Opinion

Examining the latest research on preventing food allergies in children


Melanie McGrice


18/06/2018 3:42:00 PM

Australia has one of the highest rates of food allergies for both children and adults in the world. Dietitian Melanie McGrice looks at the latest research in the prevention of allergies in children.

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Dietitian Melanie McGrice said research has found dietary changes before conception, during pregnancy and while breastfeeding impact on the likelihood of infants developing food allergies.

According to the 2011 Murdoch Children’s Research Institute’s ‘Health Nuts’ study – one of the most comprehensive research studies on childhood food allergies conducted in Australia – more than 10% of one-year-olds had a proven food allergy, and rates are on the increase. 
 
Current research has found that dietary changes in the lead-up to conception, during pregnancy and while breastfeeding have a significant impact on the likelihood of an infant developing food allergies. 
 
Below are some of the key dietary interventions found to reduce allergy rates:
 
Including allergens during pregnancy and breastfeeding
Many women believe they should avoid allergens during pregnancy to reduce the risk of infant food allergies. However, current research suggests that including allergens (such as nuts, seafood and dairy products) frequently throughout pregnancy and breastfeeding helps to strengthen the baby’s immune tolerance.
 
Adequate omega-3 intake
Long-chain omega-3 fats found in oily fish have anti-inflammatory properties, which may lower the risk of allergic disease in infants. 
 
For example, a randomised controlled trial looking at how fish oil supplementation during pregnancy modifies immune responses found that infants in the fish oil group were three times less likely to have a positive skin prick test to egg at age one.
 
Optimum vitamin D intake
Low levels of vitamin D have been associated with a higher prevalence of allergic disease. 
 
For example, an Australian cohort study involving infants with a parental history of allergic disease found that reduced foetal exposure to vitamin D increases the risk of eczema in infants by 12 months of age. 
 
Folic acid supplementation
Folic acid is important before conception and in the first trimester to minimise risk of foetal defects and aid development of the central nervous system.
 
However, continued supplementation with folic acid into the later stage of pregnancy does not reduce that risk, and there is growing evidence that this may increase the risk of allergies in offspring.
 
Optimised gut flora
A healthy balance of gut flora is essential for the development of a healthy immune system.  Prebiotics such as onions, asparagus and bananas are great for keeping good gut bacteria thriving.  Furthermore, research suggests that probiotic supplements may also be beneficial. 
 
Breastfeeding for as long as possible
A systematic review looking at correlation between breastfeeding and asthma strongly suggests that breastfeeding is protective against the development of childhood asthma.
 
The review found that the longer infants were breastfed, the greater the reduction of the onset of asthma and wheezing. The strongest association was found in children 0–2 years of age.
 
Education for mums on the timing for introducing solids
Current infant feeding guidelines recommend introducing solids at six months of age; however, there is emerging evidence that introducing solids after four months and before six months while breastfeeding is beneficial in reducing the risk of some allergies.
 
Research has also found that there is a window where immunological gut tolerance starts to develop from four months of age. Although most current recommendations state it is important to ensure the introduction of solids does not occur before four months of age, the optimum time to introduce solids needs to be researched further.
 
To help reduce the risk of allergies and optimise early life nutrition, consider referring your patients to a prenatal dietitian, or encourage them to download a pregnancy meal plan.



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