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Modifying the infant's diet to prevent food allergy
  1. Kate Grimshaw1,
  2. Kirsty Logan2,
  3. Sinead O'Donovan3,
  4. Mairead Kiely3,4,
  5. Karine Patient5,
  6. Jolanda van Bilsen6,
  7. Kirsten Beyer7,
  8. Dianne E Campbell8,
  9. Vanessa Garcia-Larsen9,
  10. Linus Grabenhenrich10,
  11. Gideon Lack2,11,
  12. Clare Mills12,
  13. Jean-Michel Wal13,
  14. Graham Roberts1,14
  1. 1Clinical and Experimental Sciences and Human Development in Health Academic Unit, Faculty of Medicine, University of Southampton, Southampton, UK
  2. 2Guy's and St Thomas’ NHS Foundation Trust, London, UK
  3. 3Vitamin D Research Group, School of Food and Nutritional Science, University College Cork, Cork, Ireland
  4. 4The Irish Centre for Fetal and Neonatal Translational Research, University College Cork, Cork, Ireland
  5. 5INRA_UIAA, Gif sur Yvette, France
  6. 6TNO, Zeist, The Netherlands
  7. 7Charite-Universitatsmedizin Berlin, Department of Paediatric Pneumology & Immunology, Berlin, Germany
  8. 8Department of Allergy and Immunology, Children's Hospital Westmead, Sydney University, Sydney, New South Wales, Australia
  9. 9Respiratory Epidemiology, Occupational Medicine and Public Health Group, National Heart and Lung Institute, Imperial College, London, UK
  10. 10Charite-Universitatsmedizin Berlin, Institute for Social Medicine, Epidemiology and Health Economics, Berlin, Germany
  11. 11King's College London, MRC and Asthma UK Centre in Allergic Mechanisms of Asthma, Division of Asthma, Allergy and Lung Biology, UK
  12. 12Institute of Inflammation and Repair, Manchester Academic Health Science Centre, Manchester Institute of Biotechnology, The University of Manchester, Manchester, UK
  13. 13INRA AgroParisTech, Gif sur Yvette, Paris, France
  14. 14NIHR Southampton Respiratory Biomedical Research Unit, University Hospital Southampton NHS Foundation Trust, Southampton, UK
  1. Correspondence to K Grimshaw, Clinical Experimental Science Academic Unit, Mailpoint 803, Level F, South Academic Block, Southampton General Hospital, Tremona Road, Southampton SO16 6YD, UK; kecg{at}soton.ac.uk

Abstract

Recommendations and guidelines on the prevention of food allergy have changed in recent decades. The aim of this review of the current evidence and ongoing studies is to provide a comprehensive and up to date picture of prevention of food allergy for healthcare professionals. The review was undertaken as part of the European Union funded Integrated Approaches to Food Allergy and Allergen Management (iFAAM) study. This is a wide ranging project bringing together expertise across the breadth of food allergy research. Specifically, the review discusses dietary manipulation in food allergy prevention, and covers the possible preventive strategies of allergen avoidance, early allergen introduction, general nutrition and supplements, as well as other strategies, such as prebiotics and probiotics. The review concludes that despite agreement that allergen avoidance strategies should not be undertaken for allergy prevention, there is currently no consensus regarding what actions should be recommended beyond exclusive breastfeeding for the first 4–6 months of life. Recent and upcoming trial results, which are detailed in this review, should help inform the debate and add clarity to the topic.

  • Allergy
  • Infant Feeding
  • Nutrition
  • prevention

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Footnotes

  • KG and KL contributed equally.

  • Contributors GR, KG and KL planned the manuscript. All authors contributed to drafting the manuscript and reviewing the final version.

  • Funding This work was supported by the European Union within the Seventh Framework Programme for research, technological development and demonstration under grant agreement No 312147 (iFAAM).

  • Competing interests MK, KB, GL, CM and GR received funding from the European Union within the Seventh Framework Programme for research, technological development and demonstration under grant agreement No 312147 (iFAAM). KG provided educational material for Danone. GR provided scientific advice to Danone, ALK-Abello and ThermoFisher. CM has board memberships with Novartis and the UK Food Safety Agency, and is a consultant for PepsiCo International. KB has received funding for research activities from Danone, ThermoFisher and DST Diagnostics. MK has received a grant from Danone Nutricia.

  • Provenance and peer review Not commissioned; externally peer reviewed.

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