• Clinical and Experimental Pediatrics
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• 제62권5호
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• pp.149-154
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• 2019

The World Health Organization recommends that infants should be exclusively breastfed for the first 6 months of life to provide optimal nutrition in this critical period of life. After this, infants should receive nutritionally adequate and safe complementary foods while breastfeeding continues for up to 2 years of age or beyond. For nonbreastfed infants, infant formula is an available option to provide the nutrition needed. Infant formula is usually prepared from industrially modified cow's milk and processed to adjust for the nutritional needs of infants. However, cow's milk is one of the most common causes of food allergy, affecting 2%-5% of all formula-fed infants during their first year of life. One strategy to prevent cow's milk allergy in nonbreastfed infants is the use of partially hydrolyzed formula (pHF) in high-risk infants, which are infants born in families with atopic disease. However, based on an epidemiological study, approximately half of the infants who develop allergy are not part of the at-risk group. This is because the non-at-risk group is significantly larger than the at-risk group and the non-at-risk infants have approximately 15% risk of developing allergies. This study aimed to evaluate the effects of partially hydrolyzed whey formula (pHF-W) in nonbreastfed infants and determine whether pHF-W can prevent atopic disease in high-risk infants and can be used as routine starter formula regardless of the allergy risk status.

• 한국식품조리과학회지
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• 제12권4호
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• pp.487-492
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• 1996

The purpose of this report is to present a list of Korean foods containing histamine, that is known to cause food allergy and chronic urticaria. For the measurement of histamine in foods, the application of spectrofluorimeter is used. Among the food groups, sea foods (mackerel, pacific saury, spanish mackerel, anchovy, hair, tail, tuna) contain most high amount of histamine, and the contents of see weeds (sea mustard, laverare) are also high. Milk and milk products (mozzarella cheese, yogurt) contain more histamine than animal meats. Plant foods like cereals, vegetables or fruits contain much less histamine than other food groups, except spinach. The contents of dried sesame, sesame oil, and mugicha, green tea, ginseng tea, mayonnaise, tomato ketchup are relatively high. This paper will be used as a fundamental guideline in planning dietary management of allergy and for the operational plans for the future nutrition education intervention. Because the foods rich in histamine may cause allergy-like syptoms, it may be reqoiled to label the foods containing histamine.

• Pediatric Gastroenterology, Hepatology & Nutrition
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• 제17권2호
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• pp.61-73
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• 2014

Presented are guidelines for the prevention, diagnosis, and treatment of cow's milk protein allergy (CMPA) which is the most common food allergy in infants. It manifests through a variety of symptoms that place a burden on both the infant and their caregivers. The guidelines were formulated by evaluation of existing evidence-based guidelines, literature evidence and expert clinical experience. The guidelines set out practical recommendations and include algorithms for the prevention and treatment of CMPA. For infants at risk of allergy, appropriate prevention diets are suggested. Breastfeeding is the best method for prevention; however, a partially hydrolyzed formula should be used in infants unable to be breastfed. In infants with suspected CMPA, guidelines are presented for the appropriate diagnostic workup and subsequent appropriate elimination diet for treatment. Exclusive breastfeeding and maternal dietary allergen avoidance are the best treatment. In infants not exclusively breastfed, an extensively hydrolyzed formula should be used with amino acid formula recommended if the symptoms are life-threatening or do not resolve after extensively hydrolyzed formula. Adherence to these guidelines should assist healthcare practitioners in optimizing their approach to the management of CMPA and decrease the burden on infants and their caregivers.

• Pediatric Gastroenterology, Hepatology & Nutrition
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• 제7권1호
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• pp.40-47
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• 2004

목 적: 효율적인 진단과 치료 및 적절한 의학적 교류를 목적으로 소아 위장관 알레르기 질환의 새로운 분류법이 발표되었다(J Pediatr Gastroenterol Nutr 2000;30:S87-94). 그러나 명칭과 분류의 변경으로 이미 알려진 질환들이 새로운 질환으로 보고되기도 하는데, 저자들은 새로운 분류법에 따른 소아 위장관 알레르기 질환의 질병군에 관하여 알아보고, 국내에서 이미 보고된 관련 문헌을 함께 고찰하여 의학적 교류에 혼선을 최소화 하고자 한다. 방 법: 2003년 3월부터 7월까지 계명대학교 의과대학 소아과를 방문하여, 우유 유발 및 제거시험, 내시경을 이용한 조직생검 등을 이용하여 소아 GI-CMA로 진단된 37례(남 19, 여 18)를 대상으로 후향성 조사하였다. 새로운 분류에는 포함되지 않았으나 위식도역류 관련 알레르기를 추가하였다. 국내 문헌은 소아과학회지, 소아소화기영양학회지, 소아알레르기호흡기학회지를 근거로 고찰하였다. 결 과: 1) 대상 환아의 연령은 2주~15개월, 평균 $5.4{\pm}4.8$개월이었다. 2) 출생체중은 전례에서 10~90백분위수를 차지하였으며, 25~75백분위수가 25례(68%)를 차지하였다. 내원 당시 체중은 3백분위수 이하가 18례(49%)이었다. 3) 증상발현에서 진단까지 걸린 시간은 2주~12개월, 평균 $2.4{\pm}3.3$개월이었다. 4) IgE 군인 IgE 매개형 우유알레르기(IGE) 6례(16%), IgE와 Non-IgE 혼합군인 호산구성 위장관염(EOS) 2례(5%), Non-IgE군인 전형적 우유 단백질 유발 장관염(CMPIE-T) 7례(19%), 비전형적 우유 단백질 유발 장관염(CMPIE-AT) 5례(14%), 알레르기성 대장염(AC) 12례(32%)이었다. 위식도역류증 관련 우유 알레르기(GERA)는 5례(14%)이었다. CMPIE-T 전례에서 소장 조직생검상 장병증이 관찰되었다. 5) 진단 당시 연령은 IGE $4.3{\pm}0.8$개월, EOS 생후 2주와 14개월, CMPIE-T $3.8{\pm}4.6$개월, CMPIE-AT $10.4{\pm}3.8$개월, AC $3.4{\pm}3.9$개월, GERA $7.8{\pm}5.7$개월로 질환군간 유의한 차이를 보였다(p<0.05). 6) 내원 당시 3백분위수 이하를 보인 경우가 IGE 17%, EOS 0%, CMPIE-T 86%, CMPIE-AT 60%, AC 25%, GERA 100%로 질환군간 유의한 차이를 보였다(p<0.05). 7) 국내 문헌을 고찰하여 소아 위장관 우유 알레르기 질환은 만성설사, 난치성설사, 우유 불내성, 우유 알레르기, 위장관 알레르기, 우유 과민성 장병증, 호산구성 위장관염, 알레르기성 대장염 등의 용어로 보고되었다. 결 론: 새로운 분류법에 따른 소아 위장관 우유 알레르기 질환은 연령, 임상 증상, 위장관 침범 부위에 따라 특징적인 유형으로 구분할 수 있으며, 임상적으로 드물지 않다. 국내의 문헌을 통하여 다양한 용어로 각 유형의 알레르기 질환들은 연구 보고되어 왔다.

• Nutrition Research and Practice
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• 제7권6호
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• pp.488-494
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• 2013

A food allergy is an adverse health effect arising from a specific immune response that occurs reproducibly upon exposure to a given food. In those with food allergies that are thought to cause aggravation of eczema, food avoidance is important. The objective of this study was to research the nutritional status of patients with food allergies. A total of 225 subjects diagnosed with atopic dermatitis underwent a skin prick test as well as measurement of serum immunoglobulin E. Food challenge tests were conducted using seven food items: milk, eggs, wheat, soybeans, beef, pork, and chicken. At post-food challenge visits to the test clinic, participants completed a three-day dietary record, which included two week days and one weekend day, in order to evaluate energy intake and diet quality during the challenge. We analyzed nutrient intake based on differential food allergens. Subjects with a food allergy to milk showed lower intake of Ca, Zn, and vitamin B2, and subjects with a food allergy to egg showed lower intake of vitamin A, B1, B2, niacin, and cholesterol. Subjects with a food allergy to wheat and soybean showed lower intake of Ca, P, Fe, K, Zn, vitamin B2, vitamin B6, and niacin; and subjects with a food allergy to beef, pork, and chicken showed lower intake of Fe and higher intake of K, vitamin A, B2. Subjects with atopic dermatitis were lacking in several nutrients, including vitamin A and vitamin C. A greater number of food allergies showed an association with a greater number of nutrient intake deficiencies. Allergen avoidance is the basic treatment for atopic dermatitis. However, when the allergen is food, excessive restriction can lead to nutrition deficiency. Findings of this study suggest the necessity for enhanced nutritional education in order to provide substitute foods for patients with food allergies who practice food restriction.

• Pediatric Gastroenterology, Hepatology & Nutrition
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• 제24권4호
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• pp.392-402
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• 2021

Purpose: The present study assessed the role of an amino acid-based formula (AAF) in the growth of infants with cow's milk protein allergy (CMPA). Methods: Non-breastfed, term infants aged 0-6 months with symptoms suggestive of CMPA were recruited from 10 pediatric centers in China. After enrollment, infants were started on AAF for two weeks, followed by an open food challenge (OFC) with cow's milk-based formula (CMF). Infants with confirmed CMPA remained on AAF until 9 months of age, in conjunction with a cow's milk protein-free complementary diet. Body weight, length, and head circumference were measured at enrollment and 9 months of age. Measurements were converted to weight-for-age, length-for-age, and head circumference-for-age Z scores (WAZ, LAZ, HCAZ), based on the World Health Organization growth reference. Results: Of 254 infants (median age 16.1 weeks, 50.9% male), 218 (85.8%) were diagnosed with non-IgE-mediated CMPA, 33 (13.0%) tolerated CMF, and 3 (1.2%) did not complete the OFC. The mean WAZ decreased from 0.119 to -0.029 between birth and enrollment (p=0.067), with significant catch-up growth to 0.178 at 9 months of age (p=0.012) while being fed the AAF. There were no significant changes in LAZ (0.400 vs. 0.552; p=0.214) or HCAZ (-0.356 vs. -0.284; p=0.705) from the time of enrollment to age 9 months, suggesting normal linear and head growth velocity. Conclusion: The amino acid-based study formula, in conjunction with a cow's milk proteinfree complementary diet, supported normal growth till 9 months of age in a cohort of Chinese infants with challenge-confirmed non-IgE-mediated CMPA.

• Journal of Dairy Science and Biotechnology
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• 제24권2호
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• pp.1-9
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• 2006

Goat milk is digested better than cow milk, because the fat globules in goat milk are smaller and the protein is similar to human milk, and assimilated easily. Goat milk is particularly rich in taurine (4.7mg/100mL) and retinol (40mg/100mL). Therefore, it might be recommened to heal dyspepsia and infants allergy by cow milk. However, during winter, supply of goat milk products are unsteady in Korea, because unbalance of demand and supply is resulted from seasonal breeding. Dairy industry for goat milk will be able to grow much more, if goat milk products can keep steady supply without changing by season. This review includes the physicochemical characteristics of goat milk, domestic production of goat milk, domestic goat milk products and future development.

• Journal of Dairy Science and Biotechnology
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• 제26권1호
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• pp.27-36
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• 2008

This review was written to introduce updated data on the structure and function of the major milk proteins identified as allergens, the characterization of their epitopes in each allergenic milk proteins, and the reduction of milk protein allergenicity. Most mammalian milk protein, even protein present at low concentration, are potential allergens. Epitopes identified in milk proteins are both conformational(structured epitope) and sequential epitopes(linear epitope), throughout the protein molecules. Epitopes on casein and whey proteins are reported to be sequential epitope and conformational epitopes, respectively. Conformational epitopes on whey protein are changed into sequential epitope by heat denaturation during heat treatment. Several methods have been proposed to reduce allergenicity of milk proteins. Most ideal and acceptable method to make hypoallergenic milk or formula, so far, is the hydrolysis of allergenic milk proteins by enzymes that has substrate specificity, such as pepsin, trypsin, or chymotrypsin. Commercial formulas based on milk protein hydrolysate are available for therapeutic purpose, hypoantigenic formula for infants from families with a history of milk allergy and hypoallergenic formula for infants with existing allergic symptoms.

• 대한지역사회영양학회지
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• 제26권5호
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• pp.396-407
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• 2021

Objectives: We examined the common allergenic foods, symptoms and management of food allergies in children attending the facilities registered at Center for Children's Foodservice Management in Gangdong-gu, Korea. Methods: The survey was conducted among the directors or head teachers of 186 children's food service facilities with 7,591 children in 2019. The questionnaire consisted of three parts, including general information about food service facilities, information related to food allergies and allergenic foods and symptoms in individual children. Results: The number of children with food allergy was 271 (3.6%), and the proportion decreased with the increase of age. There were 91 children (33.6%) with a medical certificate, and these children had a significantly higher number of allergenic foods and symptoms than those without a medical certificate. Allergenic food groups included meat, fish, eggs and legumes (59.1%), fruits (12.4%), milk and dairy products (8.9%), cereals (7.8%), vegetables (6.2%), processed foods (3.8%) and oils and sugars (1.9%). Eggs accounted for 22.1%, followed by peanut and tree nuts (18.6%), fruits (12.4%), milk and dairy products (8.9%), shellfish (8.6%), vegetables (6.2%), fish (5.7%), cereals (4.3%) and meat (1.1%). The common allergenic foods were eggs, peanuts, walnuts, kiwi, shrimp, milk, tomatoes, mackerel, blue-green fish, peaches, shellfish (clams and abalone), buckwheat, wheat and soybeans. The most common allergic symptoms were skin and mucous membrane symptoms, such as hives, rash, itching and oral angioedema. Meal management for children with food allergies showed different trends depending on the causative food. Conclusions: The objective diagnosis by an allergist should be done for food allergy management in children's catering facilities. A system for systematic meal management of causative foods should be prepared.

• 동의생리병리학회지
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• 제16권5호
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• pp.831-839
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• 2002

Allergy has a born predominant cause of atopy in body and react oversenstively several meterial. The cause of allergy are tick, house dust, egg, milk, bean, cosmetics, virus, bacteria, flesh and meat in Western medicine. While, Oriental medicine did not have an application on the allergy, but recognized that allergy is connected with fetal toxicosis, heat-syndrome in new born, syndrome characterized by dyspnea, sneezing, stuffy nose, nasal discharge and phlegm. Therefor, We knowed method of medical treatment following cause of disease and pathogenesis against allergy. Allergic disease(atopic dermatitis, bronchial asthma, rhinitis) were related with lung, spleen, kidney. To prevent allergic disease in born, Oriental medicine taked a serious view of fetal education. In Western medicine, The cause of allergy applied to exopathogen of Oriental medicine. In Oriental medicine, Treatment of allergy used generally strengthening the body resistance to eliminate pathogenic factors.