Abstract:
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.
摘要:
背景:最近的证据表明,引入的时机,类型,补充食物/过敏食物的数量可能会影响过敏性疾病的风险。然而,证据尚未更新和全面综合。
方法:Cochrane图书馆,EMBASE,WebofScience,和PubMed数据库从每个数据库开始到2023年5月31日进行搜索(2000年之前的文章被手动排除)。使用RevMan5进行统计分析。采用分级方法对证据的确定性进行评级。这项研究在PROSPERO注册,CRD42022379264。
结果:与>6个月相比,早期引入鸡蛋(≤6个月大)可能会降低年龄<6岁的学龄前儿童的食物过敏风险(OR,0.65;95CI,0.53-0.81),但对哮喘或特应性皮炎(AD)无影响。与12个月后的后期引入相比,在6-12个月时食用鱼类可能会降低儿童哮喘(5-17岁)的风险(OR,0.61;95CI,0.52-0.72)。引入≤6个月大的过敏性食物,与>6个月相比,是未来AD风险(≤10岁儿童)的保护因素(OR,0.93;95CI,0.89-0.97)。对过敏性疾病高危婴儿的益生菌干预显着降低了0-3岁时食物过敏的风险(OR,0.72;95CI,0.56-0.94),6-12岁的哮喘(OR,0.61;95CI,0.41-0.90),和年龄<6岁的AD(3-6岁:OR,0.70;95CI,0.52-0.94;0-3年:或,0.73;95CI,0.59-0.91)。在婴儿期早期引入辅食或高剂量维生素D补充剂与发生食物过敏的风险无关。哮喘,或AD在童年。
结论:为正常婴儿早期引入潜在的过敏原食物,或为过敏高危婴儿早期引入益生菌,可以预防过敏性疾病的发展。