Early Introduction of Allergenic Foods and the Prevention of Food Allergy

Abstract

The increasing prevalence of food allergies is a growing public health problem. For children considered high risk of developing food allergy (particularly due to the presence of other food allergies or severe eczema), the evidence for the early introduction of allergenic foods, and in particular peanut and egg, is robust. In such cases, the consensus is clear that not only should such foods not be delayed, but that they should be introduced at approximately 4 to 6 months of age in order to minimize the risk of food allergy development. The early introduction of allergenic foods appears to be an effective strategy for minimizing the public health burden of food allergy, though further studies on the generalizability of this approach in low-risk populations is needed.

Keywords: allergy; atopic dermatitis; atopy; early food introduction; eczema; food allergy; oral tolerance; prevention; sensitization.

Figure 1

Exposure to foods via ingestion results in oral tolerance in contrast to cutaneous or inhalational exposures that promote IgE-sensitization [11].

Figure 2

Other directions currently being investigated for food allergy prevention; (a) risk factors; (b) interventions. Modified with permission from Prescott and Nowak-Węgrzyn [45]. Legend: n-3PUFA: n-3 Polyunsaturated Fatty Acids, which can include eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA) can provide multiple health benefits including anti-inflammatory effects [46]. HMO: Human milk oligosaccharides, a naturally present constituent of human milk that can modulate the immune system [47].