THE LATE INTRODUCTION OF FOOD INTO THE DIET PREDISPOSES TO DEVELOPING ALLERGIES

This weekend, the XIV edition of the "Controversies and News in Allergy" meeting was organized in Madrid, organized by the Foundation of the Spanish Society of Allergology and Clinical Immunology (SEAIC).

During the congress, which has brought together more than 400 national and international allergists, topics of great interest have been addressed, such as the early introduction of food into the diet to prevent the risk of allergies, or the possible nutritional deficiencies that children with exclusion diets may have.

Delaying the introduction of food: a possible cause of allergy

The Food allergies affect more than 17 million people in Europe, of which three and a half million are under 25 years old. The most notable increase in numbers is being seen in children, and according to SEIAC, only in our country the prevalence of allergies has increased from 3.6% in 1992 to 10.1% in 2015.

But not only have the numbers of allergy sufferers increased, but also the number of serious reactions caused by certain foods.

There is many theories that would explain the increase in allergy cases, but at the "Controversies and News in Allergies" meeting, Dr. Montserrat Fernández-Rivas explained that excessive hygiene and a late introduction of certain foods in the babies' diet could be the main causes of this alarming increase in figures.

Therefore, one of the recommendations that has been taking place in pediatric consultations for a long time is that of do not delay the incorporation of complementary feeding in the baby, if there is no medical cause that justifies it.

Therefore, and after six months of exclusive breastfeeding advised by WHO, we could start introducing almost any food into the diet, even those potentially allergic such as nuts, eggs or fish.

In the case of peanuts, for example, Dr. Gloria Requena already told us in this interview that the latest studies talk about an early introduction to the baby's diet could decrease the likelihood of developing allergy in the future:

"There is no reason to delay the introduction of any food if there is no medical indication. It has been shown, for example, that the introduction around six or seven months of food like peanuts (always ground by the risk of choking !!) in the diet of children with high allergy potential, the probability of developing allergy to this dried fruit in the future decreases "

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But these indications a few years ago were not like that ...

These last conclusions have been reached relatively recently, since the tendency during the last 20 years was to strictly avoid those foods that could cause allergies: "But now we know that is false" - Dr. Monserrat Fernández-Rivas said at the meeting.

That is why pediatric recommendations for the introduction of complementary feeding are changing, as are the indications that pregnant women and nursing mothers receive that they have to eat everything.

In the case of the egg, for example, Years ago, many parents received the guideline of incorporating it into the diet of our children between nine and twelve months of age. But now it is known that babies can start consuming eggs after six months, which would also minimize the risk of allergy.

The same goes for fish, another of the foods that has been undergoing different variations when recommending its introduction into the diet, until reaching the current recommendations of offering it to children from six months (although it should be avoided large fish for the amount of mercury they accumulate).

In summary, the delay in the introduction of complementary feeding would not only not be justified, but to do so could favor the appearance of food allergies. Therefore, food should be introduced after six months and always gradually, observing reactions to detect possible allergies or food intolerances, especially if the baby has an allergic predisposition.

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And when does a food allergy already exist?

When a food allergy already exists, mainly in cases of allergy to cow's milk and egg proteins, the latest studies carried out by the Spanish Society of Clinical Immunology, Allergology and Pediatric Asthma (SEICAP) and presented in the "World scientific guide on oral food immunotherapy "they talk about the early exposure to the allergen food as an effective method to achieve tolerance.

This system, known as oral immunotherapy, consists in offering the child the food to which he is allergic in small quantities, and always under medical supervision. Gradually the amounts will increase force the immune system to develop a tolerance.

Dr. Luis Echeverría, coordinator of the Food Allergy Working Group of SEICAP, explained in this article the impact that this new form of "cure" of food allergies has for allergic children:

"Studies carried out by experts have shown that the sooner oral immunotherapy begins to foods to which the child is allergic, the better prognosis of cure has"

Similarly, the meeting analyzed another of the lines in which Spanish allergists have been working for some time and which consists of the progressive introduction of processed milk or egg as a form of intervention to favor the development of tolerance in allergic children.

"It has been seen that processed products reduce their allergenicity without altering their impact on the immune system so that their introduction into desensitization guidelines can accelerate their tolerance induction" - said Dr. Fernández-Rivas.

Thus, even in cases of food allergies, we see that the trend is changing after an early introduction of the allergen food that helps the patient reach tolerance.

And to conclude, from the SEAIC Foundation They also remember the importance of having a dietitian or nutrition expert monitor the patient with food allergies, since exclusion diets may incur nutritional deficiencies that affect the speed of growth (something we already analyzed in detail a few months ago in cases of allergy to cow's milk proteins).

"The assessment, based on the medical history, physical examination and biochemical determination of nutritional parameters among other elements, must be complemented with the identification of possible deficiencies as a result of maturation or changes in activity and with the verification of tolerance development."
"The nutritional intervention must be individualized in each case according to the characteristics of the patient and the excluded food, without forgetting the energy requirements and the distribution of immediate principles according to the age and sex of the patient" - said Dr. Montserrat Fernández-Rivas at the SEAIC meeting.