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Follow-up of nutritional status and dietary survey in children with cow's milk allergy
A Paganus1, K Juntunen-Backman, E Savilahti
1Children's Hospital, University of Helsinki, Finland.
Insights
Children with cow's milk allergy on elimination diets showed decreased weight and low serum prealbumin and zinc. Nutritional status requires careful monitoring during dietary restrictions for food allergies.
Area of Science:
- Pediatric Nutrition
- Allergy and Immunology
- Clinical Dietetics
Background:
- Cow's milk allergy (CMA) is common in children, often coexisting with other food allergies.
- Elimination diets are standard for managing CMA, but nutritional adequacy requires monitoring.
- Nutritional status in children with multiple food allergies on elimination diets is not fully understood.
Purpose of the Study:
- To assess the nutritional status of children with CMA during an elimination diet.
- To evaluate anthropometric measurements and key laboratory indices.
- To identify potential nutritional deficiencies and dietary inadequacies.
Main Methods:
- Follow-up study of 19 children (mean age 2 years) with verified CMA.
- Anthropometric measurements (weight, height) and laboratory tests (protein, minerals, vitamins) at 3-month intervals.
- Dietary intake assessment via 7-day food records.
Main Results:
- Relative height remained stable but slightly retarded; relative weight decreased significantly (p<0.05).
- Low serum prealbumin (8/19) and serum zinc (12/19) were prevalent.
- Low serum iron (2/19) and high serum alkaline phosphatase (2/19) were observed; energy intake was low in some, protein intake high, and riboflavin intake low in some.
- Soy-based formula was used in only two children.
Conclusions:
- Children with CMA on elimination diets are at risk for decreased weight and specific nutrient deficiencies, particularly zinc and protein status markers.
- Careful dietary management and supplementation are crucial to ensure adequate nutrition during elimination diets for pediatric food allergies.
- Further research is needed to optimize dietary strategies for children with multiple food allergies.
Abstract:
The nutritional status of children with cow's milk allergy was followed during an elimination diet in 19 children (9 boys and 10 girls) beginning at the mean age of two years (range 0.6-4.1 years). The cow's milk allergy had been verified in hospital by a challenge test at a mean age of 0.9 years (range 0.2-1.9 years). Weight, height and laboratory indices to test protein, mineral and vitamin status were measured at three follow-up visits at three-month intervals. In addition to cow's milk allergy all these children had some other food allergies, and six of the 19 children were allergic to soy protein. Only two of the 19 children were given a soy-based formula. In the diets of the other children, cow's milk was replaced by increasing amounts of other foodstuffs and supplementary calcium. At the beginning of the study the relative heights of the children were slightly retarded (-0.6 SD) and remained unchanged during follow-up (-0.8 SD at the end of the study). The relative weights were found to be decreased during follow-up (p less than 0.05). There was a significant reduction in serum prealbumin values; eight of the 19 children showed abnormally low values. Low serum zinc values were seen in 12 children. Serum iron concentration was low in two children and two had high serum alkaline phosphatase values. Seven-day food recording indicated that dietary intake of energy was below the recommendation in some children, but protein intake was high. Some children had low intakes of riboflavin.(ABSTRACT TRUNCATED AT 250 WORDS)