• About Us
    • Contact Us
    • Login
    • ObGFirst
  • COVID-19
  • Alerts
  • OB
  • 2T US Atlas
  • The Genome
  • GYN
    • GYN
    • Sexual Health
  • Primary Care
  • Your Practice
  • GrandRounds
  • My Bookshelf
  • Now@ObG
  • Media
About Us Contact Us Login ObGFirst
  • COVID-19
  • Alerts
  • OB
  • 2T US Atlas
  • The Genome
  • GYN
    • GYN
    • Sexual Health
  • Primary Care
  • Your Practice
  • GrandRounds
  • My Bookshelf
  • Now@ObG
  • Media
Grand Rounds

Does Timing of Introduction of Allergenic Food Affect Risk of Allergic or Autoimmune Disease in Infants

image_pdfFavoriteLoadingFavorite

PURPOSE:

  • Ierodiakonou et al. (JAMA, 2016) synthesized previous research to determine the influence of the timing of introduction of allergenic foods into the infant diet and risk of allergic and autoimmune disorders

METHODS:

  • Systematic review and meta-analysis
  • Intervention and observational studies that assessed introduction of allergenic food in the first year of life
  • Allergenic foods included
    • Milk, egg, fish, shellfish, tree nuts, wheat, peanuts and soya
  • Primary outcomes
    • Wheeze, eczema, allergic rhinitis, food allergy, allergic sensitization, type 1 diabetes mellitus, celiac disease, inflammatory bowel disease, autoimmune thyroid disease, and juvenile rheumatoid arthritis

RESULTS:

  • 24 intervention trials evaluated allergic outcomes in 13,298 participants and 5 intervention trials assessed autoimmune diseases in 5623 participants
  • 9 observational studies reported allergic outcomes in 142,103 participants and 48 observational studies evaluated autoimmune diseases in 63,576 participants
  • Peanut introduction at age 4 to 11 months was associated with
    • lower risk of peanut allergy (risk ratio [RR], 0.29; 95% CI, 0.11-0.74; P = .009)
  • Egg introduction (from 4-6 months) based on moderate-certainty evidence was associated with
    • Lower risk of egg allergy (RR, 0.56; 95% CI, 0.36-0.87; P = .009)
  • Fish introduction (before 6-9 months) based on low- to very low-certainty evidence was associated with reduced allergic sensitization and rhinitis
  • Gluten introduction was not associated with risk of celiac disease based on high-certainty evidence
  • Risk reductions not seen for other allergenic foods including cow’s milk

CONCLUSION:

  • This study demonstrated early peanut and egg introduction appears to be associated with lower risk of allergy
  • The data suggests that in humans, oral tolerance appears to be antigen specific (i.e. introduction of peanuts doesn’t protect against egg allergy)
  • Authors suggest that a possible mechanism for early introduction of fish in reducing allergic sensitization are the effects of anti-inflammatory omega-3 polyunsaturated fatty acids found in fish

Learn More – Primary Sources:

Timing of Allergenic Food Introduction to the Infant Diet and Risk of Allergic or Autoimmune Disease: A Systematic Review and Meta-analysis

image_pdfFavoriteLoadingFavorite

< Previous
All Grand Rounds Posts
Next >

Related ObG Topics:

FDA Revision: Fish Consumption Advice for Pregnant and Breastfeeding Mothers and Young Children
NIH Guidance: Early Introduction of Peanuts to Prevent Severe Allergy

Sections

  • COVID-19
  • Alerts
  • OB
  • GYN
    • GYN
    • Sexual Health
  • 2T US Atlas
  • The Genome
  • Primary Care
  • Your Practice
  • Grand Rounds
  • My Bookshelf
  • Now@ObG
  • Media

Are you an
ObG Insider?

Get specially curated clinical summaries delivered to your inbox every week for free

  • Site Map/
  • © ObG Project/
  • Terms and Conditions/
  • Privacy/
  • Contact Us/
© ObG Project
SSL Certificate


  • Already an ObGFirst Member?
    Welcome back

    Log In

    Want to sign up?
    Get guideline notifications
    CME Included

    Sign Up

Get Guideline Alerts Direct to Your Phone
Try ObGFirst Free!

Sign In

Lost your password?

Sign Up for ObGFirst and Stay Ahead

  • - Professional guideline notifications
  • - Daily summary of a clinically relevant
    research paper
  • - Includes 1 hour of CME every month

ObGFirst Free Trial

Already a Member of ObGFirst®?

Please log in to ObGFirst to access the 2T US Atlas

Password Trouble?

Not an ObGFirst® Member Yet?

  • - Access 2T US Atlas
  • - Guideline notifications
  • - Daily research paper summaries
  • - And lots more!
ObGFirst Free Trial

Media - Internet

Computer System Requirements

OBG Project CME requires a modern web browser (Internet Explorer 10+, Mozilla Firefox, Apple Safari, Google Chrome, Microsoft Edge). Certain educational activities may require additional software to view multimedia, presentation, or printable versions of their content. These activities will be marked as such and will provide links to the required software. That software may be: Adobe Flash, Apple QuickTime, Adobe Acrobat, Microsoft PowerPoint, Windows Media Player, or Real Networks Real One Player.

Disclosure of Unlabeled Use

This educational activity may contain discussion of published and/or investigational uses of agents that are not indicated by the FDA. The planners of this activity do not recommend the use of any agent outside of the labeled indications.

The opinions expressed in the educational activity are those of the faculty and do not necessarily represent the views of the planners. Please refer to the official prescribing information for each product for discussion of approved indications, contraindications, and warnings.

Disclaimer

Participants have an implied responsibility to use the newly acquired information to enhance patient outcomes and their own professional development. The information
presented in this activity is not meant to serve as a guideline for patient management. Any procedures, medications, or other courses of diagnosis or treatment discussed or suggested in this activity should not be used by clinicians without evaluation of their patient’s conditions and possible contraindications and/or dangers in use, review of any applicable manufacturer’s product information, and comparison with recommendations of other authorities.

Jointly provided by

NOT ENOUGH CME HOURS

It appears you don't have enough CME Hours to take this Post-Test. Feel free to buy additional CME hours or upgrade your current CME subscription plan

Subscribe

JOIN OBGFIRST AND GET CME/CE CREDITS

One of the benefits of an ObGFirst subscription is the ability to earn CME/CE credits from the ObG entries you read. Tap the button to learn more about ObGFirst

Learn More
Leaving ObG Website

You are now leaving the ObG website and on your way to PRIORITY at UCSF, an independent website. Therefore, we are not responsible for the content or availability of this site