International survey on growth indices and impacting factors in children with food allergies.


Journal

Journal of human nutrition and dietetics : the official journal of the British Dietetic Association
ISSN: 1365-277X
Titre abrégé: J Hum Nutr Diet
Pays: England
ID NLM: 8904840

Informations de publication

Date de publication:
04 2019
Historique:
pubmed: 10 11 2018
medline: 25 6 2020
entrez: 10 11 2018
Statut: ppublish

Résumé

Elimination diets required for the management of food allergies increase the risk for poor growth in children. Currently, no worldwide data exist on this topic and limited published data exist on the impact of atopic comorbidity, type of allergy and foods eliminated on growth. We therefore set out to perform a worldwide survey on growth and impacting factors in food allergic children. A prospective growth survey was performed of children (aged 0-16 years) on an elimination diet with confirmed immunoglobulin (Ig)E and non-IgE mediated food allergies. Data collected included: weight-for-age, weight-for-height, height-for-age, head circumference, body mass index, type of food allergy and eliminated foods, allergic comorbidities and replacement milk/breast milk. Multivariable regression analysis was used to establish factors that affected growth. Data from 430 patients from twelve allergy centres were analysed: median age at diagnosis and data collection was 8 months and 23 months, respectively. Pooled data indicated that 6% were underweight, 9% were stunted, 5% were undernourished and 8% were overweight. Cow's milk elimination lead to a lower weight-for-height Z-scores than other food eliminations and mixed IgE and non-IgE mediated allergy had lower height-for-age Z-scores than IgE mediated allergy. Children with only non-IgE mediated allergies had lower weight-for-height and body mass index. Atopic comorbidities did not impact on growth. Stunting is more common in children with food allergies than low weight. Children particularly at risk of poor growth are those with non-IgE and mixed IgE and non-IgE mediated allergies, as well as those with cow's milk allergy.

Sections du résumé

BACKGROUND
Elimination diets required for the management of food allergies increase the risk for poor growth in children. Currently, no worldwide data exist on this topic and limited published data exist on the impact of atopic comorbidity, type of allergy and foods eliminated on growth. We therefore set out to perform a worldwide survey on growth and impacting factors in food allergic children.
METHODS
A prospective growth survey was performed of children (aged 0-16 years) on an elimination diet with confirmed immunoglobulin (Ig)E and non-IgE mediated food allergies. Data collected included: weight-for-age, weight-for-height, height-for-age, head circumference, body mass index, type of food allergy and eliminated foods, allergic comorbidities and replacement milk/breast milk. Multivariable regression analysis was used to establish factors that affected growth.
RESULTS
Data from 430 patients from twelve allergy centres were analysed: median age at diagnosis and data collection was 8 months and 23 months, respectively. Pooled data indicated that 6% were underweight, 9% were stunted, 5% were undernourished and 8% were overweight. Cow's milk elimination lead to a lower weight-for-height Z-scores than other food eliminations and mixed IgE and non-IgE mediated allergy had lower height-for-age Z-scores than IgE mediated allergy. Children with only non-IgE mediated allergies had lower weight-for-height and body mass index. Atopic comorbidities did not impact on growth.
CONCLUSIONS
Stunting is more common in children with food allergies than low weight. Children particularly at risk of poor growth are those with non-IgE and mixed IgE and non-IgE mediated allergies, as well as those with cow's milk allergy.

Identifiants

pubmed: 30412327
doi: 10.1111/jhn.12610
doi:

Types de publication

Journal Article Research Support, Non-U.S. Gov't

Langues

eng

Sous-ensembles de citation

IM

Pagination

175-184

Informations de copyright

© 2018 The British Dietetic Association Ltd.

Auteurs

R Meyer (R)

Department Paediatrics, Imperial College, London, UK.

K Wright (K)

Allergy Service, Department of Paediatric Medicine, KK Women's and Children's Hospital, Singapore, Singapore.

M C Vieira (MC)

Center for Pediatric Gastroenterology (Hospital Pequeno Príncipe) and School of Medicine (Pontifical University of Paraná), Curitiba, Brazil.

K W Chong (KW)

Allergy Service, Department of Paediatric Medicine, KK Women's and Children's Hospital, Singapore, Singapore.

P Chatchatee (P)

Division of Allergy and Immunology, Department of Pediatrics, Faculty of Medicine, King Chulalongkorn Memorial Hospital, Chulalongkorn University, Bangkok, Thailand.

B J Vlieg-Boerstra (BJ)

Department of Paediatrics, OLVG, Amsterdam, The Netherlands.

M Groetch (M)

Division of Paediatric Allergy & Immunology, Icahn School of Medicine at Mount Sinai, New York, NY, USA.

G Dominguez-Ortega (G)

Gastroenterology and Nutrition Department, Children Hospital Niño Jesús University Children Hospital, Madrid, Spain.

S Heath (S)

Department of Dietetics, Kings College Hospital NHS Trust, London, UK.

A Lang (A)

Wits University Donald Gordon Medical Centre, Johannesburg, South Africa.

L Archibald-Durham (L)

Wits University Donald Gordon Medical Centre, Johannesburg, South Africa.

R Rao (R)

KK women's and Children's Hospital, Singapore, Singapore.

R De Boer (R)

Department of Pediatric Allergy, Guy's and St. Thomas National Health Service Trust, London, UK.

A Assa'ad (A)

Division of Allergy and Immunology, Cincinnati Children's Hospital, Cincinnati, OH, USA.

E Trewella (E)

Department Nutrition and Dietetics, Chelsea and Westminster Hospital, London, UK.

C Venter (C)

Children's Hospital Colorado, Aurora, Colorado, USA.

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