Medline ® Abstracts for References 22,23
of 'Oral food challenges for diagnosis and management of food allergies'
Fatty acid deficiency profile in children with food allergy managed with elimination diets.
Aldámiz-Echevarría L, Bilbao A, Andrade F, Elorz J, Prieto JA, Rodríguez-Soriano J
Acta Paediatr. 2008;97(11):1572.
AIM: To evaluate plasma fatty acid (FA) composition of children with food allergy undergoing elimination diets that avoided the offending antigens.
METHODS: Twenty-five children (14 male, 11 female) aged 3.8 +/- 1.6 years (range 2-7 years) affected of multiple food allergy and managed with elimination diets participated in a cross-sectional study. Results of plasma fatty acids were compared with data obtained in 61 healthy children.
RESULTS: The patients had significantly lower values for plasma content in total polyunsaturated fatty acids, omega3 polyunsaturated fatty acids and long-chain omega3 polyunsaturated fatty acids (p<0.001) and particularly, in eicosapentaenoic acid (EPA) (20:5omega3) and docosahexaenoic acid (DHA) (22:6omega3) (p<0.001). Moreover, all established indices (essential fatty acid [EFA]index ((omega3 +omega6)/(omega7 +omega9)) (p<0.001) and sufficiency of docosahexaenoic acid index (C22:6omega3/C22:5omega6) (p<0.001)) confirmed the presence of EFA deficiency.
CONCLUSION: Children with food allergy managed with restricted intake of foods such as milk, egg, fish and vegetables are at risk of developing a deficiency in EFA and particularly in omega3 long-chain polyunsaturated fatty acids, which are especially necessary for adequate growth, neurological development and cardiovascular health.
Divisions of Metabolism, Department of Pediatrics, Hospital de Cruces, Basque University School of Medicine, Bilbao, País Vasco, Spain. firstname.lastname@example.org
Parental anxiety before and after food challenges in children with suspected peanut and hazelnut allergy.
Zijlstra WT, Flinterman AE, Soeters L, Knulst AC, Sinnema G, L'Hoir MP, Pasmans SG
Pediatr Allergy Immunol. 2010;21(2 Pt 2):e439.
As ingestion of peanut and hazelnut by allergic children is potentially life threatening, parents of these children need to be vigilant about their child's dietary intake. This may cause high levels of anxiety. To assess parental anxiety about food-allergic reaction in their child (state anxiety) and their personal disposition to anxiety (trait anxiety). Parental anxiety was investigated again after food challenges. Fifty-seven children (3-16 yr, mean age 7.2) with suspected peanut or hazelnut allergy (mean specific IgE 20.9) were evaluated by double-blind, placebo-controlled food challenge (DBPCFC). Thirty-two children (56%) developed an allergic reaction. All parents completed the Spielberger State-Trait Anxiety Inventory (STAI) prior to DBPCFC and 2 wk, 3 months and 1 yr thereafter. The mean anxiety scores on these moments were compared with each other and with general Dutch norms. The STAI was also investigated in a group that refused DBPCFC. Prior to DBPCFC, parents had high levels of state anxiety in contrast to a lower trait anxiety compared to the norm group. After DBPCFC, the state anxiety was significantly lower, regardless of a positive or negative outcome (p<or=0.05). The state anxiety was still significant lower after 1 yr (p<or=0.03). The trait anxiety remained unchanged in mothers and slightly decreased in fathers. The state anxiety in the group that refused DBPCFC was comparable to the challenge group, but the trait anxiety was significantly higher (p=0.038). Parents of children with suspected peanut or hazelnut allergy show high levels of anxiety about a food-allergic reaction. After DBPCFC, the anxiety was significantly lower, even in the group with a positive outcome.
Department of Pediatric Psychology, University Medical Center Utrecht, Utrecht, The Netherlands. email@example.com