AllergiesPseudoallergies and Food Intolerances

Food Allergy: Prevention

To prevent food allergy, attention must be paid to reducing individual risk factors. Behavioral risk factors

  • Diet
    • Unilateral overeating
    • Spices – substance that promotes absorption.
  • Consumption of stimulants
    • Alcohol – substance that promotes resorption
    • Tobacco (smoking)
      • Passive smoking in the womb and in early childhood → risk increase for sensitization to food at ages 4, 8, and 16 years.
  • Women who do not breastfeed their newborn children.
  • Inhalation of allergens such as house dust or animal dander.

Prevention factors (protective factors)

  • Maternal diet during pregnancy and lactation should be balanced and nutritious. On the consumption patterns of the mother and the effects on the child:
    • however, there is no evidence that dietary restriction (avoidance of potent food allergens) is useful; the opposite seems to be true:
      • Increased maternal consumption of peanuts in the first trimester (first three months of pregnancy) was associated with a 47% lower likelihood of allergic reactions to peanuts.
      • Increased consumption of milk by the mother in the first trimester was associated with less bronchial asthma and less allergic rhinitis (hay fever; allergic rhinitis).
      • Increased consumption of wheat by the mother in the second trimester was associated with less atopic eczema (neurodermatitis).
    • LEAP study: high-risk children were less likely to develop peanut allergy if they ate at least six grams of peanuts weekly from age one; the same was true for cashews.
    • There is evidence that fish (omega-3 fatty acids; EPA and DHA) in the mother’s diet during pregnancy or lactation is a protective factor for the development of atopic diseases in the child.
  • Breastfeeding (full breastfeeding) for at least 4 months.
  • Breast milk substitutes in high-risk infants: if the mother cannot breastfeed or cannot breastfeed adequately, the administration of hydrolyzed infant formula is recommended for high-risk infants up to 4 months of age; there is no evidence of a preventive effect for soy-based infant formula; there are no recommendations for goat’s, sheep’s, or mare’s milk
  • Supplemental feeding from the beginning of 5 months of age is reported to be associated with promoted tolerance development; early fish consumption is reported to have protective value.
  • Diet after the 1st year of life: there are no recommendations for allergy prevention in terms of a special diet.
  • Recommendations for children at risk for peanut allergy:
    • High risk (pronounced atopic dermatitis and/or a chicken egg allergy):
      • SIgE measurement and/or prick test and if necessary, food challenge (oral food challenge, OFC) → if necessary, introduce peanut-containing diet; as early as possible (after four to six months), if necessary, first portion of peanut-containing infant food under supervision of a physician
    • Medium risk (moderately severe neurodermatitis):
      • Introduce diet containing peanuts
    • Low risk (no neurodermatitis, no egg allergy):
      • Introduce diet containing peanuts
  • Food consumption in childhood
    • Increased consumption of foods containing cow’s milk, breast milk, and oats was inversely (unreversely) related to the risk of allergic asthma.
    • Early fish consumption was associated with a lower risk of allergic and nonallergic asthma.
  • Exposure to tobacco smoke: tobacco smoke should be avoided – this is especially true during pregnancy.
  • Note on vaccinations: there is no evidence that vaccinations increase the risk of allergy; children should be vaccinated according to STIKO recommendations.
  • To reduce inhalation of allergens and contact with allergens from pets; furthermore, avoid indoor and outdoor air pollutants, including exposure to tobacco smoke; it is recommended not to acquire a cat in children at risk.
  • Body weight: an increased BMI (body mass index) is positively correlated with bronchial asthma – especially in bronchial asthma.

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