Identifying children at risk of growth and nutrient deficiencies in the food allergy clinic.

Food allergy allergist malnutrition management nutrients registered dietitian/nutritionist

Journal

The journal of allergy and clinical immunology. In practice
ISSN: 2213-2201
Titre abrégé: J Allergy Clin Immunol Pract
Pays: United States
ID NLM: 101597220

Informations de publication

Date de publication:
25 Jan 2024
Historique:
received: 27 11 2023
revised: 16 01 2024
accepted: 19 01 2024
medline: 28 1 2024
pubmed: 28 1 2024
entrez: 27 1 2024
Statut: aheadofprint

Résumé

Food allergies impact growth in children by decreasing availability of nutrients through decreased dietary intake, increased dietary needs, food-medication interactions, and psychosocial burden. Guidelines on food allergy management frequently recommend nutrition counseling and growth monitoring of children with food allergies. To provide clear guidance for clinicians to identify those with food allergies who are at nutritional risk and ensure prompt intervention. We provide a narrative review summarizing information from national and international guidelines, retrospective studies, population studies, review articles, case reports, and case series to identify those with food allergy at greatest nutritional risk, to determine the impact of nutritional interventions on growth, and to develop guidance for risk reduction in children with food allergies. Children with food allergies are at increased risk of nutritional deficiencies and poor growth. Nutritional assessment and intervention can improve outcomes. Identifying poor growth is an important step in the nutrition assessment, therefore growth should be assessed at each allergy evaluation. Interventions to ensure adequate dietary intake for growth include appropriately prescribed elimination diets, breastfeeding support and assessment, supplemental formula, vitamin mineral supplementation, appropriate milk substitutes and timely introduction of nutrient-dense complementary foods. Access to foods of appropriate nutritional value is an ongoing concern. Nutrition intervention or referral to registered dietitian nutritionists (RDNs) with additional training and/or experience in food allergy may result in improved growth and nutrition outcomes.

Sections du résumé

BACKGROUND BACKGROUND
Food allergies impact growth in children by decreasing availability of nutrients through decreased dietary intake, increased dietary needs, food-medication interactions, and psychosocial burden. Guidelines on food allergy management frequently recommend nutrition counseling and growth monitoring of children with food allergies.
OBJECTIVE OBJECTIVE
To provide clear guidance for clinicians to identify those with food allergies who are at nutritional risk and ensure prompt intervention.
METHODS METHODS
We provide a narrative review summarizing information from national and international guidelines, retrospective studies, population studies, review articles, case reports, and case series to identify those with food allergy at greatest nutritional risk, to determine the impact of nutritional interventions on growth, and to develop guidance for risk reduction in children with food allergies.
RESULTS RESULTS
Children with food allergies are at increased risk of nutritional deficiencies and poor growth. Nutritional assessment and intervention can improve outcomes. Identifying poor growth is an important step in the nutrition assessment, therefore growth should be assessed at each allergy evaluation. Interventions to ensure adequate dietary intake for growth include appropriately prescribed elimination diets, breastfeeding support and assessment, supplemental formula, vitamin mineral supplementation, appropriate milk substitutes and timely introduction of nutrient-dense complementary foods. Access to foods of appropriate nutritional value is an ongoing concern.
CONCLUSION CONCLUSIONS
Nutrition intervention or referral to registered dietitian nutritionists (RDNs) with additional training and/or experience in food allergy may result in improved growth and nutrition outcomes.

Identifiants

DOI: 10.1016/j.jaip.2024.01.027 PMID: 38280452
pubmed: 38280452
pii: S2213-2198(24)00079-5
doi: 10.1016/j.jaip.2024.01.027
pii:
doi:

Types de publication

Journal Article

Langues

eng

Sous-ensembles de citation

IM

Informations de copyright

Copyright © 2024. Published by Elsevier Inc.

Auteurs

C Venter (C)

Section of Pediatric Allergy and Immunology, Children's Hospital Colorado, University of Colorado. Electronic address: Carina.Venter@childrenscolorado.org.

R Meyer (R)

Department of Medicine, Imperial College London, UK; Department of Nutrition and Dietetics, University of Winchester, UK; Department of Medicine, KU Leuven, Belgium. Electronic address: r.meyer@imperial.ac.ukmaureen.

M Bauer (M)

Section of Pediatric Allergy and Immunology, Children's Hospital Colorado, University of Colorado. Electronic address: bauer@childrenscolorado.org.

J A Bird (JA)

Department of Pediatrics, Division of Allergy and Immunology, UT Southwestern Medical Center, Dallas, TX. Electronic address: drew.bird@utsouthwestern.edu.

D M Fleischer (DM)

Section of Pediatric Allergy and Immunology, Children's Hospital Colorado, University of Colorado. Electronic address: david.fleischer@childrenscolorado.org.

A Nowak-Wegrzyn (A)

Hassenfeld Children's Hospital, Department of Pediatrics, NYU Grossman School of Medicine, New York, NY, USA; Department of Pediatrics, Gastroenterology and Nutrition, Collegium Medicum, University of Warmia and Mazury, Olsztyn, Poland. Electronic address: anna.nowak-wegrzyn@nyulangone.org.

A Anagnostou (A)

Section of Allergy and Immunology, Baylor College of Medicine, Houston, TX; Section of Allergy and Immunology, Department of Pediatrics, Texas Children's Hospital, Houston, TX. Electronic address: katherine.anagnostou@gmail.com.

B P Vickery (BP)

Children's Healthcare of Atlanta, Atlanta, GA, USA; Emory University, Atlanta, GA, USA. Electronic address: brian.p.vickery@emory.edu.

J Wang (J)

Division of Pediatric Allergy and Immunology, Icahn School of Medicine at Mount Sinai, New York, NY, USA. Electronic address: julie.wang@mssm.edu.

M Groetch (M)

Division of Pediatric Allergy and Immunology, Icahn School of Medicine at Mount Sinai, New York, NY, USA. Electronic address: marion.groetch@mssm.edu.

Classifications MeSH