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Trial Lecture – time and place
See Trial Lecture.
Adjudication committee
- First opponent: Professor Mika Mäkelä, Helsinki University Hospital, Finland
- Second opponent: Associate Professor Martin Sørensen, The Arctic University of Norway
- Third member and chair of the evaluation committee: Professor Anne Flem Jacobsen, University of Oslo
Chair of the Defence
Associate Professor Hans Christian Erichsen Landsverk, University of Oslo
Principal Supervisor
Senior Consultant Håvard Ove Skjerven, Oslo University Hospital
Summary
Food allergy and asthma are allergic diseases that commonly develop early in childhood. Theoretically these could be prevented by reducing the common risk factors atopic dermatitis and allergic sensitisation.
The objective of this thesis was to determine if food allergy or asthma can be reduced in 3-year-old children subjected to primary preventive measures in infancy aiming at inducing food allergen tolerance by early food introduction and reducing allergic sensitisation and/or atopic dermatitis by early skin care. We also aimed to establish the prevalence of allergic sensitisation at 6 months of age by reading the skin prick test at both 10 and 15 minutes.
In the Preventing Atopic Dermatitis and ALLergies in children (PreventADALL) study, 2397 infants were randomised at birth to no intervention, skin intervention (regular skin emollients from 2-32 weeks of age), food intervention (tastes of peanut, milk, wheat, and egg from 3 to 6 months of age) or both interventions.
The prevalence of allergic sensitisation by skin prick test at 6 months of age was 10.4% when including reading after both time points. At 3 years, allergy to any of the interventional foods was diagnosed in 44 children with a prevalence of 1.1% in the food intervention group and 2.6% in the no food intervention group. Asthma was defined in 13% by 3 years.
Randomisation to the primary prevention intervention with tastes of peanut, milk, wheat, and egg from 3 months of age, more than halved the risk of documented food allergy at 3 years of age with a risk difference of -1.6% (95%CI -2.7 to -0.5), but there was no evidence of reduced asthma by 3 years in this general population. The food intervention did not affect breastfeeding rate at 6 months of age. No evidence was found that the skin intervention prevented food allergy or asthma.
Early introduction of common allergenic food in infancy appears to be a safe way of preventing food allergy and should be considered as a general advice to the population.
Additional information
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