An individualized nutrition plan is the cornerstone of safe food allergy management for those affected by food allergies. During the pediatric years, the nutrition focus is to prevent acute and chronic food allergy reactions by avoiding the offending or foods. Simultaneously, there is equal importance to provide an adequate, nutritionally balanced and personalized diet prescription to ensure adequate growth and development.
As a Registered Dietitian-Nutritionist with 25 years of diverse work experience, I have spent the past six years running a food allergy kitchen at a sleep away camp. Based on front line experience and compassion for these children with multiple allergies, I directed my learning and career towards food allergies. After an exhausted search, I came to discover how little support, education and resources exist for individuals and families affected by food allergies.
In order to validate the title of Food Allergy Registered Dietitian, I pursued additional education. I have completed a 9-month Certificate of Training in Pediatric Food Allergy through FARE (Food Allergy Research & Education), an additional Masters in Nutrition and Health Promotion from Simmons University and became an allied health member of the American Academy of Allergy, Asthma & Immunology.
Why is a Registered Dietitian that specializes in food allergy important?
Inadequate growth in children affected by food allergy, compared with healthy peers, is well documented. Studies have found lower caloric intake in the diets of allergic children and different growth patterns compared with healthy children, even when nutrient intake is similar. The hypothesis for the poor growth in the food allergy pediatric population can be related not only to the high number of foods to be excluded due to allergy, but also to a persistent sub-inflammatory state of the gastrointestinal mucosa. It may reduce the absorption of fuels and substrates and increase intestinal permeability and, consequently, nutrient loss.
The allergy-specialist dietitian creates a customized diet, with the aim to:
- give the family clear guidance regarding the elimination of the food [native, its derivatives, foods that contain it as an ingredient (known source) or as a hidden source]
- guide the family in reading and interpreting labels
- provide a detailed list of substitute foods
- ensure proper nutritional intakes and growth milestones are met
- identify any deficits and provide vitamin and/or trace element supplements suggestions
- use appropriate supplements, in the case of extremely restrictive diets
Personalized nutrition
In practice, the dietitian provides healthy eating advice on an adequate and balanced diet, advising proper substitutes for excluded foods, all while reducing as much as possible the impact on quality of life. The dietitian also has the role of teaching how to correctly interpret food labels in order to reduce the possibility of an inadvertent exposure to the culprit foods.
All children with FA should be reassessed periodically as appropriate follow-up allows to assess dietary compliance and ensure optimal growth. The dietitian, taking all this information into account, can devise an individualized nutritional plan that best suits the patient’s needs and schedule periodic reassessments to evaluate the course of the disease and/or the resolution of specific allergies.
