Asia Pac Allergy.  2018 Oct;8(4):e34. 10.5415/apallergy.2018.8.e34.

Growth of children with food allergies in Singapore

Affiliations
  • 1Allergy Service, Department of Paediatric Medicine, KK Women's and Children's Hospital, Singapore 229899. chong.kok.wee@singhealth.com.sg
  • 2Department of Paediatrics, Imperial College, London, United Kingdom.

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 (≤-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% ≥5 foods. Only 1% were underweight (WA ≤ -2 z-score) and 3% had WA ≥ +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 ≤ -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 ≤ -2 z-score) and 1.4% were overweight (WH ≥ +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

MeSH Terms

Asia
Child*
Comorbidity
Cross-Sectional Studies
Data Collection
Diagnosis
Eczema
Food Hypersensitivity*
Growth Disorders
Humans
Hypersensitivity
Immunoglobulin E
Malnutrition
Nutritionists
Overweight
Singapore*
Skin
Thinness
World Health Organization
Immunoglobulin E
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