title: Dietary elimination of children with food protein induced gastrointestinal allergy - micronutrient adequacy with and without a hypoallergenic formula?
abstract: BACKGROUND
  The cornerstone for management of Food protein-induced gastrointestinal allergy (FPGIA) is dietary exclusion; however the micronutrient intake of this population has been poorly studied. We set out to determine the dietary intake of children on an elimination diet for this food allergy and hypothesised that the type of elimination diet and the presence of a hypoallergenic formula (HF) significantly impacts on micronutrient intake.
  
  
  METHODS
  A prospective observational study was conducted on children diagnosed with FPIGA on an exclusion diet who completed a 3 day semi-quantitative food diary 4 weeks after commencing the diet. Nutritional intake where HF was used was compared to those without HF, with or without a vitamin and mineral supplement (VMS).
  
  
  RESULTS
  One-hundred-and-five food diaries were included in the data analysis: 70 boys (66.7%) with median age of 21.8 months [IQR: 10 - 67.7]. Fifty-three children (50.5%) consumed a HF and the volume of consumption was correlated to micronutrient intake. Significantly (p <0.05) more children reached their micronutrient requirements if a HF was consumed. In those without a HF, some continued not to achieve requirements in particular for vitamin D and zinc, in spite of VMS.
  
  
  CONCLUSIONS
  This study points towards the important micronutrient contribution of a HF in children with FPIGA. Children, who are not on a HF and without a VMS, are at increased risk of low intakes in particular vitamin D and zinc. Further studies need to be performed, to assess whether dietary intake translates into actual biological deficiencies.
authors.affiliation: Gastroenterology Department, Great Ormond Street Hospital for Children NHS foundation Trust, London, UK.
authors.forename: Rosan
authors.initials: R
authors.lastname: Meyer
authors.affiliation: Gastroenterology Department, Great Ormond Street Hospital for Children NHS foundation Trust, London, UK ; Department of Nutrition and Dietetics, Chelsea and Westminster Hospital NHS Foundation Trust, London, UK.
authors.forename: Claire
authors.initials: C
authors.lastname: De Koker
authors.affiliation: Gastroenterology Department, Great Ormond Street Hospital for Children NHS foundation Trust, London, UK.
authors.forename: Robert
authors.initials: R
authors.lastname: Dziubak
authors.affiliation: Gastroenterology Department, Great Ormond Street Hospital for Children NHS foundation Trust, London, UK.
authors.forename: Heather
authors.initials: H
authors.lastname: Godwin
authors.affiliation: Gastroenterology and Nutrition Department, Niño Jesús Children University Hospital, Madrid, Spain.
authors.forename: Gloria
authors.initials: G
authors.lastname: Dominguez-Ortega
authors.affiliation: Gastroenterology Department, Great Ormond Street Hospital for Children NHS foundation Trust, London, UK ; Katholic University Hospital, TARGID, Leuven, Belgium.
authors.forename: Neil
authors.initials: N
authors.lastname: Shah