Experts address measures to curb rise in food allergies

By Stephen Daniells

- Last updated on GMT

The growing number of people suffering from allergies is due to
changes in European diets over the past 30 years, says a new review
from the Global Allergy and Asthma European Network
(GA2LEN).

But by targeting several key areas, particularly how children are fed early in life, including breastfeeding, their early diet and increasing the use of pre- and probiotics could have a direct positive effect on the subsequent development of asthma and allergies.

According to the European Federation of Allergy and Airways Diseases Patients' Associations, an estimated four per cent of adults and eight per cent of children in the 380m EU population suffer from food allergies.

However, the new review reports that the real figures are actually lower than this. Writing in the journal, the reviewers state: "The true prevalence of food allergy is low among adults with an estimated prevalence of one to two per cent as confirmed by proper diagnostic criteria.

"In contrast prospective studies in children have shown a cumulated prevalence of food allergy of up to six to eight percent of children below three years of age with a decreasing prevalence in later childhood."

As a result, the "free-from"​ food market has been enjoying sales growth of over 300 per cent in the UK since 2000, according to market analyst Mintel.

The new review, published in the journal in Clinical and Experimental Allergy Reviews​ (Vol. 6, pp. 117-188) and authored by 12 European experts, led by Professor Philip Calder, Institute of Human Nutrition, University of Southampton, reports three main areas producing key findings: breastfeeding, intake of certain nutrients, and pre- and probiotics.

The reviewers report that there is sufficient evidence to conclude that exclusive breastfeeding for four months could protect the child from cows milk protein allergy until 18 months, may reduces the incidence skin allergy until three years, and could cut asthma up to the age of six.

However, the long-term benefits of breast-feeding is not known, said the reviewers, and requires further research.

A second major area of importance that may determine allergy (food or otherwise) appears to be dietary components, said the reviewers. Antioxidants in the diet, such as vitamin C, vitamin E and selenium, may have a protective effect, they said.

"If antioxidants exert their beneficial influence early in life, antioxidant strategies would only be successful if targeted towards mothers during pregnancy and very young children (0 to 5 years,"​ wrote the reviewers.

Additionally, fats found in milk, butter, vegetable oils and fish may also have different effects on allergy development, they said.

And the review also extends the salt reduction debate, by reporting that, despite "clear-cut evidence"​, reducing sodium intake may help some people suffering from allergies, particularly asthma.

"However much of the research conducted to date [in the area of early diet] has not been systematic in its approach and this makes the drawing of hard conclusions very difficult,"​ said GA2​LEN in a statement.

The role of probiotics and prebiotics in the diet is promising, said the reviewers, and a double blind, placebo-controlled study has recently shown that probiotics can help reduce the risk of atopic disease. This has also remained a key area of research for many companies involved in pre- and probiotics.

Despite being early days for the possible benefits of prebiotics in this area, a number of studies have already been published that show a significant effect of prebiotics due to the impact of non-digestible carbohydrates like inulin and oligofructose on metabolic functions in the intestine. These, in turn, impact on local immune cells in this area, and particularly on the gut-associated lymphoid-tissue, which plays a role in the immune system.

The network has identified ways of meeting the challenge of allergies, saying: "Key focuses should be identification of dietary patterns or factors likely to be involved in altering risk of development of allergies and asthma, and developing the evidence base about whether supplementation with specific fats or probiotics could contribute both to the protection and treatment of allergic diseases."

Allergen labelling regulations came into force on 25 November and require companies to label all pre-packed foods if they contain any of the 12 listed allergenic foods as an ingredient.

The mandatory inclusion on food labels of the most common food allergen ingredients and their derivatives covers cereals containing gluten, fish, crustaceans, egg, peanut, soybeans, milk and dairy products including lactose, nuts, celery, mustard, sesame seed, and sulphites.

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