Ultra‐processed foods, allergy outcomes and underlying mechanisms in children: An EAACI task force report

Author:

Berni Canani Roberto1234ORCID,Carucci Laura12ORCID,Coppola Serena12ORCID,D'Auria Enza5ORCID,O'Mahony Liam6ORCID,Roth‐Walter Franziska78ORCID,Vassilopolou Emilia910ORCID,Agostoni Carlo1011ORCID,Agache Iaona12ORCID,Akdis Cezmi13ORCID,De Giovanni Di Santa Severina Fiorenza12,Faketea Gaby1415,Greenhawt Matt16ORCID,Hoffman Karin8ORCID,Hufnagel Karin78ORCID,Meyer Rosan1718ORCID,Milani Gregorio Paolo1011ORCID,Nowak‐Wegrzyn Anna1920ORCID,Nwaru Bright21ORCID,Padua Ines222324ORCID,Paparo Lorella12ORCID,Diego Peroni25ORCID,Reese Imke26ORCID,Roduit Caroline2728ORCID,Smith Peter K.29ORCID,Santos Alexandra303132ORCID,Untersmayr Eva33ORCID,Vlieg‐Boerstra Berber3435ORCID,Venter Carina16ORCID

Affiliation:

1. Department of Translational Medical Science University of Naples Federico II Naples Italy

2. ImmunoNutritionLab at the CEINGE Advanced Biotechnologies Research Center University of Naples Federico II Naples Italy

3. Task Force on Microbiome Studies University of Naples Federico II Naples Italy

4. European Laboratory for the Investigation of Food‐Induced Diseases University of Naples Federico II Naples Italy

5. Allergy Unit‐Buzzi Children's Hospital‐University of Milan Milan Italy

6. Department of Medicine, School of Microbiology APC Microbiome Ireland, University College Cork Cork Ireland

7. Department of Interdisciplinary Life Sciences, Messerli Research Institute University of Veterinary Medicine, Medical University and University of Vienna Vienna Austria

8. Center of Pathophysiology, Infectiology and Immunology Institute of Pathophysiology and Allergy Research, Medical University of Vienna Vienna Austria

9. Department of Nutritional Sciences and Dietetics School of Health Sciences, International Hellenic University Thessaloniki Greece

10. Department of Clinical Sciences and Community Health University of Milan Milan Italy

11. Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico Milan Italy

12. Faculty of Medicine Transylvania University Brasov Romania

13. Swiss Institute of Allergy and Asthma Research (SIAF) University of Zurich Davos Switzerland

14. Department of Pediatrics "Karamandaneio" Children's Hospital of Patra Patras Greece

15. Department of Pharmacology “luliu Hatieganu” University of Medicine and Pharmacy Cluj‐Napoca Romania

16. Section of Pediatric Allergy and Immunology University of Colorado, Children's Hospital Colorado Aurora Colorado USA

17. Department of Nutrition and Dietetics Winchester University Winchester UK

18. Department of Medicine KU Leuven Leuven Belgium

19. Department of Pediatrics Hassenfeld Children's Hospital, NYU Grossman School of Medicine New York New York USA

20. Department of Pediatrics, Gastroenterology and Nutrition Collegium Medicum, University of Warmia and Mazury Olsztyn Poland

21. Krefting Research Centre Institute of Medicine, University of Gothenburg Gothenburg Sweden

22. Department of Sciences University Institute of Health Sciences Gandra Portugal

23. i4HB/UCIBIO – Translational Toxicology Research Laboratory Gandra Portugal

24. CUF Porto Trindade Hospital Porto Portugal

25. Department of Clinical and Experimental Medicine, Section of Pediatrics University of Pisa Pisa Italy

26. Practice for Dietary Advice & Nutrition Therapy in Adverse Food Reactions Munich Germany

27. Division of Respiratory Medicine and Allergology, Department of Paediatrics Inselspital, University of Bern Bern Switzerland

28. CK‐CARE Christine Kühne‐Center for Allergy Research and Education (CK‐CARE) Davos Switzerland

29. Griffith University Southport Queensland Australia

30. Department of Women and Children's Health (Pediatric Allergy), Faculty of Life Sciences and Medicine School of Life Course Sciences, King's College London London UK

31. Peter Gorer Department of Immunobiology School of Immunology and Microbial Sciences, King's College London London UK

32. Children's Allergy Service Evelina London Children's Hospital, Guy's and St Thomas' Hospital London UK

33. Center for Pathophysiology, Infectiology and Immunology Institute of Pathophysiology and Allergy Research, Medical University of Vienna Vienna Austria

34. Department of Paediatrics OLVG Hospital Amsterdam The Netherlands

35. Rijnstate Allergy Centre Rijnstate Hospital Arnhem The Netherlands

Abstract

AbstractBackgroundConsumption of ultra‐processed foods [UPFs] may be associated with negative health outcomes. Limited data exist regarding the potential role of UPFs in the occurrence of allergic diseases. The underlying mechanisms underpinning any such associations are also poorly elucidated.MethodsWe performed a systematic review and narrative evidence synthesis of the available literature to assess associations between UPF consumption and pediatric allergy outcomes (n = 26 papers), including data on the association seen with the gut microbiome (n = 16 papers) or immune system (n = 3 papers) structure and function following PRISMA guidelines.ResultsDietary exposure to fructose, carbonated soft drinks, and sugar intake was associated with an increased risk of asthma, allergic rhinitis, and food allergies in children. Commercial baby food intake was associated with childhood food allergy. Childhood intake of fructose, fruit juices, sugar‐sweetened beverages, high carbohydrate UPFs, monosodium glutamate, UPFs, and advanced glycated end‐products (AGEs) was associated with the occurrence of allergic diseases. Exposure to UPFs and common ingredients in UPFs seem to be associated with increased occurrence of allergic diseases such as asthma, wheezing, food allergies, atopic dermatitis, and allergic rhinitis, in many, but not all studies.ConclusionMore preclinical and clinical studies are required to better define the link between UPF consumption and the risk of allergies and asthma. These observational studies ideally require supporting data with clearly defined UPF consumption, validated dietary measures, and mechanistic assessments to definitively link UPFs with the risk of allergies and asthma.

Funder

European Academy of Allergy and Clinical Immunology

Publisher

Wiley

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