Dietary Intervention during Weaning and Development of Food Allergy: What Is the State of the Art?

Abstract

Food allergy (FA) affects approximately 6-8% of children worldwide causing a significant impact on the quality of life of children and their families. In past years, the possible role of weaning in the development of FA has been studied. According to recent studies, this is still controversial and influenced by several factors, such as the type of food, the age at food introduction and family history. In this narrative review, we aimed to collect the most recent evidence about weaning and its role in FA development, organizing the gathered data based on both the type of study and the food. As shown in most of the studies included in this review, early food introduction did not show a potential protective role against FA development, and we conclude that further evidence is needed from future clinical trials.

Keywords: FA in weaning; early introduction; egg allergy; food allergy; weaning.

Figure 2

Various microrganisms, known as gut microbiota, colonize human intestine lumen. These microorganisms are responsible for the production of SCFA (acetate, butyrate, propionate), which bind specific G protein-coupled receptors (GPRs) on the IEC’s surfaces; for example, GPR43. Recently, it has been demonstrated that these receptors play a main role in inflammation control, GI functions, allergy development and other manifestations [59]. Created with biorender.com/ (accessed on 12 January 2024).

Figure 1

Increased protein uptake in allergic individuals. The IgE receptor CD23 is upregulated on the enterocytes surface of atopic subjects and the formation of the complex IgE/CD23 after allergen exposure allows for passage through the epithelial layer (phase 1). Once the allergens get in contact with the subepithelial mast cells, the degranulation response is induced. The mediators released by the mast cells modify the cells junctional complex, increasing the paracellular space and protein uptake (phase 2). Created with biorender.com/ (accessed on 12 January 2024).