PURPOSE OF THE STUDY.
To assess whether the timing and diversity of complementary foods introduced during infancy affects the development of allergic sensitization by the age of 5 years.
This analysis included 3675 children who were part of the Finnish Type 1 Diabetes Prediction and Prevention prospective cohort, which started in 1994. These children participated in a nutrition study during infancy and underwent an allergy evaluation at age 5.
This was a prospective cohort study nested in the larger Diabetes Prediction and Prevention population-based cohort. The child’s diet was assessed during infancy (3, 6, and 12 months) by dietary questionnaires, which asked specifically about breastfeeding, use of formula and cow’s milk, dietary supplements, and complementary food introduction. When the child reached 5 years, he or she underwent testing for specific immunoglobulin E to select environmental and food allergens.
Early introduction of oats (<5.5 months), wheat (<6.5 months), rye (<7 months), barley (<7.5 months), fish (<9 months), and egg (<11 months) decreased the risk of subsequent sensitization to both food and inhalant allergens. The risk of sensitization was also decreased when children had 4 or more complementary foods introduced by 4 and 6 months. These associations were stronger when looking at children with eczema or a parental history of atopy.
The results of this study show that early introduction of cereals, fish, and egg, as well as a greater diversity of foods introduced between 3 and 6 months, was protective against subsequent allergic sensitization. This effect was most pronounced in those at high risk for developing atopy.
This study supports the theory that early introduction of complementary foods is protective against the development of allergic disease, particularly in those at high risk for developing allergies. Nonetheless, this remains observational data and more conclusive evidence on this topic is expected to be generated soon from randomized controlled trials currently under way.
- Copyright © 2013 by the American Academy of Pediatrics