Dietary assessment in children adhering to a food allergen avoidance diet for allergy prevention.
OBJECTIVE
The purpose of this investigation was to verify if avoidance of allergenic foods in children adhering to a food allergen avoidance diet from birth was complete and feasible, and whether dietary assessment can be used as a tool in predicting the outcome of double-blind, placebo-controlled food challenges (DBPCFCs).


METHODS
Children adhering to an allergen avoidance diet from birth underwent DBPCFCs. The investigator-dietician verified whether the elimination was complete, using food frequency questionnaires for common allergenic foods.


METHODS
University Medical Centre Groningen, the Netherlands.


METHODS
Thiry-eight children aged 1-13 years, who were consecutively referred to the University Medical Centre Groningen for DBPCFC between January 2002 and February 2004.


RESULTS
Among the 38 children undergoing DBPCFCs, there were 15 challenges with egg, 15 with peanut, five with hazelnut and three with soy. Fifteen food challenges (39%) were positive. Small quantities of allergenic foods were inadvertently present in the diets of 13 patients (34%), were possibly present in the diets of 14 patients (37%) and could not be identified in the diets of 11 patients (29%). Seven patients (54%) who had inadvertently ingested small quantities of allergenic foods without sequelae had a positive DBPCFC.


CONCLUSIONS
Dietary avoidance was incomplete and not feasible in most cases. Tolerance of small amounts of allergenic foods does not preclude positive challenge reactions. Dietary assessment does not seem a useful tool in predicting the outcome of DBPCFC in children adhering to an elimination diet.


BACKGROUND
The Stichting Astma Bestrijding (Foundation for the Prevention of Asthma), The Netherlands.
Vlieg-Boerstra
B J
BJ
Department of Paediatrics, Division of Paediatric Allergy and Paediatric Pulmonology, University Medical Centre Groningen, University of Groningen, The Netherlands. b.vlieg@bkk.umcg.nl
van der Heide
S
S
Bijleveld
C M A
CM
Kukler
J
J
Duiverman
E J
EJ
Wolt-Plompen
S A A
SA
Dubois
A E J
AE
D000284:Administration, Oral; D000293:Adolescent; D000485:Allergens / Q000008:administration & dosage* / Q000276:immunology*; D002648:Child; D002675:Child, Preschool; D004032:Diet; D004306:Dose-Response Relationship, Immunologic; D004311:Double-Blind Method; D005260:Female; D005512:Food Hypersensitivity / Q000175:diagnosis / Q000517:prevention & control*; D006801:Humans; D006969:Hypersensitivity, Immediate / Q000175:diagnosis / Q000517:prevention & control; D007073:Immunoglobulin E / Q000097:blood / Q000276:immunology; D007223:Infant; D008297:Male; D015596:Nutrition Assessment; D010919:Placebos
D000485:Allergens; D010919:Placebos; D007073:Immunoglobulin E