Dietary approaches to the prevention of food allergy.
OBJECTIVE
The primary prevention of food allergy and atopy has become a public health priority in developed countries. Although some preventive dietary interventions have entered common practice, the level of evidence underpinning these strategies varies.


RESULTS
Exclusive breast-feeding and delayed introduction of complementary foods from the age of 4-6 months are key strategies in primary food allergy and atopy prevention. Maternal elimination diets during pregnancy and lactation are currently not recommended. Partially and extensively hydrolyzed formulae may confer a small preventive effect in high-risk infants. Amino acid-based formula is, however, considered a treatment formula and not recommended for primary allergy prevention. The effect of prebiotic oligosaccharides and probiotic bacteria in prevention of food allergy remains unclear and requires further investigation. Maternal fish oil supplementation during pregnancy shows promise in reducing the risk of allergic sensitization in the infant, but prospective long-term data are required. Fish oil supplementation in young infants was not effective.


CONCLUSIONS
Although there is evidence for the primary dietary prevention of eczema and possible respiratory allergies, data on food allergy prevention have, so far, remained less convincing. Further prospective research is needed to clarify the effectiveness of dietary interventions in primary food allergy prevention.
Heine
Ralf G
RG
Department of Allergy and Immunology, Royal Children's Hospital, Department of Paediatrics, University of Melbourne, Parkville, VIC 3052, Australia. ralf.heine@rch.org.au
Tang
Mimi Lk
ML
D001942:Breast Feeding; D002675:Child, Preschool; D019317:Evidence-Based Medicine; D005260:Female; D005395:Fish Oils / Q000008:administration & dosage; D005512:Food Hypersensitivity / Q000178:diet therapy / Q000517:prevention & control*; D006801:Humans; D007223:Infant; D041943:Infant Formula; D007227:Infant Nutritional Physiological Phenomena / Q000276:immunology* / Q000502:physiology; D007231:Infant, Newborn; D039382:Maternal Nutritional Physiological Phenomena / Q000502:physiology*; D008895:Milk, Human / Q000276:immunology*; D011247:Pregnancy; D011322:Primary Prevention; D019936:Probiotics; D014886:Weaning
D005395:Fish Oils