The proverbial “rule of thumb” has always been simple and conveyed as a constantly reechoed message saying: strictly avoid the foods you are allergic to! And even when you eat out, dine out defensively! This works and also is a straightforward instruction. But at an unprecedented state; things are pretty much evolving.

Extensive research spurred on by the increased prevalence of allergies in adults and children alike in the last two decades has given vital insights and an extensive body of knowledge and clues on how to prevent and treat allergies. Some studies have shown that by modifying what children at a high risk eat, we can reduce the prevalence of allergies. And that also, sometimes through exposure to these allergens at an early age together with supplementation of the diet of children and expectant mothers with carefully considered ingredients, we can lower the risk for developing allergies in children.

Some of the studied hypotheses include:

• The hygiene hypothesis: Since gut microbiota and environmental microorganisms can play a crucial role in early immune development. It is posited that growing up in an environment, say a farm or generally rural home where one is easily exposed to microbial burden; this environment is more likely to influence immunological events that lead to allergy. Hence children that are exposed to environmental microbial burdens carry a significantly low risk of developing allergies.
• Food allergen immunotherapy: One of the modern ways to manage food allergies has been targeted nutrition. Also known as the proactive allergen introduction that is usually done at 4 months of growth in children. This primary food allergy prevention aims to reduce the infant’s risk of sensitization to food allergens. This was first done by Schofield in 1908 in a 13-year-old boy with egg allergy who was successfully desensitized by introducing egg in incremental doses. The focus has so far mainly been on children with the most prevalent food allergies to peanut, egg, and cow’s milk.

Nutritional considerations include supplementation with the following ingredients:

• Vitamin D: Several studies have shown an association between low vitamin D levels and food allergy. The deficiency has been shown to exacerbate sensitization and allergic symptoms in food allergies although there have been contradictory reports. The Vitamin D effects have been largely attributed to its effect on the immune system where calcitriol (an active form of vitamin D) influences the epithelial cells, T cells, B cells, and macrophages. Almost all cells of the adaptive immune system express the vitamin D receptor, making them also capable of being vitamin responsive.
• Omega 3 supplements: There is some evidence that maternal Omega 3 polyunsaturated fatty acid supplementation helps reduce the risk of allergies in children although not all studies share it.
• Probiotics e.g. Lactobacillus Rhamnosas: With their ability to adhere to intestinal epithelial cells where they modulate and stabilize the composition of gut microflora, probiotics bacteria may play an important role in the regulation of intestinal and systemic immunity. They actually seem capable of restoring the intestinal microbic equilibrium and modulating the activation of immune cells.
• Prebiotics e.g. Fructo-Oligosaccharides, Galacto-oligosaccharides Prebiotics are non-digestible food ingredients that beneficially influence the health of the host by acting directly on several compartments (epithelial and immune cells) and are therefore of central interest in allergy prevention for their potential to promote a more robust immunological tolerance through these multiple pathways.
• Human Oligosaccharides: Human milk oligosaccharides (HMO) promote the colonization of the gut with Bifidobacteria which is thought to promote mucosal tolerance via interaction with regulatory T-lymphocytes and Toll-like receptors

 References

1. Schofield AT: A case of egg poisoning. Lancet 1908; 1: 716.