By Sherry Coleman Collins, MS, RDN, LD
Preventing food allergies got a big boost in July 2023 when experts, researchers, and clinicians from across the globe met together in Chicago for the inaugural Global Food Allergy Prevention Summit. Hosted by Center for Food Allergy & Asthma Research (CFAAR) at Northwestern University Feinberg School of Medicine and Ann & Robert H. Lurie Children’s Hospital of Chicago, the event included more than 2 days of presentations and workgroup sessions dedicated to moving food allergy prevention forward.
"The Global Food Allergy Prevention summit gathered every branch of allergy prevention research, from genetics to environment to the microbiome, into one room to formulate a comprehensive blueprint for how we can decrease the incidence of food allergy globally over the next decade,” said Ruchi Gupta, MD, MPH, professor of pediatrics and medicine at the Northwestern University Feinberg School of Medicine and director of CFAAR. “Some factors we know and others we are still exploring. Early introduction of peanut and egg products to babies around 4 to 6 months, can prevent allergies to those foods. We need to make sure there is equity through education, awareness and access to these foods to prevent increasing disparities in food allergy."
Presentations at the event ran the gamut of ongoing food allergy prevention research. There was a significant focus on early infant diet because research, including the LEAP Study published in 2015, has proven that early feeding of peanut containing foods is an effective intervention. Current guidance from NIAID and Dietary Guidelines for Americans encourages parents to introduce peanut-containing foods in an infant-safe way starting at around 4-6 months of age, depending on individual risk factors. Research on early introduction of other allergens was also discussed, with egg being recommended, and a lack of research cited for other common allergens. Ongoing research to determine whether and when to introduce allergens beyond peanut and egg for prevention is underway. Because evidence does not support avoidance, the recommendation from American Academy of Pediatrics is that no foods be avoided in infancy; there is no need to delay the introduction of allergenic foods beyond 6 months of age and that they should not be introduced before 4 months of age to prevent food allergy.
Other contributing factors were discussed at the meeting too. Addressing atopic dermatitis (AD) through prevention and treatment was among the hottest topics. Having AD, such as moderate to severe eczema, is a significant risk factor for the development of food allergies. With that in mind, researchers are exploring how they can identify infants at highest risk for eczema, maternal interventions during pregnancy to reduce risk, and the impact of moisturization and cleaning of the skin.
Another hot topic was that of the gut microbiota. Since infants with food allergies have gut microbiota that is significantly different from those who do not, it is suspected that microbiota manipulation could have an impact on atopy in a way that is protective against food allergies, however more research is needed. Current research in this area includes interventions at birth such as transferring vaginal microbes to babies born via cesarian by swabbing the mother’s vaginal mucosa and spreading it over baby’s skin; introducing pre or probiotics to babies in the first few weeks of life; and the impact of prebiotics such as human milk oligosaccharides on gut maturation. Other research is attempting to quantify the impact of detergents and cleaning agents in the household and further understanding how pollution may alter microbiota.
According to Bob Parker, CEO and president of National Peanut Board, “I am so glad I took the time to go to GFAPS. Not only did I learn a lot about food allergy from the amazing presenters, but the smaller conference also allowed for more personal connections with members of the food allergy research community from the U.S. and other countries. I was gratified to see the strong buy-in from this group on the need to implement early introduction of peanuts and other allergenic foods at early ages, perhaps even sooner than four to six months to maximize the effectiveness.”
Conference organizers and attendees were invited to participate in working groups across the days of the conference in specific topic areas. Sherry Coleman Collins, MS, RDN, LD, registered dietitian nutritionist for NBP, participated in the Early Diet and Infant Feeding working group.
“I was excited to participate in these conversations focused on solutions to barriers that prevent parents and caregivers from implementing early introduction of peanut foods to infants in the U.S. We discussed challenges including fear of reactions and misperception; lack of knowledge and urgency by healthcare providers; and problems with access to accurate information and peanut containing foods by marginalized communities. But we also spent a lot of time discussing solutions, including how everyone who attended the conference can participate in a meaningful way to move early introduction into the standard of care through education and advocacy at their local, state, and national level,” said Coleman Collins.
This global effort is working to coalesce the clinical and research food allergy community and NPB is proud to be at the table to participate in the solutions.