The Evidence Centre, London, UK.
Allergy. 2014 May;69(5):581-9. doi: 10.1111/all.12334. Epub 2014 Jan 16.
Food allergies can have serious physical, social, and financial consequences. This systematic review examined ways to prevent the development of food allergy in children and adults.
Seven bibliographic databases were searched from their inception to September 30, 2012, for systematic reviews, randomized controlled trials, quasi-randomized controlled trials, controlled clinical trials, controlled before-and-after studies, interrupted time series studies, and prospective cohort studies. Experts were consulted for additional studies. There were no language or geographic restrictions. Two reviewers appraised the studies using appropriate tools. Data were not suitable for meta-analysis due to heterogeneity, so were narratively synthesized.
Seventy-four studies were included, one-third of which were of high quality. There was no good evidence to recommend that pregnant or breastfeeding women should change their diet or take supplements to prevent allergies in infants at high or normal risk. There were mixed findings about the preventive benefits of breastfeeding for infants at high or normal risk, but there was evidence to recommend avoiding cow's milk and substituting with extensively or partially hydrolyzed whey or casein formulas for infants at high risk for the first 4 months. Soy milk and delaying the introduction of solid foods beyond 4 months did not have preventive benefits in those at high or normal risk. There was very little evidence about strategies for preventing food allergy in older children or adults.
There is much to learn about preventing food allergy, and this is a priority given the high societal and healthcare costs involved.
食物过敏会带来严重的身体、社交和经济后果。本系统评价旨在研究预防儿童和成人食物过敏的方法。
从建库到 2012 年 9 月 30 日，我们检索了 7 个文献数据库，以获取系统评价、随机对照试验、准随机对照试验、对照临床试验、对照前后研究、时间序列中断研究和前瞻性队列研究。我们还向专家咨询了其他研究。无语言或地域限制。两位评价员使用适当的工具评价研究。由于异质性，数据不适合进行荟萃分析，因此进行了叙述性综合。
共纳入 74 项研究，其中三分之一的研究质量较高。没有充分证据推荐孕妇或哺乳期妇女改变饮食或服用补充剂来预防高或正常风险婴儿的过敏。母乳喂养对高或正常风险婴儿的预防作用存在混合结果，但有证据表明高风险婴儿在前 4 个月应避免饮用牛奶，而用深度或部分水解乳清或酪蛋白配方奶替代。高或正常风险婴儿饮用豆浆和延迟 4 个月以上添加固体食物并无预防作用。对于大龄儿童或成人预防食物过敏的策略，证据很少。
预防食物过敏有很多知识有待研究，鉴于所涉及的高社会和医疗保健成本，这是当务之急。
