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Complementary feeding practices are related to the risk of food allergy in the ELFE cohort
T Adam1,2, A Divaret-Chauveau2,3, C Roduit4,5,6
1Department of Dermatology and Allergology, University Hospital of Nancy, Vandoeuvre-Lès-Nancy, France.
Insights
Delayed introduction of major allergenic foods increases the risk of childhood food allergies. This finding supports updated allergy prevention guidelines for complementary feeding (CF) practices.
Area of Science:
- Pediatrics
- Allergy and Immunology
- Nutrition Science
Background:
- Conflicting research exists on the link between complementary feeding (CF) practices and childhood allergies.
- Understanding the impact of CF timing, food diversity, and allergenic food introduction is crucial for allergy prevention.
Purpose of the Study:
- To investigate the association between early childhood allergic diseases and complementary feeding (CF) practices.
- To analyze the influence of age at CF introduction, food diversity, and delayed introduction of major allergenic foods on allergy development.
Main Methods:
- Analysis of 6662 children from the French ELFE cohort, collecting feeding data from 3 to 10 months.
- Calculation of age at CF introduction, food diversity score, and number of major allergenic foods not introduced at 8 and 10 months.
- Logistic regression analysis of parent-reported allergy-related events (1-5.5 years), with sensitivity analysis excluding early allergic cases.
Main Results:
- Late CF introduction (>6 months) correlated with a higher risk of food allergy.
- Low food diversity at 8 months was linked to an increased risk of asthma.
- Failure to introduce two or more major allergenic foods by 10 months significantly increased the risk of rhinoconjunctivitis and food allergy, with the latter remaining significant after excluding early cases.
Conclusions:
- Delayed introduction of major allergenic foods is associated with an elevated risk of developing food allergies in early childhood.
- These findings reinforce current guidelines recommending timely introduction of allergenic foods for allergy prevention.
Background:
Conflicting results have been obtained when analyzing the relationship between complementary feeding (CF) practices and allergic diseases in childhood. This study aims to further explore the association between allergic diseases in early childhood (10.1016/j.jaci.2012.02.036) and the age at CF introduction (10.1016/S0140-6736(15)00149-X), food diversity in the first year of life (10.1016/j.ijporl.2019.109759) and the delayed introduction of major allergenic foods.
Methods:
This analysis focused on 6662 children from the French nationwide ELFE cohort. Data on feeding practices were collected monthly from 3 to 10 months old. Their age at CF introduction was calculated alongside a diversity score, and the number of major allergenic foods (out of eggs, fish, wheat, and dairy products) not introduced at 8 and 10 months. Their associations with parent-reported allergy-related health events between 1 and 5.5 years were assessed using logistic regressions adjusted for confounding factors. A sensitivity analysis excluding early allergic cases (occurring between 2 months and 1 or 2 years) was conducted.
Results:
Late CF (>6 months) was related to a higher risk of food allergy (OR [95% CI] = 1.35 [1.02; 1.78]), a low diversity score at 8 months to a higher risk of asthma (OR [95% CI] = 1.22 [1.01; 1.48]), and two allergenic foods or more not being introduced at 10 months to a higher risk of rhinoconjunctivitis (OR [95% CI] = 1.20 [1.00; 1.44]) and food allergy (OR [95% CI] = 2.46 [1.77; 3.42]). Only this last association remained significant after the exclusion of early cases.
Conclusion:
The delayed introduction of major allergenic foods is related to a higher risk of food allergy, which supports the updated guidelines for allergy prevention.
