A new score to predict allergic march in patients with IgE-mediated cow milk allergy.

Background: Cow milk allergy (CMA) is the most common food allergy in infants. Some patients will express, in the future, other allergic diseases (allergic march). Objective: To evaluate if a new scoring system could determine the risk of developing allergic march. Methods: A retrospective observational cohort study of subjects who were immunoglobulin E (IgE) mediated was conducted. We defined a risk score for atopy (RSA), including clinical and laboratory variables. Three risk groups were defined according to the RSA. We defined as dependent variables atopy (one or more allergic diseases) and atopy+ (two or more allergic diseases). A multivariate logistic regression model was created, which included RSA and the type of formula (high-grade extended hydrolyzed formula [EHF] with Lactobacillus rhamnosus GG (LGG), high-grade EHF without LGG, and other formulas). Results: A total of 211 patients were recruited. When we analyzed the risk of atopy+, we found an increased risk for RSA intermediate-risk (odds ratio [OR 2.08] [95% confidence interval {CI}, 0.95-4.56) and high-risk (OR 24.74 [95% CI, 6.26-97.73]) groups, and a decreased risk for the subjects fed with high-grade EHF (OR 0.42 [95% CI, 0.20-0.87]) and also in those subjects fed with high-grade EHF plus LGG (OR 0.30 [95% CI, 0.09-0.98]). Conclusion: RSA is a simple and useful tool to predict the risk of developing other allergic diseases in patients with IgE-mediated CMA.

Association between Caesarean Delivery and Isolated Doses of Formula Feeding in Cow Milk Allergy.

BACKGROUND: Cow milk allergy (CMA) is the most common food allergy in breastfed infants. The aim of this study is to verify whether certain perinatal factors may influence the development of CMA immunoglobulin E (IgE)+. METHODS: A retrospective, observational study of case and control groups was carried out. Information was collected of patients with CMA IgE+ from our department during the years 1990-2013. Patients of the same age and sex were recruited for the control group. Information on the following variables was collected: sex, age, pregnancy tolerance, duration of pregnancy, type of delivery, isolated doses of formula feeding in hospital (FFH), duration of breastfeeding, and family history of allergy (defined as ≥1 first-degree family member with allergic disease). Statistical analysis was performed using multivariate logistic regression techniques. RESULTS: A total of 211 cases were included in this study. Multivariate analysis showed an influence of duration of breastfeeding, FFH to be a risk factor (OR 4.94; 95% CI 2.68-9.08), especially in caesarean delivery (OR 11.82; 95% CI 2.64-47.50), and prematurity (OR 0.29; 95% CI 0.09-0.92) to be a protective factor. CONCLUSIONS: Perinatal factors play a key role in the development of CMA IgE+, with an influence of breastfeeding duration, FFH and caesarean delivery as risk factors and prematurity as a protective factor. While family history had no important role, environmental factors were more decisive.

Hábitos alimentarios en una población universitaria / Food habits in a university population

Fundamento: La dieta mediterranea esta considerada como prototipo de dieta saludable, Se analiza si los hábitos alimentarios en una poblacibn universitaria se ajustan al Modelo dietético mediterráneo. Método: Registro de consumo de alimentos de un día lectivo (recuerdo de 24 horas) a una muestra aleatoria de 500 universitarios. De cada encuestado se registraba sexo, edad, estudios universitarios, horario de clases y tipo de residenda Resultados: Sus hábitos alimentarios se caracterizaban por un consumo excesivo de carne y azúcares refinados, junto a un consumo deficiente de cereales, legumbres, frutas y pescados, No existian diferencias estadisticamente significativas en la ingesta de alimentos y/o macronutrientes en relación con el sexo, edad, tipo de residencia, estudios universitarios y horarios de clases. Las proteinas aportaban el 18,7% de la ingesta calórica; los hidríatas de carbono, el 37,7%; los Iípidos, el 43,1% y las grasas saturadas, el 13,6%. La ingesta de colesterol era excesiva (458.7 mg). Conclusiones: El moddo dietético de los universitarias difiere del prototipo mediterráneo, con un excesivo aporte de proteínas animales, grasas saturadas y colestarol, en detrimento de hidratos de carbono complejos. Sería preceptivo fomentar el consejo dietético en los programas de atención primaria, e incluso desarrollar programas de alimentación y nutrición en la enseñanza universitaria(AU)

Introduction: Mediterranean diet is considered a modelo f healthy diet. We analyzed if food habits in a university population fit a Mediterranean dietetic model. Methods: Registry of food intake during a school day (24 hour recall) in a random sample of 500 university students aged 19-24 years. Gender age, university studies, class timetable, and type of residence were collected. Results: Food habits were characterized by an excessive consumption of meat and refined sugar, whereas cereals, legumes, fruits and fish intake was deficient. There were no statistical differences in food and/or macronutrients intake in relation to sex, age, type of residence, university studies or schedule. Proteins represented 18.7% of calories intake; carbohydrates 37.7%, fat counted for 43.1% and saturated fat 13.6%. Cholesterol intake was excessive (458.7mg). Conclusions: University students dietary models differs from the Mediterranean prototype, showing and excessive contribution of animal proteins, saturated fat and cholesterol, at the expense of a lower intake of complex carbohydrates. We propose to promote dietary counselling in primary attention programs, and even to develop food and nutrition programs in university education(AU)

Hábitos y preferencias alimentarias en la población escolar / Alimentary habits and preferences in schoolchildren

Se registra el consumo cualitativo de alimentos y su distribución en las diferentes ingestas diarias, así como las preferencias alimentarias, mediante una encuesta-recordatorio de 24 horas en una población escolar rural (n = 160; 74 niños y 86 niñas). El 95,0 por ciento desayunaba, siendo la leche (85,0 por ciento) y los dulces (52,5 por ciento) los alimentos más consumidos.El 45,0 por ciento realizaba ingesta a media mañana, siendo los dulces (30,0 por ciento) los alimentos más consumidos. En el almuerzo, las carnes (70,0 por ciento) y el pan (61,3 por ciento) fueron los alimentos más consumidos, siendo menor el consumo de verduras (35,0 por ciento), pastas (26,3 por ciento), frutas (26,3 por ciento) y legumbres (18,8 por ciento). El 100 por ciento merendaba, siendo el pan (87,5 por ciento) y los dulces (52,5 por ciento) los alimentos más consumidos. En la cena, las carnes (42,5 por ciento), la leche (40,0 por ciento) y el pan (33,8 por ciento) fueron los alimentos más consumidos. No se han encontrado diferencias significativas en el consumo porcentual de los distintos alimentos en relación con el sexo, salvo en el consumo de frutas, que era mayor en las niñas (60,4 por ciento frente a 32,4 por ciento). Los alimentos preferidos como primer plato eran las pastas (58,1 por ciento) y el arroz (24,3 por ciento); como segundo plato,las carnes (76,7 por ciento) con patatas fritas (32,9 por ciento), y como postre, las frutas (34,2 por ciento), yogures (30,1 por ciento) y dulces (23,3 por ciento). Las verduras (48,9 por ciento), los pescados (14,1 por ciento) y las legumbres (13,0 por ciento) eran los alimentos menos deseados. Los hábitos alimentarios prevalentes en la edad escolar se caracterizan por un excesivo consumo porcentual de carnes y azúcares refinados junto a un deficiente consumo proporcional de frutas, verduras, cereales, legumbres y pescados. Es necesario llevar a cabo programas de educación sanitaria y nutricional, en el contexto escolar y familiar, que garanticen unos conocimientos y habilidades óptimos que permitan consolidar unos hábitos dietéticos saludables (AU)