Currently, the only treatment for coeliac disease (CD) is a strict, lifelong gluten-free diet (GFD); however, their completeness with regard to energy and macro- and micronutrients remains poorly understood. Paediatric studies are often limited by a low quality and a lack of controls, and their findings should be interpreted with caution. The aim of the present study was to evaluate nutritional imbalances in children with CD on a strict GFD. Methods: A single-centre prospective cohort study was conducted. A total of 48 children with CD (33 girls, mean age 11.8 ± 3.68 years) on a strict GFD (mean duration 5.02 ± 3.87 years) were compared with 50 non-coeliac subjects (26 girls, mean age 10.2 ± 3.97 years). In both groups, anthropometric measurements (body height, weight and BMI) and laboratory tests (haemoglobin level, calcium and magnesium serum concentration, folic acid, vitamin B₁, B₂, B₆ and B₁₂ level) were checked. Additionally, in coeliac subjects, a 3-day food record for energy and macro- and micronutrient intake assessment were determined, and the values were compared to those in non-CD participants and the dietary reference intake (DRI) standards. Results: The CD children were more likely to demonstrate significantly lower serum vitamin B₁ and folic acid levels compared to controls (p = 0.01 and p = 0.002, respectively). Although mean serum calcium values were within normal ranges, they were significantly lower in CD subjects than controls (p = 0.01). Mean calcium, folic acid and vitamin D intake was below the dietary recommendations in the CD group (69.9%, 71.2% and 68.9% DRI, respectively) but did not differ significantly between CD and non-coeliac subjects. In turn, the mean supply of proteins and carbohydrates in the CD group substantially exceeded the recommended levels (190.3% and 189.4% DRI, respectively) but was similar to controls. A significantly higher number of CD children were classified as underweight, and a significantly lower number as overweight or obese, compared with controls (p < 0.001). Conclusion: Although children with CD receive nutritional education at diagnosis, a GFD often does not provide a balanced set of macro- and micronutrients. This is mainly due to unhealthy dietary habits, as commonly observed in the general population. Children with CD should be informed that while their diet should be free of gluten, it should nevertheless cover all their nutrition requirements in the long term.

Background: The key role of dietary factors in immunotolerance promotion and allergic diseases prevention has been emphasised. The aim of the study was the analysis of the impact of immunomodulatory dietary components, consumed by pregnant women, on the development of cow's milk allergy (CMA) in their offspring. Materials and methods Fifty-one pairs of mothers and their CMA-offspring were included in the study group. The analysis of a daily intake of selected dietary components was conducted retrospectively with the application of a seven-day diet of a mother in the third trimester of gestation and the authors’ own questionnaire. The Diet 5.D programme was used. Results: An average daily retinol intake by study-group mothers was significantly lower than by control-group mothers and valued 375.6 μg/d vs. 543.7 μg/d (p = 0.040), respectively. Folates intake in the study group was 598.8 μg/d vs. 361.1 μg/d in the control group (p = 0.001). Vitamin D in the study group was statistically lower – 3.6 μg/d, comparing to the control group – 6.9 μg/d (p = 0.038). Average LC-PUFA intake by mothers with allergic children was 0.09 g/d, while in the control group 0.18 g/d (p = 0.016). An analysis of the diet revealed that significantly more mothers of children from the control group (n = 12; 48%) consumed fish 2–3 times per month in comparison to the study group (n = 9; 17.6%) (p = 0.007). Conclusions: Vitamin D, A, LC-PUFA, retinol, riboflavin and fish consumption by pregnant mothers of CMA-children was significantly lower, whereas beta-carotene and folates consumption was significantly higher than that of mothers with non-allergic children.

The study examines the influence of a diversified diet, changes in the consistency of introduced foods, and the method of meal preparation during infancy on the development of sensitization and/or allergy in toddlers. Introducing more product groups into the diet reduced the risk of allergy at 6 months of age (adjusted odds ratio [aOR] = 0.17; 95% confidence interval [CI] 0.04-0.71; P = 0.015) and at 12 months (aOR = 0.14; 95% CI 0.03-0.57; P = 0.006). Children with allergy and/or sensitization had been introduced to fewer product groups at 6 months ( P = 0.003; P < 0.001; P = 0.008) and at 12 months ( P = 0.001, P < 0.001; P = 0.001) compared with those without allergy and/or sensitization. Children with allergy and/or sensitization were fed ready-made, ie, purchased, products significantly more often than self-prepared foods compared with children without allergy and/or sensitization ( P = 0.001; P = 0.006). Allergic and/or sensitized children tended to be switched to solids later (11 vs 10 months, P = 0.041; P = 0.037) (12 vs 10 months, P = 0.013) than children without sensitization and/or allergy. The earlier introduction of a varied diet reduced the risk of allergy and/or sensitization. Delaying the introduction of solid foods and using ready-made products instead of self-prepared ones increases the risk of allergy in toddlers.

Background: Allergy is known to be influenced by both diet and the immune system. In addition, the time of first exposure to food allergens and their type appear to play a particularly important role in the development of allergies. Aim: To determine the influence of the time of exposure, and the type, degree of processing, and frequency of supply of complementary foods and the development of sensitization and allergies in children up to three years of age. Materials and metods: The study was conducted prospectively in two stages. The first stage included 106 children aged 6–18 months, while the second stage included 86 children selected from the first stage, after a further 12 months. A questionnaire based on validated FFQ sheets was created for the purpose of the study. The following were assessed: nutrition in the first year of life (time, type, degree of processing), frequency of supply of complementary foods and allergic symptoms, sIgE concentration against 10 foods and 10 inhalant allergens. Four groups of patients were formed. This paper presents the results of the second stage of the study. Results: For all participants, allergenic products, viz. hen’s egg, milk, peanuts, wheat, soybean, fish, tree nuts and shellfish were typically introduced at an age of 7 to 12 months. During this period, egg white was introduced in 47 (85.5%) children with allergy (p = 0.894), in 29 (82.9%) with allergy and sensitization (p = 1.00), and in 38 (82.6%) children with sensitization alone (p = 0.533). Milk was introduced at 7 to 12 months in 35 (64.8%) children with allergy (p = 0.64), 22 (64.7%) with both allergy and sensitization (p = 0.815), and 26 (57.8%) children with sensitization alone (p = 0.627). For other foods, the time of introduction appeared not to significantly influence the presence of allergies or sensitization. Heat-treated peanuts were introduced significantly more often to children without allergies and without sensitization (n = 9; 56.2%) than those without allergies but with sensitization (n = 6; 54.5%) (p = 0.028). Fish was consumed significantly more often by children with allergies, i.e., 1–3x/week (n = 43; 79.6%) than children without allergies, i.e., 1–3x/month (n = 9; 30%) (p = 0.009). Conclusions: No relationship was observed between the introduction time of complementary foods, including allergenic ones, or their type, and the development of allergies and sensitization in children up to three years of age. The degree of processing and the frequency of supply of products may affect the development of allergies and sensitization.