KMID : 1143120180080040034
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Asia Pacific Allergy 2018 Volume.8 No. 4 p.34 ~ p.34
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Growth of children with food allergies in Singapore
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Chong Kok Wee
Wright Karen Goh Anne Meyer Rosan Rao Rajeshwar
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Abstract
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Background: Although it is known that children with food allergies are at risk of impaired growth, this has not been well studied in South-East Asia.
Objective: The aim of this cross-sectional study is to survey the growth of children with food allergies in Singapore and the factors impacting it.
Methods: Anthropometric data, demographic data, type of food allergy, foods eliminated, and atopic comorbidities were recorded. Malnutrition was defined using World Health Organization standards (¡Â-2 z-score for weight-for-height [WH], weight-for-age [WA], and height-for-age [HA]).
Results: Seventy-four patients (51% male) were recruited over 1 month, with median age at diagnosis of 8 months (interquartile range [IQR], 4?13 months) and at data collection of 25 months (IQR, 14?48 months). Sixty-two (84%) had IgE-mediated allergy, 8 (11%) mixed IgE and non-IgE, and 4 (5%) non-IgE-mediated allergy. Food exclusions: 55% one food, 27% two foods, 8% three to four foods, and 10% ¡Ã5 foods. Only 1% were underweight (WA ¡Â -2 z-score) and 3% had WA ¡Ã +2 z-score. Having a mixed type food allergy significantly reduced WA (p = 0.023). WA was significantly lower for those referred to the dietitian (p = 0.027). 5.4% were stunted (HA ¡Â -2 z-score). Factors significantly associated with stunting were underlying eczema (p = 0.03) and having an IgE-mediated (p = 0.03) or mixed type food allergy (p = 0.002). One point four percent (1.4%) were undernourished (WH ¡Â -2 z-score) and 1.4% were overweight (WH ¡Ã +2 z-score). Multivariate regression analysis found that children with mixed type food allergies were significantly shorter (z-score -1 lower). Children had a lower WA if they had skin involvement as part of their symptom presentation.
Conclusion: This is the first survey documenting growth in children with food allergy in Singapore. Eczema, IgE-mediated and mixed type allergies are associated with poorer growth rates in these children. Early, individualised nutritional intervention is recommended for all children with food allergy.
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KEYWORD
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Child, Food allergy, Food elimination, Growth, Singapore
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