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Patterns of allergenic food introduction in Los Angeles inner-city children
Kenny Yat-Choi Kwong1, Erica Chen1, Paulina Tran2
1Division of Allergy-Immunology, Department of Pediatrics, Los Angeles County + University of Southern California Medical Center, Los Angeles, CA, USA.
Insights
Early introduction of allergenic foods can prevent allergies, but many inner-city children are not receiving them on time. This study highlights potential delays in introducing common allergens like peanut and soy.
Area of Science:
- Pediatric Allergy and Immunology
- Public Health Nutrition
- Clinical Pediatrics
Background:
- Current guidelines recommend early introduction of allergenic foods to mitigate food allergy development.
- Adherence to these recommendations in diverse urban populations remains uncertain.
Purpose of the Study:
- To investigate the patterns and timing of allergenic food introduction in a cohort of inner-city children.
- To assess whether current clinical recommendations are being followed by caregivers in the greater Los Angeles area.
Main Methods:
- A prospective study involving 200 caregivers of children aged 12-24 months in an inner-city academic pediatric practice.
- Anonymous surveys collected data on the age of introduction for common allergens (egg, soy, wheat, peanut, tree nuts, fish, shellfish) and child's atopic history.
Main Results:
- Average introduction ages ranged from 9.2 months (egg) to 11.5 months (shellfish).
- By 24 months, significant proportions of children had not been introduced to soy (62.3%), tree nuts (52.3%), shrimp (51.8%), or shellfish (69.8%).
- Children with eczema or egg allergy showed delayed introduction of peanut, with only 50% receiving it by 11 months.
Conclusions:
- Caregivers in this inner-city population may not be introducing allergenic foods according to established guidelines.
- Timely introduction of allergenic foods is crucial, especially for high-risk infants, to prevent food allergies.
Background:
Early introduction of allergenic foods is recommended to reduce the risk of developing food allergies, but it is unclear whether recommendations are being followed.
Objective:
We examine patterns of allergenic food introduction in inner-city children enrolled in an academic pediatric practice in the greater Los Angeles area.
Methods:
This was a prospective study with patients ages 12 to 24 months recruited from the pediatrics continuity clinic at an inner-city tertiary medical center in the greater Los Angeles area. Caregivers were asked via anonymous surveys about their child's history of atopic diseases and at what age they first introduced egg, soy, wheat, peanut, tree nuts, fish, shrimp, and shellfish into their child's diet.
Results:
Two hundred caregivers responded to the survey. The average age of introduction of egg was 9.2 months, soy 10 months, wheat 9.3 months, peanut 10.5 months, tree nuts 10.9 months, fish 10.9 months, shrimp 11.3 months, and shellfish 11.5 months. Between ages 4-11 months, 65.3% of children were introduced egg, 19.1% soy, 55.8% wheat, 28.6% peanut, 17.1% tree nuts, 28.1% fish, 13.6% shrimp, and 7.0% shellfish. By age 24 months, 92% of children were introduced egg, 37.7% soy, 85.4% wheat, 67.3% peanut, 47.7% tree nuts, 67.8% fish, 48.2% shrimp, and 30.2% shellfish. Of the 14 children with eczema or egg allergy, 26.1% were introduced peanut by age 4-6 months and 50% by age 4-11 months.
Conclusion:
Despite recommendations, inner-city caregivers may not be introducing allergenic foods in a timely manner to their children.
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