The immune‐supportive diet in allergy management: A narrative review and proposal

Author:

Vlieg‐Boerstra Berber123ORCID,Groetch Marion4,Vassilopoulou Emilia5,Meyer Rosan67ORCID,Laitinen Kirsi8ORCID,Swain Anne9,Durban Raquel10,Benjamin Olga111,Bottse Rachelle3ORCID,Grimshaw Kate12,Netting Merryn131415,O'Mahony Liam161718ORCID,de Jong Nicolette1920,Skypala Isabel J.621ORCID

Affiliation:

1. Department of Paediatrics OLVG Hospital Amsterdam The Netherlands

2. Rijnstate Allergy Centre Rijnstate Hospital Arnhem The Netherlands

3. Vlieg Dieticians, Private Practice for Dietary Management of Food Allergy Arnhem, Amsterdam The Netherlands

4. Pediatric Allergy and Immunology Icahn School of Medicine at Mount Sinai New York New York USA

5. Department of Nutritional Sciences and Dietetics International Hellenic University Thessaloniki Greece

6. Department Paediatrics Imperial College London UK

7. Department Dietetics Winchester University Winchester UK

8. Institute of Biomedicine and Functional Foods Forum University of Turku Turku Finland

9. Allergy Unit Royal Prince Alfred Hospital Sydney New South Wales Australia

10. Carolina Asthma and Allergy Center Charlotte North Carolina USA

11. Department of Paediatrics Hospital Group Noord West, Location Alkmaar Alkmaar The Netherlands

12. Salford Royal NHS Foundation Trust Salford UK

13. Women and Kids Theme South Australian Health and Medical Research Institute (SAHMRI) North Adelaide South Australia Australia

14. Discipline of Paediatrics, Faculty of Health and Medical Sciences The University of Adelaide Adelaide South Australia Australia

15. Department of Nutrition Women's and Children's Hospital North Adelaide South Australia Australia

16. APC Microbiome Ireland National University of Ireland Cork Ireland

17. Department of Medicine National University of Ireland Cork Ireland

18. School of Microbiology National University of Ireland Cork Ireland

19. Internal Medicine, Allergology and Clinical Immunology, Paediatric Allergology University Medical Centre Rotterdam Rotterdam The Netherlands

20. Sophia Children Hospital Erasmus MC University Medical Centre Rotterdam Rotterdam The Netherlands

21. Royal Brompton and Harefield Hospitals Part of Guys and St Thomas' NHS Foundation Trust London UK

Abstract

AbstractThe role of nutrition is increasingly recognized in the management of chronic immune diseases. However, the role of an immune‐supportive diet as adjuvant therapy in the management of allergic disease has not been similarly explored. This review assesses the existing evidence for a relationship between nutrition, immune function, and allergic disease from a clinical perspective. In addition, the authors propose an immune‐supportive diet to enhance dietary interventions and complementing other therapeutic options for allergic disease from early life to adulthood. A narrative review of the literature was conducted, to determine the evidence of the relationship between nutrition and immune function, overall health, epithelial barrier function, and gut microbiome, particularly in relation to allergy. Studies on food supplements were excluded. The evidence was assessed and utilized to develop a sustainable immune‐supportive diet to complement other therapies in allergic disease. The proposed diet consists of a highly diverse range of fresh, whole, and minimally processed plant‐based and fermented foods supplemented with moderate amounts of nuts, omega‐3‐rich foods and animal‐based products in proportional amounts of the EAT‐Lancet diet, such as (fatty) fish, (fermented) milk products which may be full‐fat and eggs, lean meat or poultry, which may be free‐range or organic.

Publisher

Wiley

Subject

Immunology,Immunology and Allergy

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