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stringlengths 12
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listlengths 384
384
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vitamin\tC,\tbeta-carotene,\ncalcium,\tiron,\tand\nmagnesium\nOnly\tthose\tfoods\tthat\tcause\tsymptoms\tshould\nbe\texcluded,\tensuring\tthat\ta\tvariety\tof\nother\tplant\tfoods\tare\tconsumed.\nIndividuals\twith\tPFAS\tcan\tusually\ttolerate\nproblematic\tfoods\twhen\tthey\tcooked\nor\tprocessed.\nSeafood\nProtein,\tcalcium\t(fish\tbones),\niodine,\tvitamins\tA\tand\tD,\nvitamin\tB\n12
|
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] |
Protein,\tcalcium\t(fish\tbones),\niodine,\tvitamins\tA\tand\tD,\nvitamin\tB\n12\n,\tomega-3\tfatty\nacids\nIndividuals\twith\tseafood\tallergy\tare\trarely\nallergic\tto\tall\tseafood.\tPeople\twith\tfish\nallergy\tmay\tbe\table\tto\teat\tshellfish,\tand\nthose\tallergic\tto\tshellfish\tmay\ttolerate\tfin\nfish.\tEven\tthose\twith\tshellfish\tallergy\tmay\nbe\ttolerant\tof\tother\ttypes\tof
|
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be\ttolerant\tof\tother\ttypes\tof\n\tshellfish\t(e.g.,\nan\tindividual\tallergic\tto\tprawns\n[crustaceans]\tmay\tbe\table\tto\teat\tmollusks,\ne.g.\tclams,\tmussels,\tscallops,\tor\toysters).\nFlaxseeds/linseeds\tare\talso\ta\tsource\tof\nomega-3\tfatty\tacids,\tas\tare\tsome\nanimal\tproducts\tto\ta\tlimited\textent.\nIodine\tis\tadded\tto\tiodized\ttable\tsalt.\tSea
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based\tdiets.\tWhole\tgrains\tare\talso\tan\nimportant\tsource.\tIt\tis\timportant\tthat\tonly\nthose\tfoods\tcausing\tsymptoms\tare\navoided.\nWheat\nEnergy,\tprotein,\tfiber,\tB\nvitamins\t(folic\tacid,\nniacin,\tpantothenic\tacid,\nriboflavin,\tthiamin,\tB\n6\n),\niron,\tmagnesium,\nphosphorous,\tselenium,\nzinc\nA\tvariety\tof\tnonwheat\tflours\tare\tavailable\tfor
|
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] |
zinc\nA\tvariety\tof\tnonwheat\tflours\tare\tavailable\tfor\ncooking\tand\tbaking,\tsuch\tas\toat,\tbarley,\nrye,\tamaranth,\tbuckwheat,\tmillet,\tquinoa,\nrice,\tsorghum,\ttapioca,\tand\tteff.\nMilk\tand\teggs\tprovide\tenergy,\tprotein,\ncalcium,\tand\tB\tvitamins.\nFiber\tcan\tbe\tobtained\tfrom\tother\tplant\nfoods.\nGood\tsources\tof\tiron\tare\nmeat/fish/poultry\tand\tsome\tplant
|
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] |
foods.\nGood\tsources\tof\tiron\tare\nmeat/fish/poultry\tand\tsome\tplant\nfoods.\tIron\tsupplementation\tmay\tbe\nThe\tgrains\tbarley,\noat,\tand\trye\nmust\talso\tbe\navoided\twhen\ngluten\talso\nneeds\tto\tbe\talso\nbe\teliminated.\nFiber\tcan\tbe\nobtained\nfrom\tother\nwhole\tgrains
|
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necessary.\nThose\tavoiding\tboth\n\tmilk\tand\twheat,\nespecially\tif\tvegetarian\tor\tvegan,\tmay\nneed\tsupplements\tof\tB\tvitamins,\ncalcium,\tiron,\tand\ttrace\tminerals.\nand\tplant\nfoods.\nBecause\tfood\tis\tan\timportant\tpart\tof\ta\tperson’s\tculture,\tthe\tsocial\taspects\tof\teating\tcan\tmake\nadherence
|
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adherence\n\tto\tan\telimination\tdiet\tchallenging.\tNutritional\tissues\tcan\talso\tarise\tdue\tto\tincreased\tanxiety\nand\tstress\tencountered\twith\tchanges\tin\tlifestyle\tassociated\twith\telimination\tdiets.\tIn\taddition,\tthe\nplethora\tof\tonline\tsources\tof\tinformation\tand\tsocial\tmedia\tnow\tavailable\tcan\tcontribute\tto\tincreased\nconfusion\tabout\twhat\tis\tbest\tto\teat\t(
|
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] |
confusion\tabout\twhat\tis\tbest\tto\teat\t(\nSkypala\tand\tMcKenzie,\t2018\n).\tContinued\tpersonalized\tdietary\nsupport\n\tfrom\tan\texperienced\tregistered\tdietitian\tnutritionist\t(RDN)\tis\tneeded\tto\toptimally\tguide\tpatients\nmanaging\tfood\tallergies\tand\tintolerances\tand\tto\tminimize\tthe\teffect\tof\tdietary\tand\tlifestyle\tchanges\ton
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family\tand\tsocial\tlife.\tStrategies\tlisted\tin\t\nBox\t25.8\n\tcan\thelp\tfamilies\tand\tindividuals\tcope\twith\tadverse\nfood\treactions\tand\tstill\tmaintain\tquality\tof\tlife.\nBOX\t25.8\nStrategies\tfor\tCoping\twith\n\t\nFood\tAllergy\nFood\tsubstitutions\nTry\tto\tsubstitute\titem-for-item\tat\tmeals.\tFor\texample,\tif\tthe\tfamily\tis\teating\tpasta\tfor\tdinner,
|
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] |
substitution\tof\ta\tgluten-free\tpasta\tmay\tbe\tbetter\taccepted\tfor\tthe\tgluten-sensitive\tor\twheat-allergic\nperson\tthan\ta\tdissimilar\titem.\nDining\tout\tand\teating\taway\tfrom\thome\nEating\tmeals\taway\tfrom\thome\tcan\tbe\trisky\tfor\tindividuals\twith\tfood\tallergies.\tWhether\tat\ta\n\tfancy
|
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fancy\nrestaurant\tor\ta\tfast-food\testablishment,\tinadvertent\texposure\tto\tan\tallergen\tcan\toccur,\teven\tamong\nthe\tmost\tknowledgeable\tindividuals.\tHere\tare\tsome\tprecautions\tto\ttake:\n•\t\nBring\t“safe”\tfoods\talong\tto\tmake\teating\tout\teasier.\tFor\tbreakfast,\tbring\talong\tan\tappropriate\nmilk\tif\tothers\twill\tbe\thaving\tcereal\twith\tmilk.\n•
|
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Label\treading\nLabeling\tlegislation\t(see\t\nBox\t25.7\n)\tmakes\tit\teasier\tto\tidentify\tcertain\tpotential\tallergens\tfrom\tthe\ningredient\tlist\ton\tfood\tlabels.\tFor\texample,\twhen\tfood\tmanufacturers\tuse\tprotein\thydrolysates\tor\nhydrolyzed\tvegetable\tprotein,\tthey\tmust\tnow\tspecify\tthe\tsource\n\tof\tprotein\tused\t(e.g.,\thydrolyzed\tsoy
|
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of\tprotein\tused\t(e.g.,\thydrolyzed\tsoy\nor\thydrolyzed\tcorn).\tAlthough\treactions\tto\tfood\tcolors\tor\tfood\tdyes\tare\trare,\tindividuals\twho\tsuspect\nan\tintolerance\twill\tfind\tthem\tlisted\tseparately\ton\tthe\tfood\tlabel,\trather\tthan\tcategorized\tsimply\tas\n“food\tcolor.”\nEarly\tfeeding\n•\tExclusive\tbreastfeeding\tfor\t4\tto\t6\tmonths
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Early\tfeeding\n•\tExclusive\tbreastfeeding\tfor\t4\tto\t6\tmonths\n•\tIf\texclusive\tbreastfeeding\tis\tnot\tpossible,\tuse\twhey-based,\tpartially\thydrolyzed\n\tformula\nIntroduction\tof\tcomplementary\tfoods\n•\t\nFrom\t4\tmonths,\tearly\tintroduction\tof\tpotential\tfood\tallergens\t(peanut,\tegg,\tand\tothers)\tin\tinfants\nat\thigh\trisk\tof\tdeveloping\tfood\tallergies
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at\thigh\trisk\tof\tdeveloping\tfood\tallergies\nMicrobiome-modifying\tinterventions\n•\t\nHuman\tmilk\toligosaccharides\n•\t\nPrebiotics\t(e.g.,\tfructo-oligosaccharides\tand\tgalacto-oligosaccharides)\n•\t\nProbiotics\t(e.g.,\t\nLactobacillus\trhamnosus\n)\nImmune\tmodulating\n\tnutrients\n•
|
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] |
Lactobacillus\trhamnosus\n)\nImmune\tmodulating\n\tnutrients\n•\t\nMaternal\tomega-3\tpolyunsaturated\tfatty\tacid\tsupplementation\t(docosahexaenoic\tacid\t(DHA)\tand\neicosapentaenoic\tacid\t(EPA)\n•\t\nVitamin\tD\nGeneral\n•\t\nStrengthen\timmunity\tby\tincreasing\tconnection\tto\tnatural\tenvironments,\tpets,\tand\tfarms
|
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•\t\nStrengthen\timmunity\tby\tregular\texercise\n•\t\nConsume\tfermented\tfood\tor\tother\tprobiotic\tpreparations\tto\tstrengthen\timmune\tsystem\n•\t\nUse\tantibiotics\n\tonly\twhen\tnecessary;\tthe\tmajority\tof\tmicrobes\tare\tuseful\tand\thelp\tbuild\thealthy\nimmune\tfunction\n•\t\nDo\tnot\tsmoke;\tparental\tand\tfamily\tsmoking\taround\tinfants\tand\tchildren\tcan\tincrease\trisk\tof\nasthma
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] |
asthma\nSources:\tHeine\tRG:\tFood\tallergy\tprevention\tand\ttreatment\tby\ttargeted\tnutrition,\t\nAnn\tNutr\tMetabol\n\t72(suppl\n3):34,\t2018.\t\nHaahtela\tT\tet\tal:\tThe\tbiodiversity\thypothesis\tand\tallergic\tdisease:\tworld\tallergy\n\torganization\tposition\nstatement,\t\nWorld\tAllergy\tOrgan\n\tJ\t6:3,\t2013.\nPrevention\tof\tfood\tallergies
|
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] |
World\tAllergy\tOrgan\n\tJ\t6:3,\t2013.\nPrevention\tof\tfood\tallergies\nIntensive\tresearch\tis\tbeing\tfocused\ton\tprevention\tstrategies\tfor\tallergic\tdisease,\twith\temphasis\ton\npotential\tgenetic,\tepigenetic,\tenvironmental,\tand\tmodifiable\tlifestyle\trisk\tfactors.\tThere\tis\tgrowing
|
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prevention\taims\tto\tprevent\tthe\tclinical\texpression\tof\tallergic\tdisease\tin\tindividuals\twho\tare\teither\nallergen\tsensitized\tor\twho\talready\tmanifest\tother\tallergic\tdisorders\tsuch\n\tas\teczema\tor\tasthma.\tAllergy\nprevention\tguidelines\thave\tgradually\tshifted\taway\tfrom\tprolonged\tallergen\tavoidance\tto\ta\tgreater\tfocus
|
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on\tthe\tearly\tintroduction\tof\tcomplementary\tor\t“solid\tfoods”\tinto\tthe\tdiets\tof\tinfants\t(\nHeine,\t2018\n;\t\nWest,\n2017\n).\nThe\tCanadian\tHealthy\tInfant\tLongitudinal\tDevelopment\t(CHILD)\tstudy\tis\tone\tof\tthe\tlargest\tlongitudinal\nstudies,\tinvolving\tmore\tthan\t1000\tCanadian\tmothers\n\tand\tinfants,\tto\tadvance\tknowledge\tabout\tthe
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and\tinfants,\tto\tadvance\tknowledge\tabout\tthe\ngenetic\tand\tenvironmental\tdeterminants\tof\tatopic\tdiseases\t(\nCHILD\tstudy,\t2018\n).\tData\tfrom\tthis\tstudy\tand\nothers\thave\tcontributed\tto\tguidelines\ton\tprevention\tand\tinterventions\tthat\tappear\tto\treduce\tthe\trisk\tof\ndeveloping\tfood\tallergy\t(\nBox\t25.9
|
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developing\tfood\tallergy\t(\nBox\t25.9\n).\tA\tnumber\tof\thypotheses\thave\tbeen\tproposed\tfor\tthe\tprevention\tof\nfood\tallergy\tthat\twarrant\tfurther\texamination.\nBOX\t25.9\nRecommendations\tto\tPromote\tOral\tTolerance\tand\tPrevent\tAllergy\n•\t\nSupport\tbreastfeeding\tand\tdelay\tintroduction\tof\tsolid\tfoods\tuntil\t4\tto\t6\tmonths.\n•
|
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•\t\nStrengthen\timmunity\tby\tincreasing\tconnection\tto\tnatural\tenvironments,\tpets,\tand\tfarms.\n•\t\nStrengthen\timmunity\tby\tregular\tphysical\texercise.\n•\t\nUse\tantibiotics\tonly\twhen\tnecessary;\tthe\tmajority\tof\tmicrobes\tare\tuseful\tand\thelp\tbuild\n\thealthy\nimmune\tfunction.\n•\t\nConsume\tfermented\tfood\tor\tother\tprobiotic\tpreparations\tto\tstrengthen\timmune\tsystem.\n•
|
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•\t\nDo\tnot\tsmoke:\tparental\tand\tfamily\tsmoking\taround\tinfants\tand\tchildren\tcan\tincrease\trisk\tof\nasthma.\nFrom\tHaahtela\tT\tet\tal:\tThe\tbiodiversity\thypothesis\tand\tallergic\tdisease:\tworld\tallergy\torganization\tposition\nstatement,\t\nWorld\tAllergy\tOrgan\tJ\n\t6:3,\t2013.\nMicrobial\texposure\n\thypotheses
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Heine,\t2018\n).\tThe\tmicrobial\thypothesis\tproposes\tthat\ta\ndecrease\tin\tearly\tchildhood\texposure\tto\tmicrobes\timpairs\tthe\tdevelopment\tof\timmune\tregulation\tand\toral\ntolerance.\tIt\tincorporates\ttwo\tearlier\tconcepts\treferred\tto\tas\tthe\t“hygiene\thypothesis”\n\tand\tthe\t“old
|
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] |
and\tthe\t“old\nfriends\thypothesis.”\tThese\thypotheses\tassume\tthat\timmune\tdysregulation\tis\tdue\tto\treduced\tmicrobial\nexposure\tand\ta\tlack\tof\tfecal\tmicrobial\tdiversity.\nThe\thygiene\thypothesis\twas\tproposed\tby\tDr.\tDavid\tStrachan\tin\t1989\tand\tposits\tthat\tthe\tincreasing
|
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] |
incidence\tof\tboth\tallergic\tand\tautoimmune\tdiseases\tcould\tbe\texplained\tby\ta\tlack\tof\tearly\tchildhood\nexposure\tto\tinfectious\tagents\twhich\tsuppressed\n\timmune\tsystem\tdevelopment.\tA\tprotective\teffect\tagainst\ndeveloping\tallergic\trhinitis\twas\tobserved\twith\tan\tincreasing\tnumber\tof\tsiblings\tin\ta\thousehold.\tThis\twas
|
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related\tto\tthe\tshared\texposure\tof\tcommon\tpathogens\ttransmitted\tthrough\tdirect\tcontact\twith\tother\nsiblings.\tHowever,\tthe\tInternational\tScientific\tForum\ton\tHome\tHygiene\t(IFH;\t\nhttps://www.ifh-\nhomehygiene.org\n)\tproposes\tthat\tthe\tterm\thygiene\n\thypothesis\tbe\tabandoned\tand\tinstead\trecommends\ta
|
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hypothesis\tbe\tabandoned\tand\tinstead\trecommends\ta\n“targeted\thygiene”\tframework\tto\tmaximize\tprotection\tagainst\tpathogen\texposure\twhile\tallowing\tthe\nspread\tof\tessential\tmicrobes\tbetween\tfamily\tmembers\t(\nBloomfield\tet\tal,\t2016\n).\nThe\told\tfriends\thypothesis,\tproposed\tby\tDr.\tGraham\tRook\tin\t2003,\tmaintains\tthat\tmicrobe\texposure
|
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(\nBloomfield\tet\tal,\t2016\n).\nRoute\tof\tdelivery\nWhen\tan\tinfant\tis\tborn\tby\tcesarean\tdelivery,\tthe\tinfant\tis\tnot\texposed\tto\tthe\tmicrobial\twash\tof\tthe\nmother’s\tvagina.\tVaginally\tdelivered\tinfants\thave\tbacterial\tcommunities\treflecting\tthe\tmother’s\tvaginal
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microbiota,\twhereas\tinfants\tborn\tby\tcesarean\tdelivery\thave\tbacterial\tcommunities\tsimilar\tto\tthose\tfound\non\tthe\n\tskin\t(\nDominguez-Bello\tet\tal,\t2010\n).\tStudies\texamining\tmode\tof\tdelivery\tand\trisk\tof\tfood\tallergy\nhave\tyielded\tconflicting\tresults,\talthough\tone\tsystematic\treview\tdid\tfind\tan\tassociation\tbetween
|
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increased\trisk\tof\tdeveloping\tfood\tallergy\tor\tfood\tsensitization\tin\tchildren\tdelivered\tby\tcesarean\tsection\n(\nMarrs\tet\tal.\t2013\n).\nAntibiotic\tuse\nIt\tis\twell\testablished\tthat\tantibiotics\tcan\tcause\tperturbations\n\tin\tthe\tgut\tmicrobiota.\tInfants\tcan\tbe
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in\tthe\tgut\tmicrobiota.\tInfants\tcan\tbe\nexposed\tto\tantibiotics\tprenatally,\tat\tbirth,\tor\tpostnatally.\tSome\tinfants\tmay\thave\tmultiple\texposures\tover\ntime,\twhen\ttheir\tmicrobiome\tis\tstill\tbeing\tshaped.\tA\tlink\tbetween\tantibiotic\tuse\tin\tearly\tlife\tand\tfood
|
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allergies\thas\tbeen\tdemonstrated\talthough\tthe\trelationship,\tincluding\ttiming\tand\tfrequency\tof\texposure,\nneeds\tfurther\texploration\t(\nNASEM,\t2017\n).\nPrebiotics\tand\tprobiotics\nConsidering\tthe\timportance\tof\tthe\tmicrobiome\tin\timmune\tsystem\tregulation,\tthe\trole\tof\tprebiotics\tand
|
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probiotics\tin\tallergy\tprevention\tcontinues\tto\tbe\tan\texploding\tarea\tof\tinvestigation.\tA\t\nprebiotic\n\tis\ta\nsubstrate\tthat\tis\tselectively\tutilized\tby\thost\tmicroorganisms\tconferring\ta\thealth\tbenefit\t(\nHill\tet\tal,\t2014\n).\nBreastmilk\tcontains\thuman\tmilk\toligosaccharides\t(HMO),\twhich\n\tare\tnondigestible\tcarbohydrates\twith
|
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are\tnondigestible\tcarbohydrates\twith\nprebiotic\tproperties\tthat\tprovide\tthe\tsubstrate\tfor\tspecific\tearly\tmicrobial\tcolonization.\tPrebiotics\thave\nbeen\tadded\tto\tinfant\tformulas,\twhich\twere\tpreviously\tdevoid\tof\toligosaccharides,\tas\tthey\tmay\tdecrease\nthe\tincidence\tof\tatopic\tdermatitis.\tThe\trole\tof\tHMO\tremains\tan\tactive\tarea\tof\tinvestigation\t(
|
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] |
Heine,\t2018\n).\nProbiotics\n\tare\tlive\tmicroorganisms\tthat,\twhen\n\tadministered\tin\tadequate\tamounts,\tconfer\ta\thealth\nbenefit\ton\tthe\thost\t(\nHill\tet\tal,\t2014\n).\tInfants\twith\tallergies\thave\tbeen\tshown\tto\thave\ta\tmicrobial\ncomposition\twith\tlower\tnumbers\tof\t\nBifidobacteria\n\tcompared\twith\thealthy\tinfants\t(\nHeine,\t2018\n).\tThe
|
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Bifidobacteria\n\tcompared\twith\thealthy\tinfants\t(\nHeine,\t2018\n).\tThe\nadministration\tof\tprobiotics\tin\tthe\tlast\tweeks\tof\tpregnancy\tand\tto\tinfants\tduring\tthe\tfirst\tfew\tmonths\tof\nlife\tis\tassociated\twith\ta\tsignificant\treduction\n\tin\tatopic\teczema.\tHowever,\tthe\teffect\tof\tthe\tindividual
|
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] |
in\tatopic\teczema.\tHowever,\tthe\teffect\tof\tthe\tindividual\nprobiotic\tstrain,\tdose,\ttiming,\tfood\tmatrix,\tand\tenvironmental\tfactors\tthat\taffect\tcolonization\tneed\tto\tbe\nexplored\tfurther\tsince\tresults\thave\tbeen\tvaried\t(\nInternational\tScientific\tAssociation\tfor\tProbiotics\tand\nPrebiotics,\t2016\n).
|
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] |
Prebiotics,\t2016\n).\nThe\tSynergy\tin\tMicrobiota\tResearch\t(SyMBIOTA)\tproject\tis\tone\tof\tthe\tlargest\tinfant\tmicrobiome\nstudies\tin\tthe\n\tworld\t(\nCHILD\tstudy,\t2018\n).\tIt\texamines\trelationships\tbetween\tthe\tinfant\tmicrobiome\tand\nvariations\tin\tthis\tinternal\tecosystem\tsuch\tas\tantibiotic\tuse,\tpresence\tof\tpets,\tand\tfood\tsensitization,\tthat
|
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affect\thealth\tand\tdisease\t(\nKozyrskyj,\t2015\n;\t\nNASEM,\t2017\n).\tThe\tdata\tsuggest\tthat\tlower\tspecies\trichness\nin\tmicrobiota\tof\tinfants\tmight\tbe\ta\tpredictor\tof\tfood\tsensitization\t(i.e.,\tmilk,\tegg,\tpeanut)\teven\n\twhen\nadjustments\tfor\tdelivery\tmode,\tantibiotic\tuse,\tand\tbreastfeeding\tare\tconsidered\t(\nAzad\tet\tal,\t2015\n).\tThey
|
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Azad\tet\tal,\t2015\n).\tThey\nalso\tfound\tthat\tsensitization\toccurred\tafter\tchanges\tin\tmicrobiota\tdiversity\tand\trichness\tand\tthat\tthis\nratio\tcould\tbe\ta\tpotential\tpredictor\tof\tfood\tsensitization.\nAllergen\tavoidance\thypothesis\nAllergen\texposure\tat\tconception\tand\tduring\tpregnancy\tand\tlactation\tcontinues\tto\tbe\ta\tfocus\n\tof\tresearch
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] |
prevention.\tHowever,\thigh-quality\tstudies\ton\tmaternal\tdiets\tconclude\tthat\n\tthe\tevidence\tis\tnot\tstrong\nenough\tto\trecommend\tchanging\tthe\tdiet\tof\tpregnant\tand\tbreastfeeding\twomen\tto\tprevent\tfood\tallergies\nin\tinfants\tat\tnormal\tor\thigh\trisk\tof\tfood\tallergies\t(\nNASEM,\t2017\n).\tThus\telimination\tdiets\tduring
|
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] |
NASEM,\t2017\n).\tThus\telimination\tdiets\tduring\npregnancy\tand\tlactation\tfor\tthe\tpurpose\tof\tallergy\tprevention\tare\tnot\twarranted.\nBreastfeeding\nBreastfeeding\tis\tone\tof\tthe\tmain\tinfluences\ton\tthe\tinfant\tgut\tmicrobiota\n\tdevelopment.\tHuman\tmilk\tis\ta\nnutritional\tmatrix\twith\ta\thost\tof\tbioactive\tcompounds,\tincluding\tgrowth\tfactors\tand\tmaternal\tantibodies
|
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that\timpact\timmune\tresponses.\tThere\tare\tmany\twell-documented\tbenefits\tof\tbreastfeeding\tincluding\nprotection\tagainst\tinfections,\tobesity,\tand\tchronic\tdiseases,\tand\tit\tis\tassociated\twith\ta\tfecal\tmicrobiota\nhigh\tin\tbeneficial\t\nBifidobacteria\n.\tMany\tstudies\thave\texamined\n\tthe\tassociation\tbetween\tbreastfeeding\tand
|
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] |
the\tassociation\tbetween\tbreastfeeding\tand\nthe\tdevelopment\tof\tfood\tallergy\tand\tthe\tdata\tis\tinconsistent.\tInfants\twho\tare\texclusively\tbreastfed\tcan\nexpress\tclinical\tmanifestations\tof\tfood\tallergy,\tincluding\tFPIES\tas\talready\tdescribed,\tand\tmultiple\tfood\nintolerances\tof\tinfancy\t(\nHeine,\t2018
|
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] |
intolerances\tof\tinfancy\t(\nHeine,\t2018\n).\tThe\tuse\tof\ta\thypoallergenic\tmaternal\telimination\tdiet\tthat\neliminates\tallergens\tsuch\tas\tcow’s\tmilk\tcan\tbe\n\thelpful\tif\tallergic\tsymptoms\tare\tpresent\tin\tthe\tinfant.\nHowever,\tmaternal\tdietary\trestrictions\tduring\tpregnancy\tand\tlactation\tfor\tthe\tsole\tpurpose\tof\tallergy\nprevention\tare\tnot\trecommended\t(
|
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prevention\tare\tnot\trecommended\t(\nHeine,\t2018\n).\tThe\texact\trole\tof\tbreastfeeding\tin\tallergy\tprevention\nremains\tunclear,\tand\tit\tappears\tthat\tit\tmay\tnot\treliably\tconfer\ta\tprotective\teffect\tagainst\tfood\tallergies,\nalthough\tmore\tresearch\tis\tneeded.\n\tAt\tleast\t6\tmonths\tof\texclusive\tbreastfeeding\tis\trecommended\tfor\tall
|
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At\tleast\t6\tmonths\tof\texclusive\tbreastfeeding\tis\trecommended\tfor\tall\ninfants\tregardless\tof\tfamily\tallergy\trisk\t(see\t\nBox\t25.9\n).\nInfant\tformulas\nThe\tuse\tof\tinfant\tformulas\tto\tprevent\tallergy\tin\thigh-risk\tinfants\twho\tare\tunable\tto\texclusively\tbreastfeed
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] |
is\tbeing\texplored.\tA\tsystematic\treview\tand\tmeta-analysis\twas\tconducted\tby\tBoyle\tet\tal.\tto\tdetermine\nwhether\tuse\tof\ta\thydrolyzed\tformula\treduces\n\tthe\trisk\tof\tallergic\tdisease\tin\thigh-risk\tinfants\t(\nBoyle\tet\tal,\n2016\n).\tTheir\tconclusion,\talong\twith\tother\tsystematic\treviews,\tfound\tthat\tthere\tis\tnot\tsufficient\tevidence
|
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] |
to\tsupport\tthe\tuse\tof\thydrolyzed\tcow’s\tmilk\tformulas—partially\thydrolyzed\tformulas\t(PHF)\tor\tEHF—over\nbreastmilk\tfor\tthe\tprevention\tof\tfood\tallergy\tand\tfood\tsensitization.\tIn\taddition,\tthe\tevidence\tis\tnot\nstrong\tenough\tto\tconclude\n\tthat\thydrolyzed\tformulas\treduce\tthe\trisk\tof\tfood\tallergy\tand\tfood\tsensitization\ncompared\twith\tstandard\tformulas\t(
|
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] |
compared\twith\tstandard\tformulas\t(\nNASEM,\t2017\n).\nDual\tallergen\thypothesis\nThe\t\ndual\tallergen\thypothesis\n\tproposes\tthat\tallergic\tsensitization\tto\tfoods\tmay\toccur\tfrom\ta\tdisrupted\nskin\tbarrier\tearly\tin\tlife,\tas\toccurs\tin\tinfantile\teczema.\tThe\tloss\tof\tskin\tbarrier\tintegrity\tincreases\nenvironmental\texposure\tto\tlow\tdoses
|
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environmental\texposure\tto\tlow\tdoses\n\tof\tfood\tallergens\tthrough\tthe\tskin.\tData\tsuggests\tthat\tloss\tof\nfunction\tof\tfilaggrin,\ta\tprotein\timportant\tfor\tepithelial\tstructure,\talong\twith\ta\tcompromised\tskin\tbarrier,\nincreases\tthe\trisk\tfor\tfood\tsensitization\tfrom\tthe\tenvironment\t(\nRenz\tet\tal,\t2018\n).
|
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] |
Renz\tet\tal,\t2018\n).\nThe\thypothesis\talso\tpostulates\tthat\toral\texposure\tto\tthese\tsame\tallergens\tthrough\tconsumption\tof\tthe\nallergenic\tfoods\tearly\tin\tlife\tleads\tto\n\toral\ttolerance\tand\tprevents\tthe\tdevelopment\tof\tsensitization\tand\nallergy\teven\twith\tsubsequent\texposures\t(\nRenz\tet\tal,\t2018\n).\tThis\thypothesis\tis\talso\tthought\tto\texplain\tthe
|
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] |
Renz\tet\tal,\t2018\n).\tThis\thypothesis\tis\talso\tthought\tto\texplain\tthe\n“atopic\tmarch,”\n\ta\tpattern\tthat\tdescribes\ta\tprocess\tin\twhich\tatopic\tdisorders\tprogress\tover\ttime\tfrom\neczema\t(i.e.,\tatopic\tdermatitis)\tto\tasthma\tto\tmultiple\tallergic\tdisorders\tincluding\tfood\tallergy\t(\nNASEM,\n2017\n).\nThe\tdual\tallergen
|
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] |
NASEM,\n2017\n).\nThe\tdual\tallergen\n\thypothesis\twas\tborn\tout\tof\tthe\tobservation\tthat\tinfants\twith\teczema\thave\ta\thigh\trisk\nof\tdeveloping\tIgE-mediated\tfood\tallergies.\tSupporting\tthis\thypothesis\tare\tdata\tsuggesting\tthat\tearly\ndietary\tintroduction\tof\tpeanut\tproducts\tmay\tconfer\tprotection\tagainst\tpeanut\tallergy.
|
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] |
However,\tmany\tquestions\tremain\tabout\tthe\tmechanisms\tby\twhich\tsensitization\tand\ttolerance\toccur,\nand\tabout\tthe\telements\tof\tthe\n\timmune\tsystem\tthat\trepresent\tthe\tmost\timportant\tcontributors\tto\tthe\nseverity\tof\tfood\tallergy\tor\tthe\testablishment\tof\ttolerance.\nTiming\tof\tintroduction\tof\tsolids\tand\tinfant\tfeeding
|
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Timing\tof\tintroduction\tof\tsolids\tand\tinfant\tfeeding\nEarlier\tfood\tallergy\tprevention\tstrategies\trecommended\tdelayed\tintroduction\tof\tcommon\tallergenic\tfoods\ninto\tthe\tinfant’s\tdiet.\tThere\tis\tnow\tdirect\tevidence\tfrom\trandomized\tcontrolled\ttrials\tthat\tthe\tparadigm\tis\nshifting\n\tfrom\tavoidance\tto\tcontrolled\texposure\t(\nWest,\t2017
|
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shifting\n\tfrom\tavoidance\tto\tcontrolled\texposure\t(\nWest,\t2017\n).\tAlthough\tthe\t“optimal”\tperiod\tfor\nintroduction\tof\tcomplementary\tfoods\tfor\tallergy\tprevention\tis\tnot\tknown,\ta\t“window\tperiod”\tbetween\t4\tto\n6\tmonths\tof\tage\twhen\tsolids\tare\tintroduced\tis\trecommended\tby\tmost\tinternational\tguidelines\tfor\tthe\ninduction\tof\ttolerance\t(\nHeine,\t2018\n;
|
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] |
induction\tof\ttolerance\t(\nHeine,\t2018\n;\t\nWest,\t2017\n).\tThe\tAustralian\tHealthNuts\tstudy,\tthe\tLearning\tEarly\nAbout\n\tPeanut\t(LEAP),\tand\tEnquiring\tAbout\tTolerance\t(EAT)\tare\tsome\tof\tthe\tkey\tstudies\tthat\tassess\tearly\nversus\tlate\tintroduction\tof\tcomplementary\tfoods\tfor\tallergy\tprevention\tand\tprovide\tinsights\ton\tthe\tbest
|
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] |
timing\tof\tthe\tdietary\tintroduction\tof\tfood\tallergens\tin\thigh-risk\tinfants\t(\nFleischer\tet\tal,\t2015\n;\t\nHeine,\n2018\n;\t\nWest,\t2017\n;\t\nDuToit\tet\tal,\t2015\n)\t(see\t\nBox\t25.9\n).\nThe\tpivotal\tLEAP\ttrial\tprovides\tstrong\n\tevidence\tthat\tearly\tintroduction\tof\tpeanuts\t(from\t4\tto\t11\tmonths
|
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0.040597930550575256,
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0.01504028681665659
] |
evidence\tthat\tearly\tintroduction\tof\tpeanuts\t(from\t4\tto\t11\tmonths\nof\tage)\tincreases\tprotection\tagainst\tpeanut\tallergy\tin\tinfants\twho\tare\tat\thigh\trisk\t(defined\tby\tearly-onset\neczema\tand/or\tegg\tallergy)\t(\nNASEM,\t2017\n;\t\nWest,\t2017\n;\t\nHeine,\t2018\n;\t\nTogias\tet\tal,\t2017\n).
|
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] |
NASEM,\t2017\n;\t\nWest,\t2017\n;\t\nHeine,\t2018\n;\t\nTogias\tet\tal,\t2017\n).\nThe\trole\tof\tdiet\tdiversity\tin\tearly\tlife\tfeeding\tpractices\tmay\tbe\tanother\tinfluential\tfactor\tin\tfood\tallergy\nprevention.\tIncreased\tdiversity\n\tof\tcomplementary\tfoods,\tincreased\tvegetables\tand\tfruit,\tand\tmore\thome-
|
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] |
prepared\tmeals\tin\tthe\tfirst\tyear\tof\tlife\thave\tbeen\tassociated\twith\ta\treduced\trisk\tof\tfood\tallergy\t(\nNASEM,\n2017\n;\t\nDu\tToit\tet\tal,\t2018\n).\nMany\tquestions\tremain\ton\tthe\tbest\tstrategies\tto\toptimize\tinfant\tfeeding\tregimens\tand\tsupport\tthe\tmost\nfavorable\t“tolerogenic”\tmicroenvironment\tin\tthe\tgut\tduring\tthe\tperiod\tof\tfood\tallergen\tintroduction,
|
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] |
since\tthe\timmunomodulatory\tcapacity\tof\tthe\tGI\ttract\tis\tinfluenced\tby\tmultiple\tfactors\t(\nWest,\t2017\n;\t\nRenz\net\tal,\t2017\n).\nNutritional\timmunomodulation\nA\tbalanced\timmune\tsystem\tis\tessential\tto\thealth,\tand\tnutrition\tis\ta\tmajor\tfactor\tthat\timpacts\nimmunocompetence.\tThe\timmunoregulatory\tnetwork\tis\torchestrated\tby\ta\tvariety\tof\tnutrients\tsuch\tas
|
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vitamin\tD,\tfolate,\tand\tomega-3\tfatty\tacids,\tand\tis\tinfluenced\n\tnot\tonly\tby\tdietary\tintake\tbut\talso\tby\ndigestive\tdynamics\tand\tmicrobial\tinterplay.\nVitamin\tD\nVitamin\tD\thas\treceived\tincreased\trecognition\tfor\tits\trole\tin\timmune\tregulation,\tas\tseveral\tstudies\thave
|
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] |
provided\tevidence\tthat\tvitamin\tD\tdeficiency\tis\tassociated\twith\tfood\tallergy.\tEvidence\tsuggests\tvitamin\tD\nhelps\tpromote\timmunoregulation\tthrough\tinduction\tof\tT\nreg\n\tcells\tand\tT-cell\tdifferentiation.\n\tA\tshift\tto\tTh2\nresponses\toccurs\twith\tlow\tor\tvitamin\tD–deficient\tconditions\t(\nRenz\tet\tal,\t2018\n).\tA\tfew\tstudies\thave\talso
|
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] |
Renz\tet\tal,\t2018\n).\tA\tfew\tstudies\thave\talso\nexamined\tthe\teffect\tof\tmaternal\tvitamin\tD\tstatus,\tcord\tblood,\t25(OH)D\n3\n\tlevels,\tand\tthe\tdevelopment\tof\nfood\tallergy,\twith\tconflicting\treports.\tMultiple\tgenes\tare\tinvolved\tin\tvitamin\tD\tmetabolism\tand\tregulatory\npathways,\tand\tfuture\tstudies\tthat\tconsider\tgenetic\tpolymorphisms\twill
|
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pathways,\tand\tfuture\tstudies\tthat\tconsider\tgenetic\tpolymorphisms\twill\n\thelp\tclarify\tthe\trelationship\nbetween\tvitamin\tD\tand\tfood\tallergy\t(\nJones\tet\tal,\t2015\n;\t\nNASEM,\t2017\n).\nFatty\tacids\nThe\trole\tof\tdietary\tfats\tin\tallergy\tdevelopment\thas\tbeen\tthe\tsubject\tof\tinvestigation,\twith\tthe\tomega-3
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] |
fatty\tacids\tbeing\tthe\tmost\textensively\tstudied.\tThe\tamount\tof\tomega\t3-fatty\tacids\tin\tthe\tU.S.\tdiet\thas\ndecreased\tover\ttime\talong\twith\ta\tcorresponding\tincrease\tin\tomega-6\tfatty\tacids\n\tintake,\tand\tthis\nimbalance\tis\tthought\tto\tbe\ta\tcritical\tnutrition\tfactor\tin\tthe\tprevalence\tof\tchronic\tdisease,\tincluding\nallergic\tdisorders\t(\nHeine,\t2018\n).
|
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] |
allergic\tdisorders\t(\nHeine,\t2018\n).\nOmega-3\tfatty\tacids\thave\tantiinflammatory\tand\timmunomodulatory\teffects.\tSome\tstudies\tsuggest\tthat\nmaternal\tconsumption\tof\tfish\toil\t(a\tsource\tof\tomega-3\tfatty\tacids)\tin\tpregnancy\tprotects\tagainst\tthe\ndevelopment\tof\tasthma,\teczema,\tand\tallergic\n\tsensitization\tin\tthe\tinfant,\twhereas\tothers\tdo\tnot\tshow
|
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allergy\tprevention\tand\ttheir\n\trole\tin\tthe\tinflammatory\tcascade\t(see\t\nChapter\t7\n).\nFolate\nThere\tis\trenewed\tinterest\tin\tfolate\tas\ta\tdietary\tmethyl\tdonor\tthat\talters\tgene\texpression\tand\timpacts\nimmune\tfunction\tthrough\tepigenetic\tmechanisms\t(\nBrown\tet\tal,\t2014\n).\tFolate\texposure\tin\tutero\tcan\taffect
|
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Brown\tet\tal,\t2014\n).\tFolate\texposure\tin\tutero\tcan\taffect\nDNA\tmethylation\tduring\tfetal\tdevelopment\tand\tinfluence\ttranscriptional\tactivity\tand\tmay\tbe\tinvolved\tin\nT-cell\tdifferentiation.\tMost\n\tstudies\tto\tdate\thave\tfocused\ton\tasthma,\twith\ta\tvery\tlimited\tnumber\texamining
|
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the\trelationship\tof\tfolate\tto\tfood\tallergy\tand\tfood\tsensitization.\tThe\tsignificant\trole\tthat\tfolate\tplays\tin\nmethylation\tof\tkey\tregulatory\tgenes\tand\tits\tpotential\tin\tallergic\tpredisposition\twarrants\tfurther\ninvestigation.\nOther\tnutrients\nFew\tstudies\thave\texamined\tthe\trelationship\tbetween\tmaternal\tdietary\tantioxidant\n\tintake\t(beta-carotene,
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] |
intake\t(beta-carotene,\nvitamins\tC\tand\tE,\tcopper,\tand\tzinc)\tduring\tpregnancy\tand\tthe\trisk\tof\tdeveloping\tfood\tallergy.\tIn\taddition,\nnutrient\tassessment\tof\tindividuals\twith\tfood\tallergies\tand\tintolerances\thas\tnot\tbeen\tthoroughly\texamined\nin\tresearch\tand\tis\tan\tavenue\tripe\tfor\texploration\t(\nNASEM,\t2017\n).\nFuture\tdirections
|
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NASEM,\t2017\n).\nFuture\tdirections\nThere\tare\ta\tnumber\tof\tareas\tthat\tare\tbeing\tintensely\tstudied\tas\tpotential\n\ttherapeutics\tfor\tfood\tallergy.\nImmunotherapy\nThe\tconcept\tof\t\nallergen\timmunotherapy\t(AIT)\n,\twhich\taims\tto\tprovide\tdesensitization\tin\ta\tsystematic
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,\twhich\taims\tto\tprovide\tdesensitization\tin\ta\tsystematic\nstepwise\tprocess,\twas\tfirst\tdescribed\tin\tthe\tearly\t1900s.\tIt\tis\ta\tprocedure\tinducing\ttolerance\tto\ta\tspecific\nallergen\tby\trepetitive\tadministration\tof\tsmall\tamounts\tof\tan\tallergen,\tand\tit\thas\tbeen\teffective\tin\nrespiratory\tallergy\tand\tvenom\thypersensitivity.
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] |
respiratory\tallergy\tand\tvenom\thypersensitivity.\n\tThree\tmain\tclinical\timmunotherapy\tconcepts\thave\nemerged\tsince\tthen,\tincluding\toral\timmune\ttherapy\t(OIT),\tsublingual\timmune\ttherapy\t(SLIT)\tand\nepicutaneous\timmunotherapy\t(EPIT).\tOngoing\tstudies\tof\tthese\tmethods\thave\tidentified\tbenefits\tand
|
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] |
limitations\tof\teach,\tincluding\tside\teffects\tand\tadverse\treactions.\nThe\teffectiveness\tof\tthe\ttherapies\tin\tfood\tallergy\tremains\tunder\tinvestigation,\tincluding\n\tthe\tpotential\tof\ncombination\ttherapies\tsuch\tas\tOIT\tplus\timmune\tmodulation\twith\tprobiotics\tor\ttraditional\tChinese\nmedicine\t(\nSicherer\tand\tSampson,\t2018
|
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medicine\t(\nSicherer\tand\tSampson,\t2018\n).\tA\tgrowing\tbody\tof\tevidence\tsupports\tthe\tuse\tof\tAIT\tfor\tsubsets\nof\tpatients\twith\tfood\tallergies;\thowever,\tbiomarkers\tthat\tare\tpredictive\tof\tfavorable\toutcomes\tand\nstrategies\tto\timprove\tthe\tsafety\tand\tefficacy\tof\tAIT\tare\tneeded\t(\nFeuille\tand\tNowak-Węgrzyn,\t2018\n).\nGenetics\tand\tomics
|
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] |
Feuille\tand\tNowak-Węgrzyn,\t2018\n).\nGenetics\tand\tomics\nThe\tpotential\tof\tgenetic\tdata\tand\t“omics”\ttechnologies\tsuch\tas\tepigenomics,\tproteomics,\ttranscriptomics,\nmetabolomics,\tmicrobiomics,\tand\texposomics\tis\tnow\tbeing\trecognized\t(see\t\nChapter\t6\n).\tFor\texample,
|
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] |
Chapter\t6\n).\tFor\texample,\nmetabolomics\tcan\tprovide\tdata\ton\tthe\tmetabolic\tpathway\tactivity\tassociated\twith\tegg\tand\tpeanut\tallergy,\nwhereas\tmicrobiomics\tcan\tidentify\tmicrobial\trisk\tfactors\tthat\tare\n\tinfluencing\tgut\tphysiology.\tOther\n“omics”\tapproaches\tcan\tprovide\tmeasurements\tof\tproteins\tinvolved\tin\tfood\tallergy\timmune\tresponses
|
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] |
for\tboth\tthe\tprevention\tand\ntreatment\tof\tthis\tdisease\t(\nDhondalay\tet\tal,\t2018\n).\nFuture\tinnovations\nInnovative\tapproaches\tsuch\tas\tmodification\tof\trelevant\tfood\tallergens\t(to\tmake\tthem\tless\tallergenic\twhile\nmaintaining\ttheir\timmunogenicity)\tor\tcombining\tother\ttherapies\t(e.g.,\tprobiotic\tsupplementation\tduring
|
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] |
food\tchallenges)\tto\tincrease\tefficacy\tand/or\tsafety\twill\tcontinue\tto\tdominate\tthe\tfood\n\tallergy\tlandscape\n(\nNeerven\tand\tSavelkoul,\t2017\n).\nUseful\twebsites\nAllergy\tAware\tCanada\nAmerican\tAcademy\tof\tAllergy,\tAsthma\tand\tImmunology\nThe\tAsthma\tand\tAllergy\tFoundation\tof\tAmerica\nFood\tAllergy\tResearch\tEducation
|
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Food\tAllergy\tResearch\tEducation\nInternational\tNetwork\tfor\tDiet\tand\tNutrition\tin\tAllergy\nReferences\nAlhmoud\tT,\tHanson\tJA,\tParasher\tG.\t\nEosinophilic\tgastroenteritis:\tan\tunderdiagnosed\tcondition\n\tDig\nDis\tSci\n\t2016;61:\t2585-2592.\nAli\tA,\tWeiss\tTR,\tMcKee\tD.\tet\tal.\t\nEfficacy\tof\tindividualized\tdiets\tin\tpatients\twith\tirritable\tbowel
|
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Efficacy\tof\tindividualized\tdiets\tin\tpatients\twith\tirritable\tbowel\nsyndrome:\ta\trandomized\tcontrolled\ttrial\n\tBMJ\tOpen\tGastroenterol\t2017;4:\te000164.\nAmerican\tLatex\tAllergy\tAssociation:\t\nWhat\tis\ta\tlatex\tallergy?\n\tAvailable\tat:\nhttps://www.allergyhome.org/\n.\nAppel\tMY,\tNachshon\tL,\tElizur\tA.\tet\tal.\t\nEvaluation\tof\tthe\tbasophil\tactivation\ttest\tand
|
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] |
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