Allergy in children: practical recommendations of the Finnish Allergy Programme 2008–2018 for prevention, diagnosis, and treatment

Pelkonen, Antti; Kuitunen, Mikael; Dunder, Teija; Reijonen, Tiina M.; Valovirta, Erkka; Mäkelä, Mika J.

doi:10.1111/j.1399-3038.2012.01298.x

Cited by 37 publications

(62 citation statements)

References 42 publications

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“…With the development of Finnish Current Care Guidelines on Food Allergy, the diagnostic criteria for food allergy have changed [23]. Previously, positive reactions to specific immunoglobulin E tests could lead to an allergy diagnosis and the children were put on elimination diets more easily, whereas currently the diagnosis relies on elimination-provocation tests [24]. These reasons can also explain the high prevalence of milk allergy observed in this study.…”

Section: Discussionmentioning

confidence: 97%

A History of Cow’s Milk Allergy Is Associated with Lower Vitamin D Status in Schoolchildren

Rosendahl¹,

Fogelholm²,

Pelkonen³

et al. 2017

Horm Res Paediatr

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Background/Aims: Vitamin D insufficiency is common in children. We aimed to evaluate the main determinants of vitamin D status in Finnish school-aged children, including the history of allergic diseases. Methods: We conducted a cross-sectional study on 171 ten-year-olds where serum 25-hydroxyvitamin D (25[OH]D) levels were measured, and data on food consumption and use of vitamin D supplements were collected. The history of allergic diseases was evaluated with a validated questionnaire. Results: Vitamin D insufficiency (<50 nmol/L) was observed in 16% of the children. In children with a history of cow’s milk allergy, the mean 25(OH)D levels were lower than in children without allergy (60.5 ± 12.6 nmol/L vs. 75.5 ± 22.3 nmol/L, p = 0.004). Lack of vitamin D supplementation, female gender, non-Caucasian ethnicity, and a history of milk allergy were associated with lower vitamin D status. Conclusion: The vitamin D status in our study sample of Finnish schoolchildren was sufficient, which suggests that health policy strategies – such as the recommendation of vitamin D supplementation and the fortification of food products with vitamin D – have been successful in improving vitamin D status in children. Special concern should be given to children with a history of milk allergy to ensure their vitamin D sufficiency.

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Section: Discussionmentioning

confidence: 97%

A History of Cow’s Milk Allergy Is Associated with Lower Vitamin D Status in Schoolchildren

Rosendahl¹,

Fogelholm²,

Pelkonen³

et al. 2017

Horm Res Paediatr

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“…The delayed onset of symptoms in FA (6 hours to as long as 48 hours after the food challenge) makes observation difficult, although as many as 25% of cases will present within 1-2 hours of ingestion [8]. There are no specific laboratory tests for FAs; therefore, diagnoses are made using elimination diets and oral challenges [9,10] as well as food challenge tests [11,12]. Several food challenge methods have been proposed, including double-blind placebo-controlled food challenges (DBPCFC) and open food challenges (OFC) [3].…”

Section: Introductionmentioning

confidence: 99%

“…Various studies have highlighted cases of reported growth delay and nutrient deficiency in patients experiencing excessive food limitation [2,8,15]. However, few studies on food limitation in FA patients in countries including Korea have been reported [10,16]. …”

Section: Introductionmentioning

confidence: 99%

The effects of elimination diet on nutritional status in subjects with atopic dermatitis

et al. 2013

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A food allergy is an adverse health effect arising from a specific immune response that occurs reproducibly upon exposure to a given food. In those with food allergies that are thought to cause aggravation of eczema, food avoidance is important. The objective of this study was to research the nutritional status of patients with food allergies. A total of 225 subjects diagnosed with atopic dermatitis underwent a skin prick test as well as measurement of serum immunoglobulin E. Food challenge tests were conducted using seven food items: milk, eggs, wheat, soybeans, beef, pork, and chicken. At post-food challenge visits to the test clinic, participants completed a three-day dietary record, which included two week days and one weekend day, in order to evaluate energy intake and diet quality during the challenge. We analyzed nutrient intake based on differential food allergens. Subjects with a food allergy to milk showed lower intake of Ca, Zn, and vitamin B2, and subjects with a food allergy to egg showed lower intake of vitamin A, B1, B2, niacin, and cholesterol. Subjects with a food allergy to wheat and soybean showed lower intake of Ca, P, Fe, K, Zn, vitamin B2, vitamin B6, and niacin; and subjects with a food allergy to beef, pork, and chicken showed lower intake of Fe and higher intake of K, vitamin A, B2. Subjects with atopic dermatitis were lacking in several nutrients, including vitamin A and vitamin C. A greater number of food allergies showed an association with a greater number of nutrient intake deficiencies. Allergen avoidance is the basic treatment for atopic dermatitis. However, when the allergen is food, excessive restriction can lead to nutrition deficiency. Findings of this study suggest the necessity for enhanced nutritional education in order to provide substitute foods for patients with food allergies who practice food restriction.

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“…As an example of recent tools, practical recommendations for the childhood allergies were published in March 2012 [6, 7]. Mild allergic symptoms are very common and should not be medicalised unnecessarily.…”

Section: Methodsmentioning

confidence: 99%

The Finnish Allergy Programme 2008-2018 - scientific rationale and practical implementation

Haahtela

Valovirta

Kauppi

et al. 2012

Asia Pacific Allergy

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There are no nationwide, comprehensive public health programmes on allergic disorders with set goals and systematic follow-up. The Finnish initiative is based on the idea that the so called allergy epidemic in modern, urban societies is caused by inadequately developed or broken tolerance. The immune system is not trained to make the difference between danger and non-danger (allergy) or the difference between self and non-self (autoimmune diseases). The immune dysfunction leads to inappropriate inflammatory responses and clinical symptoms. The 10-year implementation programme is aimed to reduce burden of allergies both at the individual and societal levels. This is done by increasing both immunological and psychological tolerance and changing attitudes to support health instead of medicalising common and mild allergy symptoms. Severe forms of allergy are in special focus, e.g. asthma attacks are prevented proactively by improving disease control with the help of guided self-management. Networking of allergy experts with primary care doctors and nurses as well with pharmacists is the key for effective implementation. Non-governmental organizations have started a campaign to increase allergy awareness and knowledge among patients and general public. It is time to act, when allergic individuals are becoming a majority of Western populations and their numbers are in rapid increase worldwide. The first results of the Finnish Programme indicate that allergy burden can be reduced with relatively simple means.

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Allergy in children: practical recommendations of the Finnish Allergy Programme 2008–2018 for prevention, diagnosis, and treatment

Cited by 37 publications

References 42 publications

A History of Cow’s Milk Allergy Is Associated with Lower Vitamin D Status in Schoolchildren

A History of Cow’s Milk Allergy Is Associated with Lower Vitamin D Status in Schoolchildren

The effects of elimination diet on nutritional status in subjects with atopic dermatitis

The Finnish Allergy Programme 2008-2018 - scientific rationale and practical implementation

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