Skip to main content

Thank you for visiting nature.com. You are using a browser version with limited support for CSS. To obtain the best experience, we recommend you use a more up to date browser (or turn off compatibility mode in Internet Explorer). In the meantime, to ensure continued support, we are displaying the site without styles and JavaScript.

  • Original Article
  • Published:

Dietary assessment in children adhering to a food allergen avoidance diet for allergy prevention

European Journal of Clinical Nutrition volume 60, pages 1384–1390 (2006)Cite this article

Abstract

Objective:

The purpose of this investigation was to verify if avoidance of allergenic foods in children adhering to a food allergen avoidance diet from birth was complete and feasible, and whether dietary assessment can be used as a tool in predicting the outcome of double-blind, placebo-controlled food challenges (DBPCFCs).

Design:

Children adhering to an allergen avoidance diet from birth underwent DBPCFCs. The investigator-dietician verified whether the elimination was complete, using food frequency questionnaires for common allergenic foods.

Setting:

University Medical Centre Groningen, the Netherlands.

Subjects:

Thiry-eight children aged 1–13 years, who were consecutively referred to the University Medical Centre Groningen for DBPCFC between January 2002 and February 2004.

Results:

Among the 38 children undergoing DBPCFCs, there were 15 challenges with egg, 15 with peanut, five with hazelnut and three with soy. Fifteen food challenges (39%) were positive. Small quantities of allergenic foods were inadvertently present in the diets of 13 patients (34%), were possibly present in the diets of 14 patients (37%) and could not be identified in the diets of 11 patients (29%). Seven patients (54%) who had inadvertently ingested small quantities of allergenic foods without sequelae had a positive DBPCFC.

Conclusion:

Dietary avoidance was incomplete and not feasible in most cases. Tolerance of small amounts of allergenic foods does not preclude positive challenge reactions. Dietary assessment does not seem a useful tool in predicting the outcome of DBPCFC in children adhering to an elimination diet.

Sponsorship:

The Stichting Astma Bestrijding (Foundation for the Prevention of Asthma), The Netherlands.

This is a preview of subscription content, access via your institution

Access options

Buy this article

  • Purchase on SpringerLink
  • Instant access to full article PDF
Buy now

Prices may be subject to local taxes which are calculated during checkout

Similar content being viewed by others

References

  • Altshul AS, Scherrer DL, Muñoz-Furlong A, Sicherer SH (2001). Manufacturing and labelling issues for commercial products: relevance to food allergy. J Allergy Clin Immunol 108, 468.

    Article  Google Scholar 

  • American Academy of Pediatrics, Committee on Nutrition (2000). Hypoallergenic infant formulas. Pediatrics 106, 346–349.

  • Bindslev-Jensen C, Ballmer-Weber BK, Bengtsson U, Blanco C, Ebner C, Hourihane J et al. (2004). Standardization of food challenges in patients with immediate reactions to foods – position paper from the European Academy of Allergology and Clinical Immunology. Allergy 59, 690–697.

    Article  CAS  Google Scholar 

  • Bruynzeel-Koomen C, Ortolani C, Aas K, Bindslev-Jensen C, Bjorksten B, Moneret-Vautrin D et al. (1995). Adverse reactions to food. European Academy of Allergology and Clinical Immunology Subcommittee. Allergy 50, 623–635.

    Article  Google Scholar 

  • Commissie ‘Standaard’ (2005). Landelijke standaard voedselallergie bij zuigelingen. Standaard voor de diagnose, behandeling en preventie van voedselallergie bij zuigelingen op het consultatiebureau [Committee on food hypersensitivity. Nation-wide standard for the diagnosis, treatment and prevention of food hypersensitivity in infants at the well-baby clinic]. 5th ed. Den Haag: Voedingscentrum.

  • European Parliament and Council (2003). Directive 2003/89/EC amending Directive 2000/13/EC. Official Journal of the European Union L 308, 25.11.03, p. 15.

  • Fukushima Y, Kawata Y, Onda T, Kitagawa M (1997). Consumption of cow milk and egg by lactating women and the presence of β-lactoglobulin in breast milk. Am J Clin Nutr 65, 30–35.

    Article  CAS  Google Scholar 

  • Gowland MH (2001). Food allergen avoidance – the patient's viewpoint. Allergy 56 (Suppl 67), 117–120.

    Article  Google Scholar 

  • Høst A, Koletzko B, Dreborg S, Muraro A, Wahn U, Aggett P et al. (1999). Dietary products used in infants for treatment and prevention of food allergy. Joint statement of the European Society for Paediatric Allergology and Clinical Immunology (ESPACI) Committee on hypoallergenic formulas and the European Society for Paediatric Gastroenterology, Hepatology and Nutrition (ESPGHAN) Committee on nutrition. Arch Dis Child 81, 80–84.

    Article  Google Scholar 

  • Joshi P, Modifi S, Sicherer SH (2002). Interpretation of commercial food ingredient labels by parents of food-allergic children. J Allergy Clin Immunol 109, 1019–1021.

    Article  Google Scholar 

  • Lack G, Fox D, Northstone K, Golding J (2003). Factors associated with the development of peanut allergy in childhood. N Engl J Med 348 (11), 977–985.

    Article  Google Scholar 

  • Muraro A, Dreborg S, Halken S, Høst A, Niggeman B, Aalberse R et al. (2004). Dietary prevention of allergic diseases in infants and small children. Part III: Critical review of published peer-reviewed observational and interventional studies and final recommendations. Pediatr Allergy Immunol 15, 291–307.

    Article  Google Scholar 

  • Sampson HA (2001). Utility of food-specific IgE concentrations in predicting symptomatic food allergy. J Allergy Clin Immunol 107, 891–896.

    Article  CAS  Google Scholar 

  • Taylor SL, Hefle SL (2001). Ingredient and labelling issues associated with allergenic foods. Allergy 56 (Suppl 67), 64–69.

    Article  Google Scholar 

  • Vierk K, Falci K, Wolyniak C, Klontz KC (2002). Recalls of foods containing undeclared allergens reported to the US Food and Drug Administration, fiscal year 1999. J Allergy Clin Immunol 109, 1022–1026.

    Article  Google Scholar 

  • Vlieg-Boerstra BJ, Bijleveld CMA, van der Heide S, Beusekamp BJ, Wolt-Plompen SAA, Kukler J et al. (2004). Development and validation of challenge materials for double-blind, placebo-controlled food challenges in children. J Allergy Clin Immunol 113, 341–346.

    Article  Google Scholar 

  • World Allergy Organization, Johansson SGO, Haahtela T (eds). (2004). World Allergy Organization guidelines for prevention of allergy and allergic asthma Condensed version. Int Arch Allergy Immunol 135, 83–92.

    Article  Google Scholar 

  • Wood RA (2002). Food manufacturing and the allergenic consumer: Accidents waiting to happen. J Allergy Clin Immunol 109, 920–922.

    Article  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Department of Paediatrics, Division of Paediatric Allergy and Paediatric Pulmonology, University Medical Centre Groningen, University of Groningen, The Netherlands

    B J Vlieg-Boerstra, C M A Bijleveld, J Kukler, E J Duiverman, S A A Wolt-Plompen & A E J Dubois

  2. Department of Allergology, University Medical Centre Groningen, University of Groningen, The Netherlands

    S van der Heide & A E J Dubois

Authors
  1. B J Vlieg-Boerstra
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. S van der Heide
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. C M A Bijleveld
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. J Kukler
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. E J Duiverman
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. S A A Wolt-Plompen
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. A E J Dubois
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to B J Vlieg-Boerstra.

Additional information

Guarantor: BJ Vlieg-Boerstra

Contributors: BJV-B was responsible for the study design, the performance of the study and the writing of the paper, under direct supervision of AEJD and EJD. CMAB, Svan der H and SAAW-P collaborated in the study design, discussion and interpretation of the results and comments upon the manuscript. JK performed the food challenges.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Vlieg-Boerstra, B., van der Heide, S., Bijleveld, C. et al. Dietary assessment in children adhering to a food allergen avoidance diet for allergy prevention. Eur J Clin Nutr 60, 1384–1390 (2006). https://doi.org/10.1038/sj.ejcn.1602468

Download citation

  • Received:

  • Revised:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1038/sj.ejcn.1602468

Keywords

This article is cited by

Search

Advanced search

Quick links