Dietary Management of Food Allergy

Durban, Raquel; Groetch, Marion; Collins, Sherry Coleman; Elverson, Wendy; Friebert, Alyssa; Kabourek, Jamie; Marchand, Stephanie; McWilliam, Vicki; Netting, Merryn; Skypala, Isabel; Brennan, Taryn; Vassilopoulou, Emillia; Vlieg‐Boerstra, Berber; Venter, Carina

doi:10.1016/j.iac.2021.01.009

Cited by 23 publications

(26 citation statements)

References 139 publications

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“…6 Although there is some evidence from observational and, to a lesser extent intervention studies, regarding the effect of diet on the development of some allergic diseases, for example, asthma, 7 the dietary management of food allergy remains largely focused on the elimination of trigger foods, maintaining an age-appropriate intake of energy and nutrients, and ensuring optimal growth. 8 Less attention has been paid to the overall dietary composition as adjuvant therapy to support immune function, despite the recognition that nutrients and foods have immunomodulatory and pharmacological effects on immune function and gut permeability. 9,10 Based on data published for other disorders and epidemiological links already identified, consideration should be given as to whether the effect of nutritional intake on immune function could improve the management of allergic disease.…”

Section: Introductionmentioning

confidence: 99%

“…Nutrition science has progressed from an early focus on individual nutrients, and the prevention of nutritional deficiencies to evaluate whether dietary components and healthy dietary patterns promote, prevent, or even treat non‐communicable diseases, for example, in IBD 5 and rheumatoid arthritis 6 . Although there is some evidence from observational and, to a lesser extent intervention studies, regarding the effect of diet on the development of some allergic diseases, for example, asthma, 7 the dietary management of food allergy remains largely focused on the elimination of trigger foods, maintaining an age‐appropriate intake of energy and nutrients, and ensuring optimal growth 8 . Less attention has been paid to the overall dietary composition as adjuvant therapy to support immune function, despite the recognition that nutrients and foods have immunomodulatory and pharmacological effects on immune function and gut permeability 9,10 …”

Section: Introductionmentioning

confidence: 99%

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The immune‐supportive diet in allergy management: A narrative review and proposal

Vlieg‐Boerstra

Groetch

Vassilopoulou

et al. 2023

Allergy

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The role of nutrition is increasingly recognized in the management of chronic immune diseases. However, the role of an immune‐supportive diet as adjuvant therapy in the management of allergic disease has not been similarly explored. This review assesses the existing evidence for a relationship between nutrition, immune function, and allergic disease from a clinical perspective. In addition, the authors propose an immune‐supportive diet to enhance dietary interventions and complementing other therapeutic options for allergic disease from early life to adulthood. A narrative review of the literature was conducted, to determine the evidence of the relationship between nutrition and immune function, overall health, epithelial barrier function, and gut microbiome, particularly in relation to allergy. Studies on food supplements were excluded. The evidence was assessed and utilized to develop a sustainable immune‐supportive diet to complement other therapies in allergic disease. The proposed diet consists of a highly diverse range of fresh, whole, and minimally processed plant‐based and fermented foods supplemented with moderate amounts of nuts, omega‐3‐rich foods and animal‐based products in proportional amounts of the EAT‐Lancet diet, such as (fatty) fish, (fermented) milk products which may be full‐fat and eggs, lean meat or poultry, which may be free‐range or organic.

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Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

The immune‐supportive diet in allergy management: A narrative review and proposal

Vlieg‐Boerstra

Groetch

Vassilopoulou

et al. 2023

Allergy

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“…Management of food allergies includes avoiding offending allergens and consuming suitable substitutes. However, micronutrient deficiencies and poor growth frequently occur [ 23 ]. The burden of food allergies ranges from lower quality of life, increased caregiver burden and greater anxiety, social consequences, and financial costs [ 24 ].…”

Section: Nutrient and Food Guidelinesmentioning

confidence: 99%

Young Child Nutrition: Knowledge and Surveillance Gaps across the Spectrum of Feeding

et al. 2022

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The first 1000 days is a critical window to optimize nutrition. Young children, particularly 12–24 month-olds, are an understudied population. Young children have unique nutrient needs and reach important developmental milestones when those needs are met. Intriguingly, there are differences in the dietary patterns and recommendations for young children in the US vs. globally, notably for breastfeeding practices, nutrient and food guidelines, and young child formulas (YCFs)/toddler drinks. This perspective paper compares these differences in young child nutrition and identifies both knowledge gaps and surveillance gaps to be filled. Parental perceptions, feeding challenges, and nutrition challenges are also discussed. Ultimately, collaboration among academia and clinicians, the private sector, and the government will help close young child nutrition gaps in both the US and globally.

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“…Dietary restrictions are known to worsen the quality of life, increase psychologic burden, and risk of inadequate nutrient intake. [36][37][38] Milk allergy and multiple food allergies, in particular, negatively affect nutritional status and diet diversity. [39][40][41] Other benefits may include the convenience of introducing food at home, which reduces the need for multiple doctors' appointments, less time reading a food label, particularly as there is no need for avoiding precautionary allergy labeling (PAL), less financial strain, and less time spent buying foods.…”

Section: B Enefits and Con Cern S Of Us Ing Food Allerg En L Adder Smentioning

confidence: 99%

“…Egg, milk, soy, and wheat are found in a wide range of foods across many cultures, particularly in baked and/or processed products. Dietary restrictions are known to worsen the quality of life, increase psychologic burden, and risk of inadequate nutrient intake 36–38 . Milk allergy and multiple food allergies, in particular, negatively affect nutritional status and diet diversity 39–41 …”

Section: Benefits and Concerns Of Using Food Allergen Laddersmentioning

confidence: 99%

Food allergen ladders: A need for standardization

Venter

Ebisawa

Athanasopoulou

et al. 2021

Pediatric Allergy Immunology

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Introduction:The process of gradually reintroducing food allergens into an individual's diet is referred to as food allergen "ladders". There remain many questions regarding the foods chosen, structure and composition of the ladder, and medical and safety considerations. The COVID-19 pandemic has propelled us into an era where medicine is increasingly practiced via online platforms, highlighting the need for standardized food allergen ladder approaches for successful and safe introduction of food allergens. Methods:We performed a search of currently published food allergen ladders and obtained published information and clinical expertise to summarize current knowledge and suggest future standardized approaches for using food allergen ladders.Results: There are currently a limited number of published milk, egg, wheat, and soy ladders. We suggest the following points should be considered when developing food ladders: (1) Food allergen: dose, time, and temperature of heating of the food allergen, simplicity of the ladder and recipes, the possible role of the wheat matrix, and testing for allergenic protein levels to standardize doses; (2) Nutritional factors: health and nutritional value of the foods in the ladder, taste, texture, and cultural appropriateness of foods should be considered; and (3) Medical aspects: consideration of which patients are safe to undergo ladders outside of the clinical setting, other safety aspects and risk factors for severe reactions, number of days suggested per steps, and availability and provision of rescue medication. Written instructions and recipes should be provided to families who wish to use food allergen ladders.Discussion: Food allergen ladders used for gradual reintroduction of food allergens into a food allergic individual's diet are increasingly being used internationally.Standardization regarding the foods included in the ladder and medical considerations are required to practice patient-centered care, best assist patients and families, and ensure safety.

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Dietary Management of Food Allergy

Cited by 23 publications

References 139 publications

The immune‐supportive diet in allergy management: A narrative review and proposal

The immune‐supportive diet in allergy management: A narrative review and proposal

Young Child Nutrition: Knowledge and Surveillance Gaps across the Spectrum of Feeding

Food allergen ladders: A need for standardization

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