Food Allergies: Avoidance vs. Adequacy

Health Check on Food Allergies

Health Check on Food Allergies

Getting children to eat a wide variety of food in general to help them grow and thrive is difficult enough for parents, but when children with food allergies have to avoid the food(s) they are allergic to, it leaves the question of are they getting enough nutrients in their diet?

One study revealed that children with two or more food allergies were shorter, based on height-for-age percentiles, than those with one food allergy; and more than 25% of children with one or more food allergens consumed less than 67% of the Recommended Daily Allowance (RDA) for calcium, Vitamin D and E. This can lead to secondary problems, including rickets and even seizures (related to a low calcium level in the blood). It’s important for parents to get an accurate diagnosis from an allergist on what foods to avoid. Over restricting a child’s diet and being extremely cautious in order to stay safe is natural for any parent, however, not replacing these nutrients can be harmful.  The goal is to only remove the foods that cause an adverse reaction.

A study published in December 2014 by the American College of Allergy, Asthma and Immunology (ACAAI), stated that advice from a dietitian is a key component of effective food allergy management. Mothers would like dietitians to help them ensure their child will be safe, and guide them through the process of creating a nutritionally complete diet. Parents of food  allergic children also want to maintain a sense of normalcy for their child and promote independence.

The study indicated that if the child and family received nutrition counseling on alternative ways to obtain calories and nutrients from safe & well tolerated foods, the risk of deficiency and additional illness was lowered.

So, how do you ensure your child is receiving adequate nutrients while avoiding the necessary allergens in the diet?

A diet analysis will determine if all the nutrients are being met and what areas need to be increased for any found deficiencies, but the results are only as accurate as the details of the information that is recorded.

A 7-day food journal will give a better indication of the types of foods eaten over a longer period of time verses a 3-day journal which may not include other foods normally eaten.

The 3 major areas to review in the diet are: total caloric intake; carbohydrates, protein and fat; and vitamins and minerals, especially calcium, Vitamin D and Vitamin E for those with multiple allergies and/or avoiding dairy.  The analysis is based on age, gender, activity level, height and weight.

Once the analysis is completed and reviewed, recommendations are given for the major food groups (grains, vegetables, fruits, dairy and protein) and a detailed list of nutrients for vitamins and minerals based on the RDA of recommendation vs. intake.

The dietitian should provide rationale for any recommendations with substitutions and/or additional suggestions from the results of the nutritional analysis for improvements to diet adequacy. Any additional supplementation is determined based on the results of the analysis and if other foods cannot meet the nutritional needs.

Nutrition counseling can benefit everyone, but is essential for those following special dietary recommendations to be sure they’re receiving all the necessary nutrients. Keep in mind, children diagnosed with food allergies should have a yearly nutritional assessment and review, to prevent any potential growth problems and/or inadequate nutrient intake.

In optimal health,


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