A new review says food allergies may begin in childhood. This way

A Canadian-led team of researchers who conducted the study of 2.8 million participants in 40 countries, one of the largest reviews of its kind, says children face five key risk factors early in life that can predispose them to developing food allergies.

They include infant eczema — a condition where the skin is dry, red and itchy — family history of food allergies, delaying introduction of foods like peanuts or fish after 12 months, as well as parental migration, the team reported in a meta-analysis published in Monday’s issue of JAMA Pediatrics.

Food allergies are on the rise worldwide and can cause life-threatening anaphylaxis. But predicting who will develop them remains a challenge. The review’s authors believe the results could help lead to new prevention strategies.

Dr. Derek Chu, the study’s senior author and assistant professor at McMaster University, sees patients with food allergies every day. He said the most common question he gets from parents is whether they have done something wrong. He said, the response coming from the review is reassuring.

“Most…food allergies are not triggered by just one thing,” Chu said, instead calling it a perfect storm. “There’s no big factor that mom or dad might have done that has a big impact on the risk.”

Give peanut products to children early

For the review, Chu’s team synthesized 190 studies to identify the strongest and most reliable risk factors for developing food allergies, as well as more minor factors.

“We are now armed with a whole list of information about what is important in triggering food allergies, and so it naturally tells us how we can prevent it,” he said.

The five major risk factors highlighted by the researchers include:

• Allergic dermatitis, also known as eczema.
• Other allergic diseases early in life, such as allergic rhinitis or hay fever.
• Family history of food allergies or other allergic conditions.
• Quickly dry skin.
• Delay in introduction of food allergens.

In Canada and the United States, parents and caregivers are advised to feed children non-choking foods common allergies As early as peanuts, at about six months of age. the advice was 2015 randomized trial conductedWhich found that doing so reduced the risk of developing legume allergies in high-risk infants by the age of five.

For infants who tolerate allergy-provoking foods, current Canadian guidelines also emphasize continuing to offer items a few times a week.

The same applies to other common allergy-causing foods like fish, eggs and fruits.

Eczema Another Risk Factor

In addition to delaying the introduction of these foods, researchers found that atopic dermatitis Or eczema early in life was another major risk factor for food allergies.

“Very early atopic dermatitis and eczema should be addressed directly and rapidly,” Chu said.

Dr. Christine McCusker, a pediatrician and immunologist at Montreal Children’s Hospital, who was not involved in the paper, said the findings reinforce important concepts in food allergies.

McCusker said that for children with a genetic history, patients can apply the cream to reduce the risk of developing food allergies.

“It focuses on good skin care in very young infants and children. And with good skin care, sometimes it’s as simple as using emollient treatments and/or removing soap from the bath.”

emollients It is applied directly to the skin to soothe and hydrate the skin. He said, if needed, eczema can be treated with various types of medicines.

Researchers also identified the use of antibiotics during the first month of life as a major risk factor. However, Chu said antibiotics are important to treat serious infections in infants.

Chu said it’s possible that early antibiotics disrupt the body’s microbiome, referring to the bacteria inside and outside our bodies that can cause food allergies, but that needs to be studied further.

According to the review, other early life factors were not tied to a statistically higher risk of developing food allergies, including low birth weight, preterm birth, partial breastfeeding, maternal diet, and stress during pregnancy.

Researchers say more trials are needed

The researchers acknowledged that more robust randomized trials are still needed to disentangle any cause-and-effect relationships, which take longer to do and are more expensive than observational population studies.

McCusker said that, while they sorted through a large number of papers and analyzed them as a group, the problem was that the papers were not uniform, because they occurred in different countries.

As Lucille Friesen, 17, of Annville Island, B.C., wrote at CBC first person According to the story, he was first diagnosed with an anaphylactic peanut allergy at the age of two, followed by tree nut and soy allergies. Friesen said that after a reaction that sent him to the hospital, concerns about allergies led to extra precautions in checking food ingredients.

Friesen’s mother said her eldest daughter had eczema as a child. She is also an example of someone who was introduced to allergy-provoking foods later than guidelines for parents and caregivers suggest.

“I couldn’t control where the science was,” Friesen told CBC News about the state of understanding about allergies when she was a child.

“I’m just happy that it’s gotten to where it is now, that it can help other people. Maybe their quality of life can be better.”