Five key risk factors identified in a large-scale review of nearly three million infants across 40 countries may support predict the development of food allergies, according to research published Monday in JAMA Pediatrics. The Canadian-led study points to infant eczema, a family history of food allergy, delayed introduction of allergenic foods after 12 months, parental migration and early dry skin as significant contributors.
Food allergies are an increasing global health concern, with the potential to cause severe, life-threatening reactions. Researchers, led by Dr. Derek Chu of McMaster University, analyzed 190 studies in an effort to pinpoint the most influential factors in the development of these allergies. “Most food allergy is not driven by just one thing,” Chu said, describing the situation as a “perfect storm.”
The review highlighted the importance of early exposure to common allergens. Current guidelines in Canada and the U.S. Recommend introducing non-choking forms of foods like peanuts around six months of age. This advice stems from a 2015 trial that demonstrated a significant reduction – as much as a 40 percent decrease – in peanut allergies among high-risk infants when peanuts were introduced early, according to a report from Village Report.
For infants who tolerate these foods, Canadian guidelines emphasize continued, regular exposure – several times a week – to maintain tolerance. This approach extends to other common allergens, including fish, eggs, and certain fruits.
Beyond delayed introduction of allergens, the presence of atopic dermatitis, commonly known as eczema, emerged as a major risk factor. Researchers stressed the need for prompt and effective management of eczema in early infancy. Dr. Christine McCusker, a pediatric allergist and immunologist at the Montreal Children’s Hospital, who was not involved in the study, noted that proactive skin care, including emollient therapies and avoiding harsh soaps, can help mitigate the risk for children with a genetic predisposition.
The study too identified antibiotic utilize during the first month of life as a potential risk factor. While acknowledging the necessity of antibiotics for treating severe infant infections, Chu suggested that early antibiotic exposure may disrupt the gut microbiome, potentially contributing to the development of allergies. Further research is needed to fully understand this connection, as reported by Allergic Living.
Interestingly, the review found no statistically significant link between several factors and an increased risk of food allergies, including low birth weight, post-term birth, partial breastfeeding, maternal diet during pregnancy, or maternal stress during pregnancy.
Researchers acknowledge the need for more rigorous, randomized controlled trials to establish definitive cause-and-effect relationships. The diversity of study locations and methodologies across the analyzed papers presented a challenge, according to McCusker.
Lucille Friesen, a 17-year-vintage from British Columbia, shared her experience with anaphylactic peanut, tree nut, and soy allergies, diagnosed at age two. Friesen’s early experiences included eczema as an infant and a later introduction to allergenic foods than currently recommended. “I’m just happy that it’s gotten to a place where This proves now, that it can help other people. Maybe their quality of life could be better,” Friesen told CBC News.
