Early introduction of allergenic foods for the prevention of food allergy from an Asian perspective—An Asia Pacific Association of Pediatric Allergy, Respirology & Immunology (APAPARI) consensus statement

Abstract

Emerging evidence for the early introduction of allergenic foods for the prevention of food allergies, such as peanut allergy in Western populations, has led to the recent publication of guidelines in the USA and Europe recommending early peanut introduction for high-risk infants with severe eczema or egg allergy. Peanut allergy is, however, much less prevalent in Asia compared to the West. Varying patterns of food allergy are seen even within Asian countries-such as a predominance of wheat allergy in Japan and Thailand and shellfish allergy in Singapore and the Philippines. Customs and traditions, such as diet and infant feeding practices, also differ between Asian populations.Hence, there are unique challenges in adapting guidelines on early allergenic food introduction to the Asian setting. In this paper, we review the evidence and discuss the possible approaches to guide the timely introduction of allergenic food in high-risk infants in Asia.

Retrospective study identified fish and milk as the main culprits in cases of food protein‐induced enterocolitis syndrome

“…The age at the time of the FPIES diagnosis varied according to the offending food and reflected, in general, the chronological pattern of food introduction in infants. Indeed, the presence of conflicting evidence, and the absence of contemporary national guidelines on food introduction, make many practitioners in Greece avoid the early introduction of foods like fish as some children can be allergic to them . As expected, we did not observe cases of soya FPIES, since soya and soya milk are rarely consumed in Greece.…”

Peanut allergy among Mexican adults with allergic respiratory diseases: prevalence and clinical manifestations

“…18,19 These studies have also reported varying genetics within the population, concluding that peanut allergy may be linked to a microbial exposure and the environment. 20,21 Previous studies in Mexico were carried out among children with allergic diseases, where it was observed that peanut allergy prevalence was at 3.3%. 5 In our country, there are limited studies that have looked into the risk factors associated with peanut allergy; primarily, exposure and sensitization to pollens, oral allergy syndrome, job occupations, and contact with food proteins through direct skin contact, soaps or body lotions.…”

Food and drug allergy, and anaphylaxis in EAACI journals (2018)

“…The Asia Pacific Association of Pediatric Allergy, Respirology & Immunology proposed a consensus statement on the early introduction of allergenic foods for the prevention of FA. 50 An observational birth cohort study in Icelandic children (n = 1304) prospectively followed from birth to 2.5 years with detailed questionnaires found that fish oil supplementation in infancy (6 months or younger) reduces the sensitization to food allergens and DBPCFC-confirmed FA by half at 2.5 years of age in a dose-dependent manner. 51 A recent study investigated the association between secondhand smoking (SHS) and pediatric food hypersensitivity using data from BAMSE, a longitudinal, population-based birth cohort of 4089 Swedish children born between 1994 and 1996.…”