Diet for atopic dermatitis in children, list of safe and dangerous foods

General recommendations for creating a menu for atopic dermatitis

An allergy or hypersensitivity reaction is a specific condition of the body that occurs upon contact with certain substances, allergens.

They enter the bloodstream and lead to the appearance of extensive red spots and rashes on the skin, which may be accompanied by itching and fever.

To prevent such a reaction, it is recommended to introduce certain restrictions into the child’s diet.

What are the general recommendations when creating a menu for a baby with this disease:

1. It is worth excluding potentially dangerous products that can lead to allergies, such as various canned foods, marinades rich in vinegar and spices, semi-finished products whose composition is unclear, and mushrooms.
2. Limit the consumption of fatty and unhealthy foods: pork, chicken, eggs, even sawn eggs will be prohibited.
3. Red vegetables and fruits are also dangerous for children with a similar diagnosis; they can lead to skin rashes.
4. Dairy products with a high level of fat are not recommended for dermatitis and can cause harm to the body.
5. Baked goods, sweets and snacks, they are rich in harmful substances, irritate the mucous membrane of the stomach and intestines and contribute to the accumulation of toxins.
6. Carbonated drinks and packaged juices are prohibited for children of all ages, as they overload the gastrointestinal tract and liver.

Three basic rules to follow when following a diet.

Table 1. Diet rules

It is advisable to consult a doctor when creating a menu; he will help you eliminate foods that can lead to similar problems.

Choosing a medicinal mixture for allergies to CMP

When mixed or artificial feeding, it is necessary to exclude mixtures based on cow's milk and complementary foods containing BCM or other, unmodified, dairy animal proteins (for example, goat's, sheep's milk). You can use a mixture based on highly hydrolyzed protein or a mixture based on amino acids.

According to modern requirements, all medicinal mixtures are enriched with a complex of vitamins, macro- and microelements. For children with severe skin and gastrointestinal manifestations of PA, mixtures based on highly hydrolyzed casein or whey proteins

, which contain medium chain triglycerides.

For mild skin manifestations of atopy, mixtures based on highly hydrolyzed whey proteins containing lactose can be used.

Amino acid mixtures

are mixtures that eliminate the risk of contact with BCM allergens. All such mixtures have a balanced composition and can be used both for a short period to diagnose allergies to milk proteins, and as the basis of a diet for long-term use.

Application of mixtures based on soy protein

is currently limited and is allowed only in children over 6 months of age with mild manifestations of allergy to CMP and the absence of gastrointestinal disorders and sensitivity to soy protein.

Mixtures based on hydrolyzed rice protein

are currently not registered on the territory of the Russian Federation.

Goat milk based formulas

should not be used in the nutrition of children with an allergy to CMP.

Elimination diet for atopic dermatitis

It is difficult for children to tolerate strict dietary restrictions; a growing body needs nutrients and minerals.

It is recommended for such children:

• gradually introduce new products to the menu, monitoring the reaction;
• At first, limit the consumption of meat, fermented milk and other dishes.

They start with porridges, cereals and low-fat meat broths, which are easily absorbed by the body and do not cause digestive problems.

Gradually, new products are added to the diet, carefully monitoring the body's reaction to their use. It is better to fix the menu, write down everything that the baby eats. If an inadequate reaction occurs, the product is removed.

Sources

• Oluwagbemigun K., O'Donovan AN., Berding K., Lyons K., Alexy U., Schmid M., Clarke G., Stanton C., Cryan J., Nöthlings U. Long-term dietary intake from infancy to late adolescence is associated with gut microbiota composition in young adulthood. // Am J Clin Nutr - 2022 - Vol113 - N3 - p.647-656; PMID:33471048
• Ye Q., Wang H., Xia X., Zhou C., Liu Z., Xia ZE., Zhang Z., Zhao Y., Yehenala J., Wang S., Zhou G., Hu K., Wu B ., Wu CT., Wang S., He Y. Safety and efficacy assessment of allogeneic human dental pulp stem cells to treat patients with severe COVID-19: structured summary of a study protocol for a randomized controlled trial (Phase I / II) . // Trials - 2022 - Vol21 - N1 - p.520; PMID:32532356
• Stallings VA., Tindall AM., Mascarenhas MR., Maqbool A., Schall JI. Improved residual fat malabsorption and growth in children with cystic fibrosis treated with a novel oral structured lipid supplement: A randomized controlled trial. // PLoS One - 2022 - Vol15 - N5 - p.e0232685; PMID:32384122
• Turkalj M., Matišić V., Šimić A., Juginović A., Erceg D., Tješić Drinković D., Höppner W., Primorac D. Cystic fibrosis presentation in del. F508 and p. Tyr109Glyfs compound heterozygote CFTR state: a case report. // Croat Med J - 2022 - Vol60 - N3 - p.246-249; PMID:31187952
• Stallings V.A., Sainath N., Oberle M., Bertolaso ​​C., Schall JI. Energy Balance and Mechanisms of Weight Gain with Ivacaftor Treatment of Cystic Fibrosis Gating Mutations. // J Pediatr - 2018 - Vol201 - NNULL - p.229-237.e4; PMID:30029855
• Ikuse T., Kudo T., Arai K., Fujii Y., Ida S., Ishii T., Mushiake S., Nagata K., Tamai H., Toki A., Tomomasa T., Ushijima K., Yanagi T. ., Yonekura T., Taguchi T., Shimizu T. Shwachman-Diamond syndrome: Nationwide survey and systematic review in Japan. // Pediatr Int - 2022 - Vol60 - N8 - p.719-726; PMID:29804317
• Patni N., Quittner C., Garg A. Orlistat Therapy for Children With Type 1 Hyperlipoproteinemia: A Randomized Clinical Trial. // J Clin Endocrinol Metab - 2022 - Vol103 - N6 - p.2403-2407; PMID:29659879
• Zavala GA., García OP., Camacho M., Ronquillo D., Campos-Ponce M., Doak C., Polman K., Rosado JL. Intestinal parasites: Associations with intestinal and systemic inflammation. // Parasite Immunol - 2022 - Vol40 - N4 - p.e12518; PMID:29364525
• Gianni M.L., Roggero P., Baudry C., Fressange-Mazda C., le Ruyet P., Mosca F. No effect of adding dairy lipids or long chain polyunsaturated fatty acids on formula tolerance and growth in full term infants: a randomized controlled trial. // BMC Pediatr - 2018 - Vol18 - N1 - p.10; PMID:29357820
• Song XX., Fang DH., Quan YQ., Feng DJ. The pathogenic detection for 126 children with diarrhea and drug sensitivity tests. // Eur Rev Med Pharmacol Sci - 2022 - Vol21 - N4 Suppl - p.95-99; PMID:29165756

Rotation diet for atopic dermatitis

It has a different principle, it consists in observing the following rules:

1. The menu is designed in such a way that a new product appears on it at least once every 4 days.
2. A menu is created for the day from one type of meat, cereal, and vegetables.
3. If a child develops an allergy, then after 5 days a new product is given in combination with others.
4. The reaction is repeated - completely excluded from the diet.

This diet will help identify the allergen; it is suitable for those children who, according to their parents, react “to everything.”

Child nutrition

Foods that cause PA are excluded from the child’s diet. When treating allergies in breastfed children, the pediatrician’s task is to preserve breast milk in the child’s diet to the maximum extent possible. If you are allergic to cow's milk proteins, the mother completely excludes all products containing these proteins, beef and veal, from her diet. Often several foods cause a reaction; With such multiple allergies, a nursing woman is prescribed a hypoallergenic diet. At the same time, the severity of the restrictions and the range of products in it are individual and depend on the manifestations of the child and the presence of allergies in the mother.

Table of allergenicity of products from the Union of Pediatricians

If we talk about the allergenicity of food products, then it largely depends on the body’s susceptibility to food allergens. But there are general recommendations that the Union of Pediatricians recommends following.

Table 2. Permitted and prohibited products

More often, skin rashes appear after eating honey, nuts, red fruits, and citrus fruits. This reaction is also observed when fish dishes are included in the menu. It is rich in mercury, which accumulates under the fins and gills. Therefore, children with atopic dermatitis who are forced to follow a diet do not have fish or seafood in their diet.

Diet therapy for allergic diseases in adolescents

What principles should be followed when preparing a therapeutic diet for a patient with allergies? What foods most often cause allergic reactions? What should a doctor do when examining and treating a patient with polyvalent sensitization?

Diet therapy is an important component of the complex treatment of any disease. Properly structured, adequate nutrition allows you to provide the body with the necessary nutrients in accordance with the age-related needs of a person. For allergic diseases, diet therapy helps to more quickly achieve and maintain remission of the disease.

Considering diet therapy for allergic diseases in adolescents from the standpoint of the modern theory of adequate nutrition [1], it should be emphasized the need to prescribe to the patient a balanced diet that is adequate to his needs in terms of quantity and quality (set of nutrients), the nature of culinary processing of food, the rhythm of nutrition, as well as the state of enzyme systems body. Particular importance in the theory of adequate nutrition is given to the role of food ballast substances as a factor that contributes to maintaining the health of the entire macroorganism-microflora ecosystem. In case of illness, therapeutic nutrition should be prescribed taking into account the pathogenetic mechanisms of the disease, the condition of various organs and systems.

In this case, adequate nutrition is aimed at normalizing metabolic processes and impaired functions of internal organs and systems, which contributes to the patient’s recovery.

When preparing a therapeutic diet for a patient with an allergic disease, the clinician is traditionally guided primarily by the principle of elimination - products containing causally significant allergens and cross-allergens are excluded; products with high sensitizing activity; containing artificial food additives; promoting histamine liberation; containing large amounts of histamine and other biogenic amines. It should be emphasized that the second, no less important principle is the adequate replacement of excluded products in order to maximize the correction of the quantitative composition of the diet in terms of main nutrients. The third principle of constructing a therapeutic diet is adherence to “functional nutrition” - the use of foods in the diet that are most beneficial for achieving and maintaining the health of a child or adolescent.

Elimination diets are effective in patients with various clinical manifestations of allergies: atopic dermatitis, bronchial asthma, hay fever, Quincke's edema, urticaria. However, diet therapy becomes most important in cases where the existing clinical manifestations are caused by the presence of food allergies [2]. The diet of this category of patients, of course, requires the most careful and painstaking correction, however, the effect of properly administered diet therapy can be very significant.

Exclusion of causally significant foods is carried out on the basis of patient examination data, which includes a thorough collection of anamnesis, taking into account information about intolerance to certain foods, and, if necessary, keeping a food diary. The most accurate and specific method of examining a patient to identify food allergies is an open elimination-provocative test. In cases where it is difficult to carry out, as well as in cases of polyvalent sensitization and the impossibility of excluding a wide range of foods from the diet for a long time, research methods such as the determination of specific antibodies of various classes (IgE and IgG) to food proteins in vitro are of undoubted value, skin tests, provocative sublingual tests. The most frequently identified cause-significant food allergens in adolescents include fish and seafood, eggs, chicken, citrus fruits, nuts, and honey. It should be noted that even a thorough examination does not always make it possible to differentiate the manifestations of food allergies and reactions to food of a non-immune nature (so-called pseudo-allergic reactions to food). This is explained by the fact that the same food products can cause both reactions associated with the production of specific antibodies and nonspecific intolerance reactions caused by the liberation of histamine and other biogenic amines (Table 1), the presence of food additives in food products introduced during the process production (Table 2) [3, 4, 5]. Regardless of the form of food intolerance - an allergic reaction or a non-immune reaction to food, if there are pronounced clinical signs of intolerance to a particular product, it is recommended to completely exclude it from the diet for a long period. The “pseudo-allergic” type of food intolerance is often indicated by the “dose-dependent” nature of the reaction. In such cases, it may be possible to include a small amount of the partially tolerated product in the adolescent's diet. In this case, the question of the quantity of the introduced product is decided individually.

When prescribing an elimination diet, the possibility of cross-sensitization between different groups of allergens should also be taken into account (Table 3).

It should be noted that even if a teenager suffering from one or another allergic disease does not have signs of food allergy itself, to reduce the overall histamine load on the body, a nonspecific hypoallergenic diet should be recommended - diet No. 5ga [6].

The purpose of diet No. 5ga is to reduce the antigenic effect of food on the child’s body and create conditions for normalizing the functional state of the digestive organs. The content of basic nutrients and energy value of diet No. 5ga correspond to the age-related physiological needs of children. Products and dishes that have increased sensitizing activity, containing food additives (dyes, preservatives, emulsifiers, flavors, as well as dishes that have the properties of nonspecific irritants of the gastrointestinal tract) are excluded from the diet (Table 4). Fried foods and the use of broths are excluded; foods are boiled or steamed, baked or stewed after boiling. Food temperature is from 20 to 60°C. Eating 5 times a day. Table 5 presents approximate average daily sets of products in diet No. 5ga for teenagers.

The principle of adequate nutrition

Adolescence, which is one of the critical periods of ontogenesis, is characterized by rapid growth rates. In this regard, it is extremely important that a teenager’s diet meets his physiological needs. At the same time, the results of population studies of the nutritional status of large groups of the Russian population indicate a decrease in the intake of various micro- and macronutrients into the body of children, and especially adolescents [7, 8, 9]. The most pronounced deficiency of a number of vitamins is observed in adolescents, while deep deficiency is more common in boys.

We analyzed the actual nutrition of 72 adolescents who were treated in the allergological department of the Research Institute of Pediatrics of the Scientific Center for Children of the Russian Academy of Medical Sciences using a questionnaire method. As a study of the average daily diets of adolescents has shown, in most cases significant deviations from the recommended intakes of essential nutrients are revealed, and often a significant imbalance of nutrition. Thus, a deficiency of protein consumption in the diet of more than 20% compared to the age norm was identified in 53% of cases, while in 11% of adolescents it exceeded 50%. An analysis of fat consumption showed a deficiency of more than 20% of the age norm in 44% of adolescents, a deficiency exceeding 50% in 8% of those examined. Significant deviations were also noted when analyzing carbohydrate consumption, as well as the energy value of the diet. In general, only 11% of children in the group had a diet that met age-specific needs for all major nutrients. The reasons for this are different: only in 28% of patients in the examined group, the cause of inadequate nutrition can be considered restrictions associated with intolerance to certain foods. Table 5 presents the main food groups that are most often subject to restrictions when following elimination diets and the associated possible nutrient deficiencies. However, in most cases, eating disorders are explained by the peculiarities of eating habits: in particular, in girls - with dietary restrictions on their own initiative in order to lose weight, as well as other psychological aspects of nutrition. Thus, replacing “unloved” dairy products with sweet carbonated drinks, chips and cookies leads to the fact that in half of the cases the calcium content in the diet of adolescents does not exceed 50% of the age norm.

If it is necessary to exclude such valuable protein products as milk, fish, chicken from the diet, meat, fermented milk and soy products are used (taking into account tolerance) to correct the protein component of the diet.

The most difficult aspect of diet adaptation is the correction of its micronutrient composition: the content of vitamins, minerals, essential amino acids, polyunsaturated fatty acids, etc. (Table 6). Children who have been suffering from allergic diseases for a long time and especially those receiving elimination nutrition are often deprived of important sources of vitamins (fruits, vegetables and dairy products, eggs, cereals), calcium (milk and its derivatives), iodine (fish and seafood), etc. It should be emphasized that it is not always possible to balance a therapeutic diet by using only natural food products: the use of special medicinal products and approved [10] biologically active additives (BAA) - nutraceuticals, which allow you to correct existing nutrient deficiencies - is often required.

Limited consumption of foods containing calcium is a serious prerequisite for the development of osteoporosis [11]. Achieving normal peak bone mass in adolescents depends on the amount of dietary calcium consumed. Long-term exclusion or restriction of such an important source of calcium as dairy products from the diet of adolescents with allergies can lead to calcium deficiency in the body. The situation is aggravated by smoking or drinking alcohol, which reduce the absorption of calcium in the body, as well as due to excessive enthusiasm among young people for drinks such as Coca-Cola, as a result of which phosphorus consumption increases and bone formation is impaired. Another important factor contributing to the development of osteoporosis in children with allergic diseases is the use of glucocorticoid therapy. In this regard, dietary measures for a teenager with allergies should be carried out taking into account the correction of calcium intake both through food products, such as dairy and specialized products fortified with calcium, and with the use of pharmacological drugs (calcium lactate, calcium glycerophosphate, calcium-D3 and etc.).

Studies examining the iodine supply of various age groups of the population show that, against the background of a high need for iodine in adolescence (200 mg/day), it is in this age group that the most significant iodine deficiency is observed [12]. In children who suffer from allergic diseases for a long time, especially in cases of long-term adherence to elimination diets, from which such important sources of iodine as fish and seafood are excluded, the problem of iodine deficiency in the diet is even more acute. In order to prevent iodine deficiency in the diet, the following should be used: iodized salt, iodine-bromine mineral waters, iodine-enriched food products, iodine-rich seaweed, both in natural form and in the form of iodine-containing dietary supplements (klamin, kelp, fucus, iodine-active, energolam-plus). If it is impossible to create a diet that meets the need for iodine, as well as in cases of clinical manifestations of iodine deficiency, correction should be carried out using long-term use of iodine-containing drugs. It should be borne in mind that regardless of the methods of replenishing iodine, it is most optimally absorbed with sufficient protein, iron, zinc, copper, vitamins A and E in the diet.

Long-term exclusion of fish from the diet leads to insufficient intake of such essential nutritional factors as polyunsaturated fatty acids (PUFAs) of the ω-3 class (linolenic, eicosapentaenoic, docosopentaenoic and docosohexaenoic), contained mainly in fish oil and some vegetable oils ( pumpkin, flax). ω-3 fatty acids play an important role in the metabolism of phospholipids and contribute to the stabilization of cell membranes, influence immune functions by activating the macrophage-plasma cell reaction in lymphoid organs, and affect tissue hormones - prostaglandins involved in the regulation of T-lymphocyte formation. The listed properties underlie the hypoallergenic and immunocorrective effect of ichthyene fat in patients with allergic pathology. To increase the content of ω-3 PUFAs in the diet, special food additives of marine (polyene, eikonol) or vegetable (pumpkin, linseed oil, ecolen) origin are used. Fat nutraceuticals do not contain protein and carbohydrate components; they can be prescribed to adolescents in therapeutic doses (3–6 g/day) during the subacute period of the disease, as well as during the period of remission for preventive purposes in doses from 2 to 4.5 g/day for 30 –40 days. The use of these drugs in children with atopic dermatitis helps reduce atopy, itching, peeling of the skin, as well as restore their elasticity, and prolongs the remission of the disease.

An important pathogenetic mechanism of many diseases, including allergic ones, is “oxidative stress,” which is accompanied by excessive production of reactive oxygen species. In this regard, it is of great importance to use foods with antioxidant properties in the diet, primarily fresh vegetables and fruits, as well as study the possibility and effectiveness of using antioxidant drugs in adolescents with allergies. It is known that insufficient supply of an antioxidant such as selenium is a factor contributing to the development of allergic diseases. We studied the provision of one of the most important antioxidants - selenium - in children and adolescents with allergic diseases. A study of the level of selenium in the blood serum in 67 patients aged 6 to 16 years suffering from allergic diseases (bronchial asthma, atopic rhinitis, atopic dermatitis) showed that the supply of selenium for this category of patients varied significantly and in general was not lower than on average among Moscow children of the same age. Correction of selenium status was carried out by prescribing dietary supplements containing organic selenium. 16 patients received the dietary supplement Vitasil-Selenium (Russia), including autolysate of selenium-containing baker's yeast, 19 children received the dietary supplement Lunovit Plus (Russia), including autolysate of selenium-containing baker's yeast and tocopherol. The advantage of these drugs is that they contain selenium in organic form. It differs from inorganic selenium in its higher bioavailability and wide range of therapeutic effects. The control group consisted of 20 children who were not prescribed selenium-containing dietary supplements. As a result of taking nutraceuticals in children, an improvement in the supply of selenium was established with a high degree of reliability, against the background of which there was a pronounced tendency towards normalization of certain indicators of lipid peroxidation. The use of dietary supplements containing tocopherol (Viardot) and β-carotene (Vetoron) in patients with allergies has also been confirmed.

The concept of functional nutrition is based not only on the nutritional properties of food, but is also built taking into account the characteristics of the biologically active components contained in food products [13, 14]. The most widely used products at present are those containing pro- and prebiotics, dietary fiber and other components that help maintain normal microbiocenosis of the gastrointestinal tract, improve digestion processes and thereby help maintain the body’s defenses (Table 6). Most adolescents with allergic diseases experience certain dysfunctions of the digestive organs; quite often, gastritis and gastroduodenitis, biliary dyskinesia, and intestinal dysbiosis are detected as concomitant pathologies. The intestinal biocenosis plays a huge role in maintaining the health of the macroorganism. Endogenous flora is considered one of the most important components of the intestinal barrier, providing antagonistic activity against opportunistic and pathogenic bacteria, as well as stimulation of local immune defense. The most important function of microbiocenosis is its participation in metabolic processes, the synthesis of a number of vitamins, amino acids, and growth factors.

Disturbances in the composition of the intestinal microflora as a component of the intestinal barrier can lead to the development of food sensitization and the intensification of existing manifestations of food allergy through various mechanisms. It is known that some toxins of opportunistic bacteria increase the permeability of the intestinal barrier to macromolecules. The direct triggering effect of bacteria on allergy target cells through both a specific IgE-mediated pathway and a nonspecific lectin-dependent type of histamine liberation has also been described. Active vegetation of opportunistic bacteria in the intestinal lumen may also be associated with the development of bacterial sensitization.

Probiotic preparations in dosage forms are widely used for the correction and prevention of microecological disorders of the intestine. However, for patients with food allergies, especially against the background of reactive changes in the digestive organs, often leading to accelerated transit of chyme through the gastrointestinal tract, the most adequate form of administering probiotics is to administer them in a viable state, for example, including them in fermented milk products. This shortens the latent period of action of the probiotic, due to its release from suspended animation caused by lyophilization. It is especially important that with probiotic products the patient receives a complex of biologically active substances that improve the function of the digestive system. Table 7 lists factors that contribute to the colonization of the intestine by normal microflora. In particular, for milk protein intolerance, fermented soy-based products have proven themselves well.

In this regard, when prescribing a therapeutic diet, it is necessary to use fermented milk products in the diet, as well as products with the addition of probiotics. In addition, foods rich in dietary fiber with prebiotic properties or special foods fortified with prebiotics should be recommended; if necessary, as a supplement to nutrition, dietary supplements containing dietary fiber can be prescribed.

As noted earlier, in adolescence, not only the nutritional properties of food, but also the psychological aspects of nutrition, which are called “problems of food preferences” in the literature, become of great importance [15]. When prescribing nutritional therapy for a teenager, the doctor is often faced with a negative attitude towards the need to follow a diet. This is often due to the fact that the dietary or simply healthy products offered are outside the area of ​​adolescents’ food preferences, which were formed partly under the influence of advertising and the social environment. In cases where the diet is followed, psychological problems of two kinds may also arise. On the one hand, with long-term adherence to the elimination regime, a whole complex of psychological deviations is formed, caused by the ban on taking certain products; on the other hand, violating the diet entails the formation of a certain complex of guilt and dissatisfaction with oneself. In this regard, recommendations for a teenager’s nutrition should be discussed not only with parents, but also, first of all, with the patient himself, with his active participation. Conducting diet therapy in patients in this age category becomes possible only if it is possible to interest the teenager himself; psychological support from the family, environment or a psychologist is also desirable.

Thus, when preparing a diet for a teenager suffering from an allergic disease, attention should be paid not only to the elimination regimen, but also to how well the proposed diet meets the needs of a rapidly growing body for basic nutrients, as well as microelements and vitamins. Correction of the diet is carried out by replacing excluded products, taking into account tolerance (and, if possible, food preferences) with similar ones in composition; it is advisable to use special therapeutic and preventive products enriched with vitamins and microelements, “functional food” products, and, if necessary, dietary supplements.

Literature

1. Ugolev A. M. Theory of adequate nutrition and trophology. - St. Petersburg: Nauka, 1991. - 271 p.
2. Guide to therapeutic nutrition for children / Ed. K. S. Ladodo. - M.: Medicine, 2000. - 384 p.
3. Pascual CY, Crespo JF, Perez PG, Esteban MM. Food allergy and intolerance in children and adolescents, an update. Eur J Clin Nutr, 2000 Mar, 54 Suppl 1. - S. 75-8.
4. David T.J. Adverse reactions and intolerance to foods. Br Med Bull 2000, 56:1, 34 - 50.
5. Taylor SL. Dormedy ES The role of flavoring substances in food allergy and intolerance. Adv Food Nutr Res, 1998, 42. - P. 1 - 44.
6. Organization of therapeutic nutrition for children in hospitals (a manual for doctors) / Ed. A. A. Baranova, K. S. Ladodo. - 2001. - 239 p.
7. Belyaev E. N., Chiburaev V. I., Ivanov A. A. et al. Characteristics of actual nutrition and health of children in the regions of the Russian Federation // Nutrition Issues. - 2000. - No. 6. — P. 3 — 7.
8. Gorelova Zh. Yu. On the nutritional status of schoolchildren // Issues of children's dietology. - 2003. -T. 1. - No. 3. — P. 60 — 63.
9. Vzhersinskaya O. A., Kodentsova V. M., Trofimenko A. V. et al. Vitamin and iron provision in school-age children // Issues of pediatric dietology. - 2003. - T. 1. - No. 5. — P. 56.
10. Federal Register of Biologically Active Food Additives. - M., 2001.
11. Baranov A. A., Shcheplyagina L. A. Problems of adolescence (selected chapters). - M., 2003. - 477 p.
12. Kasatkina E. P. Iodine deficiency conditions in children and adolescents // Attending Physician. - 2000. - No. 10.
13. Shenderov B. A. Human microbiocenoses and functional nutrition // Russian Journal of Gastroenterology, Hepatology, Coloproctology. - 2001. - T. XI. - No. 4. — P. 78 — 90.
14. Roberfroid MB. Prebiotics and probiotics: are they functional foods? Am J Clin Nutr 2000 Jun 71:6 Suppl 1682S-7S.
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T. E. Borovik , Doctor of Medical Sciences, Professor S. G. Makarova , Candidate of Medical Sciences I. I. Balabolkin , Doctor of Medical Sciences, Professor N. V. Yukhtina , Doctor of Medical Sciences, Scientific Center for Children's Health of the Russian Academy of Medical Sciences, Moscow

Cross-reactivity of some products

What is compatibility and what products are best combined with each other?

Table 3. Product compatibility

You should not combine cereals with meat, cheese, and pasta with butter; it is better to use olive oil.

The most allergenic and safest products for children with atopic dermatitis

When compiling a diet, the degree of safety and danger of products is taken into account; the indicators are shown in Table 4.

Table 4

Dangerous foods are excluded from the diet in any case, since when they are consumed, there is a high probability of developing a hypersensitivity reaction. But when consuming safe ones, such problems do not arise.

Breast-feeding

It is advisable to keep a child suffering from atopic dermatitis on breastfeeding .

• Firstly, the proteins in human milk are completely devoid of allergic properties and are easily broken down by the baby’s enzymes.
• Secondly, breast milk contains a lot of secretory immunoglobulin A, which protects the intestinal mucosa from large allergen molecules.
• And finally, this is the best prevention of dysbiosis.

Obligate allergens (citrus fruits, tropical fruits, strawberries, chocolate, caviar, fish, eggs, strong tea, coffee, sharp cheeses, spices, smoked meats, etc.), as well as foods that cause allergic reactions in a particular mother, are excluded from the diet of a nursing mother. child. In addition, nursing mothers should not overload their diet with fresh milk products - it is better to replace them with fermented milk.

Diet for adults and teenagers

There are no serious differences and consists in following basic rules. Food allergies occur more often in children than in adolescents and adults.

What should be excluded from the diet:

• coffee and drinks containing high concentrations of caffeine;
• strong tea with herbs and berries - can lead to a rash on the body;
• various types of alcohol, since its consumption leads to the accumulation of toxins and harmful substances;
• bakery and pasta products made from refined flour;
• various sushi, snacks rich in herbs and spices are also prohibited.

Over the years, with the correct menu design, it will be possible to remove from the diet those foods that are most dangerous for humans. So, teenagers and adults are not prohibited from eating carrots, bananas, soybeans, and potatoes. They are conditionally safe for the body. But they are prohibited for children.

Disputes also arise regarding cheeses; preference is given to those that are not high in fat, but it is better not to give them to children.

Diet for pregnant and lactating women

If, during the period of bearing a child, a woman does not monitor her diet, then the risk of the baby developing dermatitis increases. On average it increases by 15-20%.

What foods are prohibited for pregnant and nursing mothers:

1. Fatty and fried foods, chocolate and drinks containing caffeine.
2. Exotic fruits because they may contain harmful preservatives.
3. Carbonated drinks, smoked foods, salty canned food and processed foods will cause swelling and increase blood pressure levels.
4. Sweets in large quantities, fatty sauces and pickled dishes, garlic, onions.
5. Red and orange fruits and vegetables are often the cause of food allergies.

The diet should be balanced; a woman is recommended to eat food in small portions; if she is very hungry, then have snacks. Drink kefir and eat apples.

How do food allergies manifest?

The initial symptoms that may occur in the first days and weeks of a child’s life often do not in themselves indicate an allergy. These may be skin manifestations: redness, diaper rash, a small rash. Symptoms from the gastrointestinal tract may also appear. They will also be general, nonspecific, as doctors say. Excessive regurgitation and/or vomiting, colic, and constipation are possible. It is believed that at least 10-15% of cases of colic in infants are associated with food allergies.

Even refusal to take the product or anxiety after eating can be confirmation of an allergic reaction. Dyspepsia, diarrhea, lack of weight gain, abdominal pain, severe colic and persistent constipation are possible. With an allergy to CMP, blood can often be observed in the stool of children. Cow's milk proteins are the most common cause of allergic enterocolitis in children of the first year of life.

Please note: there are cases when the only symptom of an allergy to CMP in children is chronic iron deficiency anemia.

Features of cooking porridge

We will cook with milk, with the addition of butter, provided that its fat content does not reach 82.5%. What to do:

1. Add milk to the water and add cereal; first soak it and rinse it under running water.
2. We wait until the porridge boils and reduce the temperature, bring the dish to readiness, stirring occasionally.
3. At the final stage, add salt (just a little), and before serving, add butter.

We must heat-treat the milk and do not add it to ready-made porridge cooked in water. This will increase the risk of developing a lactose allergy.

Soups

We will cook with meat broth, choosing a suitable piece of tenderloin, what to do:

• Boil the meat, drain the water twice during cooking, after boiling;
• then place the vegetables for the soup into the boiling broth, after chopping them;
• remove the meat and let it drain; when the vegetables are almost ready, add it to the soup;
• Add salt a few minutes before the dish is ready, mix everything thoroughly with a wooden spoon.

Using this scheme, you can prepare any soup, taking into account the child’s preferences. We select the ingredients correctly, avoiding red vegetables, which lead to the development of an allergic reaction.

You should not prepare milk soup for a baby with allergic dermatitis; pasta in combination with milk can lead to a rash.