Sieferle Katharina, Bitzer Eva M
Public Health & Health Education, University of Education Freiburg, Freiburg im Breisgau, Germany.
Matern Child Nutr. 2025 Apr;21(2):e13779. doi: 10.1111/mcn.13779. Epub 2024 Dec 13.
Recommendations on Early Childhood Allergy Prevention (ECAP) are found in Clinical Practice Guidelines (CPG) and Food-Based Dietary Guidelines (FBDG). This synthesis of guidelines aims to compare the methodological quality and content of recommendations in CPGs and FBDGs for ECAP. We searched MEDLINE, the FAO directory of FBDGs and other guideline databases, including the Association of the Scientific Medical Societies in Germany (AWMF), the WHO and the Guideline International Networks database on clinical guidelines (GIN) for CPGs and FBDGs about ECAP and child nutrition. Guidelines had to be published from 2010 onwards, target infants or pregnant/breastfeeding women and contain recommendations on primary preventative interventions to decrease the onset of IgE-mediated allergies, including atopic eczema or asthma. We retrieved a sample of 36 guidelines (23 CPGs, 13 FBDGs) and assessed their methodological quality with the Appraisal of Guidelines for Research and Evaluation tool (AGREE) II. On a subset of recommendations, we performed an in-depth analysis by the type of intervention for direction and strength of recommendation and level of evidence. Descriptive analysis was conducted with SPSS 27. CPGs score higher than FBDGs in most AGREE domains (3, 4, 5 and 6). The 36 guidelines contain 287 recommendations on ECAP, with 70 addressing the introduction of complementary foods and common allergens. We found only slight differences between those recommendations in CPGs and FBDGs. FBDGs on ECAP are of lower quality than CPGs. This does not affect their recommendations on the introduction of complementary foods and common allergens but may compromise their trustworthiness.
《幼儿过敏预防（ECAP）建议》见于临床实践指南（CPG）和基于食物的膳食指南（FBDG）。本指南综合旨在比较CPG和FBDG中关于ECAP建议的方法学质量和内容。我们检索了MEDLINE、粮农组织FBDG目录以及其他指南数据库，包括德国科学医学协会联合会（AWMF）、世界卫生组织以及临床指南的指南国际网络数据库（GIN），以获取有关ECAP和儿童营养的CPG和FBDG。指南必须自2010年起发布，针对婴儿或孕妇/哺乳期妇女，并包含关于降低IgE介导的过敏（包括特应性皮炎或哮喘）发病的一级预防干预措施的建议。我们检索到36份指南样本（23份CPG，13份FBDG），并使用研究与评价指南工具（AGREE）II评估其方法学质量。对于一部分建议，我们按干预类型对建议的方向、强度和证据水平进行了深入分析。使用SPSS 27进行描述性分析。在大多数AGREE领域（3、4、5和6）中，CPG的得分高于FBDG。这36份指南包含287条关于ECAP的建议，其中70条涉及辅食和常见过敏原的引入。我们发现CPG和FBDG中的这些建议仅有细微差异。关于ECAP的FBDG质量低于CPG。这并不影响它们关于辅食和常见过敏原引入的建议，但可能会损害其可信度。
