Solid Food Introduction in Relation to Eczema: Results from a Four-Year Prospective Birth Cohort Study

Filipiak, Birgit; Zutavern, Anne; Koletzko, Sibylle; Berg, Andrea von; Brockow, Inken; Grübl, A.; Berdel, Dietrich; Reinhardt, D.; Bauer, Carl Peter; Wichmann, HE; Heinrich, Joachim

doi:10.1016/j.jpeds.2007.05.018

Cited by 165 publications

(139 citation statements)

References 26 publications

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“…10,11 The effect of the comorbidity of type 1 diabetes and IgE-mediated allergy at the population level remains controversial. [12][13][14] The direction and magnitude of the effects observed in our study are in accordance with findings of other studies in the general population, 1,[3][4][5]15 which gives credence to our findings. Therefore, it is unlikely that the HLA-based selection biased our results.…”

Section: Discussionsupporting

confidence: 93%

Age at the Introduction of Solid Foods During the First Year and Allergic Sensitization at Age 5 Years

et al. 2010

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OBJECTIVE: The goal was to examine the relationship between age at the introduction of solid foods during the first year of life and allergic sensitization in 5-year-old children. METHODS: We analyzed data from the Finnish Type 1 Diabetes Prediction and Prevention nutrition study, a prospective, birth cohort study. We studied 994 children with HLA-conferred susceptibility to type 1 diabetes mellitus for whom information on breastfeeding, age at the introduction of solid foods, and allergen-specific immunoglobulin E levels at 5 years was available. The association between age at the introduction of solid foods and allergic sensitization was analyzed by using logistic regression. RESULTS: The median duration of exclusive breastfeeding was 1.8 months (range: 0–10 months). After adjustment for potential confounders, late introduction of potatoes (>4 months), oats (>5 months), rye (>7 months), wheat (>6 months), meat (>5.5 months), fish (>8.2 months), and eggs (>10.5 months) was significantly directly associated with sensitization to food allergens. Late introduction of potatoes, rye, meat, and fish was significantly associated with sensitization to any inhalant allergen. In models that included all solid foods that were significantly related to the end points, eggs, oats, and wheat remained the most important foods related to sensitization to food allergens, whereas potatoes and fish were the most important foods associated with inhalant allergic sensitization. We found no evidence of reverse causality, taking into account parental allergic rhinitis and asthma. CONCLUSION: Late introduction of solid foods was associated with increased risk of allergic sensitization to food and inhalant allergens.

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Section: Discussionsupporting

confidence: 93%

Age at the Introduction of Solid Foods During the First Year and Allergic Sensitization at Age 5 Years

et al. 2010

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“…This finding is in line with Nwaru and coworkers, who showed that introduction of eggs after 11 months of age was associated with an increased risk of asthma, allergic rhinitis, and atopic sensitization at 5 years of age compared to introduction up through 11 months of age [29]. Moreover, Filipiak and coworkers observed a higher risk of eczema in the first 4 years in children who had eggs introduced after 1 year of age [37]. In a large, randomized, controlled intervention of three-month-old infants, early introduction of eggs reduced the risk of egg allergy [16].…”

Section: Discussionsupporting

confidence: 83%

“…However, nuts were introduced significantly earlier to the diet of farm children, and peanuts tended to be introduced earlier among the farmers. Delayed introduction of nuts [37], and peanuts [15,16], have previously been linked to an increased risk of developing allergy. However, the 0.01 < 0.05 P -value may be subjected to type I errors due to multiple comparisons.…”

Section: Discussionmentioning

confidence: 99%

Late introduction of fish and eggs is associated with increased risk of allergy development – results from the FARMFLORA birth cohort

Jönsson

Barman

Brekke

et al. 2017

Food & Nutrition Research

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The prevalence of allergy is markedly low in children growing up on farms. An increasing number of studies indicate that the timing of food introduction may affect allergy development. We aimed to investigate if protection against allergy in farm environments may be mediated through differences in food-introduction practices between farm and non-farm families, using an explorative approach. Twenty-eight farm and 37 non-farm children were included in the FARMFLORA birth cohort. Practices of breastfeeding and introduction of formulas and complementary foods were collected by questionnaires at 6, 12, and 18 months of age. Allergy was diagnosed by pediatricians at 3 years of age. The only difference in food-introduction practices observed between farm and non-farm children was an earlier introduction of nuts in farmers (median month: 11 [IQR: 8–6] in farmers, 15 [12–19] in non-farmers). One farm child (4%) and 10 non-farm children (27%) were allergic at 3 years of age. Lower risk of allergy development was associated with early exclusive breastfeeding (continuous variable; OR = 0.59, 95% CI: 0.39–0.89), but also having received eggs (OR = 0.08, 95% CI: 0.13–0.54) and fish (logistic regression not applicable, P = 0.01 in likelihood ratio testing [χ2]) at 10 months of age or earlier compared to later. Our results were not affected by reverse causation, as judged by a questionnaire sent to the families in retrospect. Timing of introduction of complementary foods is unlikely to contribute to the lower risk of allergy among farm children. Although early exclusive breastfeeding was associated with a lower rate of allergy development, postponed introduction of complementary foods might increase the risk of developing allergy. Owing to the limited sample size, our results are only indicative, but support prior findings.

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“…Moreover, even less is known about the optimal timing for introducing solid foods and its impact on AD. However, the few available studies do not support an association between delayed introduction of solid foods beyond 6 months of age and AD prevalence [126][127][128]. Further research is necessary to determine whether breastfeeding is truly protective in childhood AD and the complex relationship between breastfeeding and introducing solid foods.…”

Section: Breast-feedingmentioning

confidence: 99%

Environmental risk factors and their role in the management of atopic dermatitis

Kantor

Silverberg

2016

Expert Review of Clinical Immunology

263

225

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Introduction-The etiology of atopic dermatitis (AD) is multifactorial with interaction between genetics, immune and environmental factors.Areas covered-We review the role of prenatal exposures, irritants and pruritogens, pathogens, climate factors, including temperature, humidity, ultraviolet radiation, outdoor and indoor air pollutants, tobacco smoke exposure, water hardness, urban vs. rural living, diet, breastfeeding, probiotics and prebiotics on AD.Expert commentary-The increased global prevalence of AD cannot be attributed to genetics alone, suggesting that evolving environmental exposures may trigger and/or flare disease in predisposed individuals. There is a complex interplay between different environmental factors, including individual use of personal care products and exposure to climate, pollution, food and other exogenous factors. Understanding these complex risk factors is crucial to developing targeted interventions to prevent the disease in millions. Moreover, patients require counseling on optimal regimens for minimization of exposure to irritants and pruritogens and other harmful exposures.

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Solid Food Introduction in Relation to Eczema: Results from a Four-Year Prospective Birth Cohort Study

Cited by 165 publications

References 26 publications

Age at the Introduction of Solid Foods During the First Year and Allergic Sensitization at Age 5 Years

Age at the Introduction of Solid Foods During the First Year and Allergic Sensitization at Age 5 Years

Late introduction of fish and eggs is associated with increased risk of allergy development – results from the FARMFLORA birth cohort

Environmental risk factors and their role in the management of atopic dermatitis

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