Can food allergies be prevented?

iStock_000002766942_ExtraSmallWith the increasing prevalence of food allergies among children (now up to 5% of all children less than 5 years old), being able to pinpoint preventive measures would come as a huge welcome to both parents and medical providers alike. And while we know that the development of food allergies is a highly complex mix of both genetic and environmental factors, decreasing that risk would mean less children at risk for anaphylaxis and more parents able to breathe a little bit easier whenever they send their children off to school or to a birthday party.

That’s why I’ve been really encouraged to read about so many studies in the news this week, giving us some direction and more clues about what we can do to potentially decrease this risk among children during the first year of life when these interventions and advice are the  most critical.

Introduction of highly allergenic foods sooner rather than later

New guidelines by The American Academy of Allergy, Asthma and Immunology now suggest that introducing the common allergenic foods such as wheat, dairy, eggs, peanut products, and fish early on when infants are starting solid foods between 4-6 months of age could potentially prevent the development of food allergies in susceptible children.

The highlights of the report (based on years of observational studies) include:

  • Introduction of these allergenic foods after infant has tried and accepted traditional first foods such as rice cereal, fruits, and vegetables.
  • Exclusive breastfeeding for 4-6 months (preferably 6 months) to decrease risk of developing allergic diseases. The longer an infant is breastfed, the less risk for development of other allergic diseases such as asthma and eczema.
  • No maternal diet restrictions while pregnant or nursing unless otherwise recommended by a doctor for known maternal medical illness/allergy or evidence of allergy in infant.
  • Consultation with an allergist for infants with strong family history of food allergies to determine best/safest way to introduce allergenic foods.
  • More interventional studies are needed (and are under way) before making these suggestions a routine recommendation for all infants.

You can read the full report here and a nice summary by The Wall Street Journal here.

Vitamin D Deficiency and Food Allergies

This study show a direct link between food allergies among children and vitamin D deficiency within the first year of life. It’s why exclusively breastfed infants need a vitamin D supplement and why infants starting solid foods need foods that are rich in vitamin D.

Early antibiotic exposure and food allergies

This study shows an association with higher incidence in food allergies among children who received more than 3-4 courses of antibiotics in their first year of life in comparison to those children who did not.

Other factors

Experts have long supported the hygiene hypothesis as another factor bumping up our rates of food allergies. Many believe that our westernized culture has become so hygenic in many degrees that this prevents children from being exposed to different types of germs and thus, their immune systems are not challenged which affects its development and function. And of course, you have the genetic predisposition part.

Regardless, I think this is exciting research. Granted so much more needs to be done and association does not equal causation. But currently, so much of our efforts are focused on diagnosing, treating, and managing food allergies among children. Can you imagine if we could also focus on prevention and know that those efforts were worthwhile and effective?

Promising indeed.

More resources for food allergies and children/adults:

Guidelines for the diagnosis and management of food allergy in The United States

Food Allergies: AAAAI

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