Assessment of children's nutritional attitudes before oral food challenges to identify patients at risk of food reintroduction failure: a prospective study

Polloni, Laura; Ferruzza, Emilia; Ronconi, Lucia; Toniolo, Alice; Lazzarotto, Francesca; Bonaguro, Roberta; Celegato, Nicolò; Muraro, Antonella

doi:10.1111/all.13055

Cited by 15 publications

(33 citation statements)

References 24 publications

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“…31,32 Even after a negative oral food challenge (OFC), maternal anxiety before the OFC has been found to be correlated to a following limited level of change in the child's nutritional habits. 33 The emotional/ behavioural influence of FA may affect nutritional status over time if fear of having a reaction impacts willingness to eat. A case of an 11-year-old boy with peanut allergy reporting a selective diet related to an anxiety disorder has been described.…”

Section: Anxiety and Fa Managementmentioning

confidence: 99%

Anxiety and food allergy: A review of the last two decades

Polloni

Muraro

2020

Clin Experimental Allergy

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Food allergy (FA) is recognized as a growing public health burden affecting 5%‐10% of children worldwide. Several unique features specific to FA elicit high levels of emotional distress and anxiety in patients and caregivers, the first among all the possibility of a life‐threatening reaction. Anxiety disorders are highly prevalent in patients with chronic disease, but remain undertreated despite significant negative consequences on patient health. This review aimed to offer a comprehensive overview of literature data on FA and anxiety of the last two decades. A review of the medical and psychological literature from the year 2000 (MEDLINE, PubMed and PsycINFO) was done using the keywords “anxiety” and “food allergy.” Clinical implications for disease management, various manifestations in different target groups, proper interventions and possible explanations on the nature of the association between FA and anxiety have been discussed, as well as limitations and further research directions. The relationship between FA and anxiety is attributed to FA‐specific fears and anxiety, rather than a general propensity towards anxiety. Some anxiety—short‐lived and related to key events–is to be expected and may even be helpful if it sustains allergen avoidance and preparedness to emergency. However, some data reported that increased anxiety did not improve adherence. Rather, high levels of anxiety have been demonstrated counterproductive and related to maladaptive coping. Further research is needed to elucidate the association between FA and anxiety, especially to understand biopsychosocial directions of the underlying mechanisms and to build proper, effective, standardized protocols of intervention. Clinicians must be aware of the association between FA and anxiety, understand their role in recognizing maladaptive anxiety and encouraging to seek psychological support when needed.

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Section: Anxiety and Fa Managementmentioning

confidence: 99%

Anxiety and food allergy: A review of the last two decades

Polloni

Muraro

2020

Clin Experimental Allergy

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“…In fact, a prospective study that assessed the nutritional attitudes of children with food allergy before and after OFC in relation to their mothers' anxiety showed a negative correlation between anxiety of mothers before OFC and degree of change in nutritional habits of their children after OFC. 18 The authors stated that a positive attitude of mothers toward food before OFC promoted subsequent food reintroduction, which increased children's interest in tasting new foods, and led to favorable changes in nutritional habits. A negative initial maternal attitude, on the other hand, led to an unfavorable attitude in the child.…”

Section: Discussionmentioning

confidence: 99%

“…5,16,17 In addition, it was reported that mothers with a high level of anxiety, even after a negative OFC for their child, were reluctant to reintroduce the offending food. 18 Psychological factors may affect the natural history of food allergy.…”

Section: Introductionmentioning

confidence: 99%

A good QoL is beneficial for outgrowing egg allergy

Hamada¹,

Nagao²,

Imakiire³

et al. 2020

Preprint

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Background: Safely liberalizing the diet to include an allergenic food may accelerate resolution of food allergy. The outcome of liberalization, however, varies among patients. Methods: We conducted a prospective observational study to identify factors associated with outcome for egg allergy 1 year after oral food challenge (OFC). We enrolled children < 72 months-old who had egg allergy and underwent OFC for determination of the safe intake quantity of egg allergen. At enrollment, each child’s clinical background was recorded. The Food Allergy Quality of Life Questionnaire–Parent Form (FAQLQ–PF) was administered to the caregivers to assess their children’s QoL. Dietary advice based on the OFC result was then provided to support safe consumption of eggs. At 1 year after OFC, the quantity of egg each child safely consumed in daily life was surveyed. We classified the egg allergy outcome as Outgrowing (Group O) if the quantity increased during the 1 year, or as Non-outgrowing (Group N) if it did not. Factors associated with the outcome were investigated by multivariate logistic regression analysis. Results: A total of 93 children were enrolled, and after 1 year 57 finished in Group O and 36 in Group N. The mean FAQLQ-PF score at baseline was significantly lower (i.e., better QoL) in group O than in group N. Multivariate logistic regression analysis identified comorbid asthma, comorbid atopic dermatitis and a poor QoL as factors predicting an unfavorable outcome. Conclusion: QoL may affect food allergy outcome. Intervention focusing on QoL may promote outgrowing food allergies.

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“…47 One trait that has been prospectively identified as associated with failure of reintroduction in children is a lack of interest in eating a new food. 48 Rarely, a patient may react at home after passing an observed OFC. This could be explained by either a higher dose triggering a reaction than was fed in a clinic or cofactors that lowered the triggering threshold.…”

Section: Incorporation Of the Foodmentioning

confidence: 99%