Meyer R, De Koker C, Dziubak R, Venter C, Dominguez-Ortega G, Cutts R, Yerlett N, Skrapak A-K, Fox A T, Shah N
Department of Gastroenterology, Great Ormond Street Hospital for Children NHS Foundation Trust, London, UK.
J Hum Nutr Diet. 2014 Jun;27(3):227-35. doi: 10.1111/jhn.12149. Epub 2013 Aug 13.
The mainstay of dietary management of food allergies remains the elimination diet. However, the removal of major food groups may predispose children to an inadequate nutrient intake. We therefore set out to establish growth status in food allergic children receiving dietetic input in the UK.
Dietitians were approached via the Food Allergy and Intolerance Specialist Group from the British Dietetic Association and asked to submit anthropometrical data for children with food allergies. Data collected related to the systems involved and number of foods excluded. Malnutrition was defined according to World Health Organization standards.
Data from 13 different centres yielded 97 patients (51 male and 46 female) of which 66 excluded ≤2 foods and 31 excluded ≥3 foods. Data indicated that 8.5% had a weight for age ≤ -2 Z-score and, conversely, 8.5% were ≥2 Z-score. For height for age, 11.1% were ≤ -2 Z-score and, for weight for height, 3.7% were ≤ -2 Z-score and 7.5% ≥2 Z-score. Type of allergy, system involved and specific food elimination did not impact on the level of malnutrition. However, the elimination of ≥3 foods significantly impacted on weight for age (P = 0.044).
The present study demonstrates that children with food allergies are more underweight than the general UK population, which appears to be linked to the number of foods excluded. However, the impact of the disease process itself should not be disregarded. Additionally, obesity can also occur in this population despite dietary elimination.
食物过敏饮食管理的主要方法仍然是排除饮食法。然而，去除主要食物类别可能会使儿童营养摄入不足。因此，我们着手确定在英国接受饮食指导的食物过敏儿童的生长状况。
通过英国饮食协会的食物过敏与不耐受专家组联系营养师，要求他们提交食物过敏儿童的人体测量数据。收集的数据涉及相关系统和排除的食物数量。根据世界卫生组织标准定义营养不良。
来自13个不同中心的数据产生了97名患者（51名男性和46名女性），其中66名排除≤2种食物，31名排除≥3种食物。数据表明，8.5%的儿童年龄别体重≤-2 Z评分，相反，8.5%的儿童≥2 Z评分。对于年龄别身高，11.1%的儿童≤-2 Z评分，对于身高别体重，3.7%的儿童≤-2 Z评分，7.5%的儿童≥2 Z评分。过敏类型、涉及的系统和特定食物排除对营养不良程度没有影响。然而，排除≥3种食物对年龄别体重有显著影响（P = 0.044）。
本研究表明，食物过敏儿童比英国普通人群体重更轻，这似乎与排除的食物数量有关。然而，疾病过程本身的影响也不应被忽视。此外，尽管进行了饮食排除，该人群中也可能出现肥胖。
