The Effects of Dietary Counseling on Children with Food Allergy: A Prospective,Multicenter Intervention Study |
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| Affiliation: | 1. Allergy and Immunology Institute, “Assaf-Harofeh” Medical Center, Zerifin, Israel;2. School of Public Health, University of Haifa, Haifa, Israel;3. School of Nutritional Sciences, The Hebrew University of Jerusalem, Rehovot, Israel;4. Department of Pediatrics, Sackler Faculty of Medicine, Tel Aviv, Israel;5. Raymond and Beverly Sackler School of Physics and Astronomy, Tel Aviv University, Tel Aviv, Israel;1. Smith Child Health Research Program, Ann & Robert H. Lurie Children''s Hospital of Chicago, Chicago, Ill;2. Northwestern University Feinberg School of Medicine, Chicago, Ill;3. Department of Pediatrics, Allergy Section, Children''s Hospital Colorado, University of Colorado Denver School of Medicine, Denver, Colo;4. Department of Population, Family and Reproductive Health, Center on the Early Life Origins of Disease, Johns Hopkins Bloomberg School of Public Health, Baltimore, Md;5. Edward J. Hines Jr. VA Hospital, Spinal Cord Injury QUERI, Center for Management of Complex Chronic Care, Hines, Ill |
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| Abstract: | Although dietary counseling is generally recommended in children with food allergy (FA), its effect on the nutritional status of these patients has not yet been evaluated. Our nonrandomized multicenter prospective intervention study was undertaken to investigate the effects of dietary counseling on children with FA. Anthropometric data, dietary intakes, and laboratory biomarkers of nutritional status were evaluated in children with FA (aged 6 to 36 months) before and after dietary counseling, by multidisciplinary teams composed of pediatricians, dietitians, and nurses. Ninety-one children with FA (49 boys and 42 girls; mean age 18.9 months, 95% CI 16.5 to 21.3) were evaluated; 66 children without FA (41 boys and 25 girls; mean age 20.3 months, 95% CI 17.7 to 22.8) served as controls providing baseline values only. At enrollment, energy and protein intakes were lower in children with FA (91 kcal/kg/day, interquartile range [IQR]=15.1, minimum=55.2, maximum=130.6; and 2.2 g/kg/day, IQR=0.5, minimum=1.5, maximum=2.7, respectively) than in children without FA (96 kcal/kg/day, IQR=6.1, minimum=83.6, maximum=118.0; and 4.6 g/kg/day, IQR=1.2, minimum=2.0, maximum=6.1, respectively; P<0.001). A weight to length ratio <2 standard deviations was more frequent in children with FA than in children without FA (21% vs 3%; P<0.001). At 6 months following dietary counseling, the total energy intake of children with FA was similar to the baseline values of control children. Dietary counseling also resulted in a significant improvement of their anthropometric and laboratory biomarkers of nutritional status. The results of our study support the crucial role of dietary counseling in the clinical management of children with FA. |
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| Keywords: | Dietitian Elimination diet Fatty acids Nutritional status Cow's milk allergy |
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