38. Prevention of Food Allergy

  1. Dean D. Metcalfe MD2,
  2. Hugh A. Sampson MD3,
  3. Ronald A. Simon MD4,5 and
  4. Gideon Lack MBBCh (Oxon), MA (Oxon), FRCPCH6
  1. Gideon Lack and
  2. George Du Toit

Published Online: 24 FEB 2014

DOI: 10.1002/9781118744185.ch38

Food Allergy: Adverse Reactions to Foods and Food Additives, Fifth Edition

Food Allergy: Adverse Reactions to Foods and Food Additives, Fifth Edition

How to Cite

Lack, G. and Du Toit, G. (2013) Prevention of Food Allergy, in Food Allergy: Adverse Reactions to Foods and Food Additives, Fifth Edition (eds D. D. Metcalfe, H. A. Sampson, R. A. Simon and G. Lack), John Wiley & Sons Ltd, Chichester, UK. doi: 10.1002/9781118744185.ch38

Editor Information

  1. 2

    Chief, Laboratory of Allergic Diseases, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, MD, USA

  2. 3

    Kurt Hirschhorn Professor of Pediatrics, Dean for Translational Biomedical Sciences, Director, Jaffe Food Allergy Institute Department of Pediatrics, Icahn School of Medicine at Mount Sinai, New York, NY, USA

  3. 4

    Head, Division of Allergy, Asthma and Immunology, Scripps Clinic, San Diego, CA, USA

  4. 5

    Adjunct Professor, Department of Molecular and Experimental Medicine, Scripps Research Institute, La Jolla, CA, USA

  5. 6

    Professor of Paediatric Allergy, King's College London Clinical Lead for Allergy Service, Guy's and St Thomas' NHS Foundation Trust, St Thomas' Hospital, London, UK

Author Information

  1. Department of Paediatric Allergy, King's College London Clinical Lead for Allergy Service, Guy's and St Thomas' NHS Foundation Trust, St Thomas' Hospital, London, UK

Publication History

  1. Published Online: 24 FEB 2014
  2. Published Print: 10 DEC 2013

ISBN Information

Print ISBN: 9780470672556

Online ISBN: 9781118744185

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Keywords:

  • food allergy;
  • oral tolerance induction;
  • prevention of food allergy;
  • allergy risk factors

Summary

The conventional wisdom is that early exposure to allergenic food proteins during pregnancy, lactation, or infancy leads to the development of food allergy and that prevention strategies should aim to eliminate allergenic food proteins during these periods of “immunologic vulnerability,” especially in high-risk subgroups. However the evidence does not support this and there are data suggesting that environmental food allergen exposure may lead to allergic sensitization and that early consumption of food antigens could induce tolerance. There is some evidence to support the use of dietary interventions in high-risk pregnant and/or lactating women, especially for the outcome of atopic eczema. Exclusive breast-feeding for at least the first 3 months of life offers some protection against allergic disease in high-risk infants. The protective effect of exclusive breast-feeding beyond 4 months of age remains uncertain. For high-risk infants who are not exclusively breast-fed, or where supplementation of breast-feeding is required, the use of certain hydrolyzed formulae may offer some protection against the development of eczema. The findings of dietary interventions such as long-chain polyunsaturated fatty acids (LCPUFAs), antioxidants, pre-and probiotics, and vitamin supplementation are unconvincing, inconsistent, or not adequately tested. There are safety concerns surrounding some of the interventions trialled to date. In order to advance our understanding of the prevention of food allergy, additional studies are needed, which apply rigorous study designs able to overcome the many unique methodological challenges that apply to this field of research.