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Hatzinger LA, Victoria P, Miecznikowski JC, Ferrante MJ, Balantekin KN. Parents of 5-to-12-year-old children with food allergies report more frequent use of structure-based food parenting practices. Prev Med Rep 2024; 43:102758. [PMID: 38798908 PMCID: PMC11127510 DOI: 10.1016/j.pmedr.2024.102758] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2024] [Revised: 05/07/2024] [Accepted: 05/08/2024] [Indexed: 05/29/2024] Open
Abstract
Objectives Food parenting practices (FPP) can have effects on children's eating behaviors. Over 8 million children in the US have food allergies, however, little is known about FPP for those who have children with food allergies. The objective of this study was to describe FPP among children with food allergies. Methods Recruited across the United States using ResearchMatch in February and March 2021, parents of children ages 5-12 years (n = 346; n = 77 with food allergies) completed a single, online survey which measured health history, demographics, and FPP. Linear regressions were used to examine associations between FPP of children with and without food allergies, and associations between food allergy factors and FPP. Results Parents of children with food allergies reported greater use of limit exposure than parents of children without food allergies (B = 0.131; [CI], 0.021-0.293; P = 0.024), with no differences in other types of FPP. Conclusions Parents of children with food allergies reported more frequent structure-based FPP than parents of children without food allergies. More work is needed to explore mechanisms that promote positive food parenting among this population.
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Affiliation(s)
- Lori A. Hatzinger
- Department of Exercise and Nutrition Sciences, University at Buffalo, 3435 Main Street, Buffalo, NY 14214, United States
| | - Peter Victoria
- University of Virginia School of Medicine, 1340 Jefferson Park Ave, Charlottesville, VA 22903, United States
| | - Jeffrey C. Miecznikowski
- Department of Biostatistics, University at Buffalo, 723 Kimball Tower, Buffalo NY 14214, United States
| | - Mackenzie J. Ferrante
- Department of Nutritional Sciences, Rutgers University, 61 Dudley Road, New Brunswick, NJ, 08901, United States
| | - Katherine N. Balantekin
- Department of Exercise and Nutrition Sciences, University at Buffalo, 3435 Main Street, Buffalo, NY 14214, United States
- Center for Ingestive Behavior Research, University at Buffalo, 355 Hochstetter Hall, Buffalo, NY 14260, United States
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Kefford J, Marshall J, Packer RL, Ward EC. Feeding Characteristics in Children With Food Allergies: A Scoping Review. JOURNAL OF SPEECH, LANGUAGE, AND HEARING RESEARCH : JSLHR 2024; 67:132-148. [PMID: 38040005 DOI: 10.1044/2023_jslhr-23-00303] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/03/2023]
Abstract
BACKGROUND Food allergy (FA) affects approximately 8% of children and may be immunoglobulin E (IgE)-mediated or non-IgE-mediated. It is recognized clinically that children with both subtypes of FA may present with features of pediatric feeding disorder (PFD); however, there is currently a limited detail of presenting characteristics. OBJECTIVE The objective of this study was to synthesize the current evidence regarding the feeding characteristics of children with FA, with a focus on the feeding skills and psychosocial domains of PFD. METHOD This study followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses Extension for Scoping Reviews guidelines. Papers published between 2001 and 2022 describing feeding characteristics in the feeding skills and psychosocial domains in children with FA/history of FA were included. Papers that focused solely on characteristics from the medical or nutritional domains were excluded. Descriptive information regarding demographics, methodology, allergy profile and history, and the characteristics of PFD observed was extracted using a preconceived data extraction form. RESULTS Overall, 40 papers contained descriptions of feeding characteristics of children with non-IgE-mediated FA (n = 22) and IgE-mediated FA (n = 11), while four were nonspecific. In the psychosocial domain, food refusal/aversion, anxiety with eating, and poor intake were the most frequently reported, regardless of FA subtype. Less information was reported regarding feeding skills, although slowness in eating, immature diet, and delays in oral sensory-motor skills were described. CONCLUSIONS Children with FA/history of FA may present with a range of characteristics that map across the feeding skill and psychosocial domains of PFD. Systematic research is needed to fully describe the feeding characteristics of children with FA. SUPPLEMENTAL MATERIAL https://doi.org/10.23641/asha.24562732.
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Affiliation(s)
- Jennifer Kefford
- School of Health and Rehabilitation Sciences, The University of Queensland, Brisbane, Australia
- Northern Sydney Local Health District, New South Wales Health, Sydney, Australia
| | - Jeanne Marshall
- School of Health and Rehabilitation Sciences, The University of Queensland, Brisbane, Australia
- Children's Health Queensland Hospital and Health Service, Queensland Children's Hospital, Brisbane, Australia
| | - Rebecca L Packer
- School of Health and Rehabilitation Sciences, The University of Queensland, Brisbane, Australia
| | - Elizabeth C Ward
- School of Health and Rehabilitation Sciences, The University of Queensland, Brisbane, Australia
- Centre for Functioning and Health Research (CFAHR), Metro South Hospital and Health Service, Brisbane, Queensland, Australia
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Skypala IJ, Reese I, Durban R, Hunter H, Podesta M, Chaddad MCC, Santos AF, Agache I. Food allergy-A holistic approach to dietary management. A joint EAACI Research & Outreach Committee and INDANA review. Pediatr Allergy Immunol 2023; 34:e14019. [PMID: 37747742 DOI: 10.1111/pai.14019] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/08/2023] [Accepted: 08/16/2023] [Indexed: 09/26/2023]
Abstract
Following a diagnosis of IgE-mediated food allergy, to secure the best outcome, the patient should receive individualized advice tailored to their specific needs, which considers the type and presentation of the food involved, level of exclusion required, risk of cross-contamination and any variance required for age, ethnicity, financial issues, and lifestyle. Issues such as food labels "may contain" statements, and variation in the threshold of reaction and impact of cofactors should also be considered. Most important is the need to ensure that the diagnosis is robust, especially given the nutritional, psychological, and socioeconomic issues that can affect an individual with a diagnosis of food allergy. Unnecessary exclusion of one or more foods that have not triggered allergic reactions, especially in individuals with allergic comorbidities, can result in severe IgE-mediated reactions on re-exposure. Given that food allergies may change over time, the diagnosis should be reviewed, to determine whether resolution is likely, or new-food triggers are reported. Regular assessment is vital, especially during childhood, to ensure reintroduction occurs at an appropriate time, thus enabling increased diversity of the diet and improvement in the quality of life. For some, an IgE-mediated food allergy may necessitate the life-long exclusion of foods, and for others, a food habitually eaten suddenly triggers an allergic reaction in adult life. People of all ages, ethnicities, and socioeconomic backgrounds deserve individual advice on the management of their food allergy to support a healthy diet and improve quality of life.
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Affiliation(s)
- Isabel J Skypala
- Department of Allergy & Clinical Immunology, Royal Brompton & Harefield Hospitals, part of Guys & St Thomas NHS Foundation Trust, London, UK
- Inflammation, Repair & Development Section, National Heart & Lung Institute, Imperial College, London, UK
| | - Imke Reese
- Nutritional Counseling and Therapy, Focus on Allergology, Munich, Germany
| | - Raquel Durban
- Carolina Asthma & Allergy Center, Charlotte, North Carolina, USA
| | - Hannah Hunter
- Department of Allergy, Guys & St Thomas NHS Foundation Trust, London, UK
- Kings College, London, UK
| | | | | | - Alexandra F Santos
- Department of Women and Children's Health (Pediatric Allergy), School of Life Course Sciences, Faculty of Life Sciences and Medicine, King's College London, London, UK
- Peter Gorer Department of Immunobiology, School of Immunology and Microbial Sciences, King's College London, London, UK
- Children's Allergy Service, Evelina London Children's Hospital, Guy's and St Thomas' Hospital, London, UK
| | - Ioana Agache
- Faculty of Medicine, Transylvania University, Brasov, Romania
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Ciciulla D, Soriano VX, McWilliam V, Koplin JJ, Peters RL. Systematic Review of the Incidence and/or Prevalence of Eating Disorders in Individuals With Food Allergies. THE JOURNAL OF ALLERGY AND CLINICAL IMMUNOLOGY. IN PRACTICE 2023; 11:2196-2207.e13. [PMID: 37088367 DOI: 10.1016/j.jaip.2023.04.010] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/13/2022] [Revised: 03/14/2023] [Accepted: 04/10/2023] [Indexed: 04/25/2023]
Abstract
BACKGROUND Chronic diseases involving strict dietary adherence have been associated with an increased risk of eating disorders (EDs). This is the first systematic review investigating the rate of EDs among individuals with food allergies (FAs). OBJECTIVE To report the incidence, prevalence, and types of EDs in individuals with FAs. METHODS Following Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines, we searched 4 databases for studies published to January 2022 that reported the prevalence or incidence of EDs in samples with immunoglobulin E (IgE) or non-IgE-mediated allergy. Risk of bias was assessed and evidence qualitatively synthesized. RESULTS From 1,180 papers identified, 9 met inclusion criteria. There were 4,161 adult and pediatric participants with IgE-mediated FAs or eosinophilic esophagitis. Avoidant/Restrictive Food Intake Disorder (ARFID) or anorexia nervosa/bulimia nervosa were the main EDs identified. The prevalence of EDs in samples with FA ranged from 0.8% to 62.9%. Among studies investigating IgE-mediated FA (n = 6), the prevalence of anorexia nervosa and/or bulimia nervosa ranged from 17.6 to 61%, ARFID was 62.9%, and unspecified EDs was 0.8% to 6%. Among samples with eosinophilic esophagitis (n = 3), ARFID prevalence ranged from 4.5% to 51%. Most studies were limited by small sample size, possible selection bias, and lack of diagnostic EDs tools validated for food allergic populations. CONCLUSIONS Eating disorders appear prevalent in individuals with FA; however, prevalence estimates varied widely. Large studies with healthy control groups and validated measures to identify EDs in individuals with FA are needed to accurately determine the prevalence of EDs.
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Affiliation(s)
- Daniela Ciciulla
- Population Health, Murdoch Children's Research Institute, Parkville, Victoria, Australia; Department of Paediatrics, University of Melbourne, Melbourne, Victoria, Australia; Centre for Food and Allergy Research (CFAR), Murdoch Children's Research Institute, Parkville, Victoria, Australia.
| | - Victoria X Soriano
- Population Health, Murdoch Children's Research Institute, Parkville, Victoria, Australia; Department of Paediatrics, University of Melbourne, Melbourne, Victoria, Australia
| | - Vicki McWilliam
- Population Health, Murdoch Children's Research Institute, Parkville, Victoria, Australia; Department of Paediatrics, University of Melbourne, Melbourne, Victoria, Australia; Department of Allergy and Immunology, Royal Children's Hospital, Melbourne, Victoria, Australia
| | - Jennifer J Koplin
- Population Health, Murdoch Children's Research Institute, Parkville, Victoria, Australia; Centre for Food and Allergy Research (CFAR), Murdoch Children's Research Institute, Parkville, Victoria, Australia; Child Health Research Centre, University of Queensland, Brisbane, St. Lucia, Queensland, Australia
| | - Rachel L Peters
- Population Health, Murdoch Children's Research Institute, Parkville, Victoria, Australia; Department of Paediatrics, University of Melbourne, Melbourne, Victoria, Australia
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Use of a Move-on Component to Increase Consumption for a Clinical Paediatric Feeding Case In-Home. BEHAVIOUR CHANGE 2021. [DOI: 10.1017/bec.2021.17] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
Abstract
Research from specialised hospital feeding programmes in the United States has shown effectiveness of a variety of treatments for packing (not swallowing food or liquid in the mouth) to increase swallowing and consumption. One potential component used in clinical practice has not been evaluated in the literature to our knowledge. This component is move-on and involves moving on to the next bite presentation rather than waiting for swallowing (i.e., clean mouth). A 5-year-old female with autism spectrum disorder and avoidant/restrictive food intake disorder participated in a home setting in Australia. We used a withdrawal/reversal single-case experimental design for a move-on component added to a treatment package. With move-on added, latency to clean mouth decreased and consumption increased to 100%. After the treatment evaluation, additional procedures (interspersal, redistribution) were needed in full plate and portion meals. Food variety was increased to 116 regular texture foods across all food groups. All (100%) of admission goals were met. Parents were trained to high procedural integrity, and the protocol was generalised to the community. Gains maintained to 1-month follow-up.
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Taylor T. Brief Report: Packing Treatment Comparison and Use of a Chaser to Increase Swallowing for a Clinical Case. J Autism Dev Disord 2021; 52:3280-3285. [PMID: 34213699 DOI: 10.1007/s10803-021-05176-5] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/27/2021] [Indexed: 11/30/2022]
Abstract
Packing involves not swallowing solids or liquids in the mouth. It is a significant mealtime behaviour to treat. Research has shown effectiveness of redistribution, but only two studies in highly specialised hospital settings in the United States have evaluated the use of a chaser. We extended this literature by conducting treatment in the home setting, and comparing a liquid and puree chaser separately to infant gum brush redistribution and a move-on to the next bite presentation component. A 4-year-old male with autism spectrum disorder and gastrostomy tube dependence participated in his home. We used a multielement single-case experimental design. With the liquid chaser, consumption increased to 100%. Swallowing latency was significantly lower with the liquid chaser compared to other packing treatments.
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Affiliation(s)
- Tessa Taylor
- Paediatric Feeding International, Double Bay, Sydney, NSW, Australia. .,University of Canterbury/Te Whare Wānanga o Waitaha, Private Bag 4800, Christchurch, 8140, New Zealand.
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Taylor T, Blampied N, Roglić N. Controlled case series demonstrates how parents can be trained to treat paediatric feeding disorders at home. Acta Paediatr 2021; 110:149-157. [PMID: 32441395 DOI: 10.1111/apa.15372] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/12/2019] [Revised: 05/12/2020] [Accepted: 05/18/2020] [Indexed: 11/30/2022]
Abstract
AIM Paediatric feeding disorders are normally managed by specialist clinics. We examined whether treatment gains were maintained when trained parents continued the programme at home and during meals out. METHODS This controlled consecutive case series recruited 26 children (22 boys) with avoidant/restrictive food intake disorder, from a private paediatric feeding disorders practice in New South Wales, Australia. Their mean age was six (2-13) years. All had severe feeding problems and mealtime skill deficits, and most had autism and developmental delays or intellectual disabilities. The children received intensive, individualised, behaviour-analytic treatment for 11 (6-21.5) days, and the parents were trained to continue it at home. The primary treatment outcomes included the range and amount of food eaten and mealtime behaviour. RESULTS The children met all of the therapeutic goals agreed at the treatment outset. They ate a mean of 92 different foods and improved how they ate, drank and behaved during mealtimes. The mean differences before and after treatment were clinically and statistically significant, and the gains were maintained during follow-up at a mean of 2.3 years. Parental satisfaction and treatment acceptability were high. CONCLUSION Specially trained parents successfully continued paediatric eating disorder treatment at home and maintained treatment gains.
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Affiliation(s)
- Tessa Taylor
- Paediatric Feeding International Sydney NSW Australia
- Department of Psychology, and the School of Health Sciences University of Canterbury/Te Whare Wānanga o Waitaha Christchurch New Zealand
| | - Neville Blampied
- Department of Psychology, and the School of Health Sciences University of Canterbury/Te Whare Wānanga o Waitaha Christchurch New Zealand
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Herbert L, DunnGalvin A. Psychotherapeutic Treatment for Psychosocial Concerns Related to Food Allergy: Current Treatment Approaches and Unmet Needs. THE JOURNAL OF ALLERGY AND CLINICAL IMMUNOLOGY-IN PRACTICE 2021; 9:101-108. [DOI: 10.1016/j.jaip.2020.10.037] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/27/2020] [Revised: 10/26/2020] [Accepted: 10/27/2020] [Indexed: 12/18/2022]
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9
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Taylor T. Increasing food texture and teaching chewing for a clinical case within the home setting in Australia. LEARNING AND MOTIVATION 2020. [DOI: 10.1016/j.lmot.2020.101651] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
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10
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Taylor T. Side Deposit with Regular Texture Food for Clinical Cases In-Home. J Pediatr Psychol 2020; 45:399-410. [PMID: 32100032 DOI: 10.1093/jpepsy/jsaa004] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2019] [Revised: 12/06/2019] [Accepted: 01/22/2020] [Indexed: 11/13/2022] Open
Abstract
Objective Research has shown effectiveness of nonremoval of the spoon and physical guidance in increasing consumption and decreasing inappropriate mealtime behavior. The side deposit has been used to treat passive refusal in 2 studies (1 in a highly specialized hospital setting) using lower manipulated-texture foods on an infant gum brush. Methods We extended the literature by using regular texture bites of food with a finger prompt and side deposit (placing bites inside the side of the child's mouth via the cheek) in an intensive home-based program setting in Australia, demonstrating that attention and tangible treatments alone were ineffective prior, fading the tangible treatment, showing caregiver training, and following up. 2 male children with autism spectrum disorder (with texture/variety selectivity; one with liquid dependence) participated in their homes. We used a reversal design to replicate effectiveness of the side deposit added to a treatment package. Results For both participants, we observed a >98% decrease in latency to acceptance, a 100% decrease in inappropriate mealtime behavior, and a 100% increase in consumption with the side deposit added. Variety was increased to over 85 regular texture foods. 100% of admission goals were met. Caregivers were trained to high procedural integrity and the protocol was generalized to school and the community. Gains maintained to 3 and 1.5 years. Conclusion This is important work in adding to the literature and support for the side deposit and expanding to regular texture, as well as replicating and extending empirically supported treatments for feeding internationally to the home setting.
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Affiliation(s)
- Tessa Taylor
- Paediatric Feeding International, University of Canterbury
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Rivera-Nieves D, Conley A, Nagib K, Shannon K, Horvath K, Mehta D. Gastrointestinal Conditions in Children With Severe Feeding Difficulties. Glob Pediatr Health 2019; 6:2333794X19838536. [PMID: 31020010 PMCID: PMC6469270 DOI: 10.1177/2333794x19838536] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2018] [Revised: 12/25/2018] [Accepted: 02/21/2019] [Indexed: 12/27/2022] Open
Abstract
Feeding aversion in children may progress to severe feeding difficulties. While oral-motor and sensory issues are usually the leading causes, organic etiologies should be considered. This study aimed to assess the prevalence of gastrointestinal conditions in children with severe feeding difficulties. We conducted a retrospective study of 93 children requiring an intensive feeding program. The medical records, radiologic and diagnostic tests, use of gastric tube feedings, preexisting medical conditions, and medications were reviewed. Fifty-two percent (52%) had esophagitis, 26.2% gastritis, and 40.7% lactase deficiency in upper endoscopy. In those who underwent an upper endoscopy, 26% of patients that were also tested for small intestinal bacterial overgrowth were found to be positive. Allergy testing was abnormal in 56.6% of those tested, while 27.5% and 75% had abnormal gastric emptying times and pH impedance results, respectively. Constipation was present in 76.3%. Thirteen of 32 were weaned off tube feedings. We conclude that gastrointestinal conditions are common in children with feeding disorders and should be investigated prior to feeding therapy.
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Affiliation(s)
- Desiree Rivera-Nieves
- Center for Digestive Health and Nutrition, Arnold Palmer Hospital for Children, Orlando, FL, USA
| | - Anita Conley
- Feeding Difficulties Center, Arnold Palmer Hospital for Children, Orlando, FL, USA
| | - Keri Nagib
- Feeding Difficulties Center, Arnold Palmer Hospital for Children, Orlando, FL, USA
| | - Kaiya Shannon
- Feeding Difficulties Center, Arnold Palmer Hospital for Children, Orlando, FL, USA
| | - Karoly Horvath
- Center for Digestive Health and Nutrition, Arnold Palmer Hospital for Children, Orlando, FL, USA.,Feeding Difficulties Center, Arnold Palmer Hospital for Children, Orlando, FL, USA
| | - Devendra Mehta
- Center for Digestive Health and Nutrition, Arnold Palmer Hospital for Children, Orlando, FL, USA.,Feeding Difficulties Center, Arnold Palmer Hospital for Children, Orlando, FL, USA
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12
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Pavić I, Kolaček S. Growth of Children with Food Allergy
. Horm Res Paediatr 2018; 88:91-100. [PMID: 28359060 DOI: 10.1159/000462973] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/24/2016] [Accepted: 02/09/2017] [Indexed: 01/08/2023] Open
Abstract
BACKGROUND The prevalence of food allergy in children is increasing worldwide. Strict avoidance of identified allergens from the diet is still the cornerstone of the management of food allergies. There are widespread concerns that food allergy and elimination diet may predispose children to nutrient deficiencies and growth failure. AIM The aim of this paper was to review the current evidence on growth of children suffering from food allergy. Summarised is literature on the effects of the number and type of offending allergens, the child's age and affected organ system, as well as the importance of supervision by a dietician/nutritionist. CONCLUSION Children suffering from food allergy are stunted at the time of diagnosis and during the elimination diets, irrespective whether or not their nutritional requirements were fulfilled, and/or were under the control of a dietician. This underscores the need for further studies to obtain more precise insight into and better understanding of the mechanisms contributing to growth failure in children suffering from food allergy.
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Kong F, Martin DM. Atopic disorders in CHARGE syndrome: A retrospective study and literature review. Eur J Med Genet 2017; 61:225-229. [PMID: 29191495 DOI: 10.1016/j.ejmg.2017.11.019] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2017] [Revised: 11/12/2017] [Accepted: 11/26/2017] [Indexed: 12/29/2022]
Abstract
BACKGROUND Atopic disorders have been reported in CHARGE syndrome, but the prevalence and underlying mechanisms are not known. METHODS We performed a retrospective study of atopic disorders in 23 individuals with CHARGE syndrome, and reviewed other published reports of atopic disorders in CHARGE syndrome. We assayed for enrichment of atopic disorders in CHARGE syndrome based on gender and presence of a CHD7 pathogenic variant. RESULTS In our cohort, 65% (15/23) of individuals with CHARGE syndrome were found to have a pathogenic CHD7 variant. Overall, 65% (15/23) of individuals with CHARGE had atopic disorders. Among the 23 individuals with CHARGE, 22% (5/23) had food allergy, 26% (6/23) exhibited drug allergy, 22% (5/23) had contact allergy, 9% (2/23) had allergic rhinitis, and 22% (5/23) had asthma. In our cohort, the proportion of males to females with CHARGE and atopic disorders was 11:4 (P < 0.01), and there was no significant difference between atopic disorders in individuals with CHD7 pathogenic variants and those without CHD7 pathogenic variants (P > 0.05). CONCLUSION In our cohort of 23 individuals with CHARGE syndrome, 15 (65%) exhibited atopic disorders, with a slight male predominance.
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Affiliation(s)
- Fang Kong
- Department of Rheumatology and Allergy, Xuanwu Hospital, Capital Medical University, Beijing, China
| | - Donna M Martin
- Department of Pediatrics and Communicable Diseases, The University of Michigan Medical School, Ann Arbor, MI, USA; Department of Human Genetics, The University of Michigan Medical School, Ann Arbor, MI, USA.
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Herbert LJ, Mehta P, Sharma H. Mealtime behavior among parents and their young children with food allergy. Ann Allergy Asthma Immunol 2017; 118:345-350. [PMID: 28094121 DOI: 10.1016/j.anai.2016.12.002] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2016] [Revised: 11/08/2016] [Accepted: 12/01/2016] [Indexed: 01/22/2023]
Abstract
BACKGROUND Food allergies are increasingly prevalent in the pediatric population. Balancing allergen avoidance with the promotion of healthy eating behaviors can be challenging for families. OBJECTIVE To characterize mealtime behaviors among parents of young children with food allergy. METHODS Seventy-four parents of young children with food allergies (≤7 years of age) completed measures of mealtime behavior, perceptions of food allergy risk and severity, pediatric parenting stress, and food allergy-related quality of life. Mealtime behavior reports were compared with published data regarding typically developing children, young children with type 1 diabetes, and children with diagnosed feeding disorders (with or without related medical factors). RESULTS Parents of young children with food allergies reported frequent mealtime concerns. Specifically, they reported significantly more mealtime behavioral concerns than typically developing peers, comparable mealtime behavioral concerns to young children with type 1 diabetes, and significantly fewer mealtime behavioral concerns than children with diagnosed feeding disorders. Parental mealtime concerns were positively correlated with other parent perceptions of food allergy, such as risk of allergen exposure, illness-related parenting stress, and food allergy-related quality of life. CONCLUSION Young children with food allergy and their parents are more likely to exhibit mealtime behavioral concerns than typically developing peers and their parents. Future research should investigate the effect of food allergies and maladaptive mealtime behaviors on children's nutrition to provide clinical guidelines for parents who may benefit from psychosocial and/or nutritional support.
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Affiliation(s)
- Linda Jones Herbert
- Division of Allergy and Immunology, Children's National Health System, Washington, DC; The George Washington University, School of Medicine and Health Sciences, Washington, DC.
| | - Priya Mehta
- The George Washington University, School of Medicine and Health Sciences, Washington, DC
| | - Hemant Sharma
- Division of Allergy and Immunology, Children's National Health System, Washington, DC; The George Washington University, School of Medicine and Health Sciences, Washington, DC
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