Effects of Early Diet on the Prevalence of Allergic Disease in Children: A Systematic Review and Meta-Analysis

Shumin Wang; Pingping Yin; Leilei Yu; Fengwei Tian; Wei Chen; Qixiao Zhai

doi:10.1016/j.advnut.2023.10.001

Effects of Early Diet on the Prevalence of Allergic Disease in Children: A Systematic Review and Meta-Analysis

Adv Nutr. 2024 Jan;15(1):100128. doi: 10.1016/j.advnut.2023.10.001. Epub 2023 Oct 10.

Authors

Shumin Wang¹, Pingping Yin¹, Leilei Yu¹, Fengwei Tian¹, Wei Chen², Qixiao Zhai³

Affiliations

¹ State Key Laboratory of Food Science and Resources, Jiangnan University, Wuxi, Jiangsu, China; School of Food Science and Technology, Jiangnan University, Wuxi, Jiangsu, China.
² State Key Laboratory of Food Science and Resources, Jiangnan University, Wuxi, Jiangsu, China; School of Food Science and Technology, Jiangnan University, Wuxi, Jiangsu, China; National Engineering Research Center for Functional Food, Jiangnan University, Wuxi, Jiangsu, China.
³ State Key Laboratory of Food Science and Resources, Jiangnan University, Wuxi, Jiangsu, China; School of Food Science and Technology, Jiangnan University, Wuxi, Jiangsu, China. Electronic address: zhaiqixiao@sina.com.

Abstract

Recent evidence suggests that the timing of introduction, types, and amounts of complementary foods/allergenic foods may influence the risk of allergic disease. However, the evidence has not been updated and comprehensively synthesized. The Cochrane Library, EMBASE, Web of Science, and PubMed databases were searched from the inception of each database up to 31 May 2023 (articles prior to 2000 were excluded manually). Statistical analyses were performed using RevMan 5. The GRADE approach was followed to rate the certainty of evidence. Compared with >6 mo, early introduction of eggs (≤6 mo of age) might reduce the risk of food allergies in preschoolers aged <6 y (odds ratio [OR], 0.65; 95% confidence interval [CI], 0.53, 0.81), but had no effect on asthma or atopic dermatitis (AD). Consumption of fish at 6-12 mo might reduce the risk of asthma in children (aged 5-17 y) compared with late introduction after 12 mo (OR, 0.61; 95% CI: 0.52, 0.72). Introduction of allergenic foods for ≤6 mo of age, compared with >6 mos, was a protective factor for the future risk (children aged ≤10 y) of AD (OR, 0.93; 95% CI: 0.89, 0.97). Probiotic intervention for infants at high risk of allergic disease significantly reduced the risk of food allergy at ages 0-3 y (OR, 0.72; 95% CI: 0.56, 0.94), asthma at 6-12 y (OR, 0.61; 95% CI: 0.41, 0.90), and AD at aged <6 y (3-6 y: OR, 0.70; 95% CI: 0.52, 0.94; 0-3 y: OR, 0.73; 95% CI: 0.59, 0.91). Early introduction of complementary foods or the high-dose vitamin D supplementation in infancy was not associated with the risk of developing food allergies, asthma, or AD during childhood. Early introduction to potential allergen foods for normal infants or probiotics for infants at high risk of allergies may protect against development of allergic disease. This study was registered at PROSPERO as CRD42022379264.

Keywords: Early diet; allergic disease; asthma; atopic dermatitis; complementary foods; food allergies; infant; meta-analysis; systematic review.

Publication types

Meta-Analysis
Systematic Review
Review

MeSH terms

Animals
Asthma* / epidemiology
Asthma* / etiology
Asthma* / prevention & control
Child
Dermatitis, Atopic* / epidemiology
Dermatitis, Atopic* / etiology
Dermatitis, Atopic* / prevention & control
Diet
Eggs
Food Hypersensitivity* / epidemiology
Food Hypersensitivity* / etiology
Food Hypersensitivity* / prevention & control
Humans
Infant
Prevalence