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Primary prevention of food allergy in children and adults: systematic review.

Abstract

BACKGROUND

Food allergies can have serious physical, social, and financial consequences. This systematic review examined ways to prevent the development of food allergy in children and adults.

METHODS

Seven bibliographic databases were searched from their inception to September 30, 2012, for systematic reviews, randomized controlled trials, quasi-randomized controlled trials, controlled clinical trials, controlled before-and-after studies, interrupted time series studies, and prospective cohort studies. Experts were consulted for additional studies. There were no language or geographic restrictions. Two reviewers appraised the studies using appropriate tools. Data were not suitable for meta-analysis due to heterogeneity, so were narratively synthesized.

RESULTS

Seventy-four studies were included, one-third of which were of high quality. There was no good evidence to recommend that pregnant or breastfeeding women should change their diet or take supplements to prevent allergies in infants at high or normal risk. There were mixed findings about the preventive benefits of breastfeeding for infants at high or normal risk, but there was evidence to recommend avoiding cow's milk and substituting with extensively or partially hydrolyzed whey or casein formulas for infants at high risk for the first 4 months. Soy milk and delaying the introduction of solid foods beyond 4 months did not have preventive benefits in those at high or normal risk. There was very little evidence about strategies for preventing food allergy in older children or adults.

CONCLUSIONS

There is much to learn about preventing food allergy, and this is a priority given the high societal and healthcare costs involved.

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  • Publisher Full Text
  • Authors+Show Affiliations

    ,

    The Evidence Centre, London, UK.

    , , , , , , , , , , , , , , , , , , ,

    Source

    Allergy 69:5 2014 May pg 581-9

    MeSH

    Adult
    Breast Feeding
    Child
    Child, Preschool
    Female
    Food Hypersensitivity
    Humans
    Infant
    Infant Formula
    Infant, Newborn
    Male
    Pregnancy
    Primary Prevention

    Pub Type(s)

    Journal Article
    Meta-Analysis
    Research Support, Non-U.S. Gov't
    Review
    Systematic Review

    Language

    eng

    PubMed ID

    24433563

    Citation

    de Silva, D, et al. "Primary Prevention of Food Allergy in Children and Adults: Systematic Review." Allergy, vol. 69, no. 5, 2014, pp. 581-9.
    de Silva D, Geromi M, Halken S, et al. Primary prevention of food allergy in children and adults: systematic review. Allergy. 2014;69(5):581-9.
    de Silva, D., Geromi, M., Halken, S., Host, A., Panesar, S. S., Muraro, A., ... Sheikh, A. (2014). Primary prevention of food allergy in children and adults: systematic review. Allergy, 69(5), pp. 581-9. doi:10.1111/all.12334.
    de Silva D, et al. Primary Prevention of Food Allergy in Children and Adults: Systematic Review. Allergy. 2014;69(5):581-9. PubMed PMID: 24433563.
    * Article titles in AMA citation format should be in sentence-case
    TY - JOUR T1 - Primary prevention of food allergy in children and adults: systematic review. AU - de Silva,D, AU - Geromi,M, AU - Halken,S, AU - Host,A, AU - Panesar,S S, AU - Muraro,A, AU - Werfel,T, AU - Hoffmann-Sommergruber,K, AU - Roberts,G, AU - Cardona,V, AU - Dubois,A E J, AU - Poulsen,L K, AU - Van Ree,R, AU - Vlieg-Boerstra,B, AU - Agache,I, AU - Grimshaw,K, AU - O'Mahony,L, AU - Venter,C, AU - Arshad,S H, AU - Sheikh,A, AU - ,, Y1 - 2014/01/16/ PY - 2013/10/24/accepted PY - 2014/1/18/entrez PY - 2014/1/18/pubmed PY - 2014/12/15/medline KW - breastfeeding KW - food allergy KW - prevention KW - systematic review SP - 581 EP - 9 JF - Allergy JO - Allergy VL - 69 IS - 5 N2 - BACKGROUND: Food allergies can have serious physical, social, and financial consequences. This systematic review examined ways to prevent the development of food allergy in children and adults. METHODS: Seven bibliographic databases were searched from their inception to September 30, 2012, for systematic reviews, randomized controlled trials, quasi-randomized controlled trials, controlled clinical trials, controlled before-and-after studies, interrupted time series studies, and prospective cohort studies. Experts were consulted for additional studies. There were no language or geographic restrictions. Two reviewers appraised the studies using appropriate tools. Data were not suitable for meta-analysis due to heterogeneity, so were narratively synthesized. RESULTS: Seventy-four studies were included, one-third of which were of high quality. There was no good evidence to recommend that pregnant or breastfeeding women should change their diet or take supplements to prevent allergies in infants at high or normal risk. There were mixed findings about the preventive benefits of breastfeeding for infants at high or normal risk, but there was evidence to recommend avoiding cow's milk and substituting with extensively or partially hydrolyzed whey or casein formulas for infants at high risk for the first 4 months. Soy milk and delaying the introduction of solid foods beyond 4 months did not have preventive benefits in those at high or normal risk. There was very little evidence about strategies for preventing food allergy in older children or adults. CONCLUSIONS: There is much to learn about preventing food allergy, and this is a priority given the high societal and healthcare costs involved. SN - 1398-9995 UR - https://www.unboundmedicine.com/medline/citation/24433563/full_citation L2 - https://doi.org/10.1111/all.12334 DB - PRIME DP - Unbound Medicine ER -