Parents of children with eczema often suspect that it is fueled by certain foods and therefore opt for an elimination diet to find the culprit. However, research shows that deleting foods from your diet can change the response of the immune system – resulting in potentially dangerous situations.
Elimination diet
Anne Marie Singh, professor and head of the allergy, immunology and rheumatology department at the University of Wisconsin-Madison (US), and her colleagues evaluated almost three hundred children with eczema evaluated who followed an elimination diet.
“We discovered that when certain foods were omitted from their diet, there was a significant increase in the risk of allergic reactions, including serious allergic reactions, Singh said.
New allergies
The results were striking: almost one in five children (nineteen percent) developed new immediate allergic reactions when the eliminated foods were reintroduced, even though they had no history of such reactions. Most were mild, but alarmingly enough, thirty percent of the responses were serious and classified as anaphylaxis.
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The danger is not limited to children. In a separate study of thirty adults who developed allergies for foods that they previously extended well, seventy percent of them had followed an elimination diet. Half got anaphylaxis and the vast majority (eighty percent) had already existing allergic disorders such as environmental allergies, asthma or eczema. For people without a history of allergies, the risk seemed much lower.
The science of food allergies
“The intestine has a little enviable task,” says Brian Vickery, head of allergy and immunology and director of the food allergy program at Emory’s Children’s Healthcare in Atlanta. ‘He must recognize and respond to a constant stream of environmental stimuli. And they can be both dangerous and favorable. “
The gastrointestinal tract, which contains more immune lymphocytes than any other body part, comes into contact with billions of microbes and more than thirty kilos of food proteins every year. Yet it knows how to defend themselves against harmful invaders, while ignoring harmless foods and friendly bacteria.
Oral tolerance
This balance exercise depends on oral tolerance, a process in which immune reactions to food proteins taken are actively suppressed and what harmful reactions such as food allergies occurs.
Although the underlying immune mechanisms are not yet fully understood, points out a new study That it starts with specialized antigen-preaching cells that collect food antigens in the intestines and instruct nearby T cells to withdraw. This signal leads to the production of antigen-specific regulatory T cells, which calm down the immune response to nutrition proteins.
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“The intestines play an important role in the emergence of tolerance,” says Michael Pistiner, director of Food Allergy Advocacy, Education and Prevention of the Food Allergy Center of the MassGeneral Hospital for Children (US). “If you are not yet allergic, early introduction to food can promote tolerance and protect babies against the development of a food allergy.”
Food allergies
That protection does not stop in childhood. Regular, continuous exposure to food helps to maintain oral tolerance throughout life.
Recent research in patients with food allergy treated with oral immunotherapywhere gradually higher doses of the allergenic food are administered, emphasizes how often continuous intake is needed to maintain a desensiticized state.
Conversely, there are indications that elimination songs can disrupt the oral tolerance for some and encourage the immune system to develop allergies.
Safe approach
Are you considering trying an elimination diet? Experts say that the safest approach depends on your risk level. Anyone who runs a higher risk (children or someone with existing allergies) should first consult a doctor before starting an elimination diet.
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“The more allergic you are, the more problems can give an elimination diet,” says Singh. Pistiner adds that “babies with eczema elimination stations can be harmful, especially in this very important period of early introduction.” Experts also recommend that children who follow an elimination diet receive close medical supervision to get enough nutrients and continue to grow healthily.
Acceptable quantities
How long the elimination diet lasts is also important. A shorter elimination phase gives less time for oral tolerance to break down. Singh notes that “two to four weeks of elimination should be enough time to know if it makes a difference, and also short enough to not risk an allergic reaction when you try again.”
In some cases, completely deleting a food is not necessary. If the symptoms are mild, maintaining small, acceptable quantities in the diet can help maintain the oral tolerance and at the same time relieve the discomfort, Singh adds.
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