Changes in risk factors for food sensitization in early life: Analysis over a period of 10 years.

Background: Although epidemiological trends of childhood food sensitization (FS) in IgE-mediated food allergy were reported in China, few studies have examined at changes in its risk factors. Objective: To investigate the change in early-life risk factors associated with childhood food sensitization during 2009-2019 in China. Methods: Data from two cross-sectional surveys conducted in 2009 and 2019 (401 and 513 children, respectively) were analyzed. The results of skin prick tests and information on food sensitization-related risk factors in children were summarized, including family history of atopic disease (FHA), demographic characteristics, method of delivery, feeding patterns, sibship size, pet ownership, and vitamin D supplementation. Binary logistic regression was used to calculate the odds ratio and the regression coefficient ß-value of risk factors in the 2009 and 2019 surveys separately. Then, coefficient ß-value differences between the two surveys were analyzed by the bdiff command in STATA to describe the change in risk factors over 10 years. Results: The 2009 survey revealed that FHA, age, only child, and feeding patterns were associated with food sensitization. The 2019 survey showed that food sensitization was affected by age, sex, and feeding patterns. However, from 2009 to 2019, the probability of food sensitization in the only-child group significantly increased by 226.0% (ß-value difference = 0.81, P = 0.024) and decreased by 65.0% in female children (ß-value difference = -1.06, P = 0.008). The effect of age on food sensitization decreased by 50.0% (ß-value difference = -0.69, P < 0.001) over 10 years. Conclusion: The effect of FHA and common lifestyle factors on food sensitization did not significantly change during 2009-2019. However, the influence of demographic characteristics on food sensitization has changed since 2009; that is, older age, male gender, and only child are more likely to develop food sensitization, which needs to be considered in future epidemiological surveys. Clinical Trial Registration: http://www.chictr.org.cn/, identifier ChiCTR1900024338.

World Allergy Organization-McMaster University Guidelines for Allergic Disease Prevention (GLAD-P): Vitamin D.

BACKGROUND: The prevalence of allergic diseases is approximately 10 % in infants whose parents and siblings do not have allergic diseases and 20-30 % in those with an allergic first-degree relative. Vitamin D is involved in the regulation of the immune system and it may play a role in the development, severity and course of asthma and other allergic diseases. OBJECTIVE: The World Allergy Organization (WAO) convened a guideline panel to develop evidence-based recommendations addressing the use of vitamin D in primary prevention of allergic diseases. METHODS: Our WAO guideline panel identified the most relevant clinical questions and performed a systematic review of randomized controlled trials and non-randomized studies (NRS), specifically cohort and case-control studies, of vitamin D supplementation for the prevention of allergic diseases. We also reviewed the evidence about values and preferences, and resource requirements (up to January 2015, with an update on January 30, 2016). We followed the Grading of Recommendations Assessment, Development and Evaluation (GRADE) approach to develop recommendations. RESULTS: Having reviewed the currently available evidence, the WAO guideline panel found no support for the hypothesis that vitamin D supplementation reduces the risk of developing allergic diseases in children. The WAO guideline panel suggest not using vitamin D in pregnant women, breastfeeding mothers, or healthy term infants as a means of preventing the development of allergic diseases. This recommendation does not apply to those mothers and infants who have other indications for prophylactic or therapeutic use of vitamin D. The panel's recommendations are conditional and supported by very low certainty evidence. CONCLUSIONS: WAO recommendations about vitamin D supplementation for the prevention of allergic diseases support parents, clinicians and other health care professionals in their decisions whether or not to use vitamin D in preventing allergic diseases in healthy, term infants.

[Immune state in lung of BALB/c mice with ovalbumin allergy and the effects of fulvotomentoside on lungs of mice].

OBJECTIVE: To investigate immune state in lung of BALB/c mice with ovalbumin (OVA) allergy and the effects of fulvotomentoside (Ful) on lungs of the mice and provide some clues for the mechanism that patients with food allergies were prone to asthma and observe the effects of the treatment with traditional Chinese medicine. METHOD: Ninety-six female BALB/c mice were randomly divided into 6 groups. Mice in group 1 and group 2 were sensitized intraperitoneally and challenged intragastrically with OVA and were exposed to phosphate buffer solution and OVA respectively by nebulized inhalation. Mice in group 3 and group 4 were treated with Ful, other processes were the same as the mice in group 1 and group 2, respectively. Mice in group 5 were not challenged intragastrically with OVA and other processes were the same as the mice in group 2. Group 6 was the control group. The number of total leukocytes and cell classification in bronchoalveolar lavage (BALF) were counted, and inflammatory characteristic of lung was scored by staining with hematoxylin and eosin. The protein expressions of transforming growth factor (TGF-ß1), interleukin-6 (IL-6), interleukin-17 (IL-17A) in lung of the mice were detected by immunohistochemical method. The activation of neutrophils in lung was assayed by the level of myeloroxidase (MPO). RESULT: There was no inflammatory cells infiltration in lung of the mice in group 1. Compared with group 6, numbers of total leukocytes and erythrocytes as well as the percentage of neutrophils and lymphocytes were increased in group 2. Inflammatory score and protein expressions of TGF-ß1 [(75 437 ± 3 638) vs. (6 118 ± 1 978)], IL-6 [(121 650 ± 25 389) vs. (15 726 ± 9 360)], IL-17A [(252 105 ± 31 651)vs. (72 644 ± 12 285)] in lung were increased, too. Inflammatory score and TGF-ß1 (11 054 ± 1 468), IL-6 (50 877 ± 11 744), IL-17A (137 864 ± 28 986) expressions in group 5 were lower than those in group 2. Eosinophils infiltration was significant in group 5. After the treatment with Ful, TGF-ß1 expression did not change and IL-6, IL-17A expressions were decreased in lung of the mice that inhaled OVA. It was not enough for Ful to relieve the neutrophil aggregation and improve inflammatory reaction in lung. CONCLUSION: The expressions of TGF-ß1, IL-6, IL-17A in lung of the mice with OVA allergy were increased markedly after they inhaled specific antigen, which caused serious inflammation that was induced by neutrophil infiltration in lung. Ful could decrease the expressions of IL-6, IL-17A to some extent, but it was not enough to improve pathologic state in lung.

[Analysis of influential factors of infant acceptance of new complementary food].

OBJECTIVE: To investigate the process to accept the new complementary food, by infants and to analyze the influential factors. METHOD: A total of 105 infants were enrolled in this study. Early infant temperament questionnaires were answered by the mothers. The infants were given 10 times to touch new food (carrot mud), and each of their mealtime score of a 5 degrees system was recorded. The distinctions of the food acceptance were analyzed by using chi-square test. The relations between feeding patterns, sex, maternal parity, education and favor of carrot were analyzed by ANOVA and multivariate correlation analysis respectively. RESULT: The infants showed a certain degree of rejection to taste the new food carrot and begin to accept after tasting for several times. By the 5(th) taste the carrot mud was accepted by most infants (87.7%). The breastfed infants were easier to accept the carrot than the formula-fed infants. There was certain degree of difference in accepting the new food between the genders. The male infants were more difficult to accept carrot than female infants. Mother's education level did not affect the baby's acceptance. CONCLUSION: Many factors affect the infant's acceptance of new food. Repeatedly tasting new foods will help the infant's acceptance. Infants need at least 5 times of tasting, preferably more than 10 times, to accept new food. Attention should be paid to increase the infant's early experience on the new food. Further research should explore whether the effects of food on the early formation of the picky eating behavior of children.

[Energy intake of infants at the age of 4-12 months].

OBJECTIVE: To investigate the total energy intake, the energy from milk and other foods in the infants aged 4 to 12 months and analyze the factors related to the energy intake. METHODS: Totally 132 infants aged 4 months, who were brought for serial measurements to the Department of Primary Child Care, from November 2004 to March 2005 were enrolled into this study and were serially followed up until 12 months of age. The infants were divided into 3 groups, group A, age 4-5 months; group B, age 6-8 months; group C, age 9-12 months. The weights and the recumbent body lengths were measured by two professional staff members. The assessment of physical growth of the infants was done by using the CDC2000 reference. As the changes of Z score on weight for age (Delta WAZ) were < -0.67 during the two visits, the participation of the infants to this study was discontinued. The dietary intakes of the infants were calculated according to 24 h dietary records or after weighing foods for sequential 3 days, RESULTS: (1) When the Delta WAZs of the participated infants were between 0.67 and -0.67, the food intakes among three groups were 119-128 g/(kg.d), the protein intakes were 1.82 g/(kg x d), 2.76 g/(kg x d) and 3.52 g/(kg x d), respectively. The milk intakes were 76-114 g/(kg x d), which accounted for 93% of energy intakes in group A, 64% in group B and 56% in group C. The energy intakes of the 3 groups were 83.9 kcal/(kg x d), 81.6 kcal/(kg x d), and 85.8 kcal/(kg x d), respectively, which were almost similar to WHO 2003 recommendations, and lower than that of Chinese RNI. (2) The data from multiple linear regression analysis showed that the food intakes and the energy density were the most important factors related to energy intakes. The energy density of all foods was 0.6-0.8 kcal/g. CONCLUSIONS: (1) The growth of the infants was within the normal range as the energy intakes were 82-86 kcal/(kg x d). (2) The infants may need 900-750 g/d of milk to meet the basic requirements of energy and protein. (3) The food intakes and the energy density were the most important factors related to the energy intakes, the appropriate energy density for infants is 0.6-0.8 kcal/g.

[Immunoregulatory effects of the Lonicera aquatic extract in the ovalbulmin-sensitized BALB/c mice].

OBJECTIVE: To evaluate the immunoregulatory effects of the Lonicera water extract in the ovalbulmin (OVA)-sensitized BALB/c mice and to explore feasibility of treating food allergy with the traditional Chinese medicine (TCM). METHODS: Forty female BALB/c mice aged 6 weeks fed with ovalbulmin-free feed, were randomly divided into 5 groups with 8 mice in each. Four groups were sensitized with OVA intraperitoneally two times and challenged intragastrically four times. Groups H, M and L were treated respectively with high (100 mg/100 ml), medium (50 mg/100ml) and low (25 mg/100 ml) concentration of the Lonicera water extract at a dose of 0.3 ml/10 g body weight just 4 hours after the first challenge and then twice daily for 10 consecutive days. The mice in group Ch were used as positive control and were sensitized intraperitoneally and treated with normal saline solution intragastrically daily. The mice in NS group were used as negative control without sensitization and challenge. Just 1 hour after the last challenge, the mice in each group were sacrificed and specimens of jejunum were taken. Histological examinations on the jejunum specimens were performed after either HE or toluidine blue staining, the levels of histamine in gut of the mice were assayed with a fluorescent method; the IFN-gamma and IL-4 production in peripheral lymph node mononuclear cell (PLNMC) and the OVA-specific IgE levels in serum were measured by using ELISA; the mRNA expression of IL-12p40 in PLNMC of the mice was evaluated by RT-PCR; the footpad swelling reactions were assessed for the OVA-induced delayed hypersensitivity. RESULTS: (1) The inflammatory reactions were significantly inhibited in the mice of group H and M; the accumulated and degranulated mast cells in lamina propria were significantly reduced in the mice by gavage with 100% or 50% of the Lonicera extract, concomitant with the increased percentage of the intact mast cells. (2) The release of histamine in gut in the mice of group H and M was significantly reduced. (3) Either the IL-4 production and the ratio of IL-4/IFN-gamma in PLNMC or the IFN-gamma generation was significantly reduced in group H and M. (4) IL-12p40 mRNA expression in PLNMC was significantly reduced in group H and M. (5) The levels of OVA-specific IgE in serum were reduced in the mice of group H and M. (6) The footpad swelling reactions induced in the allergic mice were significantly inhibited after giving the Lonicera extract of the three different concentrations. CONCLUSION: The Lonicera extract showed significant immunoregulatory effects in OVA-induced allergic mice model in this study. Lonicera extract may be of potential research value in treatment of both IgE and none IgE mediated food allergy.

[Effects of calcium supplementation on bone mineral accretion in adolescents].

The trial is conducted to evaluate the effects of calcium on bone mineral accretion in adolescents. 161 healthy adolescents aged of 9 to 20 year-old are recruited and are randomly divided into experimental groups in which 300 mg Ca is supplemented per day for each participant and control group. The dietary calcium, physical activity, SMR, distal one-third radial bone mineral content (BMC), bone width (BW), height, weight and serum total ALP are measured at both the beginning and the end of the trial. It is found that the average calcium intake from dietary sources is 500 mg/d in both groups. Increasing daily calcium intake via calcium supplementation in adolescents results in a moderate increases of BMC, and there is a significant increase of BMC in the females during the late adolescence. No significant differences in anthropometry are observed between the two groups at the end of the study while the increase of serum ALP level in the females in experiment group is significantly lower than that in the control group during the late adolescence. It is concluded that during the pubertal years when the BMC accretion is evident, there are no significant differences in bone mass accrual between the two groups. While in the females, calcium supplementation may help enhance the bone mineral accrual during late adolescence when the BMC accretion is remarkably reduced.