Early complementary feeding and risk of food sensitization in a birth cohort.
Early complementary feeding and risk of food sensitization in a birth cohort.
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DOI：
10.1016/j.jaci.2011.02.018
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发表时间：
2011-05
期刊：
影响因子：
--
通讯作者：
Johnson CC
中科院分区：
文献类型：
--
作者：
Joseph CL;Ownby DR;Havstad SL;Woodcroft KJ;Wegienka G;MacKechnie H;Zoratti E;Peterson EL;Johnson CC
在4个月之前接触固体食物或牛奶（补充食物）可能会产生免疫保护（耐受性）或损害（过敏）。在美国密歇根州底特律市的WHEALS出生队列中，我们探讨了在小于4个月时引入辅食与2岁时鸡蛋、牛奶和花生过敏原的免疫球蛋白E（IgE）之间的关系。在婴儿1、6和12个月时，母亲接受了有关喂养方法的采访。在2至3岁时采集血样，以评估对鸡蛋、牛奶或花生的致敏性（IgE ≥ 0.35 IU/ml）。在分析的594对母婴中，母亲的平均年龄为29.7岁，60.6%的母亲自称是非洲裔美国人或黑人。在< 4 months was reported by 39.7% of mothers. IgE>2岁时，分别有23.9%（95%置信区间= 20.5-27.6%）、30.6%（26.9-34.5%）和11.4%（8.9-14.3%）的儿童暴露于0.35 IU/ml鸡蛋、牛奶或花生过敏原的辅食。早期喂养和致敏之间的关联被父母的哮喘或过敏史所改变。在多变量分析中，早期喂养降低了有父母病史的儿童花生致敏的风险;校正比值比=0.2（0.1-0.7），p=0.007。当使用IgE> 0.70 IU/ml的临界值时，鸡蛋的相关性也变得显著，aOR=0.5（0.3-0.9），p=0.022。在这个队列中，补充食物引入<4个月与2-3岁时花生（可能还有鸡蛋）致敏风险降低相关，但仅适用于父母有哮喘或过敏史的儿童。喂养习惯是预防过敏的一个可改变的风险因素。通过饮食控制来避免食物过敏仍然存在争议。确定与食物致敏相关的因素可以为过敏预防提供信息。在父母有哮喘或过敏史的儿童中，早期接触辅食可降低花生和鸡蛋致敏的风险。
Exposure to solid food or cow's milk (complementary food) before age 4 months may confer immune protection (tolerance) or detriment (allergy). We explored the relationship between introduction of complementary food <4 months and Immunoglobulin E (IgE) to egg, milk, and peanut allergen at 2 years in the WHEALS birth cohort of Detroit, Michigan, USA. At infant age 1, 6, and 12 months, mothers were interviewed about feeding practices. Blood samples were collected at age 2 to 3 years to assess sensitization (IgE ≥ 0.35 IU/ml) to egg, milk or peanut. For the 594 maternal-infant pairs analyzed, maternal mean age was 29.7 years and 60.6% self-reported as African-American or Black. Infant exposure to complementary food < 4 months was reported by 39.7% of mothers. IgE>0.35 IU/ml for egg, milk, or peanut allergen at age 2 years was observed in 23.9% (95% Confidence Interval = 20.5–27.6%), 30.6% (26.9–34.5%), and 11.4% (8.9–14.3%) of children, respectively. The association between early feeding and sensitization was modified by parental history of asthma or allergy. In multivariable analysis, early feeding reduced the risk of peanut sensitization among children with a parental history; adjusted Odds Ratio=0.2 (0.1–0.7), p=0.007. The relationship also became significant for egg when a cut-off for IgE of > 0.70 IU/ml was used, aOR=0.5 (0.3–0.9), p=0.022. In this cohort, complementary food introduced <4 months was associated with a reduced risk of peanut (and perhaps egg) sensitization by age 2–3 years, but only for children with a parental history of asthma or allergy. Feeding practices represent a modifiable risk factor for prevention of allergy. Avoidance of food allergy through dietary manipulation remains controversial. Identifying factors related to food sensitization could inform allergy prevention. Among children with a parental history of asthma or allergy, exposure to early complementary food reduces the risk of peanut and egg sensitization.
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