Kalmpourtzidou Aliki, Xinias Ioannis, Agakidis Charalampos, Mavroudi Antigoni, Mouselimis Dimitrios, Tsarouchas Anastasios, Agakidou Eleni, Karagiozoglou-Lampoudi Thomai
Department of Nutritional Sciences and Dietetics, School of Health Sciences, International Hellenic University, Thermi, Greece.
3rd Department of Pediatrics, Faculty of Medicine, Aristotle University of Thessaloniki, Ippokrateion General Hospital, Thessaloniki, Greece.
Front Pediatr. 2021 Apr 23;9:658778. doi: 10.3389/fped.2021.658778. eCollection 2021.
With recent evidence suggesting that growth is no longer considered a major issue in children with food allergies (FA) on elimination diet, priority has shifted to diet quality to establish healthy eating patterns and prevent non-communicable diseases. The Diet Quality Index - International (DQI-I) could be useful for assessing the overall diet quality of FA-children. This study aimed to evaluate the impact of elimination diet on DQI-I in children with FA and the accuracy of DQI-I in reflecting nutrient intake. In a prospective, cross-sectional, cohort study of FA-children (2-14 years), nutritional intake was evaluated using a 7-day food frequency questionnaire, 24-h dietary recall, and the DQI-I. Of the 76 children recruited, 44.7% had multiple allergies. Mean overall DQI-I score was 52 points, with only 28% of participants having good overall DQI-I (≥60 points). DQI-I moderation and balance were the most affected domains. Participants with multiple allergies had higher DQI-I moderation and balance and lower vitamin D and Ca intake. Compared to toddlers, schoolchildren had higher DQI-I variety and lower moderation and received higher vitamin B2, vitamin B12, Ca, P, and Zn. The number of allergies, age, and milk avoidance were independently associated with adjusted DQI-I moderation and balance, energy, and certain micronutrient intake. Higher percentages of participants with good DQI-I received adequate amounts of Mn and vitamins A, B6, C, and folate than those with poor DQI-I. In children with FA on elimination diet, the DQI-I accurately captured the deflection of diet quality related to the development of chronic, non-communicable diseases through its moderation and balance components. This is DQI-I's main purpose as a healthy diet indicator and as such it would be a useful tool responding to the needs of the contemporary shifting of priorities in FA-children's diet from quantity to quality. Nevertheless, it does not accurately reflect the intake of certain micronutrients potentially compromised by elimination diets. Therefore, regular nutritional assessment utilizing both the DQI-I and tools assessing individual nutrient intakes along with professional nutrition counseling should be integral parts of the individualized management of children with FA to ensure adequate nutrient intake and establish healthy dietary patterns.
近期有证据表明，对于采用排除饮食法的食物过敏（FA）儿童而言，生长不再被视为一个主要问题，重点已转向饮食质量，以建立健康的饮食模式并预防非传染性疾病。国际饮食质量指数（DQI-I）可能有助于评估FA儿童的整体饮食质量。本研究旨在评估排除饮食对FA儿童DQI-I的影响以及DQI-I在反映营养摄入方面的准确性。在一项针对FA儿童（2至14岁）的前瞻性、横断面队列研究中，使用7天食物频率问卷、24小时饮食回顾和DQI-I对营养摄入进行评估。在招募的76名儿童中，44.7%患有多种过敏症。DQI-I的总体平均得分是52分，只有28%的参与者DQI-I总体良好（≥60分）。DQI-I的适度性和平衡性是受影响最大的领域。患有多种过敏症的参与者DQI-I的适度性和平衡性更高，而维生素D和钙的摄入量更低。与幼儿相比，学龄儿童的DQI-I多样性更高，适度性更低，并且摄入的维生素B2、维生素B12、钙、磷和锌更多。过敏症数量、年龄和避免饮用牛奶与调整后的DQI-I适度性和平衡性、能量及某些微量营养素摄入独立相关。与DQI-I较差的参与者相比，DQI-I良好的参与者中，摄入充足锰、维生素A、B6、C和叶酸的比例更高。对于采用排除饮食法的FA儿童，DQI-I通过其适度性和平衡性成分准确地反映了与慢性非传染性疾病发展相关的饮食质量偏差。这是DQI-I作为健康饮食指标的主要用途，因此它将是一个有用的工具，能够满足当代FA儿童饮食重点从数量向质量转变的需求。然而，它不能准确反映排除饮食法可能影响的某些微量营养素的摄入量。因此，将DQI-I与评估个体营养摄入量的工具以及专业营养咨询相结合进行定期营养评估，应成为FA儿童个体化管理的组成部分，以确保充足营养摄入并建立健康的饮食模式。
