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Effects of Early Diet on the Prevalence of Allergic Disease in Children: A Systematic Review and Meta-Analysis.

Study Design

Type
Meta-Analysis
Methods
Systematic review and meta-analysis of randomized controlled trials; databases searched from inception to 31 May 2023; statistical analyses using RevMan 5; GRADE approach for certainty of evidence.
Funding
Unclear
Recent evidence suggests that the timing of introduction, types, and amounts of complementary foods/allergenic foods may influence the risk of allergic disease. However, the evidence has not been updated and comprehensively synthesized. The Cochrane Library, EMBASE, Web of Science, and PubMed databases were searched from the inception of each database up to 31 May 2023 (articles prior to 2000 were excluded manually). Statistical analyses were performed using RevMan 5. The GRADE approach was followed to rate the certainty of evidence. Compared with >6 mo, early introduction of eggs (≤6 mo of age) might reduce the risk of food allergies in preschoolers aged <6 y (odds ratio [OR], 0.65; 95% confidence interval [CI], 0.53, 0.81), but had no effect on asthma or atopic dermatitis (AD). Consumption of fish at 6-12 mo might reduce the risk of asthma in children (aged 5-17 y) compared with late introduction after 12 mo (OR, 0.61; 95% CI: 0.52, 0.72). Introduction of allergenic foods for ≤6 mo of age, compared with >6 mos, was a protective factor for the future risk (children aged ≤10 y) of AD (OR, 0.93; 95% CI: 0.89, 0.97). Probiotic intervention for infants at high risk of allergic disease significantly reduced the risk of food allergy at ages 0-3 y (OR, 0.72; 95% CI: 0.56, 0.94), asthma at 6-12 y (OR, 0.61; 95% CI: 0.41, 0.90), and AD at aged <6 y (3-6 y: OR, 0.70; 95% CI: 0.52, 0.94; 0-3 y: OR, 0.73; 95% CI: 0.59, 0.91). Early introduction of complementary foods or the high-dose vitamin D supplementation in infancy was not associated with the risk of developing food allergies, asthma, or AD during childhood. Early introduction to potential allergen foods for normal infants or probiotics for infants at high risk of allergies may protect against development of allergic disease. This study was registered at PROSPERO as CRD42022379264.

Research Insights

  • Fish→Reduced Asthma Risk

    high-dose vitamin D supplementation in infancy was not associated with the risk of developing ... asthma ... during childhood

    Effect
    Neutral
    Effect size
    Small
  • Vitamin D→Reduced Allergic Reaction Risk

    high-dose vitamin D supplementation in infancy was not associated with the risk of developing food allergies ... during childhood

    Effect
    Neutral
    Effect size
    Small
  • Vitamin D→Reduced Asthma Risk

    high-dose vitamin D supplementation in infancy was not associated with the risk of developing ... asthma ... during childhood

    Effect
    Neutral
    Effect size
    Small
  • Vitamin D→Reduced Atopic Dermatitis Risk

    high-dose vitamin D supplementation in infancy was not associated with the risk of developing ... AD ... during childhood

    Effect
    Neutral
    Effect size
    Small
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