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Complementary feeding and food allergy, atopic dermatitis/eczema, asthma, and allergic rhinitis: a systematic review.
Am J Clin Nutr. 2019 03 01; 109(Suppl_7):890S-934S.AJ

Abstract

BACKGROUND

Nutrition during infancy and toddlerhood may influence health and disease prevention across the life span. Complementary feeding (CF) starts when human milk or infant formula is complemented by other foods and beverages, beginning during infancy and continuing to age 24 mo.

OBJECTIVES

The aim of this study was to describe systematic reviews conducted for the USDA and the Department of Health and Human Services Pregnancy and Birth to 24 Months Project to answer the following question: What is the relationship between the timing of the introduction of complementary foods and beverages (CFBs), or types and amounts of CFBs consumed, and the development of food allergy, atopic dermatitis/eczema, asthma, and allergic rhinitis?

METHODS

The literature was searched using 4 databases (CINAHL, Cochrane, Embase, PubMed) to identify articles published from January 1980 to February 2017 that met predetermined inclusion criteria. For each study, data were extracted and risk of bias was assessed. The evidence was qualitatively synthesized to develop a conclusion statement, and the strength of the evidence was graded.

RESULTS

Thirty-one included articles addressed the timing of CFB introduction, and 47 articles addressed the types and amounts of CFBs consumed.

CONCLUSIONS

Moderate evidence suggests that there is no relationship between the age at which CF first begins and the risk of developing food allergy, atopic dermatitis/eczema, or childhood asthma. Limited to strong evidence, depending on the specific food, suggests that introducing allergenic foods in the first year of life (after 4 mo) does not increase the risk of food allergy and atopic dermatitis/eczema but may prevent peanut and egg allergy. There is not enough evidence to determine a relationship between diet diversity or dietary patterns and atopic disease. Research is needed to address gaps and limitations in the evidence on CF and atopic disease, including research that uses valid and reliable diagnostic measures and accounts for key confounders and potential reverse causality.

Authors+Show Affiliations

USDA, Food and Nutrition Service, Alexandria, VA.Panum Group, Bethesda, MD.USDA, Food and Nutrition Service, Alexandria, VA.USDA-Agricultural Research Service Children's Nutrition Research Center, Department of Pediatrics, Baylor College of Medicine, Houston, TX.Department of Nutrition, University of California, Davis, Davis, CA.Department of Pediatrics, Section of Allergy and Immunology, Children's Hospital Colorado, University of Colorado School of Medicine, Aurora, CO.Mathematica Policy Research, Cambridge, MA.Department of Pediatrics, University of Wisconsin School of Medicine and Public Health, Madison, WI.Department of Pediatrics, Section of Nutrition, University of Colorado School of Medicine, Aurora, CO.USDA, Food and Nutrition Service, Alexandria, VA.USDA, Food and Nutrition Service, Alexandria, VA.

Pub Type(s)

Journal Article
Research Support, U.S. Gov't, P.H.S.
Systematic Review

Language

eng

PubMed ID

30982864

Citation

Obbagy, Julie E., et al. "Complementary Feeding and Food Allergy, Atopic Dermatitis/eczema, Asthma, and Allergic Rhinitis: a Systematic Review." The American Journal of Clinical Nutrition, vol. 109, no. Suppl_7, 2019, 890S-934S.
Obbagy JE, English LK, Wong YP, et al. Complementary feeding and food allergy, atopic dermatitis/eczema, asthma, and allergic rhinitis: a systematic review. Am J Clin Nutr. 2019;109(Suppl_7):890S-934S.
Obbagy, J. E., English, L. K., Wong, Y. P., Butte, N. F., Dewey, K. G., Fleischer, D. M., Fox, M. K., Greer, F. R., Krebs, N. F., Scanlon, K. S., & Stoody, E. E. (2019). Complementary feeding and food allergy, atopic dermatitis/eczema, asthma, and allergic rhinitis: a systematic review. The American Journal of Clinical Nutrition, 109(Suppl_7), 890S-934S. https://doi.org/10.1093/ajcn/nqy220
Obbagy JE, et al. Complementary Feeding and Food Allergy, Atopic Dermatitis/eczema, Asthma, and Allergic Rhinitis: a Systematic Review. Am J Clin Nutr. 2019 03 1;109(Suppl_7):890S-934S. PubMed PMID: 30982864.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Complementary feeding and food allergy, atopic dermatitis/eczema, asthma, and allergic rhinitis: a systematic review. AU - Obbagy,Julie E, AU - English,Laural K, AU - Wong,Yat Ping, AU - Butte,Nancy F, AU - Dewey,Kathryn G, AU - Fleischer,David M, AU - Fox,Mary Kay, AU - Greer,Frank R, AU - Krebs,Nancy F, AU - Scanlon,Kelley S, AU - Stoody,Eve E, PY - 2018/05/04/received PY - 2018/07/11/revised PY - 2018/08/06/accepted PY - 2019/4/16/entrez PY - 2019/4/16/pubmed PY - 2020/1/25/medline KW - allergic rhinitis KW - asthma KW - atopic dermatitis KW - atopic disease KW - complementary feeding KW - complementary food and beverages KW - eczema KW - food allergy KW - systematic review SP - 890S EP - 934S JF - The American journal of clinical nutrition JO - Am J Clin Nutr VL - 109 IS - Suppl_7 N2 - BACKGROUND: Nutrition during infancy and toddlerhood may influence health and disease prevention across the life span. Complementary feeding (CF) starts when human milk or infant formula is complemented by other foods and beverages, beginning during infancy and continuing to age 24 mo. OBJECTIVES: The aim of this study was to describe systematic reviews conducted for the USDA and the Department of Health and Human Services Pregnancy and Birth to 24 Months Project to answer the following question: What is the relationship between the timing of the introduction of complementary foods and beverages (CFBs), or types and amounts of CFBs consumed, and the development of food allergy, atopic dermatitis/eczema, asthma, and allergic rhinitis? METHODS: The literature was searched using 4 databases (CINAHL, Cochrane, Embase, PubMed) to identify articles published from January 1980 to February 2017 that met predetermined inclusion criteria. For each study, data were extracted and risk of bias was assessed. The evidence was qualitatively synthesized to develop a conclusion statement, and the strength of the evidence was graded. RESULTS: Thirty-one included articles addressed the timing of CFB introduction, and 47 articles addressed the types and amounts of CFBs consumed. CONCLUSIONS: Moderate evidence suggests that there is no relationship between the age at which CF first begins and the risk of developing food allergy, atopic dermatitis/eczema, or childhood asthma. Limited to strong evidence, depending on the specific food, suggests that introducing allergenic foods in the first year of life (after 4 mo) does not increase the risk of food allergy and atopic dermatitis/eczema but may prevent peanut and egg allergy. There is not enough evidence to determine a relationship between diet diversity or dietary patterns and atopic disease. Research is needed to address gaps and limitations in the evidence on CF and atopic disease, including research that uses valid and reliable diagnostic measures and accounts for key confounders and potential reverse causality. SN - 1938-3207 UR - https://www.unboundmedicine.com/medline/citation/30982864/Complementary_feeding_and_food_allergy_atopic_dermatitis/eczema_asthma_and_allergic_rhinitis:_a_systematic_review_ L2 - https://academic.oup.com/ajcn/article-lookup/doi/10.1093/ajcn/nqy220 DB - PRIME DP - Unbound Medicine ER -