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Review
. 2023 Mar;13(1):15-27.
doi: 10.5415/apallergy.0000000000000001. Epub 2023 Apr 28.

Food allergy prevention: Where are we in 2023?

Carina Venter  1 , Peter K Smith  2   3 , David M Fleischer  1
Affiliations
Review

Food allergy prevention: Where are we in 2023?

Carina Venter et al. Asia Pac Allergy. 2023 Mar.

Abstract

Food allergy prevention involves recommendations to the maternal diet during pregnancy and breast feeding, early life feeding and introduction of solid foods. Pregnant and breastfeeding women are not recommended to exclude any food allergens from their diet, but data are lacking to support active consumption of food allergens for prevention of food allergy. Breastfeeding is recommended for the many health benefits to the mother and child but has not shown any association with reduction in childhood food allergies. There is currently no recommendation regarding the use of any infant formula for allergy prevention, including the use of partially or extensively hydrolyzed formulas. Once the introduction of solid food commences, based on randomized controlled trials, it is advised to actively introduce peanuts and egg early into the infant diet and continue with consumption of these. Although there are limited data with respect to other major food allergens and whether early introduction may prevent allergy development, there is no need to delay the introduction of these allergens into the infant diet. Interpreting food allergen consumption in the context of cultural food practices has not been studied, but it makes sense to introduce the infant to family foods by 1 year of age. Consumption of foods typical of the Western diet and foods high in advanced glycation end products may be associated with an increase in food allergies. Similarly, intake of micronutrients, such as vitamin D and omega-3 fatty acids in both the maternal and infant diet, needs further clarification in the context of food allergy prevention.

Keywords: Food allergy; microbiome; nutrients; nutrition; prevention.

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Conflict of interest statement

Dr. Fleischer’s institution has received research support from Aimmune Therapeutics and DBV Technologies; serves as a nonpaid member of the Medical Advisory Board for Food Allergy and Anaphylaxis Connection Team and the Medical Advisory Council National Peanut Board; receives royalties from UpToDate; and serves as a consultant for Aquestive, DBV Technologies, Genentech, and Nasus, all of which are outside of this submitted work. Dr. Smith reports personal fees from the Nestle Nutrition Institute and speaker fee from Danone and Bayer outside of the submitted work. Dr. Venter reports grants from Reckitt Benckiser Food Allergy Research and Education, National Peanut Board; personal fees from Reckitt Benckiser, Nestle Nutrition Institute, Danone, Abbott Nutrition, Else Nutrition, Before Brands and Owen outside the submitted work.

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