Di Cesare Gianluca, Carciofi Annalisa, Borgiani Francesca, Cappelletti Deborah, Correani Alessio, Monachesi Chiara, Gatti Simona, Lionetti Maria Elena
Department of Pediatrics, Polytechnic University of Marche, 60123 Ancona, Italy.
Department of Pediatrics and Neonatology, Provincial General Hospital, 62100 Macerata, Italy.
Nutrients. 2025 May 5;17(9):1590. doi: 10.3390/nu17091590.
BACKGROUND/OBJECTIVES: Food allergies represent a growing public health challenge, showing an alarming increase in prevalence over the past few decades. Children with multiple food allergies face not only allergic reaction risks but also nutritional gaps, affecting diet, nutrition, and growth. This review summarizes the impact on nutrient intake and growth, highlighting key challenges and strategies to improve clinical care.
The literature search was conducted using a structured search strategy in PubMed up to 31 January, using MeSH terms with Boolean operators (AND, OR) to combine searches (food hypersensitivity AND growth, food hypersensitivity AND nutrition, food hypersensitivity AND micronutrient, food hypersensitivity AND vitamin, food hypersensitivity AND trace element, and soy hypersensitivity) for human studies meeting pre-defined PICOS criteria that simultaneously assessed the reproducibility and validity.
Nearly 2000 studies were identified in the literature search, with 31 articles selected for full-text evaluation and 11 articles included in the final review. Dietary restrictions imposed by the need to avoid multiple allergens can lead to a reduced intake of essential nutrients, particularly proteins, calcium, iron, zinc, iodine, folate, vitamin B12, and vitamin D. Children with multiple FAs appear to be at an increased risk of impaired growth, as evidenced by the lower height-for-age, weight-for-age, head-circumference, and weight-for-length Z-scores compared to non-allergic peers.
Evidence from the studies reviewed suggests that children with multiple FAs may be at increased risk for growth impairments and nutritional inadequacies, especially where dietary management does not adequately compensate for nutrient losses, and highlights that tailored dietary counseling is crucial.
背景/目的：食物过敏对公共卫生构成的挑战日益严峻，在过去几十年中患病率呈惊人的上升趋势。患有多种食物过敏的儿童不仅面临过敏反应风险，还存在营养缺口，这会影响饮食、营养和生长发育。本综述总结了食物过敏对营养摄入和生长发育的影响，强调了改善临床护理的关键挑战和策略。
截至1月31日，在PubMed上使用结构化检索策略进行文献检索，使用医学主题词与布尔运算符（AND、OR）组合检索词（食物超敏反应与生长、食物超敏反应与营养、食物超敏反应与微量营养素、食物超敏反应与维生素、食物超敏反应与微量元素、大豆超敏反应），以检索符合预先定义的PICOS标准且同时评估了可重复性和有效性的人体研究。
在文献检索中识别出近2000项研究，选择31篇文章进行全文评估，11篇文章纳入最终综述。因需避免多种过敏原而实施的饮食限制可能导致必需营养素摄入量减少，尤其是蛋白质、钙、铁、锌、碘、叶酸、维生素B12和维生素D。与无过敏的同龄人相比，患有多种食物过敏的儿童生长发育受损的风险似乎更高，这体现在年龄别身高、年龄别体重、头围和身长别体重的Z评分较低。
综述研究的证据表明，患有多种食物过敏的儿童生长发育受损和营养不足的风险可能更高，尤其是在饮食管理不能充分弥补营养损失的情况下，并强调了量身定制的饮食咨询至关重要。
