Ultra-processed foods, allergy outcomes and underlying mechanisms in children: An EAACI task force report

Roberto Berni Canani^{1

2

3

4}, Laura Carucci^{1

2}, Serena Coppola^{1

2}, Enza D'Auria⁵, Liam O'Mahony⁶, Franziska Roth-Walter^{7

8}, Emilia Vassilopolou^{9

10}, Carlo Agostoni^{10

11}, Iaona Agache¹², Cezmi Akdis¹³, Fiorenza De Giovanni Di Santa Severina^{1

2}, Gaby Faketea^{14

15}, Matt Greenhawt¹⁶, Karin Hoffman⁸, Karin Hufnagel^{7

8}, Rosan Meyer^{17

18}, Gregorio Paolo Milani^{10

11}, Anna Nowak-Wegrzyn^{19

20}, Bright Nwaru²¹, Ines Padua^{22

23

24}, Lorella Paparo^{1

2}, Peroni Diego²⁵, Imke Reese²⁶, Caroline Roduit^{27

28}, Peter K Smith²⁹, Alexandra Santos^{30

31

32}, Eva Untersmayr³³, Berber Vlieg-Boerstra^{34

35}, Carina Venter¹⁶

Affiliations

¹ Department of Translational Medical Science, University of Naples Federico II, Naples, Italy.
² ImmunoNutritionLab at the CEINGE Advanced Biotechnologies Research Center, University of Naples Federico II, Naples, Italy.
³ Task Force on Microbiome Studies University of Naples Federico II, Naples, Italy.
⁴ European Laboratory for the Investigation of Food-Induced Diseases, University of Naples Federico II, Naples, Italy.
⁵ Allergy Unit-Buzzi Children's Hospital-University of Milan, Milan, Italy.
⁶ Department of Medicine, School of Microbiology, APC Microbiome Ireland, University College Cork, Cork, Ireland.
⁷ Department of Interdisciplinary Life Sciences, Messerli Research Institute, University of Veterinary Medicine, Medical University and University of Vienna, Vienna, Austria.
⁸ Center of Pathophysiology, Infectiology and Immunology, Institute of Pathophysiology and Allergy Research, Medical University of Vienna, Vienna, Austria.
⁹ Department of Nutritional Sciences and Dietetics, School of Health Sciences, International Hellenic University, Thessaloniki, Greece.
¹⁰ Department of Clinical Sciences and Community Health, University of Milan, Milan, Italy.
¹¹ Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy.
¹² Faculty of Medicine, Transylvania University, Brasov, Romania.
¹³ Swiss Institute of Allergy and Asthma Research (SIAF), University of Zurich, Davos, Switzerland.
¹⁴ Department of Pediatrics, "Karamandaneio" Children's Hospital of Patra, Patras, Greece.
¹⁵ Department of Pharmacology, "luliu Hatieganu" University of Medicine and Pharmacy, Cluj-Napoca, Romania.
¹⁶ Section of Pediatric Allergy and Immunology, University of Colorado, Children's Hospital Colorado, Aurora, Colorado, USA.
¹⁷ Department of Nutrition and Dietetics, Winchester University, Winchester, UK.
¹⁸ Department of Medicine, KU Leuven, Leuven, Belgium.
¹⁹ Department of Pediatrics, Hassenfeld Children's Hospital, NYU Grossman School of Medicine, New York, New York, USA.
²⁰ Department of Pediatrics, Gastroenterology and Nutrition, Collegium Medicum, University of Warmia and Mazury, Olsztyn, Poland.
²¹ Krefting Research Centre, Institute of Medicine, University of Gothenburg, Gothenburg, Sweden.
²² Department of Sciences, University Institute of Health Sciences, Gandra, Portugal.
²³ i4HB/UCIBIO - Translational Toxicology Research Laboratory, Gandra, Portugal.
²⁴ CUF Porto Trindade Hospital, Porto, Portugal.
²⁵ Department of Clinical and Experimental Medicine, Section of Pediatrics, University of Pisa, Pisa, Italy.
²⁶ Practice for Dietary Advice & Nutrition Therapy in Adverse Food Reactions, Munich, Germany.
²⁷ Division of Respiratory Medicine and Allergology, Department of Paediatrics, Inselspital, University of Bern, Bern, Switzerland.
²⁸ CK-CARE, Christine Kühne-Center for Allergy Research and Education (CK-CARE), Davos, Switzerland.
²⁹ Griffith University, Southport, Queensland, Australia.
³⁰ Department of Women and Children's Health (Pediatric Allergy), Faculty of Life Sciences and Medicine, School of Life Course Sciences, King's College London, London, UK.
³¹ Peter Gorer Department of Immunobiology, School of Immunology and Microbial Sciences, King's College London, London, UK.
³² Children's Allergy Service, Evelina London Children's Hospital, Guy's and St Thomas' Hospital, London, UK.
³³ Center for Pathophysiology, Infectiology and Immunology, Institute of Pathophysiology and Allergy Research, Medical University of Vienna, Vienna, Austria.
³⁴ Department of Paediatrics, OLVG Hospital, Amsterdam, The Netherlands.
³⁵ Rijnstate Allergy Centre, Rijnstate Hospital, Arnhem, The Netherlands.

PMID: 39254357
DOI: 10.1111/pai.14231

Ultra-processed foods, allergy outcomes and underlying mechanisms in children: An EAACI task force report

Roberto Berni Canani et al. Pediatr Allergy Immunol. 2024 Sep.

. 2024 Sep;35(9):e14231.

doi: 10.1111/pai.14231.

Authors

Affiliations

¹ Department of Translational Medical Science, University of Naples Federico II, Naples, Italy.
² ImmunoNutritionLab at the CEINGE Advanced Biotechnologies Research Center, University of Naples Federico II, Naples, Italy.
³ Task Force on Microbiome Studies University of Naples Federico II, Naples, Italy.
⁴ European Laboratory for the Investigation of Food-Induced Diseases, University of Naples Federico II, Naples, Italy.
⁵ Allergy Unit-Buzzi Children's Hospital-University of Milan, Milan, Italy.
⁶ Department of Medicine, School of Microbiology, APC Microbiome Ireland, University College Cork, Cork, Ireland.
⁷ Department of Interdisciplinary Life Sciences, Messerli Research Institute, University of Veterinary Medicine, Medical University and University of Vienna, Vienna, Austria.
⁸ Center of Pathophysiology, Infectiology and Immunology, Institute of Pathophysiology and Allergy Research, Medical University of Vienna, Vienna, Austria.
⁹ Department of Nutritional Sciences and Dietetics, School of Health Sciences, International Hellenic University, Thessaloniki, Greece.
¹⁰ Department of Clinical Sciences and Community Health, University of Milan, Milan, Italy.
¹¹ Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy.
¹² Faculty of Medicine, Transylvania University, Brasov, Romania.
¹³ Swiss Institute of Allergy and Asthma Research (SIAF), University of Zurich, Davos, Switzerland.
¹⁴ Department of Pediatrics, "Karamandaneio" Children's Hospital of Patra, Patras, Greece.
¹⁵ Department of Pharmacology, "luliu Hatieganu" University of Medicine and Pharmacy, Cluj-Napoca, Romania.
¹⁶ Section of Pediatric Allergy and Immunology, University of Colorado, Children's Hospital Colorado, Aurora, Colorado, USA.
¹⁷ Department of Nutrition and Dietetics, Winchester University, Winchester, UK.
¹⁸ Department of Medicine, KU Leuven, Leuven, Belgium.
¹⁹ Department of Pediatrics, Hassenfeld Children's Hospital, NYU Grossman School of Medicine, New York, New York, USA.
²⁰ Department of Pediatrics, Gastroenterology and Nutrition, Collegium Medicum, University of Warmia and Mazury, Olsztyn, Poland.
²¹ Krefting Research Centre, Institute of Medicine, University of Gothenburg, Gothenburg, Sweden.
²² Department of Sciences, University Institute of Health Sciences, Gandra, Portugal.
²³ i4HB/UCIBIO - Translational Toxicology Research Laboratory, Gandra, Portugal.
²⁴ CUF Porto Trindade Hospital, Porto, Portugal.
²⁵ Department of Clinical and Experimental Medicine, Section of Pediatrics, University of Pisa, Pisa, Italy.
²⁶ Practice for Dietary Advice & Nutrition Therapy in Adverse Food Reactions, Munich, Germany.
²⁷ Division of Respiratory Medicine and Allergology, Department of Paediatrics, Inselspital, University of Bern, Bern, Switzerland.
²⁸ CK-CARE, Christine Kühne-Center for Allergy Research and Education (CK-CARE), Davos, Switzerland.
²⁹ Griffith University, Southport, Queensland, Australia.
³⁰ Department of Women and Children's Health (Pediatric Allergy), Faculty of Life Sciences and Medicine, School of Life Course Sciences, King's College London, London, UK.
³¹ Peter Gorer Department of Immunobiology, School of Immunology and Microbial Sciences, King's College London, London, UK.
³² Children's Allergy Service, Evelina London Children's Hospital, Guy's and St Thomas' Hospital, London, UK.
³³ Center for Pathophysiology, Infectiology and Immunology, Institute of Pathophysiology and Allergy Research, Medical University of Vienna, Vienna, Austria.
³⁴ Department of Paediatrics, OLVG Hospital, Amsterdam, The Netherlands.
³⁵ Rijnstate Allergy Centre, Rijnstate Hospital, Arnhem, The Netherlands.

PMID: 39254357
DOI: 10.1111/pai.14231

Abstract

Background: Consumption of ultra-processed foods [UPFs] may be associated with negative health outcomes. Limited data exist regarding the potential role of UPFs in the occurrence of allergic diseases. The underlying mechanisms underpinning any such associations are also poorly elucidated.

Methods: We performed a systematic review and narrative evidence synthesis of the available literature to assess associations between UPF consumption and pediatric allergy outcomes (n = 26 papers), including data on the association seen with the gut microbiome (n = 16 papers) or immune system (n = 3 papers) structure and function following PRISMA guidelines.

Results: Dietary exposure to fructose, carbonated soft drinks, and sugar intake was associated with an increased risk of asthma, allergic rhinitis, and food allergies in children. Commercial baby food intake was associated with childhood food allergy. Childhood intake of fructose, fruit juices, sugar-sweetened beverages, high carbohydrate UPFs, monosodium glutamate, UPFs, and advanced glycated end-products (AGEs) was associated with the occurrence of allergic diseases. Exposure to UPFs and common ingredients in UPFs seem to be associated with increased occurrence of allergic diseases such as asthma, wheezing, food allergies, atopic dermatitis, and allergic rhinitis, in many, but not all studies.

Conclusion: More preclinical and clinical studies are required to better define the link between UPF consumption and the risk of allergies and asthma. These observational studies ideally require supporting data with clearly defined UPF consumption, validated dietary measures, and mechanistic assessments to definitively link UPFs with the risk of allergies and asthma.

Keywords: advanced glycation end products; allergic rhinitis; anti‐foaming; asthma; atopic dermatitis; bulking; carbonating; eczema; emulsifiers; flavor enhancers; foaming; food additives; food allergy; gelling agents; glazing agents; gut barrier; immune system; junk foods; microbiome; monosodium glutamate; preservatives; sweeteners; thickeners.

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References

REFERENCES

1. Chen X, Zhang Z, Yang H, et al. Consumption of ultra‐processed foods and health outcomes: a systematic review of epidemiological studies. Nutr J. 2020;19(1):86.
1. Baraldi LG, Martinez Steele E, Canella DS, Monteiro CA. Consumption of ultra‐processed foods and associated sociodemographic factors in the USA between 2007 and 2012: evidence from a nationally representative cross‐sectional study. BMJ Open. 2018;8(3):e020574.
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Ultra-processed foods, allergy outcomes and underlying mechanisms in children: An EAACI task force report

Affiliations

Ultra-processed foods, allergy outcomes and underlying mechanisms in children: An EAACI task force report

Authors

Affiliations

Abstract

References

REFERENCES

Publication types

MeSH terms

Grants and funding

LinkOut - more resources

Full Text Sources

Medical