Relationships between infant diet and atopy

Article Outline

• Copyright

In this issue of The Journal, we are publishing three articles and an editorial that relate to infant diet and the development of atopy.

Filipiak et al from the GSF-National Institute for Environment and Health report the results of a large birth cohort study performed in Germany. Almost 6,000 infants were recruited for this four year study of the relationship between the introduction of solid foods in the first twelve months and the development of symptomatic eczema. They found that there was no relationship between the time of introduction of solids or the diversity of solids and the development of eczema.

Another study was also recently completed in the Netherlands. Snijders et al from Maastricht University have performed a study of breastfeeding duration and infant atopic manifestations by maternal allergic status. They found that a longer duration of breastfeeding was associated with a lower risk of eczema in infants of mothers without allergy or asthma. There was a slight effect in mothers with allergy but with no asthma. For asthmatic mothers there was no such relationship. Longer breastfeeding reduced the risk of recurrent wheezing independent of maternal allergic status or asthma status. These findings show that the maternal allergic status appears to effect the relationship between breastfeeding and infant eczema in the first two years of life. However, the protective effect of breastfeeding on recurrent wheezing may be the effect of reduced numbers of respiratory infections.

A related article from Hill et al at the Royal Children’s Hospital, Melbourne, Australia reports on the prevelance of IgE-food sensitization in a cohort of infants with moderate atopic eczema. Fifty-one infants with moderate atopic eczema were studied and IgE-food sensitization was diagnosed if they had positive skin prick tests or if food-specific serum IgE levels were greater than the 95% confidence intervals for various foods. They showed that based on the skin prick test, 86% of the infants had positive sensitization and, using the IgE values, 83%. The main allergies were to egg, peanuts, and milk. 46, or 90%, of the infants were sensitive to at least one food item so in the study atopic eczema was strongly associated with IgE sensitization to common foods.

This is a complex and also a controversial issue. In an invited editorial, Sicherer from the Elliot and Roslyn Jaffee Food Allergy Institute at Mount Sinai School of Medicine discusses the increased frequency of atopic disease and the strong interest in the role of diet in prevention and treatment of atopic disease. He provides insight into these articles and also goes on to discuss current issues in atopic disease in other studies which are in progress.