Berni Canani Roberto, Leone Ludovica, D'Auria Enza, Riva Enrica, Nocerino Rita, Ruotolo Serena, Terrin Gianluca, Cosenza Linda, Di Costanzo Margherita, Passariello Annalisa, Coruzzo Anna, Agostoni Carlo, Giovannini Marcello, Troncone Riccardo
J Acad Nutr Diet. 2014 Sep;114(9):1432-9. doi: 10.1016/j.jand.2014.03.018. Epub 2014 Jun 3.
Although dietary counseling is generally recommended in children with food allergy (FA), its effect on the nutritional status of these patients has not yet been evaluated. Our nonrandomized multicenter prospective intervention study was undertaken to investigate the effects of dietary counseling on children with FA. Anthropometric data, dietary intakes, and laboratory biomarkers of nutritional status were evaluated in children with FA (aged 6 to 36 months) before and after dietary counseling, by multidisciplinary teams composed of pediatricians, dietitians, and nurses. Ninety-one children with FA (49 boys and 42 girls; mean age 18.9 months, 95% CI 16.5 to 21.3) were evaluated; 66 children without FA (41 boys and 25 girls; mean age 20.3 months, 95% CI 17.7 to 22.8) served as controls providing baseline values only. At enrollment, energy and protein intakes were lower in children with FA (91 kcal/kg/day, interquartile range [IQR]=15.1, minimum=55.2, maximum=130.6; and 2.2 g/kg/day, IQR=0.5, minimum=1.5, maximum=2.7, respectively) than in children without FA (96 kcal/kg/day, IQR=6.1, minimum=83.6, maximum=118.0; and 4.6 g/kg/day, IQR=1.2, minimum=2.0, maximum=6.1, respectively; P<0.001). A weight to length ratio <2 standard deviations was more frequent in children with FA than in children without FA (21% vs 3%; P<0.001). At 6 months following dietary counseling, the total energy intake of children with FA was similar to the baseline values of control children. Dietary counseling also resulted in a significant improvement of their anthropometric and laboratory biomarkers of nutritional status. The results of our study support the crucial role of dietary counseling in the clinical management of children with FA.
虽然一般建议对食物过敏（FA）儿童进行饮食咨询，但其对这些患者营养状况的影响尚未得到评估。我们开展了一项非随机多中心前瞻性干预研究，以调查饮食咨询对FA儿童的影响。由儿科医生、营养师和护士组成的多学科团队对FA儿童（6至36个月）饮食咨询前后的人体测量数据、饮食摄入量和营养状况的实验室生物标志物进行了评估。对91名FA儿童（49名男孩和42名女孩；平均年龄18.9个月，95%CI为16.5至21.3）进行了评估；66名非FA儿童（41名男孩和25名女孩；平均年龄20.3个月，95%CI为17.7至22.8）仅作为提供基线值的对照。在入组时，FA儿童的能量和蛋白质摄入量（分别为91千卡/千克/天，四分位间距[IQR]=15.1，最小值=55.2，最大值=130.6；以及2.2克/千克/天，IQR=0.5，最小值=1.5，最大值=2.7）低于非FA儿童（分别为96千卡/千克/天，IQR=6.1，最小值=83.6，最大值=118.0；以及4.6克/千克/天，IQR=1.2，最小值=2.0，最大值=6.1；P<0.001）。FA儿童体重与身长比低于2个标准差的情况比非FA儿童更常见（21%对3%；P<0.001）。在饮食咨询6个月后，FA儿童的总能量摄入量与对照儿童的基线值相似。饮食咨询还使其营养状况的人体测量和实验室生物标志物得到显著改善。我们的研究结果支持饮食咨询在FA儿童临床管理中的关键作用。
