Nutrient intake and nutritional status of children following a diet free from cow's milk and cow's milk by-products

Medeiros, Lilian C. S.; Speridião, Patrícia da Graça Leite; Sdepanian, Vera Lúcia; Fagundes-Neto, Ulysses; Morais, Mauro Batista de

doi:10.2223/jped.1220

Cited by 33 publications

(26 citation statements)

References 18 publications

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“…Many cases of nutritional rickets (not included in Table ) in cow's milk allergic children have been published, representing the most severe spectrum of a vitamin D deficiency . However, low vitamin D levels and insufficient calcium intake have been reported (without rickets) by many authors in various food allergic conditions . The homeostasis between calcium, vitamin D and phosphate is well described in promoting bone growth and density in childhood .…”

Section: Micronutrient Deficienciesmentioning

confidence: 99%

Nutritional disorders resulting from food allergy in children

Meyer

2018

Pediatric Allergy Immunology

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The elimination of food allergens that contribute essential nutrients in paediatrics may lead to the development of nutritional disorders. The most common nutritional disorders include poor growth, micronutrient deficiencies and feeding difficulties. Of the aforementioned, growth faltering has been well studied and is seen as a common presenting factor in paediatric food allergy. However, the use of different criteria and cut-off values makes it difficult to establish the overall effect. The impact of number and type of foods eliminated and comorbidities has yielded varying results, although there seems to be a trend towards worsening growth with atopic dermatitis and the avoidance of cow's milk. Low micronutrient intake is common in paediatric food allergy; however, a low intake does not necessarily translate into a deficiency as measured by biomarkers. Vitamin D and calcium have been well studied, and a long-lasting impact on bone mineral density has been found. However, other micronutrient deficiencies have also been found and should also be considered. Feeding difficulties is a common complaint in clinical practice, but limited data have been published in food allergy. Poor growth and reflux/vomiting have been shown to be associated with feeding difficulties, in particular in non-IgE-mediated food allergies. There seems to be a long-lasting effect on feeding, in particular in cow's milk allergy, which needs to be taken into account with dietary input. The interplay between growth, feeding difficulties and micronutrient deficiencies has been implied in some studies, but cause and effect is not well established and requires further research.

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Section: Micronutrient Deficienciesmentioning

confidence: 99%

Nutritional disorders resulting from food allergy in children

Meyer

2018

Pediatric Allergy Immunology

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“…Se requieren más estudios prospectivos en la región para desarrollar estrategias públicas de prevención en salud y diagnóstico temprano 7,21,33,37,42,48,50,[53][54][55][56][57][58][59] .…”

Section: Discussionunclassified

“…En cuanto al estado nutricional, la falla en el crecimiento (< 2DS) en Peso/Edad en el 15% de los pacientes y el riesgo nutricional (-1-2 DS) en 32,2% es superior al encontrado en Brasil 53 . El déficit nutricional observado en el momento de la primera consulta puede ser atribuible, ya sea al uso inapropiado de sucedáneos de la leche de vaca, a un inicio tardío o duración insuficiente del tratamiento adecuado.…”

Section: Discussionunclassified

Síntomas digestivos y respuesta clínica en lactantes con alergia a la proteína de leche de vaca

Vera

Ramírez

2013

Rev. chil. pediatr.

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“…Compared to children on unrestricted diets, elimination of all foods containing CMP will usually lead to a major change in nutrient supply, with potential consequences for long-term health. Medeiros et al [16] compared the food intake and nutritional status of 26 children (mean age 19 months) on a diet free of cow's milk and cow's milk products to 30 children (mean age 17 months) with unrestricted diets. Children on a CMP-free diet had lower dietary intakes of energy (p = 0.005), protein (p < 0.001), fat (p < 0.001), calcium (p < 0.001) and phosphorous (p < 0.001) than controls, and lower standard deviation scores (z scores) for height for age (-0.81 ± 0.06 vs. +0.42 ± 0.25, p < 0.001), weight for age (-1.03 ± 1.21 vs. +0.02 ± 0.91, p < 0.001), and weight for height (-0.63 ± 1.08 vs. +0.30 ± 1.11, p = 0.004).…”

Section: Risk Of Malnutritionmentioning

confidence: 99%

Allergen Avoidance Approaches in Food Allergy Management

Koletzko¹,

Koletzko²

2009

Microbial Host-Interaction: Tolerance Versus Allergy

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Dietary elimination of causative food ingredients, usually food proteins, is the basis of treating food hypersensitivity. Proper diagnostic assessment is essential to avoid burdening children with unnecessary dietary restrictions with potential adverse effects. Diagnosis requires a detailed history, allergen elimination, and re-challenge with suspected foods. Complete elimination of causative food components depends on professional counseling and training of the patient and family, and transparent labeling of food products. Elimination diets carry the risk of inducing insufficient supplies of critical nutrients with adverse effects on health and wellbeing, particularly in children with exclusion of foods that provide a major part of dietary supply and patients with multiple food allergies. Infants and young children with cow's milk allergy, who have not been fully breastfed, require milk substitutes based on extensively hydrolyzed protein or amino acids. Elimination diets must be supervised and monitored to a similar degree as drug treatments, and the need for continued dietary elimination should be reviewed on a regular basis and re-challenges considered.

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Nutrient intake and nutritional status of children following a diet free from cow's milk and cow's milk by-products

Abstract: During the cow's milk and cow s milk by-products exclusion therapy, qualitative and quantitative food intake monitoring must be carried out periodically, so as to prevent inadequacies in meeting nutritional requirements and impairment of growth and development.

Cited by 33 publications

References 18 publications

Nutritional disorders resulting from food allergy in children

Nutritional disorders resulting from food allergy in children

Síntomas digestivos y respuesta clínica en lactantes con alergia a la proteína de leche de vaca

Allergen Avoidance Approaches in Food Allergy Management

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