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Allergic diseases among children: nutritional prevention and intervention.

Abstract

Allergic diseases comprise a genetically heterogeneous group of chronic, immunomediated diseases. It has been clearly reported that the prevalence of these diseases has been on the rise for the last few decades, but at different rates, in various areas of the world. This paper discusses the epidemiology of allergic diseases among children and their negative impact on affected patients, their families, and societies. These effects include the adverse effects on quality of life and economic costs. Medical interest has shifted from tertiary or secondary prevention to primary prevention of these chronic diseases among high-risk infants in early life. Being simple, practical, and cost-effective are mandatory features for any candidate methods delivering these strategies. Dietary therapy fits this model well, as it is simple, practical, and cost-effective, and involves diverse methods. The highest priority strategy is feeding these infants breast milk. For those who are not breast-fed, there should be a strategy to maintain beneficial gut flora that positively influences intestinal immunity. We review the current use of probiotics, prebiotics, and synbiotics, and safety and adverse effects. Other dietary modalities of possible potential in achieving this primary prevention, such as a Mediterranean diet, use of milk formula with modified (hydrolyzed) proteins, and the role of micronutrients, are also explored. Breast-feeding is effective in reducing the risk of asthma, allergic rhinitis, and atopic eczema among children. In addition, breast milk constitutes a major source of support for gut microbe colonization, due to its bifidobacteria and galactooligosaccharide content. The literature lacks consensus in recommending the addition of probiotics to foods for prevention and treatment of allergic diseases, while prebiotics may prove to be effective in reducing atopy in healthy children. There is insufficient evidence to support soy formulas or amino acid formulas for prevention of allergic disease. A healthy diet, such as the Mediterranean diet, may have a protective effect on the development of asthma and atopy in children. In children with asthma and allergic diseases, vitamin D deficiency correlates strongly with asthma, allergic rhinitis, and wheezing.

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  • Authors+Show Affiliations

    ,

    Department of Pediatrics, Section of Academic General Pediatrics, Hamad Medical Corporation, Doha, Qatar; Weill Cornell Medical College, Doha, Qatar.

    ,

    School of Pharmacy, Lebanese International University, Khiara, Lebanona.

    Weill Cornell Medical College, Doha, Qatar; Department of Pediatrics, Section of Pediatric Allergy-Immunology, Hamad Medical Corporation, Doha, Qatar.

    Source

    Pub Type(s)

    Journal Article
    Review

    Language

    eng

    PubMed ID

    27022267

    Citation

    Hendaus, Mohamed A., et al. "Allergic Diseases Among Children: Nutritional Prevention and Intervention." Therapeutics and Clinical Risk Management, vol. 12, 2016, pp. 361-72.
    Hendaus MA, Jomha FA, Ehlayel M. Allergic diseases among children: nutritional prevention and intervention. Ther Clin Risk Manag. 2016;12:361-72.
    Hendaus, M. A., Jomha, F. A., & Ehlayel, M. (2016). Allergic diseases among children: nutritional prevention and intervention. Therapeutics and Clinical Risk Management, 12, pp. 361-72. doi:10.2147/TCRM.S98100.
    Hendaus MA, Jomha FA, Ehlayel M. Allergic Diseases Among Children: Nutritional Prevention and Intervention. Ther Clin Risk Manag. 2016;12:361-72. PubMed PMID: 27022267.
    * Article titles in AMA citation format should be in sentence-case
    TY - JOUR T1 - Allergic diseases among children: nutritional prevention and intervention. AU - Hendaus,Mohamed A, AU - Jomha,Fatima A, AU - Ehlayel,Mohammad, Y1 - 2016/03/07/ PY - 2016/3/30/entrez PY - 2016/3/30/pubmed PY - 2016/3/30/medline KW - allergic KW - children KW - prebiotics KW - prevention KW - primary KW - probiotics KW - synbiotics SP - 361 EP - 72 JF - Therapeutics and clinical risk management JO - Ther Clin Risk Manag VL - 12 N2 - Allergic diseases comprise a genetically heterogeneous group of chronic, immunomediated diseases. It has been clearly reported that the prevalence of these diseases has been on the rise for the last few decades, but at different rates, in various areas of the world. This paper discusses the epidemiology of allergic diseases among children and their negative impact on affected patients, their families, and societies. These effects include the adverse effects on quality of life and economic costs. Medical interest has shifted from tertiary or secondary prevention to primary prevention of these chronic diseases among high-risk infants in early life. Being simple, practical, and cost-effective are mandatory features for any candidate methods delivering these strategies. Dietary therapy fits this model well, as it is simple, practical, and cost-effective, and involves diverse methods. The highest priority strategy is feeding these infants breast milk. For those who are not breast-fed, there should be a strategy to maintain beneficial gut flora that positively influences intestinal immunity. We review the current use of probiotics, prebiotics, and synbiotics, and safety and adverse effects. Other dietary modalities of possible potential in achieving this primary prevention, such as a Mediterranean diet, use of milk formula with modified (hydrolyzed) proteins, and the role of micronutrients, are also explored. Breast-feeding is effective in reducing the risk of asthma, allergic rhinitis, and atopic eczema among children. In addition, breast milk constitutes a major source of support for gut microbe colonization, due to its bifidobacteria and galactooligosaccharide content. The literature lacks consensus in recommending the addition of probiotics to foods for prevention and treatment of allergic diseases, while prebiotics may prove to be effective in reducing atopy in healthy children. There is insufficient evidence to support soy formulas or amino acid formulas for prevention of allergic disease. A healthy diet, such as the Mediterranean diet, may have a protective effect on the development of asthma and atopy in children. In children with asthma and allergic diseases, vitamin D deficiency correlates strongly with asthma, allergic rhinitis, and wheezing. SN - 1176-6336 UR - https://www.unboundmedicine.com/medline/citation/27022267/full_citation L2 - https://dx.doi.org/10.2147/TCRM.S98100 DB - PRIME DP - Unbound Medicine ER -