The impact of the elimination diet on growth and nutrient intake in children with food protein induced gastrointestinal allergies

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dc.citation.volume6
dc.contributor.authorMeyer, Rosan
dc.contributor.authorDe Koker, Claire
dc.contributor.authorDziubak, Robert
dc.contributor.authorGodwin, Heather
dc.contributor.authorDominguez-Ortega, Gloria
dc.contributor.authorLozinsky, Adriana Chebar [UNIFESP]
dc.contributor.authorSkrapac, Ana-Kristina
dc.contributor.authorGholmie, Yara
dc.contributor.authorReeve, Kate
dc.contributor.authorShah, Neil
dc.coverageLondon
dc.date.accessioned2020-08-14T13:44:13Z
dc.date.available2020-08-14T13:44:13Z
dc.date.issued2016
dc.description.abstractBackground: Non immunoglobulin E (IgE) mediated allergies affecting the gastrointestinal tract require an elimination diet to aid diagnosis. The elimination diet may entail multiple food eliminations that contribute significantly to macro-and micro-nutrient intake which are essential for normal growth and development. Previous studies have indicated growth faltering in children with IgE-mediated allergy, but limited data is available on those with delayed type allergies. We therefore performed a study to establish the impact on growth before and after commencing an elimination diets in children with food protein induced non-IgE mediated gastrointestinal allergies. Methods: A prospective, observational study was performed at the tertiary gastroenterology department. Children aged 4 weeks-16 years without non-allergic co-morbidities who were required to follow an elimination diet for suspected food protein induced gastrointestinal allergies were included. Growth parameters pre-elimination were taken from clinical notes and post-elimination measurements (weight and height) were taken a minimum of 4 weeks after the elimination diet. A 3-day estimated food diary was recorded a minimum of 4 weeks after initiating the elimination diet, including also any hypoallergenic formulas or over the counter milk alternatives that were consumed. Results: We recruited 130 children: 89 (68.5 %) boys and a median age of 23.3 months [IQR 9.4-69.2]. Almost all children (94.8 %) in this study eliminated CM from their diet and average contribution of energy in the form of protein was 13.8 % (SD 3.9), 51.2 % (SD 7.5) from carbohydrates and 35 % (SD 7.5) from fat. In our cohort 9 and 2.8 % were stunted and wasted respectively. There was a statistically significant improvement in weight-for-age (Wtage) after the 4 week elimination diet. The elimination diet itself did not improve any of the growth parameters, but achieving energy and protein intake improved Wtage and WtHt respectively, vitamin and/or mineral supplements and hypoallergenic formulas were positively associated with WtHt and Wtage. Conclusion: With appropriate dietary advice, including optimal energy and protein intake, hypoallergenic formulas and vitamins and mineral supplementation, growth parameters increased from before to after dietary elimination. These factors were positively associated with growth, irrespective of the type of elimination diet and the numbers of foods eliminated.en
dc.description.affiliationGreat Ormond St Hosp Children NHS Fdn Trust, Dept Gastroenterol, London, England
dc.description.affiliationChelsea & Westminster Hosp NHS Fdn Trust, Dept Nutr & Dietet, London, England
dc.description.affiliationNino Jesus Univ Children Hosp, Madrid, Spain
dc.description.affiliationUniv Fed Sao Paulo UNIFESP, Paediat Gastroenterol, Sao Paulo, Brazil
dc.description.affiliationAmer Univ Beirut, Dept Nutr & Food Sci, Fac Agr & Food Sci, Beirut, Lebanon
dc.description.affiliationUCL, Inst Child Hlth, London, England
dc.description.affiliationUnifespUniv Fed Sao Paulo UNIFESP, Paediat Gastroenterol, Sao Paulo, Brazil
dc.description.sourceWeb of Science
dc.description.sponsorshipGreat Ormond Street Hospital Charity
dc.format.extent-
dc.identifierhttp://dx.doi.org/10.1186/s13601-016-0115-x
dc.identifier.citationClinical And Translational Allergy. London, v. 6, p. -, 2016.
dc.identifier.doi10.1186/s13601-016-0115-x
dc.identifier.fileWOS000390118600001.pdf
dc.identifier.issn2045-7022
dc.identifier.urihttps://repositorio.unifesp.br/handle/11600/57543
dc.identifier.wosWOS:000390118600001
dc.language.isoeng
dc.publisherBiomed Central Ltd
dc.relation.ispartofClinical And Translational Allergy
dc.rightsinfo:eu-repo/semantics/openAccess
dc.subjectGrowthen
dc.subjectAnthropometric measuresen
dc.subjectNon-IgE mediated allergyen
dc.subjectMalnutritionen
dc.subjectNutrientsen
dc.titleThe impact of the elimination diet on growth and nutrient intake in children with food protein induced gastrointestinal allergiesen
dc.typeinfo:eu-repo/semantics/article
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