PMID- 27418957
OWN - NLM
STAT- PubMed-not-MEDLINE
DCOM- 20160715
LR  - 20200930
IS  - 2045-7022 (Print)
IS  - 2045-7022 (Electronic)
IS  - 2045-7022 (Linking)
VI  - 6
DP  - 2016
TI  - The impact of the elimination diet on growth and nutrient intake in children with 
      food protein induced gastrointestinal allergies.
PG  - 25
LID - 10.1186/s13601-016-0115-x [doi]
LID - 25
AB  - BACKGROUND: Non immunoglobulin E (IgE) mediated allergies affecting the 
      gastrointestinal tract require an elimination diet to aid diagnosis. The 
      elimination diet may entail multiple food eliminations that contribute 
      significantly to macro- and micro-nutrient intake which are essential for normal 
      growth and development. Previous studies have indicated growth faltering in 
      children with IgE-mediated allergy, but limited data is available on those with 
      delayed type allergies. We therefore performed a study to establish the impact on 
      growth before and after commencing an elimination diets in children with food 
      protein induced non-IgE mediated gastrointestinal allergies. METHODS: A 
      prospective, observational study was performed at the tertiary gastroenterology 
      department. Children aged 4 weeks-16 years without non-allergic co-morbidities 
      who were required to follow an elimination diet for suspected food protein 
      induced gastrointestinal allergies were included. Growth parameters 
      pre-elimination were taken from clinical notes and post-elimination measurements 
      (weight and height) were taken a minimum of 4 weeks after the elimination diet. A 
      3-day estimated food diary was recorded a minimum of 4 weeks after initiating the 
      elimination diet, including also any hypoallergenic formulas or over the counter 
      milk alternatives that were consumed. RESULTS: We recruited 130 children: 89 
      (68.5 %) boys and a median age of 23.3 months [IQR 9.4-69.2]. Almost all children 
      (94.8 %) in this study eliminated CM from their diet and average contribution of 
      energy in the form of protein was 13.8 % (SD 3.9), 51.2 % (SD 7.5) from 
      carbohydrates and 35 % (SD 7.5) from fat. In our cohort 9 and 2.8 % were stunted 
      and wasted respectively. There was a statistically significant improvement in 
      weight-for-age (Wtage) after the 4 week elimination diet. The elimination diet 
      itself did not improve any of the growth parameters, but achieving energy and 
      protein intake improved Wtage and WtHt respectively, vitamin and/or mineral 
      supplements and hypoallergenic formulas were positively associated with WtHt and 
      Wtage. CONCLUSION: With appropriate dietary advice, including optimal energy and 
      protein intake, hypoallergenic formulas and vitamins and mineral supplementation, 
      growth parameters increased from before to after dietary elimination. These 
      factors were positively associated with growth, irrespective of the type of 
      elimination diet and the numbers of foods eliminated.
FAU - Meyer, Rosan
AU  - Meyer R
AD  - Gastroenterology Department, Great Ormond Street Hospital for Children NHS 
      foundation Trust, London, UK.
FAU - De Koker, Claire
AU  - De Koker C
AD  - Department of Nutrition and Dietetics, Chelsea and Westminster Hospital NHS 
      Foundation Trust, London, UK.
FAU - Dziubak, Robert
AU  - Dziubak R
AD  - Gastroenterology Department, Great Ormond Street Hospital for Children NHS 
      foundation Trust, London, UK.
FAU - Godwin, Heather
AU  - Godwin H
AD  - Gastroenterology Department, Great Ormond Street Hospital for Children NHS 
      foundation Trust, London, UK.
FAU - Dominguez-Ortega, Gloria
AU  - Dominguez-Ortega G
AD  - Nino Jesus University Children Hospital, Madrid, Spain.
FAU - Chebar Lozinsky, Adriana
AU  - Chebar Lozinsky A
AD  - Paediatric Gastroenterology, Universidade Federal de Sao Paulo (UNIFESP), Sao 
      Paulo, Brazil.
FAU - Skrapac, Ana-Kristina
AU  - Skrapac AK
AD  - Department of Nutrition and Dietetics, Chelsea and Westminster Hospital NHS 
      Foundation Trust, London, UK.
FAU - Gholmie, Yara
AU  - Gholmie Y
AD  - Department of Nutrition and Food Sciences, Faculty of Agricultural and Food 
      Sciences, American University of Beirut, Beirut, Lebanon.
FAU - Reeve, Kate
AU  - Reeve K
AD  - Gastroenterology Department, Great Ormond Street Hospital for Children NHS 
      foundation Trust, London, UK.
FAU - Shah, Neil
AU  - Shah N
AD  - Gastroenterology Department, Great Ormond Street Hospital for Children NHS 
      foundation Trust, London, UK ; Institute of Child Health, University College, 
      London, UK.
LA  - eng
PT  - Journal Article
DEP - 20160714
PL  - England
TA  - Clin Transl Allergy
JT  - Clinical and translational allergy
JID - 101576043
PMC - PMC4944436
OTO - NOTNLM
OT  - Anthropometric measures
OT  - Growth
OT  - Malnutrition
OT  - Non-IgE mediated allergy
OT  - Nutrients
EDAT- 2016/07/16 06:00
MHDA- 2016/07/16 06:01
PMCR- 2016/07/14
CRDT- 2016/07/16 06:00
PHST- 2015/12/15 00:00 [received]
PHST- 2016/05/27 00:00 [accepted]
PHST- 2016/07/16 06:00 [entrez]
PHST- 2016/07/16 06:00 [pubmed]
PHST- 2016/07/16 06:01 [medline]
PHST- 2016/07/14 00:00 [pmc-release]
AID - 115 [pii]
AID - 10.1186/s13601-016-0115-x [doi]
PST - epublish
SO  - Clin Transl Allergy. 2016 Jul 14;6:25. doi: 10.1186/s13601-016-0115-x. 
      eCollection 2016.