symptoms. The results show that in the 6-hydroxydopamine (6-OHDA) model, CSS pretreatment can effectively alleviate the reactive oxygen species generation and apoptosis of SH-SY5Y cells, thereby lessening the defects in the C. elegans model including DA neuron degeneration, dopamine-mediated food sensitivity behavioral disorders, and shortened lifespan. Mechanistically, we found that CSS could restore the expression of proliferator-activated receptor gamma coactivator-1-alpha (PGC-1α), a key molecule in mitochondrial biogenesis, and its downstream related genes inhibited by 6-OHDA. We further confirmed that this is due to the enhanced activity of parkin leading to the ubiquitination and degradation of PGC-1α inhibitor protein Zinc finger protein 746 (ZNF746). Parkin siRNA treatment abolished this effect of CSS. Furthermore, we found that CSS inhibited 6-OHDA-induced expression of miR-181a, which targets parkin. The CSS's ability to reverse the 6-OHDA-induced reduction in mitochondrial biogenesis and activation of apoptosis was abolished after the transfection of anti-miR-181a and miR-181a mimics. Therefore, the neuroprotective effect of CSS mainly promotes mitochondrial biogenesis by regulating the miR-181a/Parkin/ZNF746/PGC-1α axis. CSS potentially has the opportunity to be developed into PD prevention agents.

FEEDING PRACTICES IN CHILDREN LESS THAN 3YRS AGE AND ITS RELEVANT KNOWLEDGE AMONG YOUNG MOTHERS.

ABSTRACT&#x0D; Background: It is necessary that parents are aware of the proper feeding practices for the benefit of their child’s heath status and immunity. Thus, time to time assessment should be done to find out the awareness of the parents at the given time and scenario so that necessary interventions can be carried out to educate the parents regarding healthy feeding practices. Objective: To gain information about the feeding practices currently undertaken by the mothers of children (aged less than three years) in some rural and urban localities of Rahim Yar Khan. Methodology: I Cross Sectional survey of 213 young mothers less than 35 years of age having at least one child of age below 3 years, who presented at Pediatrics outdoor indoor, Gynecology outdoor indoor and Vaccination center of Sheikh Zayed Hospital Rahim yar Khan Were selected through Convenient Sampling Data Collection &amp; Analysis: Data was collected through a self-administered questionnaire &amp; analyzed through a software SPSS. It contains statistical as well as graphical explanations. Results: This Cross Sectional survey was conducted amongst 213 female’s, Mothers Knowledge related to feeding practices of their children of less than 3 years of age has shown that 140(65.7%) mothers were Exclusive Breast Feeding their children and 130(61.0%) considered using Cow’s milk instead of formula Milk. 102 (47.9 %) introduced Solid food to their child at 6 months. Majority 119 (55.87%) were not aware of any food allergies or intolerances in their children and majority 91 (42.7%) believes in normal ways followed by 63 (29.6%) who use rewards to ensure their child takes meal. Another important finding is that 180 (84.5%) were allowing their child consume processed or fast food while 22 (10.3 %) were consuming it on daily basis while 114 (53.5 %) were not aware of the appropriate portion sizes for your child’s age and 158 (74.2%) were offering sugary snacks or desserts to your child. Conclusion: Initiation of breast feeding within one hour has shown improvement but still 40 % not knowing this basic knowledge. Moreover on one hand 80% were practicing addition of variety of protein sources and almost 100% believed in fruit consumption but at the same time more than 50% were not having idea of the portion size and almost 100% were allowing Processed or fast food consumption. These statistics emphasize comprehensive educational programs for the mothers. Future research can be focused on impact of educational programs on Nutritional practices:

Food intolerance in premature babies: possibilities of additional diagnostics

Due to the immaturity of the digestive system and gastrointestinal motility the preterm infants have a critical challenge in establishing adequate enteral nutrition, which is a frequent cause of gastrointestinal complications such as food intolerance and necrotizing enterocolitis. Modern clinical methods of assessing the maturity of the intestines and the child's readiness for enteral nutrition are subjective, this slows down the expansion of enteral nutrition, increases the duration of parenteral nutrition, and accordingly , period of a child`s hospitalizing. Objective methods of diagnosis are needed, which would contribute to the effective diagnosis and monitoring of food intolerance in preterm infants. Therefore, the purpose of our review was to search and summarize literature data on objective methods of diagnosing impaired food tolerance in premature baby, which could to provide daily monitoring, would be safe, cost-effective and easily accessible. Results and their discussion. Accordingly, three leading and most promising methods of examining the newborns gastrointestinal tract were analyzed. The were ultrasound examination (absence or reverse diastolic blood flow in the umbilical artery, high pulsation index in the fetal venous duct, indicators of blood flow in the upper mesenteric artery of the newborn), near-infrared spectroscopy (estimation of oxygen saturation of splanchnic tissue), and auscultation of intestinal sounds (phonoenterogram). Each of these methods has advantages and disadvantages, but to solve these existing problems, there has been recently an increasing amount of research on the bowel sounds using (namely their computerized assessment) as a new diagnostic tool. New research and further study of intestinal murmurs in premature newborns of different gestational ages with the development of clear criteria for data interpretation are needed to assess the maturity of the gastrointestinal tract, to create a diagnosis plan of food intolerance, and to develop an algorithm for early intervention.

Diet of the 21st-century person — food intolerances and elimination diets

In a dynamically changing world and environment, the human diet is subject to numerous changes, as well as the quality of selected products. More and more often, patients who report gastrointestinal complaints after eating certain foods come to doctors. This situation often ends with the introduction of an elimination diet, which conducted without the supervision of a specialist, can have various negative effects. The work aims to present the latest results of research on the diet of modern man, published in international journals, available in the PubMed database and the Google Schoolar. The review discusses the most common food intolerances, their mechanisms and treatment options with particular emphasis on therapy with elimination diets and their potential health consequences. The discussed health problems are related to environmental changes and at the same time, significantly reduce the quality of life of people struggling with them.

Role of gastrointestinal health in managing children with autism spectrum disorder.

Children with autism spectrum disorders (ASD) or autism are more prone to gastrointestinal (GI) disorders than the general population. These disorders can significantly affect their health, learning, and development due to various factors such as genetics, environment, and behavior. The causes of GI disorders in children with ASD can include gut dysbiosis, immune dysfunction, food sensitivities, digestive enzyme deficiencies, and sensory processing differences. Many studies suggest that numerous children with ASD experience GI problems, and effective management is crucial. Diagnosing autism is typically done through genetic, neurological, functional, and behavioral assessments and observations, while GI tests are not consistently reliable. Some GI tests may increase the risk of developing ASD or exacerbating symptoms. Addressing GI issues in individuals with ASD can improve their overall well-being, leading to better behavior, cognitive function, and educational abilities. Proper management can improve digestion, nutrient absorption, and appetite by relieving physical discomfort and pain. Alleviating GI symptoms can improve sleep patterns, increase energy levels, and contribute to a general sense of well-being, ultimately leading to a better quality of life for the individual and improved family dynamics. The primary goal of GI interventions is to improve nutritional status, reduce symptom severity, promote a balanced mood, and increase patient independence.

Beyond the Skin: Reduced Lung Function Associated With Atopic Dermatitis in Infants.

Very few studies have examined lung function parameters using tidal breath analysis (TBA) in atopic dermatitis (AD) with its high potential for progression to asthma. To measure lung functions using TBA in infants with AD and in healthy controls (HCs), and to investigate the effects of disease severity, food sensitivity, and history of recurrent wheezing on TBA parameters in infants with AD. Two hundred thirty infants were included in this prospective cross-sectional study, including an AD group (n= 150) and an HC group (n= 80). Food sensitivity was assessed by means of food-specific IgE or the skin prick test. The severity of the disease was evaluated using the SCORing Atopic Dermatitis. Lung function was assessed using TBA. The following TBA parameters were significantly lower in the AD group than in the HC group (P < .05): time to peak tidal expiratory flow, exhaled volume to peak tidal expiratory flow, ratio of time to peak tidal expiratory flow to expiratory time, ratio of exhaled volume to peak tidal expiratory flow to total expiratory volume, expiratory flow when 25% of tidal volume remains in the lungs, respiratory rate, and minute ventilation. No difference was observed in the AD group when TBA parameters were compared according to disease severity, food sensitivity, and history of recurrent wheezing (P > .05). The receiver-operating characteristic curve demonstrated by the ratio of time to peak tidal expiratory flow to expiratory time yielded an area under the curve of 0.826 (CI, 0.772-0.879), with a cutoff value of 31.65 or higher in differentiating AD, with a sensitivity of 78.7% and a specificity of 77.5%. TBA curves can be a useful tool for demonstrating expiratory airway obstruction in AD and for providing objective information for the clinician. Bronchial obstruction was detected in young children with AD irrespective of the severity of the disease, food sensitivity, and history of recurrent wheezing.

Maternal Omega-3 Supplementation During Pregnancy, but Not Childhood Supplementation, Reduces the Risk of Food Allergy Diseases in Offspring.

Omega-3 supplementation has been reported to modulate immune responses and prevent food allergies among children; however, findings are inconsistent, and the timing of supplementation, which is critical, has not been thoroughly investigated. To assess optimal timing (maternal vs childhood intake) of omega-3 supplementation for reducing food allergy risk among children in 2 periods (the first 3 years and beyond 3 years of age). We performed a meta-analysis to assess the effects of maternal or childhood omega-3 supplementation on preventing the development of infant food allergies and food sensitizations. The PubMed/MEDLINE, Embase, Scopus, and Web of Science databases were searched for related studies published until October 30, 2022. We conducted dose-response and subgroup analyses to investigate the effects of omega-3 supplementation. We found that maternal omega-3 supplementation during pregnancy and lactation was significantly associated with decreased risks of infant egg sensitization (relative risk [RR]: 0.58, 95% confidence interval [95% CI]: 0.47-0.73, P < .01) and peanut sensitization (RR: 0.62, 95% CI: 0.47-0.80, P < .01) among children. Similar results were found in subgroup analyses for food allergy, egg sensitization, and peanut sensitization during the first 3 years of age and peanut sensitization and cashew nut sensitization beyond 3 years of age. Dose-response analysis showed a linear relationship between maternal omega-3 supplementation and infant egg sensitization risk during early life. By contrast, intake of omega-3 polyunsaturated fatty acid during childhood did not appear to significantly protect against food allergies. Maternal omega-3 supplementation during pregnancy and lactation, rather than childhood intake, reduces the risk of infant food allergy and food sensitization.

Infant food allergy phenotypes and association with lung function deficits and asthma at age 6 years: a population-based, prospective cohort study in Australia.

Food allergy is considered a precursor to asthma in the context of the atopic march, but the relationship between infant food allergy phenotypes and lung function and asthma in childhood is unclear. We aimed to examine the association between food sensitisation and challenge-confirmed food allergy in infancy, as well as persistent and resolved food allergy up to age 6 years, and the risk of lung function deficits and asthma at age 6 years. The longitudinal, population-based HealthNuts cohort study in Melbourne, VIC, Australia, recruited 5276 infants children aged 1 year who attended council-run immunisation sessions between Sept 28, 2007, and Aug 5, 2011. At age 1 year, all children completed skin prick testing to four food allergens (egg, peanut, sesame, and either shrimp or cow's milk) and an oral food challenge (egg, peanut, and sesame) at the Royal Children's Hospital in Melbourne. Parents completed questionnaires about their infant's allergy history, demographic characteristics, and environmental exposures. At age 6 years, children were invited for a health assessment that included skin prick testing for ten foods (milk, egg, peanut, wheat, sesame, soy, shrimp, cashew, almond, and hazelnut) and eight aeroallergens (alternaria, cladasporum, house dust mite, cat hair, dog hair, bermuda grass, rye grass, and birch mix), oral food challenges, and lung function testing by spirometry. Questionnaires completed by parents (different to those completed at age 1 year) captured the child's allergy and respiratory history and demographics. We investigated associations between food allergy phenotypes (food-sensitised tolerance or food allergy; and ever, transient, persistent, or late-onset food allergy), lung function spirometry measures (forced expiratory volume in 1 sec [FEV1] and forced vital capacity [FVC] z-scores, FEV1/FVC ratio, forced expiratory flow at 25% and 75% of the pulmonary volume [FEF25-75%], and bronchodilator responsiveness), and asthma using regression methods. Only children with complete data on the exposure, outcome, and confounders were included in models. Infants without food sensitisation or food allergy at age 1 year and 6 years served as the reference group. Of 5276 participants, 3233 completed the health assessment at age 6 years and were included in this analysis. Food allergy, but not food-sensitised tolerance, at age 1 year was associated with reduced FEV1 and FVC (aβ -0·19 [95% CI -0·32 to -0·06] and -0·17 [-0·31 to -0·04], respectively) at age 6 years. Transient egg allergy was associated with reduced FEV1 and FVC compared with never having egg allergy (-0·18 [95% CI -0·33 to -0·03] and -0·15 [-0·31 to 0·00], respectively), whereas persistent egg allergy was not (FEV1 -0·09 [-0·48 to 0·31]; FVC -0·20 [-0·62 to 0·21]). Transient peanut allergy was associated with reduced FEV1 and FVC (FEV1 aβ -0·37 [-0·79 to 0·04] and FVC aβ -0·55 [-0·98 to -0·12]), in addition to persistent peanut allergy (FEV1 aβ -0·30 [-0·54 to -0·06] and FVC aβ-0·30 [-0·55 to -0·05]), and late-onset peanut allergy (FEV1 aβ -0·62 [-1·06 to -0·18] and FVC aβ-0·49 [-0·96 to -0·03]). Estimates suggested that food-sensitised tolerance and food allergy were associated with reduced FEF25-75%, although some estimates were imprecise. Food allergy phenotypes were not associated with an FEV1/FVC ratio. Late-onset peanut allergy was the only allergy phenotype that was possibly associated with increased risk of bronchodilator responsiveness (2·95 [95% CI 0·77 to 11·38]). 430 (13·7%) of 3135 children were diagnosed with asthma before age 6 years (95% CI 12·5-15·0). Both food-sensitised tolerance and food allergy at age 1 year were associated with increased asthma risk at age 6 years (adjusted odds ratio 1·97 [95% CI 1·23 to 3·15] and 3·69 [2·81 to 4·85], respectively). Persistent and late-onset peanut allergy were associated with higher asthma risk (3·87 [2·39 to 6·26] and 5·06 [2·15 to 11·90], respectively). Food allergy in infancy, whether it resolves or not, is associated with lung function deficits and asthma at age 6 years. Follow-up studies of interventions to prevent food allergy present an opportunity to examine whether preventing these food allergies improves respiratory health. National Health & Medical Research Council of Australia, Ilhan Food Allergy Foundation, AnaphylaxiStop, the Charles and Sylvia Viertel Medical Research Foundation, the Victorian Government's Operational Infrastructure Support Program.