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Nutrition and Allergic Diseases

A special issue of Nutrients (ISSN 2072-6643).

Deadline for manuscript submissions: closed (31 May 2017) | Viewed by 190122

Printed Edition Available!
A printed edition of this Special Issue is available here.

Special Issue Editors

Prof. Dr. R.J. Joost van Neerven

E-Mail Website
Guest Editor
Cell Biology and Immunology Group, Wageningen University & Research, Wageningen, The Netherlands
Interests: mucosal immunology; allergy; asthma; food allergy; nutrition; dairy
Special Issues, Collections and Topics in MDPI journals
Prof. Huub Savelkoul

E-Mail Website
Guest Editor
Wageningen University & Research, Cell Biology and Immunology Group, Wageningen, The Netherlands
Interests: the regulation of IgE antibody formation in allergy, the immunogenicity and allergenicity of dietary components, the basic immune-mediated mechanisms in food allergy, the immunomodulation by food and feed, and the development of allergy-linked immunodiagnostics
Special Issues, Collections and Topics in MDPI journals

Special Issue Information

Dear Colleagues,

The purpose of this Special Issue, “Nutrition and Allergic Diseases”, is to provide an overview of the role of nutrition in allergy. The prevalence of asthma, rhinitis and food allergy has increased tremendously over the last few decades. Is there a role for nutrition to help managing this global challenge? This Special Issue will touch upon the many aspects that relate to nutrition and allergy, and focuses on two fundamental questions:

1) Can nutrition play a role in allergy prevention and induction?

2) Can nutrition play a role in managing allergies?

The topics covered should range from epidemiology of nutrition and allergy prevalence, through breastfeeding, microbiota, food allergy, immunotherapy approaches for food allergy, early introduction of food components, food processing, and known effects of food components on allergy.

 

Professor Joost van Neerven

Professor Huub Savelkoul

Guest Editors

 

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Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. Nutrients is an international peer-reviewed open access semimonthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2900 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

  • Asthma
  • Breastfeeding
  • Epidemiology (nutrition and allergy)
  • (Food) allergy
  • Early food introduction and allergy
  • Food processing
  • Hydrolysates
  • Immunotherapy (food allergy)
  • Maternal diet
  • Microbiota and allergy
  • Nutrition
  • Oligosaccharides
  • Prebiotics
  • Probiotics
  • Rhinitis
  • Short chain fatty acids (SCFA)
  • Tolerance
  • Poly unsaturated fatty acids (PUFA)

Published Papers (16 papers)

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Editorial

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490 KiB  
Editorial
Nutrition and Allergic Diseases
by R.J.J. van Neerven and Huub Savelkoul
Nutrients 2017, 9(7), 762; https://doi.org/10.3390/nu9070762 - 17 Jul 2017
Cited by 24 | Viewed by 12230
Abstract
The development of IgE-mediated allergic diseases is influenced by many factors, including genetic and environmental factors such as pollution and farming, but also by nutrition. In the last decade, substantial progress has been made in our understanding of the impact that nutrition can [...] Read more.
The development of IgE-mediated allergic diseases is influenced by many factors, including genetic and environmental factors such as pollution and farming, but also by nutrition. In the last decade, substantial progress has been made in our understanding of the impact that nutrition can have on allergic diseases. Many studies have addressed the effect of breastfeeding, pre-, pro- and synbiotics, vitamins and minerals, fiber, fruit and vegetables, cow’s milk, and n-3 fatty acids, on the development of allergies. In addition, nutrition can also have indirect effects on allergic sensitization. This includes the diet of pregnant and breastfeeding women, which influences intrauterine development, as well as breastmilk composition. These include the diet of pregnant and breastfeeding women that influences intrauterine development as well as breastmilk composition, effects of food processing that may enhance allergenicity of foods, and effects via modulation of the intestinal microbiota and their metabolites. This editorial review provides a brief overview of recent developments related to nutrition and the development and management of allergic diseases. Full article
(This article belongs to the Special Issue Nutrition and Allergic Diseases)
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Research

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1525 KiB  
Article
Effect of Processing Intensity on Immunologically Active Bovine Milk Serum Proteins
by Tabea Brick, Markus Ege, Sjef Boeren, Andreas Böck, Erika Von Mutius, Jacques Vervoort and Kasper Hettinga
Nutrients 2017, 9(9), 963; https://doi.org/10.3390/nu9090963 - 31 Aug 2017
Cited by 57 | Viewed by 7723
Abstract
Consumption of raw cow’s milk instead of industrially processed milk has been reported to protect children from developing asthma, allergies, and respiratory infections. Several heat-sensitive milk serum proteins have been implied in this effect though unbiased assessment of milk proteins in general is [...] Read more.
Consumption of raw cow’s milk instead of industrially processed milk has been reported to protect children from developing asthma, allergies, and respiratory infections. Several heat-sensitive milk serum proteins have been implied in this effect though unbiased assessment of milk proteins in general is missing. The aim of this study was to compare the native milk serum proteome between raw cow’s milk and various industrially applied processing methods, i.e., homogenization, fat separation, pasteurization, ultra-heat treatment (UHT), treatment for extended shelf-life (ESL), and conventional boiling. Each processing method was applied to the same three pools of raw milk. Levels of detectable proteins were quantified by liquid chromatography/tandem mass spectrometry following filter aided sample preparation. In total, 364 milk serum proteins were identified. The 140 proteins detectable in 66% of all samples were entered in a hierarchical cluster analysis. The resulting proteomics pattern separated mainly as high (boiling, UHT, ESL) versus no/low heat treatment (raw, skimmed, pasteurized). Comparing these two groups revealed 23 individual proteins significantly reduced by heating, e.g., lactoferrin (log2-fold change = −0.37, p = 0.004), lactoperoxidase (log2-fold change = −0.33, p = 0.001), and lactadherin (log2-fold change = −0.22, p = 0.020). The abundance of these heat sensitive proteins found in higher quantity in native cow’s milk compared to heat treated milk, renders them potential candidates for protection from asthma, allergies, and respiratory infections. Full article
(This article belongs to the Special Issue Nutrition and Allergic Diseases)
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1372 KiB  
Article
Nut Allergy in Two Different Areas of Spain: Differences in Clinical and Molecular Pattern
by Elisa Haroun-Díaz, Julián Azofra, Eloína González-Mancebo, Manuel De las Heras, Carlos Pastor-Vargas, Vanesa Esteban, Mayte Villalba, Araceli Díaz-Perales and Javier Cuesta-Herranz
Nutrients 2017, 9(8), 909; https://doi.org/10.3390/nu9080909 - 21 Aug 2017
Cited by 17 | Viewed by 6098
Abstract
Introduction: Different clinical and molecular patterns of food allergy have been reported in different areas of the world. The aim of the study is to evaluate differences in allergen patterns among nut-allergic patients in two different areas of Spain. Material and methods: A [...] Read more.
Introduction: Different clinical and molecular patterns of food allergy have been reported in different areas of the world. The aim of the study is to evaluate differences in allergen patterns among nut-allergic patients in two different areas of Spain. Material and methods: A total of 77 patients with nut allergy from two different regions of Spain (Madrid and Asturias) were evaluated. Results: Hazelnut, peanut, and walnut were the three most frequent nuts eliciting allergy in both regions, but in a different order. Patients from Madrid experienced systemic reactions more often than patients from Asturias (73.5% Madrid vs. 50.0%, p < 0.05). The percentage of sensitizations to LTP (Lipid Transfer Protein) was higher than Bet v 1 (p < 0.05) in the Madrid area. The percentage of sensitizations in Asturias area was similar to LTP than Bet v 1 (Pru p 3 46.4%, Bet v 1 42.9%, ns). Bet v 1 was the predominant allergen involved among hazelnut-allergic patients (56.2%), while LTP was more common in peanut-allergic patients (61.5%). Conclusion: Walnut, hazelnut, and peanut were the most frequent nuts eliciting allergy in Spain. Despite this, important differences in molecular pattern were appreciated not only between both regions, but also among nut-allergic patients in Asturias. The different molecular pattern was linked to the frequency of systemic symptoms. Full article
(This article belongs to the Special Issue Nutrition and Allergic Diseases)
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253 KiB  
Article
Diet Quality throughout Early Life in Relation to Allergic Sensitization and Atopic Diseases in Childhood
by Anh N. Nguyen, Niels J. Elbert, Suzanne G. M. A. Pasmans, Jessica C. Kiefte-de Jong, Nicolette W. De Jong, Henriëtte A. Moll, Vincent W. V. Jaddoe, Johan C. De Jongste, Oscar H. Franco, Liesbeth Duijts and Trudy Voortman
Nutrients 2017, 9(8), 841; https://doi.org/10.3390/nu9080841 - 05 Aug 2017
Cited by 16 | Viewed by 6208
Abstract
Early-life nutrition is an important modifiable determinant in the development of a child’s immune system, and may thereby influence the risk of allergic sensitization and atopic diseases. However, associations between overall dietary patterns and atopic diseases in childhood remain unclear. We examined associations [...] Read more.
Early-life nutrition is an important modifiable determinant in the development of a child’s immune system, and may thereby influence the risk of allergic sensitization and atopic diseases. However, associations between overall dietary patterns and atopic diseases in childhood remain unclear. We examined associations of diet quality in early life with allergic sensitization, self-reported physician-diagnosed inhalant and food allergies, eczema, and asthma among 5225 children participating in a population-based cohort in the Netherlands. Diet was assessed during pregnancy, infancy, and childhood using validated food-frequency questionnaires. We calculated food-based diet quality scores (0–10 or 0–15), reflecting adherence to dietary guidelines. At age 10 years, allergic sensitization was assessed with skin prick tests. Information on physician-diagnosed inhalant and food allergies, eczema, and asthma was obtained with questionnaires. We observed no associations between diet quality during pregnancy and allergic sensitization (odds ratio (OR) = 1.05 per point in the diet score, 95% confidence interval (CI): 0.99, 1.13), allergies (0.96, 95% CI: 0.88, 1.04), eczema (0.99, 95% CI: 0.93, 1.06), or asthma (0.93, 95% CI: 0.85, 1.03) in childhood. Also, diet quality in infancy or childhood were not associated with atopic outcomes in childhood. Our findings do not support our hypothesis that a healthy dietary pattern in early life is associated with a lower risk of allergic sensitization or atopic diseases in childhood. Full article
(This article belongs to the Special Issue Nutrition and Allergic Diseases)
675 KiB  
Article
Immune Components in Human Milk Are Associated with Early Infant Immunological Health Outcomes: A Prospective Three-Country Analysis
by Daniel Munblit, Marina Treneva, Diego G. Peroni, Silvia Colicino, Li Yan Chow, Shobana Dissanayeke, Alexander Pampura, Attilio L. Boner, Donna T. Geddes, Robert J. Boyle and John O. Warner
Nutrients 2017, 9(6), 532; https://doi.org/10.3390/nu9060532 - 24 May 2017
Cited by 56 | Viewed by 8382
Abstract
The role of breastfeeding in improving allergy outcomes in early childhood is still unclear. Evidence suggests that immune mediators in human milk (HM) play a critical role in infant immune maturation as well as protection against atopy/allergy development. We investigated relationships between levels [...] Read more.
The role of breastfeeding in improving allergy outcomes in early childhood is still unclear. Evidence suggests that immune mediators in human milk (HM) play a critical role in infant immune maturation as well as protection against atopy/allergy development. We investigated relationships between levels of immune mediators in colostrum and mature milk and infant outcomes in the first year of life. In a large prospective study of 398 pregnant/lactating women in the United Kingdom, Russia and Italy, colostrum and mature human milk (HM) samples were analysed for immune active molecules. Statistical analyses used models adjusting for the site of collection, colostrum collection time, parity and maternal atopic status. Preliminary univariate analysis showed detectable interleukin (IL) 2 and IL13 in HM to be associated with less eczema. This finding was further confirmed in multivariate analysis, with detectable HM IL13 showing protective effect OR 0.18 (95% CI 0.04–0.92). In contrast, a higher risk of eczema was associated with higher HM concentrations of transforming growth factor β (TGFβ) 2 OR 1.04 (95% CI 1.01–1.06) per ng/mL. Parental-reported food allergy was reported less often when IL13 was detectable in colostrum OR 0.10 (95% CI 0.01–0.83). HM hepatocyte growth factor (HGF) was protective for common cold incidence at 12 months OR 0.19 (95% CI 0.04–0.92) per ng/mL. Data from this study suggests that differences in the individual immune composition of HM may have an influence on early life infant health outcomes. Increased TGFβ2 levels in HM are associated with a higher incidence of reported eczema, with detectable IL13 in colostrum showing protective effects for food allergy and sensitization. HGF shows some protective effect on common cold incidence at one year of age. Future studies should be focused on maternal genotype, human milk microbiome and diet influence on human milk immune composition and both short- and long-term health outcomes in the infant. Full article
(This article belongs to the Special Issue Nutrition and Allergic Diseases)
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3015 KiB  
Article
Hypoallergenic Variant of the Major Egg White Allergen Gal d 1 Produced by Disruption of Cysteine Bridges
by Pathum Dhanapala, Dulashi Withanage-Dona, Mimi L. K. Tang, Tim Doran and Cenk Suphioglu
Nutrients 2017, 9(2), 171; https://doi.org/10.3390/nu9020171 - 21 Feb 2017
Cited by 20 | Viewed by 5992
Abstract
Background: Gal d 1 (ovomucoid) is the dominant allergen in the chicken egg white. Hypoallergenic variants of this allergen can be used in immunotherapy as an egg allergy treatment approach. We hypothesised that disruption of two of the nine cysteine-cysteine bridges by site-directed [...] Read more.
Background: Gal d 1 (ovomucoid) is the dominant allergen in the chicken egg white. Hypoallergenic variants of this allergen can be used in immunotherapy as an egg allergy treatment approach. We hypothesised that disruption of two of the nine cysteine-cysteine bridges by site-directed mutagenesis will allow the production of a hypoallergenic variant of the protein; Methods: Two cysteine residues at C192 and C210 in domain III of the protein were mutated to alanine using site-directed mutagenesis, to disrupt two separate cysteine-cysteine bridges. The mutated and non-mutated proteins were expressed in Escherichia coli (E. coli) by induction with isopropyl β-d-1-thiogalactopyranoside (IPTG). The expressed proteins were analysed using sodium dodecyl sulfate polyacrylamide gel electrophoresis (SDS-PAGE) and immunoblotting to confirm expression. Immunoglobulin E (IgE) reactivity of the two proteins was analysed, by immunoblotting, against a pool of egg-allergic patients’ sera. A pool of non-allergic patients’ sera was also used in a separate blot as a negative control; Results: Mutant Gal d 1 showed diminished IgE reactivity in the immunoblot by showing lighter bands when compared to the non-mutated version, although there was more of the mutant protein immobilised on the membrane when compared to the wild-type protein. The non-allergic negative control showed no bands, indicating an absence of non-specific binding of secondary antibody to the proteins; Conclusion: Disruption of two cysteine bridges in domain III of Gal d 1 reduces IgE reactivity. Following downstream laboratory and clinical testing, this mutant protein can be used in immunotherapy to induce tolerance to Gal d 1 and in egg allergy diagnosis. Full article
(This article belongs to the Special Issue Nutrition and Allergic Diseases)
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Review

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721 KiB  
Review
Human Milk and Allergic Diseases: An Unsolved Puzzle
by Daniel Munblit, Diego G. Peroni, Alba Boix-Amorós, Peter S. Hsu, Belinda Van’t Land, Melvin C. L. Gay, Anastasia Kolotilina, Chrysanthi Skevaki, Robert J. Boyle, Maria Carmen Collado, Johan Garssen, Donna T. Geddes, Ralph Nanan, Carolyn Slupsky, Ganesa Wegienka, Anita L. Kozyrskyj and John O. Warner
Nutrients 2017, 9(8), 894; https://doi.org/10.3390/nu9080894 - 17 Aug 2017
Cited by 103 | Viewed by 19421
Abstract
There is conflicting evidence on the protective role of breastfeeding in relation to the development of allergic sensitisation and allergic disease. Studies vary in methodology and definition of outcomes, which lead to considerable heterogeneity. Human milk composition varies both within and between individuals, [...] Read more.
There is conflicting evidence on the protective role of breastfeeding in relation to the development of allergic sensitisation and allergic disease. Studies vary in methodology and definition of outcomes, which lead to considerable heterogeneity. Human milk composition varies both within and between individuals, which may partially explain conflicting data. It is known that human milk composition is very complex and contains variable levels of immune active molecules, oligosaccharides, metabolites, vitamins and other nutrients and microbial content. Existing evidence suggests that modulation of human breast milk composition has potential for preventing allergic diseases in early life. In this review, we discuss associations between breastfeeding/human milk composition and allergy development. Full article
(This article belongs to the Special Issue Nutrition and Allergic Diseases)
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271 KiB  
Review
Role of Microbial Modulation in Management of Atopic Dermatitis in Children
by Lies Hulshof, Belinda Van’t Land, Aline B. Sprikkelman and Johan Garssen
Nutrients 2017, 9(8), 854; https://doi.org/10.3390/nu9080854 - 09 Aug 2017
Cited by 29 | Viewed by 5859
Abstract
The pathophysiology of atopic dermatitis (AD) is multifactorial and is a complex interrelationship between skin barrier, genetic predisposition, immunologic development, skin microbiome, environmental, nutritional, pharmacological, and psychological factors. Several microbial modulations of the intestinal microbiome with pre- and/or probiotics have been used in [...] Read more.
The pathophysiology of atopic dermatitis (AD) is multifactorial and is a complex interrelationship between skin barrier, genetic predisposition, immunologic development, skin microbiome, environmental, nutritional, pharmacological, and psychological factors. Several microbial modulations of the intestinal microbiome with pre- and/or probiotics have been used in AD management, with different clinical out-come (both positive, as well as null findings). This review provides an overview of the clinical evidence from trials in children from 2008 to 2017, aiming to evaluate the effect of dietary interventions with pre- and/or pro-biotics for the treatment of AD. By searching the PUBMED/MEDLINE, EMBADE, and COCHRANE databases 14 clinical studies were selected and included within this review. Data extraction was independently conducted by two authors. The primary outcome was an improvement in the clinical score of AD severity. Changes of serum immunological markers and/or gastrointestinal symptoms were explored if available. In these studies some dietary interventions with pre- and/or pro-biotics were beneficial compared to control diets in the management of AD in children, next to treatment with emollients, and/or local corticosteroids. However, heterogeneity between studies was high, making it clear that focused clinical randomized controlled trials are needed to understand the potential role and underlying mechanism of dietary interventions in children with AD. Full article
(This article belongs to the Special Issue Nutrition and Allergic Diseases)
240 KiB  
Review
The Role of Nutritional Aspects in Food Allergy: Prevention and Management
by Alessandra Mazzocchi, Carina Venter, Kate Maslin and Carlo Agostoni
Nutrients 2017, 9(8), 850; https://doi.org/10.3390/nu9080850 - 09 Aug 2017
Cited by 33 | Viewed by 9291
Abstract
The prevalence of food allergy in childhood appears to be increasing in both developed and transitional countries. The aim of this paper is to review and summarise key findings in the prevention and management of food allergy, focusing on the role of dietary [...] Read more.
The prevalence of food allergy in childhood appears to be increasing in both developed and transitional countries. The aim of this paper is to review and summarise key findings in the prevention and management of food allergy, focusing on the role of dietary components and nutritional habits in the development and optimal functioning of the immune system. Essential fatty acids, zinc and vitamin D are likely to enhance the anti-inflammatory and antioxidative barrier and promote immunologic tolerance. Additionally, nutritional components such as pre- and probiotics represent a novel research approach in the attempt to induce a tolerogenic immune environment. For all these reasons, the traditional avoidance diet has been, in recent years, completely reconsidered. New findings on the protective effect of an increased diversity of food introduced in the first year of life on allergic diseases are consistent with the hypothesis that exposure to a variety of food antigens during early life might play a role in the development of immune tolerance. Accordingly, therapeutic (and even preventive) interventions should be planned on an individual basis. Full article
(This article belongs to the Special Issue Nutrition and Allergic Diseases)
2637 KiB  
Review
Food Processing: The Influence of the Maillard Reaction on Immunogenicity and Allergenicity of Food Proteins
by Malgorzata Teodorowicz, Joost Van Neerven and Huub Savelkoul
Nutrients 2017, 9(8), 835; https://doi.org/10.3390/nu9080835 - 04 Aug 2017
Cited by 137 | Viewed by 24815
Abstract
The majority of foods that are consumed in our developed society have been processed. Processing promotes a non-enzymatic reaction between proteins and sugars, the Maillard reaction (MR). Maillard reaction products (MRPs) contribute to the taste, smell and color of many food products, and [...] Read more.
The majority of foods that are consumed in our developed society have been processed. Processing promotes a non-enzymatic reaction between proteins and sugars, the Maillard reaction (MR). Maillard reaction products (MRPs) contribute to the taste, smell and color of many food products, and thus influence consumers’ choices. However, in recent years, MRPs have been linked to the increasing prevalence of diet- and inflammation-related non-communicable diseases including food allergy. Although during the last years a better understanding of immunogenicity of MRPs has been achieved, still only little is known about the structural/chemical characteristics predisposing MRPs to interact with antigen presenting cells (APCs). This report provides a comprehensive review of recent studies on the influence of the Maillard reaction on the immunogenicity and allergenicity of food proteins. Full article
(This article belongs to the Special Issue Nutrition and Allergic Diseases)
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1271 KiB  
Review
Can Early Omega-3 Fatty Acid Exposure Reduce Risk of Childhood Allergic Disease?
by Elizabeth A. Miles and Philip C. Calder
Nutrients 2017, 9(7), 784; https://doi.org/10.3390/nu9070784 - 21 Jul 2017
Cited by 103 | Viewed by 14564
Abstract
A causal link between increased intake of omega-6 (n-6) polyunsaturated fatty acids (PUFAs) and increased incidence of allergic disease has been suggested. This is supported by biologically plausible mechanisms, related to the roles of eicosanoid mediators produced from the n-6 [...] Read more.
A causal link between increased intake of omega-6 (n-6) polyunsaturated fatty acids (PUFAs) and increased incidence of allergic disease has been suggested. This is supported by biologically plausible mechanisms, related to the roles of eicosanoid mediators produced from the n-6 PUFA arachidonic acid. Fish and fish oils are sources of long chain omega-3 (n-3) PUFAs. These fatty acids act to oppose the actions of n-6 PUFAs particularly with regard to eicosanoid synthesis. Thus, n-3 PUFAs may protect against allergic sensitisation and allergic manifestations. Epidemiological studies investigating the association between maternal fish intake during pregnancy and allergic outcomes in infants/children of those pregnancies suggest protective associations, but the findings are inconsistent. Fish oil provision to pregnant women is associated with immunologic changes in cord blood. Studies performed to date indicate that provision of fish oil during pregnancy may reduce sensitisation to common food allergens and reduce prevalence and severity of atopic eczema in the first year of life, with a possible persistence until adolescence. A recent study reported that fish oil consumption in pregnancy reduces persistent wheeze and asthma in the offspring at ages 3 to 5 years. Eating oily fish or fish oil supplementation in pregnancy may be a strategy to prevent infant and childhood allergic disease. Full article
(This article belongs to the Special Issue Nutrition and Allergic Diseases)
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402 KiB  
Review
Prevention and Management of Cow’s Milk Allergy in Non-Exclusively Breastfed Infants
by Yvan Vandenplas
Nutrients 2017, 9(7), 731; https://doi.org/10.3390/nu9070731 - 10 Jul 2017
Cited by 70 | Viewed by 16687
Abstract
Introduction: The prevention and management of cow milk allergy (CMA) is still debated. Since CMA is much less frequent in breastfed infants, breastfeeding should be stimulated. Method: Literature was searched using databases to find original papers and reviews on this topic. Results: Hydrolysates [...] Read more.
Introduction: The prevention and management of cow milk allergy (CMA) is still debated. Since CMA is much less frequent in breastfed infants, breastfeeding should be stimulated. Method: Literature was searched using databases to find original papers and reviews on this topic. Results: Hydrolysates with a clinical proof of efficacy are recommended in the prevention and treatment of CMA. However, not all meta-analyses conclude that hydrolysates do prevent CMA or other atopic manifestations such as atopic dermatitis. There are pros and cons to consider partially hydrolysed protein as an option for starter infant formula for each non-exclusively breastfed infant. A challenge test is still recommended as the most specific and sensitive diagnostic test, although a positive challenge test does not proof that the immune system is involved. The Cow Milk Symptom Score (CoMiSS™) is an awareness tool that enables healthcare professionals to better recognize symptoms related to the ingestion of cow milk, but it still needs validation as diagnostic tool. The current recommended elimination diet is a cow milk based extensive hydrolysate, although rice hydrolysates or soy infant formula can be considered in some cases. About 10 to 15% of infants allergic to cow milk will also react to soy. Mainly because of the higher cost, amino acid based formula is reserved for severe cases. There is no place for infant formula with intact protein from other animals as cross-over allergenicity is high. During recent years, attention focused also on the bifidogenic effect of prebiotics and more recently also on human milk oligosaccharides. A bifidogenic gastrointestinal microbiome may decrease the risk to develop allergic disease. The addition of probiotics and prebiotics to the elimination diet in treatment may enhance the development of tolerance development. Conclusion: Breastfeeding is the best way to feed infants. Cow milk based extensive hydrolysates remain the first option for the treatment of CMA for the majority of patients, while amino acid formulas are reserved for the most severe cases. Rice hydrolysates and soy infant formula are second choice options. Partial hydrolysates with clinical proof of efficacy are recommended in some guidelines in the prevention of CMA and allergic disease in at risk infants, and may be considered as an option as protein source in starter infant formula. Full article
(This article belongs to the Special Issue Nutrition and Allergic Diseases)
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2046 KiB  
Review
Gut Microbiota as a Target for Preventive and Therapeutic Intervention against Food Allergy
by Rosita Aitoro, Lorella Paparo, Antonio Amoroso, Margherita Di Costanzo, Linda Cosenza, Viviana Granata, Carmen Di Scala, Rita Nocerino, Giovanna Trinchese, Mariangela Montella, Danilo Ercolini and Roberto Berni Canani
Nutrients 2017, 9(7), 672; https://doi.org/10.3390/nu9070672 - 28 Jun 2017
Cited by 80 | Viewed by 18067
Abstract
The gut microbiota plays a pivotal role in immune system development and function. Modification in the gut microbiota composition (dysbiosis) early in life is a critical factor affecting the development of food allergy. Many environmental factors including caesarean delivery, lack of breast milk, [...] Read more.
The gut microbiota plays a pivotal role in immune system development and function. Modification in the gut microbiota composition (dysbiosis) early in life is a critical factor affecting the development of food allergy. Many environmental factors including caesarean delivery, lack of breast milk, drugs, antiseptic agents, and a low-fiber/high-fat diet can induce gut microbiota dysbiosis, and have been associated with the occurrence of food allergy. New technologies and experimental tools have provided information regarding the importance of select bacteria on immune tolerance mechanisms. Short-chain fatty acids are crucial metabolic products of gut microbiota responsible for many protective effects against food allergy. These compounds are involved in epigenetic regulation of the immune system. These evidences provide a foundation for developing innovative strategies to prevent and treat food allergy. Here, we present an overview on the potential role of gut microbiota as the target of intervention against food allergy. Full article
(This article belongs to the Special Issue Nutrition and Allergic Diseases)
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357 KiB  
Review
Diet Hypotheses in Light of the Microbiota Revolution: New Perspectives
by Tomasz P. Wypych and Benjamin J. Marsland
Nutrients 2017, 9(6), 537; https://doi.org/10.3390/nu9060537 - 24 May 2017
Cited by 20 | Viewed by 6356
Abstract
From an evolutionary standpoint, allergy has only recently emerged as a significant health problem. Various hypotheses were proposed to explain this, but they all indicated the importance of rapid lifestyle changes, which occurred in industrialized countries in the last few decades. In this [...] Read more.
From an evolutionary standpoint, allergy has only recently emerged as a significant health problem. Various hypotheses were proposed to explain this, but they all indicated the importance of rapid lifestyle changes, which occurred in industrialized countries in the last few decades. In this review, we discuss evidence from epidemiological and experimental studies that indicate changes in dietary habits may have played an important role in this phenomenon. Based on the example of dietary fiber, we discuss molecular mechanisms behind this and point towards the importance of diet-induced changes in the microbiota. Finally, we reason that future studies unraveling mechanisms governing these changes, along with the development of better tools to manipulate microbiota composition in individuals will be crucial for the design of novel strategies to combat numerous inflammatory disorders, including atopic diseases. Full article
(This article belongs to the Special Issue Nutrition and Allergic Diseases)
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1846 KiB  
Review
Effects of Fruit and Vegetable Consumption on Risk of Asthma, Wheezing and Immune Responses: A Systematic Review and Meta-Analysis
by Banafshe Hosseini, Bronwyn S. Berthon, Peter Wark and Lisa G. Wood
Nutrients 2017, 9(4), 341; https://doi.org/10.3390/nu9040341 - 29 Mar 2017
Cited by 109 | Viewed by 15326
Abstract
Abstract: Evidence suggests that reduced intake of fruit and vegetables may play a critical role in the development of asthma and allergies. The present review aimed to summarize the evidence for the association between fruit and vegetable intake, risk of asthma/wheeze and [...] Read more.
Abstract: Evidence suggests that reduced intake of fruit and vegetables may play a critical role in the development of asthma and allergies. The present review aimed to summarize the evidence for the association between fruit and vegetable intake, risk of asthma/wheeze and immune responses. Databases including PubMed, Cochrane, CINAHL and EMBASE were searched up to June 2016. Studies that investigated the effects of fruit and vegetable intake on risk of asthma/wheeze and immune responses were considered eligible (n = 58). Studies used cross-sectional (n = 30), cohort (n = 13), case-control (n = 8) and experimental (n = 7) designs. Most of the studies (n = 30) reported beneficial associations of fruit and vegetable consumption with risk of asthma and/or respiratory function, while eight studies found no significant relationship. Some studies (n = 20) reported mixed results, as they found a negative association between fruit only or vegetable only, and asthma. In addition, the meta-analyses in both adults and children showed inverse associations between fruit intake and risk of prevalent wheeze and asthma severity (p < 0.05). Likewise, vegetable intake was negatively associated with risk of prevalent asthma (p < 0.05). Seven studies examined immune responses in relation to fruit and vegetable intake in asthma, with n = 6 showing a protective effect against either systemic or airway inflammation. Fruit and vegetable consumption appears to be protective against asthma. Full article
(This article belongs to the Special Issue Nutrition and Allergic Diseases)
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Review
Maternal Folic Acid Supplementation during Pregnancy and Childhood Allergic Disease Outcomes: A Question of Timing?
by Catrina L. McStay, Susan L. Prescott, Carol Bower and Debra J. Palmer
Nutrients 2017, 9(2), 123; https://doi.org/10.3390/nu9020123 - 09 Feb 2017
Cited by 50 | Viewed by 11505
Abstract
Since the early 1990s, maternal folic acid supplementation has been recommended prior to and during the first trimester of pregnancy, to reduce the risk of infant neural tube defects. In addition, many countries have also implemented the folic acid fortification of staple foods, [...] Read more.
Since the early 1990s, maternal folic acid supplementation has been recommended prior to and during the first trimester of pregnancy, to reduce the risk of infant neural tube defects. In addition, many countries have also implemented the folic acid fortification of staple foods, in order to promote sufficient intakes amongst women of a childbearing age, based on concerns surrounding variable dietary and supplementation practices. As many women continue to take folic acid supplements beyond the recommended first trimester, there has been an overall increase in folate intakes, particularly in countries with mandatory fortification. This has raised questions on the consequences for the developing fetus, given that folic acid, a methyl donor, has the potential to epigenetically modify gene expression. In animal studies, folic acid has been shown to promote an allergic phenotype in the offspring, through changes in DNA methylation. Human population studies have also described associations between folate status in pregnancy and the risk of subsequent childhood allergic disease. In this review, we address the question of whether ongoing maternal folic acid supplementation after neural tube closure, could be contributing to the rise in early life allergic diseases. Full article
(This article belongs to the Special Issue Nutrition and Allergic Diseases)
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