Ninety-eight children with food allergies (age 3.7 +/- 2.3 years) and 99 age-matched controls (age 4.1 +/- 2.4 years) participated in a study 1. Measurements of height and weight were recorded, and estimates of nutrient intake were based on 3-day diet records. A questionnaire was used to determine food allergies. Children with two or more food allergies were significantly shorter than those with one food allergy. More than 25 % of children consumed less than the recommended amounts of calcium, vitamin D and vitamin E. Children with cow's milk allergy, in particular, received too little dietary calcium. Counselling by a dietitian and the consumption of a suitable specialist formula or a soya product improved the intake of calcium and vitamin D.
Comment: The study concentrated on the effects of an elimination diet, since food allergy was defined with a questionnaire.
Another study 2 included patients of one clinic who had been investigated with food challenge testing (n = more than 700 patients since 1977). Patient notes were used for the retrospective screening. Food allergy was diagnosed if the child had a positive test result to a specific IgE and double-blind food challenge. Children who were less than 3 years of age and demonstrated failure to thrive were enrolled into the study. A total of 11 children fulfilled the criteria. The children were aged between 4 and 33 months, and only two were aged less than 12 months when investigated; the children screened for the study represented 5 % (9/184) of all children aged less than 3 years investigated at the clinic since 1977. The most common symptom was diarrhoea (8/11). Six of 11 had cutaneous manifestations (only one had eczema) and two had respiratory symptoms. The observed feeding times were typically characterised by constant fighting. The notes of each patient included an entry describing strong parental beliefs that certain foods caused a problem; the lists provided by parents typically included 8 (1 - 15) unsuitable foods. One child reacted quickly to milk during challenge testing, and one to egg. All other challenges were negative (according to the local protocol the challenges were short, lasting for a few hours).
An open study 3 describes 63 children from one clinic, assigned to a few-foods diet since 1980, due to severe atopic eczema (the total number of children investigated since 1980 was 600). These children either had widespread (more than 30 % of skin surface area), treatment resistant atopic eczema or they had a history of food intolerance. Forty-three children had widespread and treatment-resistant eczema; the results were analysed in 37/40 children, and the data relating to 12 months' monitoring are available. All children were assigned (without confirmed food allergy) to the same diet containing six foods: lamb, potatoes, carrots, pears, rice and rice crispies for six weeks and 20 infants also received Pregestimil. If the rash-score, which was used to estimate the results, improved more than 20 % the diet was continued after the six weeks, and new foods were introduced to the diet gradually, i.e. one food per week.
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