In an attempt to reverse the observed epidemiological trend, primary prevention strategies for decades aimed at avoiding risk factors and inhibiting their mechanism of action. More recently, attempts were initiated to promote protecting factors and stimulate their mechanisms of action.
Alimentary Ways to Protect
For numerous reasons, breast-feeding is the preferred method of infant nutrition; however, there is still controversy as to whether breast-feeding protects against the
development of allergic diseases.
On the basis of the available data, an “Expert Group” of the “European Academy of Allergology and Clinical Immunology” recommends exclusively breast-feeding for 4 to 6 month irrespective of family history of atopy.
For a long time, primary prevention strategies for asthma were almost exclusively focused on allergen avoidance measures early in life, which were supposed to prevent primary sensitization to both food and inhalant allergens.
For several years, the use of hydrolyzed formula was recommended as an alternative for infants, for whom breast milk was not available and who were genetically predisposed to atopic diseases. Indeed, the German Infant Nutritional Intervention (GINI) Study demonstrated that extensively as well as certain partially hydrolyzed formulas compared to unhydrolyzed infant formulas resulted in a lower incidence of atopic eczema during the first 3 years of life. This study still represents the only large and well-designed trial when comparing different formulas in relation to primary prevention of atopic dermatitis and sensitization to food proteins.
More recently, new alimentary strategies to prevent allergic manifestations are being studied. These include supplementation with probiotics (e.g., lactobacilli) or prebiotics (oligosaccharides influencing the intestinal microflora). So far, the information from the initial studies on supplementation with probiotics is inconclusive.
It will be interesting to see the outcomes of well-designed intervention studies focused on the efficacy of this approach.
Alimentary Ways to Protect
For numerous reasons, breast-feeding is the preferred method of infant nutrition; however, there is still controversy as to whether breast-feeding protects against the
development of allergic diseases.
On the basis of the available data, an “Expert Group” of the “European Academy of Allergology and Clinical Immunology” recommends exclusively breast-feeding for 4 to 6 month irrespective of family history of atopy.
For a long time, primary prevention strategies for asthma were almost exclusively focused on allergen avoidance measures early in life, which were supposed to prevent primary sensitization to both food and inhalant allergens.
For several years, the use of hydrolyzed formula was recommended as an alternative for infants, for whom breast milk was not available and who were genetically predisposed to atopic diseases. Indeed, the German Infant Nutritional Intervention (GINI) Study demonstrated that extensively as well as certain partially hydrolyzed formulas compared to unhydrolyzed infant formulas resulted in a lower incidence of atopic eczema during the first 3 years of life. This study still represents the only large and well-designed trial when comparing different formulas in relation to primary prevention of atopic dermatitis and sensitization to food proteins.
More recently, new alimentary strategies to prevent allergic manifestations are being studied. These include supplementation with probiotics (e.g., lactobacilli) or prebiotics (oligosaccharides influencing the intestinal microflora). So far, the information from the initial studies on supplementation with probiotics is inconclusive.
It will be interesting to see the outcomes of well-designed intervention studies focused on the efficacy of this approach.
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