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KMID : 1143120180080040034
Asia Pacific Allergy
2018 Volume.8 No. 4 p.34 ~ p.34
Growth of children with food allergies in Singapore
Chong Kok Wee

Wright Karen
Goh Anne
Meyer Rosan
Rao Rajeshwar
Abstract
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.
KEYWORD
Child, Food allergy, Food elimination, Growth, Singapore
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