Relationship between growth and food avoidance with food allergy at age 3 years: The Japan Environment and Children's Study (JECS)

Midori Saito; Hideki Hasunuma; Masumi Okuda; Aki Hotta; Tetsuro Fujino; Yasuhiro Takeshima; Masayuki Shima; Japan Environment and Children's Study Group

doi:10.1016/j.waojou.2023.100826

Relationship between growth and food avoidance with food allergy at age 3 years: The Japan Environment and Children's Study (JECS)

World Allergy Organ J. 2023 Oct 30;16(10):100826. doi: 10.1016/j.waojou.2023.100826. eCollection 2023 Oct.

Authors

Midori Saito¹, Hideki Hasunuma², Masumi Okuda¹, Aki Hotta¹, Tetsuro Fujino¹, Yasuhiro Takeshima¹, Masayuki Shima²; Japan Environment and Children's Study Group

Collaborators

Japan Environment and Children's Study Group:
Midori Saito, Hasunuma Hideki, Masumi Okuda, Aki Hotta, Tetsuro Fujino, Yasuhiro Takeshima, Masayuki Shima

Affiliations

¹ Department of Pediatrics, School of Medicine, Hyogo Medical University, Nishinomiya 663-8501, Hyogo, Japan.
² Department of Public Health, School of Medicine, Hyogo Regional Center for the Japan Environment and Children's Study, Hyogo Medical University, Nishinomiya 663-8501, Hyogo, Japan.

Abstract

Background: Basic management for food allergy (FA) is eliminating causative food from the diet, which can impact normal growth. This study examined the association between food avoidance and growth failure among children with FA aged 0-3 years using the Japan Environment and Children's Study (JECS) data.

Methods: Data on height, weight, and FA history registered were collected using self-administered questionnaires at age 1, 1.5, 2, and 3 years. A general linear model was used to examine whether dietary restriction affected body size. Height, weight, and body mass index (BMI) were adjusted for age in months using standard deviation (SD) scores for each age group by month of measurement. Presence of FA or dietary restriction was used as a binary variable.

Results: Of the 38 477 participants included in this analysis, 4070 with FAs had significantly lower SD scores for height and weight at age 3 years. With milk avoidance, significantly lower SD scores for height (male: β = -0.097 [95%CI: 0.175, -0.019], female: β = -0.103 [95%CI: 0.204, -0.002]), a significantly lower SD score for weight (male: β = -0.115[95%CI: 0.187, -0.043], female β = -0.114[95%CI: 0.203, -0.026]) were observed. Soy avoidance in males marked a lower SD score for height (β = -0.307 [95%CI: 0.474, -0.140]). Continued food avoidance until age 3 resulted in significantly lower SD score for height and weight regardless of gender.

Conclusion: Growth impairment was observed with food avoidance at age 3 years. Growth impairment were more obvious in males than in females. With regards food items, the impact of milk and soy was more significant.

Keywords: Food allergy; Food avoidance; Gender differences; Growth; Infancy.