Ricerca
Intolleranze e allergie alimentari nella prima infanzia
FOOD ALLERGIES AND INTOLERANCE IN INFANTS AND CHILDREN
ONORATO FRONGIA1, ANNA RITA BELLOMO1, GIOVANNI DI GIORGIO1, CARLA FIUMALBI1, JACQUELINE FRIZZA1, CARMEN MARESCA1, MASSIMO MARI1, RICCARDO TOMINZ1, NANCY BINKIN2, ALBERTO PERRA2, ANTONINO BELLA3, GRUPPO DI LAVORO ICONA*, MARTA CIOFI DEGLI ATTI3
2ISS, Centro Nazionale di Epidemiologia e Promozione della Salute, PROFEA
3ISS, Centro Nazionale di Epidemiologia e Promozione della Salute, Reparto di Epidemiologia delle Malattie Infettive
Ottobre 2005 - pagg. 533 -538
Abstract
The data presented in this article were obtained as part of a larger study on vaccination coverage
and child health behaviours known as ICONA 2003. All regions and autonomous provinces
of Italy participated in the study. The study population was recruited by cluster sampling
and consisted of 12-24 months old children who were resident in their respective regions.
Information were obtained through a standardized questionnaire administered to the mothers
or caretakers of the selected children in early 2003. Interviews were conducted in the child’s
home by staff of the local health authorities. The families of 4,602 children were interviewed.
Overall 7.4% of the interviewed families reported that their children had suffered from food
allergies or intolerance, with regional prevalences ranging from 4.8% in Puglia and Marches
to 15.4% in Lazio region. A total of 5.2% children were reported to be allergic or intolerant
to cow milk and its derivatives, while 2.0% were allergic to egg products. Among those who
had milk allergies or intolerance, the most common substitutive milk was soy milk (34%) followed
by hypoallergenic milk containing hydrolysed protein (21%). Although these data are
based on reports by mothers and caretakers, they provide the first national estimate of food
intolerance in early childhood. The prevalences we observed are similar to those found in
other international studies of children in this same age group. The wide geographic variability
seems to be due to different diagnostic approaches and criteria rather than to a true difference
in the prevalence of these problems. The diagnosis of these conditions should be based
on more objective criteria.
Parole chiave
Suggerite dall'AI
Classificazione MeSH
Bibliografia
1. Johansson SG, Hourihane JOB, Bousquet J,
et al. A revised nomenclature for allergy. Allergy
2001;56:813-24.
2. Brugman E, Meulmeester JF, Spee-van der Wekke A, et al. Prevalence of self-reported food hypersensitivity among school children in the Netherlands. Eur J Clin Nutr 1998;52: 577-81.
3. Ortolani C, Bruijnzeel-Koomen C, Bengston U, et al. Controversial aspects of adverse reactions to food. Allergy 1999;54:27-45.
4. Bock SA. Prospective appraisal of complaints of adverse reactions to foods in children during the first 3 years of life. Pediatrics 1987;79:683-8.
5. Eggesbo M, Botten G, Halvorsen R, Magnus P. The prevalence of CMA/CMPI in young children: the validity of parentally perceived reactions in a population – based study. Allergy 2001;56:393-402.
6. Kajosaari M. Food allergy in Finnish children aged 1 to 6 years. Acta Pediatr Scand 1982;71:815-9.
7. Sicherer SH, Munoz-Furlong A, Murphy R, Wood RA, Sampson HA. Symposium: Pediatric Food Allergy. Pediatrics 2003;6:1591-4.
8. Host A, Halken S. A prospective study of cow milk allergy in Danish infants during the first 3 years of life. Clinical course in relation to clinical and immunological type of hypersensivity reaction. Allergy 1990;45:587-96.
9. Schrander JJ, Van den Bogart JP, Forget PP, Schrander-Stumpel CT, Kuijten RH, Kester AD. Cow’s milk protein intolerance in infants under 1 year of age: a prospective epidemiological study. Eur J Pediatr 1993;152:640-4.
10. Eggesbo M, Botten G, Halvorsen R, Magnus P. The prevalence of allergy to egg: a population- based study in young children. Allergy 2001;56:403-11.
11. Gruppo di Lavoro ICONA. ICONA 2003: indagine nazionale sulla copertura vaccinale infantile. Rapporti Istisan 2003;37:1-116.
12. World Health Organization. Expanded Programme on Immunization. The EPI Coverage Survey, training for mid level managers. Geneva: WHO; 1991. (WHO/EPI/MLM/91.10).
13. Bennet S, Woods T, Liyanage WM, Smith DL. A simplified general method for clustersample surveys of health in developing countries. World Health Statistics Quarterly 1991; 44:98-106.
14. Gorstein J, Sulivan K, Yip R, et al. Issues in the assessment of nutritional status using anthropometry. Bulletin of WHO 1994;72:273-83.
15. Istituto Nazionale di Statistica. Rapporto annuale; la situazione del Paese nel 2002. Maggio 2003.
16. Fortino A, Lispi L, D’Ippolito F, Ascone G. L’eccessivo ricorso al taglio cesareo: analisi dei dati italiani. Settembre 2002. Disponibile on-line all’indirizzo: http://www.ministerosalute. it/programmazione/resources/documenti/sd o/Studio_tagli_cesarei.doc
17. Woods RK, Abramson M, Bailey M, Walters EH. International prevalences of reported allergies and intolerances. Comparisons arising from the European Community Respiratory Health Survey (ECRHS) 1991-1994. Eur J Clin Nutr 2001;55:298-304.
18. Cookson W. The alliance of genes and environment in asthma and allergy. Nature 1999; 402:B5-11.
19. Young E, Stoneham MD, Petruckevitch A, Barton J, Rona R. A population study of food intolerance. Lancet 1994;343:1127-30.
20. Sicherer SH. Food Allergy. Lancet 2002; 360:701-710
21. Eggesbo M, Halvorsen R, Tambs K, Botten G. Prevalence of parentally perceived adverse reactions to food in young children. Pediatr Allergy Immunol 1999;10:122-32.
22. Woods RK, Stoney RM, Raven J, et al. Reported adverse food reactions overestimate true food allergy in the community. Eur J Clin Nutr 2002;56:31-6.
23. Wood RA. The natural history of food allergy. Pediatrics 2003;111:1631-7.
24. Sicherer SH, Munoz-Furlong A, Sampson HA. Prevalence of peanut and tree nut allergy in the United States determined by means of a random digit dial telephone survey: a 5-year follow-up study. J Allergy Clin Immunol 2003; 112:1203-7.
25. Tariq SM, Stevens M, Matthews S et al. Cohort study of peanut and tree nut sensitisation by age 4 years. BMJ 1996;313:514-7.
26. Høst A, Koletzko B, Dreborg S, et al. Dietary products used in infants for treatment and prevention of food allergy: joint statement of the European Society for Paediatric Allergology and Clinical Immunology (ESPACI), Committee on Hypoallergenic Formulas and the European Society for Paediatric Gastroenterology, Hepatology and Nutrition (ESPGHAN), Committee on Nutrition. Arch Dis Child 1999;81:80-4.
27. Committee on Nutrition, American Academy of Pediatrics. Hypoallergenic infant formulas. Pediatrics 2000;106:346-9.
2. Brugman E, Meulmeester JF, Spee-van der Wekke A, et al. Prevalence of self-reported food hypersensitivity among school children in the Netherlands. Eur J Clin Nutr 1998;52: 577-81.
3. Ortolani C, Bruijnzeel-Koomen C, Bengston U, et al. Controversial aspects of adverse reactions to food. Allergy 1999;54:27-45.
4. Bock SA. Prospective appraisal of complaints of adverse reactions to foods in children during the first 3 years of life. Pediatrics 1987;79:683-8.
5. Eggesbo M, Botten G, Halvorsen R, Magnus P. The prevalence of CMA/CMPI in young children: the validity of parentally perceived reactions in a population – based study. Allergy 2001;56:393-402.
6. Kajosaari M. Food allergy in Finnish children aged 1 to 6 years. Acta Pediatr Scand 1982;71:815-9.
7. Sicherer SH, Munoz-Furlong A, Murphy R, Wood RA, Sampson HA. Symposium: Pediatric Food Allergy. Pediatrics 2003;6:1591-4.
8. Host A, Halken S. A prospective study of cow milk allergy in Danish infants during the first 3 years of life. Clinical course in relation to clinical and immunological type of hypersensivity reaction. Allergy 1990;45:587-96.
9. Schrander JJ, Van den Bogart JP, Forget PP, Schrander-Stumpel CT, Kuijten RH, Kester AD. Cow’s milk protein intolerance in infants under 1 year of age: a prospective epidemiological study. Eur J Pediatr 1993;152:640-4.
10. Eggesbo M, Botten G, Halvorsen R, Magnus P. The prevalence of allergy to egg: a population- based study in young children. Allergy 2001;56:403-11.
11. Gruppo di Lavoro ICONA. ICONA 2003: indagine nazionale sulla copertura vaccinale infantile. Rapporti Istisan 2003;37:1-116.
12. World Health Organization. Expanded Programme on Immunization. The EPI Coverage Survey, training for mid level managers. Geneva: WHO; 1991. (WHO/EPI/MLM/91.10).
13. Bennet S, Woods T, Liyanage WM, Smith DL. A simplified general method for clustersample surveys of health in developing countries. World Health Statistics Quarterly 1991; 44:98-106.
14. Gorstein J, Sulivan K, Yip R, et al. Issues in the assessment of nutritional status using anthropometry. Bulletin of WHO 1994;72:273-83.
15. Istituto Nazionale di Statistica. Rapporto annuale; la situazione del Paese nel 2002. Maggio 2003.
16. Fortino A, Lispi L, D’Ippolito F, Ascone G. L’eccessivo ricorso al taglio cesareo: analisi dei dati italiani. Settembre 2002. Disponibile on-line all’indirizzo: http://www.ministerosalute. it/programmazione/resources/documenti/sd o/Studio_tagli_cesarei.doc
17. Woods RK, Abramson M, Bailey M, Walters EH. International prevalences of reported allergies and intolerances. Comparisons arising from the European Community Respiratory Health Survey (ECRHS) 1991-1994. Eur J Clin Nutr 2001;55:298-304.
18. Cookson W. The alliance of genes and environment in asthma and allergy. Nature 1999; 402:B5-11.
19. Young E, Stoneham MD, Petruckevitch A, Barton J, Rona R. A population study of food intolerance. Lancet 1994;343:1127-30.
20. Sicherer SH. Food Allergy. Lancet 2002; 360:701-710
21. Eggesbo M, Halvorsen R, Tambs K, Botten G. Prevalence of parentally perceived adverse reactions to food in young children. Pediatr Allergy Immunol 1999;10:122-32.
22. Woods RK, Stoney RM, Raven J, et al. Reported adverse food reactions overestimate true food allergy in the community. Eur J Clin Nutr 2002;56:31-6.
23. Wood RA. The natural history of food allergy. Pediatrics 2003;111:1631-7.
24. Sicherer SH, Munoz-Furlong A, Sampson HA. Prevalence of peanut and tree nut allergy in the United States determined by means of a random digit dial telephone survey: a 5-year follow-up study. J Allergy Clin Immunol 2003; 112:1203-7.
25. Tariq SM, Stevens M, Matthews S et al. Cohort study of peanut and tree nut sensitisation by age 4 years. BMJ 1996;313:514-7.
26. Høst A, Koletzko B, Dreborg S, et al. Dietary products used in infants for treatment and prevention of food allergy: joint statement of the European Society for Paediatric Allergology and Clinical Immunology (ESPACI), Committee on Hypoallergenic Formulas and the European Society for Paediatric Gastroenterology, Hepatology and Nutrition (ESPGHAN), Committee on Nutrition. Arch Dis Child 1999;81:80-4.
27. Committee on Nutrition, American Academy of Pediatrics. Hypoallergenic infant formulas. Pediatrics 2000;106:346-9.
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