Preventing Allergies in Children

THROUGH PRENATAL NUTRITION

As a prenatal dietitian and a mum of four, I have certainly seen the increase in food allergies in Australia. It’s a topic I believe we should be raising awareness of, before women conceive. This is largely due to the growing link that diet and lifestyle choices and the long term health of a child are impacted before conception and during pregnancy. Emerging research into early life nutrition now highlights key life exposures that have a profound impact on both fertility, the health of offspring and reducing the risk of allergies in babies.

A closer look at allergies in Australia

In Australia according to the ASCIA the peak professional body of clinical immunology and allergy specialists in Australia and New Zealand reports that Food allergy occurs in around 1 in 20 children and 2 in 100 adults. Furthermore hospital admissions for severe allergic reactions (anaphylaxis) have doubled over the last decade in Australia, USA and UK. So this begs the question what are these food allergies and can diet really play role in reducing the risk of developing a food allergy? The short answer is yes!

Let’s delve deeper into the science

The 9 most common food allergens are:

• egg • cow’s milk • peanut • tree nuts • seafood • sesame • soy • fish • wheat

How can nutrition reduce the risk of allergies in babies?

The health of both the mother and the father of a baby are incredibly important for optimising fertility, pregnancy and the long term health of a baby. A critical time of positive influence on reducing risk of chronic disease and allergies is found to be within the first 1000 days of life (preconception through to toddlerhood. This is because of the influence on epigenetics has on a growing foetus.

We know at conception, genetic material is passed on from both parents so too is the epigenetic material, this includes but is not limited to:

• Life exposures of environmental factors: toxins and pesticides • Nutrition: nutrient deficiencies and over nutrition characterised by high body fat percentage and weight • Negative lifestyle habits: excessive alcohol intake and smoking

This can trigger changes in the growing fetus associated with a greater risk of following conditions:

• Obesity • Type 2 diabetes • Heart disease • Allergies

Increasing awareness of parental choices in the lead up to pregnancy and during can reduce the risk of these conditions. This provides an important opportunity for parents and health professionals to work collaboratively to make positive change through individualised nutrition care.

If you are planning a pregnancy see a fertility dietitian before you try to conceive as many critical nutrients for pregnancy take time to optimise, Studies have now shown that deficiency or low levels of certain micronutrients are prevalent in pregnant women that may have lasting effects on the offspring. Micronutrients and vitamins to optimise before and during pregnancy are:

• Iron • Iodine • Folate • Riboflavin • B6, • B12 • Vitamin D

A fertility dietitian will request these specific blood tests, take into account your medical and past history in developing a meal plan and appropriate supplement plan for you to follow in the lead up to conception.

Furthermore when looking specifically at reducing allergy risk a growing body of evidence suggests that what a woman eats during pregnancy is one of the most influential times to make a difference so if you are pregnant it certainly not too late! This is because during pregnancy a baby’s immune system is being programmed and developed with the exposure of a mother’s diet also.

5 key ways to optimise nutrition, to reduce the risk of food allergies in babies:

1.Build tolerance to allergenic foods while the baby is in the womb Don’t avoid allergenic foods during pregnancy…unless you have an allergy to a specific food yourself. If you have a family history of different food allergies but are not impacted yourself, it is still recommended to include these foods in your diet during pregnancy. The latest research suggests that by exposing your baby to the nine most common allergenic foods mentioned earlier during pregnancy may help to build tolerance against allergens.

2.Optimise your Vitamin D status before conception and maintain during pregnancy Vitamin D plays an important role in the developing foetus immune system. The best source of vitamin D is the sun. Some foods such as dairy, salmon and fortified with vitamin D foods, do provide small amounts of vitamin D but in most cases it is not enough. An Australian study found that women with low vitamin D levels during pregnancy were associated with higher incidences of babies with food allergies. Interestingly, the study also highlighted that women with high levels of vitamin D also had babies with food allergies, suggesting more is not better and the correct dosage of vitamin D supplementation is an important factor. This can be determined via a blood test with your physician and fertility dietitian.

3.Include Omega 3 fatty acids in your pregnancy diet Omega 3 plays an important role in the development of a baby’s the brain, retina and immunity. Adequate intake during pregnancy is important as fetal omega-3 status, particularly DHA, is determined by the maternal diet. Sources of plant based omega 3 known as ALA is found in plant oils such as flaxseed, chia seed, soybean and canola oil. However plant sources do not convert as well as oily fish sources of omega 3, which will provide DHA & EPA. Research has found a pregnancy diet rich in DHA & EPA was associated with reduced rates of allergies and improved immunity. Therefore aim to consume oily fish twice a week during pregnancy or receive tailored supplemental advice.

4.Optimise yours and your baby’s gut microbiota – by increasing your dietary diversity of plant based foods The research keeps emerging on the many roles the gut microbiome has on our health but interesting it has also been linked to reducing risk of metabolic and immune-related diseases including (but not limited to) asthma, coeliac disease and food allergies. Infants inherit an early microbiota ‘code’ from both their mother and father through the egg and sperm. Optimisingy our gut health in the lead up to pregnancy, during and while breastfeeding has been shown to have a positive effect of the baby’s gut microbiota and a reduction in the risk of allergies. Key ways to improve yours and your baby’s gut health are ensuring plenty of dietary diversity of plant based foods and prebiotics;these are the food for specific beneficial microbes known as probiotics. Examples of my favourite prebiotic foods are dried figs, garlic, leeks, almonds and legumes.

5.Seek a prenatal dietitian to help you select the right probiotic supplement during pregnancy and lactation or formula feeding Probiotics supplementation during pregnancy, breastfeeding or formula feeding may also have a benefit in reducing risk of allergies. However the type of probiotics supplementation and the timing of commencement are really important factors that should be guided by a prenatal dietitian for safety and benefit. Importantly, reducing the risk of allergies continues post-partum with both breastfeeding and the introduction of solids playing an important role. The pre and probiotics in breast milk and food diversity (including allergens) in a mother and baby’s diet are thought to improve the gut microbiome and promote immune tolerance. ASCIA guidelines published in 2016 highlighted the importance of including all the main food allergens into your baby’s diet, before 12 months of age. With delayed introduction showing an increased risk of food allergies.

Exclusive Breastfeeding is recommended for the first 6 months of life and introduction of solids at around 6 months (not before 4 months of age). Those babies who are at risk of a food allergy, i.e those who have infantile eczema, have a family member with an allergy or already have a food allergy, may benefit from earlier introduction of food allergens (particularly peanut and well cooked egg), in an age appropriate form at 4 months of age. It is recommended these babies are seen by an Allergist and Paediatric dietitian to go through this process. (Food allergens to 4-11-month-old infants have helped to reduce their risk of allergy by up to 80%).

As you can now appreciate that epigenetics, diet and lifestyle factors play a huge role in development of a strong immune system during the first 1000 days of life.

Optimising preconception nutrition helps to reduce modifiable risks, pregnancy allows the opportunity for early exposure and defence against common allergens and breast feeding and appropriately timed solids introduction, can further strengthen the immature immune system and gut microbiome. As too the final stage of influence, which is the introduction of solids that continues to build tolerance and reduce the risk of food allergies in early childhood.

By Lora Attia - Dietitian For Mums

Website: Dietitianformums.com.au Instagram: @dietitanformums Facebook: Lora Attia – Dietitian For Mums

Goji Bliss Balls

Makes 6-8

Ingredients:

• 1 cup Lotus Goji Berries • 1 cup Global Organics Coconut Chips • ¼ cup Lotus Organic Brown Rice Syrup • ¼ cup Lotus Organic Black Chia Seeds • ¼ cup Lotus Organic Cacao Powder (optional)

Method:

Combine all ingredients in a blender and pulse until well combined and slightly sticky. Roll into balls and refrigerate overnight, then serve.

Optional: toss bliss balls in extra coconut or cocoa powder.

Pumpkin Butter & Jam Sandwiches

Serves 6-8

Ingredients:

• 1 cup roasted pumpkin • 1 cup Lotus Organic Pumpkin Seeds • 1-3 tbsp Global Organics Coconut Sugar • Pinch Lotus Organic Cinnamon Powder • Pinch Gourmet Organic Nutmeg • Pinch Gourmet Organic Allspice • Fruit jam of choice • Gluten free bread of choice

Method:

Blend pumpkin with spices, seeds and sugar to taste. Blend until smooth and creamy or keep it chunky. Keep in the fridge for up to a week and use to make tasty allergy friendly sandwiches.

NATURAL SOURCE OF IODINE FROM SEAWEED

Rainbow Seaweed™ is a combination of dulse, nori, sea lettuce, winged kelp and Tasmanian wakame. Alg Seaweed condiments are an easy to use sprinkle for an instant flavour boost. Seedy Bites are reduced sugar seed-based snacks. Four square bites per pack, perfect for sharing.

Quinoa Sushi

Makes 4 rolls

Ingredients:

• 1 cup Lotus Organic White Quinoa, cooked • 2 nori sheets • 1 cup sliced veggies of choice • Sliced roast chicken, beef or tofu • Global Organics Traditional Mayonnaise • Lotus Organic Tamari

Method:

Lay nori sheets on a board and spread half the quinoa on the bottom half of each sheet. Spread the veggies and protein across. Dot with mayo and drizzle with tamari. Wet the other edge of the sheets and roll from the base where all the filling is towards the top which you have wet so it will stick. Cut in half and pack for lunch.

Green & Gold Millet Salad

Serves 6

Ingredients:

• 1 cup Lotus Organic Hulled Millet • 2 cups water • 1 pack rocket or spinach leaves • 2 mangoes • 1 tbsp Nature First Apple Cider Vinegar • 2 tbsp Global Organics Extra Virgin Olive Oil

Method:

Combine water and millet in a saucepan and cook covered over medium-high heat. Once simmering reduce the heat to low and cook for 20 minutes or until the liquid is absorbed. Fluff with a fork and allow to cool. Slice mangoes and toss all the ingredients together.

Cornbread Muffins

Makes 6

Ingredients:

• 1½ cups Lotus Organic Plain or Spelt Flour • 1 tbsp Lotus Baking Powder • ½ tsp Lotus Fine Sea Salt • 1 tsp Gourmet Organic Mexican Seasoning • 2 cups cornflakes • 1¼ cups milk of choice • 1 egg • ⅓ cup oil or melted butter • 1 cup diced vegetables • 1 cup grated cheddar cheese

Method:

For diced vegetables, use a combination of different coloured capsicum, corn kernels, brown or Spanish onion and spring onion. Sieve together the flour, baking powder, salt and spice. Mix the cornflakes and milk. Whisk the egg and oil into the milk and then add the vegetables and cheese. Combine with the flour, stirring to mix well but don’t over mix. Pour into muffin tins and bake at 180°C for 20 minutes, or until golden and cooked through.

Spicy Lentil Dahl

Serves 4

Ingredients:

• 100g Lotus Organic Basmati Rice • 100g Global Organics Brown Lentils • 1 tsp Gourmet Organic Turmeric • 2 ½ tsp Gourmet Organic Garam Masala • 1 tsp Gourmet Organic Ground Cumin Powder • ½ cup Global Organics Coconut Milk • 1 handful of coriander, chopped • 1 onion, diced • 2 garlic cloves, crushed • 2 sticks of celery, diced • 2 green chillies, chopped finely • 2 stock cubes • 1L water • 30mL ghee

Method:

In a large pot, fry onion and celery in ghee for 2-5 minutes. Once cooked, add green chillies and garlic then sauté for 1-2 minutes. Combine the rice and lentils and stir through, then add the stock and water. Stir through all powdered herbs, cover and bring to a boil. Allow mixture to simmer until all liquid is absorbed and lentils are tender. Add coconut milk prior to serving and garnish with fresh coriander.