Early exposure to solid foods and the development of eczema in children up to 4 years of age

Sariachvili, Manana; Droste, Jos; Dom, Sandra; Wieringa, Marjan H.; Hagendorens, Margo M.; Stevens, W. J.; Sprundel, Marc van; Desager, K N; Weyler, Joost

doi:10.1111/j.1399-3038.2009.00899.x

Cited by 49 publications

(55 citation statements)

References 22 publications

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“…Based on this and emerging evidence that food allergen avoidance may even lead to an increase in food allergy [72, 74•], eczema [75,76], and sensitization [77•], most expert organizations now recommend introduction of complementary foods from 4 to 6 months of age, with no specific delay in "allergenic foods" [73,[78][79][80]. Some reports suggest that starting complementary foods before 3 to 4 months of age may increase the risk of allergic disease [81], possibly because colonization is not fully established and the gut is more permeable.…”

Section: Dietary Allergensmentioning

confidence: 99%

Dietary Immunomodulatory Factors in the Development of Immune Tolerance

West

D’Vaz

Prescott

2011

Curr Allergy Asthma Rep

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Emerging evidence suggests that exposures during pregnancy and the early postnatal period can modify gene expression and disease propensity. Diet is a major environmental exposure, and dietary factors, including polyunsaturated fatty acids, probiotics, oligosaccharides, antioxidants, folate, and other vitamins, have effects on immune function. Some also have been implicated in reduced risk of allergy in observational studies. Intervention trials with polyunsaturated fatty acids, probiotics, and oligosaccharides suggest preliminary but as-of-yet-unconfirmed benefits. Food allergen avoidance during pregnancy, lactation, or infancy has provided no consistent evidence in allergy prevention and is no longer recommended. Rather, there is now a focus on food allergens in tolerance induction. Specific nutrients can induce changes in gene expression during early development and have been implicated in potentially heritable "epigenetic" changes in disease predisposition. Collectively, these observations emphasize that early exposures may modify tolerance development and that further research on these exposures should remain a priority.

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Section: Dietary Allergensmentioning

confidence: 99%

Dietary Immunomodulatory Factors in the Development of Immune Tolerance

West

D’Vaz

Prescott

2011

Curr Allergy Asthma Rep

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“…While food avoidance was proposed earlier, the results of recent observational studies have shown that delaying the introduction of solids is a risk factor for AD [49][50][51][52][53] , and today, methods favoring tolerance induction are used. For infants who cannot be breastfed, infant formulas have been developed.…”

Section: Infant Feedingmentioning

confidence: 99%

Atopic Dermatitis: Global Epidemiology and Risk Factors

2015

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Fifty percent of all those with atopic dermatitis develop other allergic symptoms within their first year of life and probably as many as 85% of patients experience an onset below 5 years of age Key insights Atopic dermatitis often begins in early childhood and is the first Key WordsAtopic dermatitis · Atopic march · Skin barrier defect · Immune dysregulation · Genetics · Environment Abstract Atopic dermatitis (AD) is a chronic inflammatory skin disease posing a significant burden on health-care resources and patients' quality of life. It is a complex disease with a wide spectrum of clinical presentations and combinations of symptoms. AD affects up to 20% of children and up to 3% of adults; recent data show that its prevalence is still increasing, especially in low-income countries. First manifestations of AD usually appear early in life and often precede other allergic diseases such as asthma or allergic rhinitis. Individuals affected by AD usually have genetically determined risk factors affecting the skin barrier function or the immune system. However, genetic mutations alone might not be enough to cause clinical manifestations of AD, and it is merely the interaction of a dysfunctional epidermal barrier in genetically predisposed individuals with harmful effects of environmental agents which leads to the development of the disease. AD has been described as an allergic skin disease, but today, the contribution of allergic reactions to the initiation of AD is challenged, and it is proposed that allergy is rather a consequence of AD in subjects with a concomitant underlying atopic constitution. Treatment at best achieves symptom control rather than cure; there is thus a strong need to identify alternatives for disease prevention. • AD usually starts in early childhood and can be the initial step of the so-called 'atopic march'.• The prevalence of AD is as high as 20% in children in some countries and continues to increase, affecting now not only developed countries but also lowincome countries.• AD is a complex disease, and the relationship between allergy and AD (allergy being a cause and/or an exacerbating factor of AD) is still debated.• Genetics has recently been shown to be an important risk factor for AD, and the strongest association so far with the gene encoding filaggrin has raised the recent interest in the role of skin barrier impairment in the development of AD.• Environmental factors and specifically exposure to microbes are also recognized to play a role in the development of the disease.• AD is a multifactorial disease presenting with different endophenotypes.• The prevention of AD should start as soon as possible (possibly even in utero), targeting both skin barrier, immune/allergy and environmental aspects.

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“…[11][12][13][14][15] One study found a protective effect of the introduction of any complementary food within the first 4 months on atopic dermatitis but only among children with allergic parents. 16 Therefore more evidence with respect to the role of early nutritional exposures is needed. The birth cohort study Protection Against Allergy-Study in Rural Environments (PASTURE) offered the opportunity to evaluate the effect of prenatal and postnatal exposures on the development of allergic diseases.…”

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confidence: 99%