Despite several intervention trials involving modifications to the maternal diet , the effect of maternal diet during pregnancy and lactation in preventing food allergy remains unclear .
Summary Earlier introduction of allergenic foods is a promising intervention to reduce the risk of some food allergies in high-risk infants .
Purpose of review In the past decade , food allergy has been increasingly recognized as an important public health issue .
The role of maternal and infant diet in the development of food allergy has been a major focus of research throughout this period .
Recently , research in this area has moved from observational studies to intervention trials , and the findings from these trials have started to influence infant feeding guidelines .
In this article , we review recent studies of dietary interventions for preventing food allergy , summarize current knowledge and discuss future research directions .
A randomized trial of egg introduction from 4 months of age in infants at risk for egg allergy
Background : Epidemiologic evidence suggests delayed introduction of egg might not protect against egg allergy in infants at risk of allergic disease . Objective : We sought to assess whether dietary introduction of egg between 4 and 6 months in infants at risk of allergy would reduce sensitization to egg . Methods : We conducted a r and omized controlled trial in infants with at least 1 first‐degree relative with allergic disease . Infants with a skin prick test ( SPT ) response to egg white ( EW ) of less than 2 mm were r and omized at age 4 months to receive whole‐egg powder or placebo ( rice powder ) until 8 months of age , with all other dietary egg excluded . Diets were liberalized at 8 months in both groups . The primary outcome was an EW SPT response of 3 mm or greater at age 12 months . Results : Three hundred nineteen infants were r and omized : 165 to egg and 154 to placebo . Fourteen infants reacted to egg within 1 week of introduction ( despite an EW SPT response < 2 mm at entry ) and were unsuitable for intervention . Two hundred fifty‐four ( 83 % ) infants were assessed at 12 months of age . Loss to follow‐up was similar between groups . Sensitization to EW at 12 months was 20 % and 11 % in infants r and omized to placebo and egg , respectively ( odds ratio , 0.46 ; 95 % CI , 0.22–0.95 ; P = .03 , χ2 test ) . The absolute risk reduction was 9.8 % ( 95 % CI , 8.2 % to 18.9 % ) , with a number needed to treat of 11 ( 95 % CI , 6–122 ) . Levels of IgG4 to egg proteins and IgG4/IgE ratios were higher in those r and omized to egg ( P < .0001 for each ) at 12 months . There was no effect on the proportion of children with probable egg allergy ( placebo , 13 ; egg , 8) . Conclusions : Introduction of whole‐egg powder into the diets of high‐risk infants reduced sensitization to EW and induced egg‐specific IgG4 levels . However , 8.5 % of infants r and omized to egg were not amenable to this primary prevention
Despite several intervention trials involving modifications to the maternal diet , the effect of maternal diet during pregnancy and lactation in preventing food allergy remains unclear .
Summary Earlier introduction of allergenic foods is a promising intervention to reduce the risk of some food allergies in high-risk infants .
Purpose of review In the past decade , food allergy has been increasingly recognized as an important public health issue .
The role of maternal and infant diet in the development of food allergy has been a major focus of research throughout this period .
Recently , research in this area has moved from observational studies to intervention trials , and the findings from these trials have started to influence infant feeding guidelines .
In this article , we review recent studies of dietary interventions for preventing food allergy , summarize current knowledge and discuss future research directions .