The prevention of food allergy in children.

PURPOSE OF REVIEW

This article reports recent advances in early nutritional strategies used in the prenatal/postnatal periods for preventing allergies in children.

RECENT FINDINGS

Exclusive breastfeeding for 6 months is a desirable goal; however, with regard to allergy, the results of studies are inconsistent, showing a protective effect, no effect, or even a predisposing effect. For infants with a documented hereditary risk of allergy (i.e., an affected parent and/or sibling) who cannot be breastfed exclusively, dietary products with confirmed reduced allergenicity are recommended. Currently, there is no convincing scientific evidence that the avoidance or delayed introduction of potentially allergenic foods beyond 4-6 months reduces allergies in infants considered to be at increased risk for the development of allergic diseases or in those not considered to be at increased risk. The timing of n-3 long-chain polyunsaturated fatty acid supplementation may play a role in preventing early childhood allergy. Weak evidence from observational trials suggests a role of vitamins A, D, and E; zinc; fruit and vegetables; and a Mediterranean diet in the prevention of atopic disease.

SUMMARY

Current evidence challenges earlier dogma. Thus, more research, preferentially from randomized controlled trials, is needed with regard to evaluating the efficacy and safety of all nutritional interventions for allergy prevention.