D'Auria Enza, Peroni Diego G, Sartorio Marco Ugo Andrea, Verduci Elvira, Zuccotti Gian Vincenzo, Venter Carina
Pediatric Department, Vittore Buzzi Children's Hospital, Universitá degli Studi di Milano, Milan, Italy.
Clinical and Experimental Medicine Department, Section of Pediatrics, University of Pisa, Pisa, Italy.
Front Pediatr. 2020 Sep 15;8:545. doi: 10.3389/fped.2020.00545. eCollection 2020.
Nutrients in foods are not eaten in isolation and food intake interacts in a complex manner, affecting health and disease outcomes. For this reason, focusing on the whole "pattern" of dietary intake instead of the single nutrients or groups of nutrients when studying diseases outcomes is increasingly appealing and growing. Diet diversity refers to the variety of foods being eaten, and the terms, diversity or variety, are often used interchangeably. When the overall diet is characterized by healthy foods, diet diversity will reflect a diversity/variety of healthy foods eaten over a period of time. The introduction of solid foods in the 1st year of life is considered a measure of increased diet diversity. Consuming a diverse range of foods and food allergens in the first year of life may increase intake of important nutrients and positively affect the gut microbiome structure and function. Intake of omega-3 fatty acids and fibers/prebiotics may be particularly important but more information is required about dose and which individuals are most likely to benefit. Increased diet diversity in the first year of life is also associated with reduced food allergy outcomes. In addition to diet diversity, diet indices are considered measures of overall diet quality and can be used as a simple assessment of dietary intake. The focus of this paper is to review and critically address the current knowledge of the association between diet diversity and diet indices and allergy outcomes. Based on the current evidence, we recommend the introduction of solid foods, including common allergenic solids, during the 1st year of life, according to the infant's neuro-developmental abilities and familial or cultural habits. For infants with severe AD and/or FA, medical assessment may be advisable before introducing common food allergens into the diet. Limited evidence exist about the role of diet indices in pregnancy and allergic disease in the offspring, and the most promising results indicate a reduction in childhood wheeze and/or asthma intake.
食物中的营养素并非孤立摄入，食物摄入量之间以复杂的方式相互作用，影响健康和疾病结果。因此，在研究疾病结果时，关注饮食摄入的整体“模式”而非单一营养素或营养素组越来越具有吸引力且日益普遍。饮食多样性指所食用食物的种类，“多样性”或“种类”这两个术语常可互换使用。当总体饮食以健康食物为特征时，饮食多样性将反映一段时间内所食用健康食物的多样性/种类。在生命的第一年引入固体食物被视为饮食多样性增加的一个指标。在生命的第一年食用多种食物和食物过敏原可能会增加重要营养素的摄入量，并对肠道微生物群的结构和功能产生积极影响。摄入ω-3脂肪酸和纤维/益生元可能尤为重要，但关于剂量以及哪些个体最可能受益还需要更多信息。生命第一年饮食多样性的增加也与食物过敏结果的减少有关。除了饮食多样性外，饮食指数被视为总体饮食质量的指标，可用于对饮食摄入量进行简单评估。本文的重点是回顾并批判性地探讨目前关于饮食多样性和饮食指数与过敏结果之间关联的知识。基于现有证据，我们建议根据婴儿的神经发育能力以及家庭或文化习惯，在生命的第一年引入固体食物，包括常见的致敏性固体食物。对于患有重度特应性皮炎和/或食物过敏的婴儿，在将常见食物过敏原引入饮食之前， advisable （此处原文有误，根据语境推测可能是“advisable”，意为“可取的、明智的”）进行医学评估。关于饮食指数在孕期和后代过敏性疾病中的作用，证据有限，最有前景的结果表明可减少儿童喘息和/或哮喘的发生。
