The introduction of allergenic foods to the infant diet in a UK cohort: the impact of family history of allergy

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Subjects/Methods: A population birth cohort study recruited eligible pregnant women while they were attending an antenatal ultrasound clinic appointment at a UK city hospital. Parental-reported family history of allergy and infant diet was collected through structured interviews at recruitment and postal questionnaires. Parents reported on their infants’ diet at around 6 months (n = 216), around 12 months (n = 193) and around 24 months of age (n = 139). Results : Most highly allergenic foods were introduced to infants at around 6-9 months. However, nut and egg were introduced much later, and 21% of children had not been exposed to egg and 35% of infants had not been exposed to nuts by 12 months. Infants with a family history of allergy were introduced to highly allergenic foods at a similar time to other infants but were more likely to have diets that avoided foods due to allergy than other infants (most commonly dairy, soya, egg and nuts). Conclusions: As many parents delayed the introduction of egg and nuts beyond one year of age and infants with a family history of allergy were more likely to have diets that avoided foods due to allergy, these behaviours might affect the development of allergies in infants and could be a modifiable risk factor for allergy development. Health sciences/Risk factors Health sciences/Health care/Nutrition Health sciences/Health care/Public health/Epidemiology Health sciences/Health care/Disease prevention/Lifestyle modification Figures Figure 1 Introduction Allergic disease is highly prevalent in the UK and worldwide. 1 Observational studies which reported an association between allergy and early exposure to allergenic foods, initially led to recommendations to introduce allergenic foods later into children’s diets as a method of preventing food allergies. However more recent, well controlled RCTs have failed to support food avoidance as a method of allergy prevention and these studies, including Learning About Peanut (LEAP 2 ) and Early Introduction of Food to Avoid Intolerance (EAT 3 ) have instead shown that early introduction of allergenic foods is associated with lower incidence of food allergies. Simons et al. 4 demonstrated that in a population cohort study, children who were introduced to peanut after 1 year of age, were more likely to have a peanut allergy at 3 years of age than children who were introduced to peanut earlier. In 2008, global allergy prevention guidelines were updated to remove the recommendation to delay the introduction of allergenic foods 5 . In 2017, the National Institute of Allergy and Infectious Disease (NIAID) recommend that high-risk children should be introduced to peanut-containing foods as early as 4-6 months of age 6 , and the Scientific Advisory Committee on Nutrition (SACN) report in the UK suggests that the introduction of peanut and egg should start along with other solids 7 . There is limited evidence of the extent to which these updated recommendations have been accepted by the UK population. However, a recent study showed that they are not being followed in Saudi Arabia, where highly allergenic foods such as peanut and fish were typically not introduced until infants were older than one year 8 . Furthermore, there has been limited research investigating whether infants at higher risk of allergic disease (those with a first degree relative with allergy) are introduced to foods, including highly allergenic foods in a different manner. Van Odijk et al. 9 reported that families with a history of allergic disease did not differ in the timing of foods, including allergenic foods, however Schoetzau et al. 10 reported that mothers with a family risk of eczema delayed introducing solid foods compared to mothers without a family history or eczema, and Venter et al. 11 reported that mothers with a family history of allergy were more likely to breastfeed exclusively for longer, and to avoid the introduction of peanuts for longer than women without a family history of allergy. Grimshaw 12,13 reported that up until one year, the diet of children with and without food allergies were similar but by 2 years of age the two groups had significantly different diets and the non-allergic children were more likely to be eating a diet richer in fruit, vegetables and home-prepared foods. Different diets or delayed introduction of allergenic foods in high risk infants might affect the development of allergies in infants and could be a modifiable risk factor for allergy development. This paper describes the introduction of highly allergenic foods in a population sample at approximately 6, 12 and 24 months of age. It also examines these factors in high risk infants with family history of allergy. The study aimed to investigate: The time and type of foods introduced into infants’ diets in a population cohort The association between family history of allergy and time and type of foods introduced to infants’ diet Methods Recruitment and eligibility Participants were part of a longitudinal population-based cohort study, the XXXXXX Birth Cohort Project in XXXXXX, UK. Pregnant women were screened to check their eligibility for the registry whilst attending an antenatal ultrasound clinic appointment at XXXXXXX’s main hospital between 21st May 2015 and the 24th July 2017. Individuals were eligible for the study if they met the following criteria: Pregnant women aged 16 or over, with a home address within the city’s eight postcodes, who had sufficient mental capacity to consent; booked to deliver their baby at the main hospital birthing centre, the midwifery led maternity centre or at home; planning to live in in the city for a year after the birth. To reduce selection bias, eligible women were approached and screened, rather than using a volunteer approach. Interpreter services were available for non-English speakers, however no women required this service. Full ethical approval for the Birth Cohort registry was given by XXXXXXX Research Ethics Committee (REC ref: XX/XX/XXXX) and all mothers gave informed consent. The Birth Cohort Registry was designed to gather data on a wide range of factors impacting on the health and development of babies, although this article is specifically focusing on the areas of the questionnaire related to allergy and diet. Participants A total of 390 participants consented to take part in the registry, with one participant joining twice with two different pregnancies, see Fig. 1 for data collection and participation flowchart. This article covers all waves of data collection to date; antenatally (Wave 0), at birth (Wave 1) when the baby was around 6 months (Wave 2), around 12 months (Wave 3), and around 24 months (Wave 4). Only live births were included in the registry for subsequent follow ups. Wave 0 data was collected by an interview conducted by a research midwife with the mother in a private area of the antenatal clinic. Wave 1 data were collected by a research midwife from the mother’s medical information. Wave 2, 3 and 4 data were collected using self-completed questionnaires. Paper versions of the questionnaires were sent with self-addressed stamped envelopes and reminder questionnaires were sent after one month to parents who had not responded. [Insert Fig. 1 here] Measures Socio-demographic and environmental characteristics Parental socio-demographic data was collected from the mother antenatally, through the Wave 0 questionnaire, including maternal age, marital status, maternal & paternal education level, maternal & paternal employment status, ethnicity and parity of pregnancy. Wave 1 collected data at birth including the infant’s sex and date of birth. Family History of Allergy In Wave 0 mother self-report of family history of allergy was collected (maternal, paternal and sibling history of asthma, hay fever, itchy rash, wheeze, runny nose and food allergies). Infant dietary intake A parent reported food frequency questionnaire was completed in Waves 2, 3 and 4. This was an amended version of the Southampton Women’s Survey FFQ at 6 months which has been shown to be a valid measure of energy and nutrient intake in infants 14 . At Wave 2 the questionnaire consisted of a list of 28 foods and 10 drinks, at Waves 3 and 4, the questionnaire consisted of a list of 77 foods and 10 drinks, reflecting the greater range of foods likely to be consumed by an older child. For each food, the frequency of consumption over the previous month of each food and drink was recorded using a multiple response grid. Variety in the infant’s diet was calculated as the number of different food items consumed over the previous month. In Waves 2 and 3 parents were also asked to report the age at which their infant was introduced to solid food and was first introduced to highly allergenic foods (including wheat, egg, milk, fish, nuts and sesame). For these responses, a single variable was created which considered replies to this question at either wave. If the parent had indicated a different answer in the two Waves e.g. reported that their infant was introduced to solid food from 20 weeks when asked at Wave 2 but reported 22 weeks when asked at Wave 3, the answer from Wave 2 was used as it was considered less affected by recall bias. In Waves 2, 3 and 4, parents were asked whether they were avoiding any food in their child’s diet due to allergy and if yes, they were asked to specify which foods Data Analysis Only questionnaires with complete responses were included in each analysis, those with missing data were excluded from analysis. SPSS (IBM, version 26) was used to analyse the data. Categorical variables were expressed as frequency and percentage and the χ 2 test was used to test these relationships. Repeated measures ANOVA was used to test the change in continuous variables (e.g. variety of foods eaten) over time. Binary logistic regressions were used to determine the effects of family history of allergy on the likelihood that infants’ introduction to each allergenic food was delayed (9 months or later, compared to before 9 months) Results Demographic characteristics of parents and infants [Insert Table 1 ] Table 1 Parental and infant demographic characteristics of sample Parental demographics Total Population Wave 2 Population Wave 3 Population Wave 4 Population N 390 216 193 139 Maternal Age Mean (SD) [Range] 31 years (4.85) [18–43] 33 years* (4.38) [19–44] 34 years* (4.25) [22–44] 35 years* (3.87) [24–45] Higher level of Maternal Education** 223 (57%) 151 (70%)* 138 (72%)* 102 (73%)* Higher level of Paternal Education** 164 (42%) 113 (52%) 99 (51%) 83 (60%) Maternal Ethnicity White British 318 (82%) 174 (81%) 161 (83%) 114 (82%) White other 44 (11%) 31 (14%) 26 (13%) 19 (14%) Mixed/multiple ethnic groups 6 (2%) 2 (1%) 1 (1%) 1 (1%) Asian/Asian British 13 (3%) 6 (3%) 4 (2%) 3 (2%) Black/African/Caribbean/Black British 6 (1.5%) 2 (1%) 1 (1%) 1 (1%) Other ethnic group 2 (1%) - - - Not specified 1 (1%) 1 (1%) - 1 (1%) Infant Demographics N 220 199 145 Sex: Male N (%) 191 (49%) 113 (51%) 97 (49%) Age (SD) [range] months 6 (0.91) [5–10] 13 (1.1) [11–17] 25 (0.99) [23–30] Birth Order: First born (no siblings) 165 (42%) 108 (50%) 98 (51%) 67 (48%) Variety of food eaten in previous month 12.1 (5.94)* 46.6 (9.32)* 48.2 (8.77)* Consulted GP about any allergic symptoms 53 (24%) 79 (40%) 42 (29%) Avoiding any foods due to allergy 32 (15%) 32 (16%) 15 (10%) Family History of Allergy (Any close family history) Asthma 149 (38%) 69 (32%) 59 (31%) 38 (27%) Hay fever 208 (53%) 114 (53%) 102 (53%) 71 (51%) Itchy Rash 117 (30%) 65 (30%) 60 (31%) 40 (29%) Wheeze 140 (36%) 25 (12%) 63 (33%) 34 (24%) Runny Nose 183 (47%) 106 (49%) 97 (50%) 66 (47%) Food Allergy 110 (28%) 60 (28%) 56 (29%) 41 (29%) Note . * p < .05, **Higher level of education refers to having obtained a higher education qualification (normally beyond age 18) which includes bachelor degrees, as well as degree apprenticeships, and foundation degrees. Demographic characteristics of participants who responded to each wave of data collection are shown in Table 1 , as well as the prevalence of allergy among close family members (biological mother, father or siblings) of the infant. Participants were predominately white British (> 80%) which is representative of XXXXXX city (79%). However, respondents to Waves 2–4 were typically highly educated (> 70% Higher Education), which is higher than average for XXXXXXX’s population (35% Higher Education). Respondents to the questionnaire were older, and more likely to have attended higher education compared to non-respondents. However, there was no difference in the percentage of mothers of white British ethnicity for respondents compared to non-respondents In all waves of data collection, hay fever was the most commonly reported allergy and more than 50% of infants had at least one close family member with hay fever. Around 28% of infants had a close family member with a food allergy, and 38% of infants had a close family member with asthma. 15% of parents reported that they were avoiding giving their infants certain foods due to allergy at Wave 2, 16% at Wave 3 and 10% at Wave 4 (see Table 1 ). The most commonly reported foods that were being avoided due to allergy at Wave 2 were: dairy (n = 14, yogurt n = 1), soya (n = 6), egg (n = 5), nuts (n = 5) and fruits (banana, n = 2; strawberries, n = 1; orange, n = 1). At Wave 3 commonly avoided foods were dairy (n = 14, milk and cheese, n = 2), egg (n = 8), nuts (n = 8), soya (n = 6) and fruits (banana n = 1; blueberries, n = 1; watermelon, n = 1; cucumber, n = 1; and strawberries, n = 1). And at Wave 4 the most commonly avoided foods were dairy (n = 6), nuts (n = 4), egg (n = 3), soya (n = 3) and fruits (banana, n = 2; raspberries, n = 1; tomato, n = 2; kiwi, n = 1; blueberries, n = 1; apricot, n = 1). Time and Type of Foods Introduced into Infants’ Diets The mean age for introduction of solid foods was 22.7 weeks (SD = 3.40, range 6–36 weeks). Most highly allergenic foods were introduced to infants at around 6–9 months. Wheat was introduced earlier than the other allergenic foods: 31% of infants were introduced to wheat before they reached 6 months, and nearly all infants had been introduced to wheat by the time they were 9 months (97%). Nuts were introduced latest with only 38% of infants being introduced to nuts by the time they were 9 months old, and 35% of infants never having exposure to nuts by Wave 3 (around 12 months). Egg and sesame were also introduced to infants later, and 21% of infants had not been exposed to eggs and 16% had not been exposed to sesame by Wave 3 (around 12 months) see Table 2 . Table 2 Number of children who were introduced to highly allergenic foods at each age (in months) Age (months) N (%) < 3 3 to < 6 6 to < 9 9 to < 12 12+ Never Wheat 2 (1%) 70 (30%) 154 (66%) 4 (2%) - 2 (1%) Egg - 9 (5%) 120 (60%) 22 (11%) 7 (4%) 41 (21%) Milk 1 (< 1%) 34 (16%) 158 (73%) 12 (6%) 4 (2%) 7 (3%) Fish - 9 (4%) 134 (63%) 52(25%) 5 (2%) 12 (6%) Nuts 1 (< 1%) 3 (2%) 69 (35%) 41 (21%) 12 (7%) 69 (35%) Sesame 1 (< 1%) 5 (3%) 91 (46%) 52 (26%) 18 (9%) 32 (16%) [Insert Table 2 ] Repeated measure ANOVA showed that the variety of foods eaten by infants increased as they aged (see Table 1 ). Both the increase in variety of foods eaten from Wave 2 to Wave 3, and the increase in Wave 3 to Wave 4, were statistically significant. The association between family history of allergy and time and type of foods introduced to infants’ diet There was no difference in the age of introduction of solid food between the infants with any family history of any allergy and infants without a family history of these allergies ( t (135) = 1.47, p = .144, ns ). As shown in Table 3 , none of the binary logistic regression models which assessed the effects of family history of allergy on the likelihood that infants’ introduction to each allergenic food was delayed, were statistically significant. Family history of allergy did not make a significant contribution to delayed introduction (9 months or later compared to before 9 month) of any of these allergenic foods. Table 3 Percentage of infants introduced late (9 months or later) to highly allergenic foods by family history of allergy Late introduction of: Wheat Egg Milk Fish Nuts Sesame Asthma No Asthma 1% 4% 22% 27% 7% 11% 27% 34% 60% 62% 45% 53% Hayfever No Hayfever 3% 2% 28% 22% 12% 7% 30% 34% 58% 65% 51% 49% Rash No Rash 4% 3% 31% 23% 14% 8% 27% 34% 60% 62% 44% 53% Wheeze No Wheeze 1% 3% 22% 27% 5% 12% 25% 35% 58% 63% 47% 52% Itch No Itch 3% 3% 28% 22% 8% 11% 29% 35% 59% 63% 53% 47% Food Allergy No Food Allergy 5% 2% 24% 26% 8% 10% 37% 30% 69% 58% 47% 51% 1 Model χ 2 p 4.058 P = .669 4.430 P = .619 10.949 P = .090 4.866 P = .561 4.414 p = .658 4.466 P = .614 Note. The model (binary logistic regression) assessed the impact of family history of all allergies on late introduction of each type of allergenic food. However, as shown in Table 4 , at Wave 2, infants with a family history of every type of allergy were more likely to have diets avoiding certain foods due to allergy compared to infants without a family history of that allergy. At Wave 3, infants with a family history of asthma, hay fever, itchy rash or food allergy were more likely to have diets avoiding foods due to allergy and at Wave 4, infants with a family history of asthma or hay fever were more likely to have diets avoiding foods due to allergy, than infants without a family history of these allergies. Table 4 The percentage of infants with diets that avoid food due to allergy in infants with compared to without a family history of allergy. Percentage of infants with diets that avoid foods due to allergy χ 2 ( p value) Family History of Asthma No family history of Asthma Wave 2 Wave 3 Wave 4 27% 24% 23% 10% 13% 6% 7.68 ( p = .006) 11.05( p = .001) 9.88 ( p = .002) Family History of Hay Fever No Family History of Hay Fever Wave 2 Wave 3 Wave 4 24% 25% 20% 8% 7% 1% 8.60 ( p = .003) 11.05 ( p = .001) 13.18 ( p < .001) Family History of Itchy Rash No Family History of Itchy Rash Wave 2 Wave 3 Wave 4 25% 25% 13% 12% 7% 10% 4.72 ( p = .030) 11.05 ( p = .001) .277 ( p = .599) ns Family History of Wheeze No Family History of Wheeze Wave 2 Wave 3 Wave 4 27% 23% 18% 11% 14% 8% 9.17 ( p = .002) 2.62 ( p = .106) ns 2.55 ( p = .116) ns Family History of Runny Nose No Family History of Runny Nose Wave 2 Wave 3 Wave 4 23% 22% 12% 10% 12% 9% 6.75 ( p = .009) 3.15 ( p = .076) ns .412 ( p = .521) ns Family History of Food Allergy No Family History of Food Allergy Wave 2 Wave 3 Wave 4 30% 32% 10% 11% 11% 10% 11.18 ( p = .001) 12.04 ( p = .001) .211( p = .646) ns [Insert Table 4 ] Repeated measures ANOVA showed that there was no significant difference in the variety of foods eaten by the infants who had a family history of allergy compared to infants without a family history of allergy (F(1) = .115, p = .735 ns ) and there was also not a significant Group X time interaction (F(2) = .428, p = .652, ns ). Discussion This study aimed to investigate the time and type of foods introduced into infants’ diets in this population cohort and whether this differed in infants with a family history of allergy compared to infants without a family history of allergy. Although there is no specific guidance for the optimal age of timing of introduction of highly allergenic foods, current guidelines for primary prevention of food allergy does not advise late introduction of allergenic foods 15–17 . And rather that highly allergenic foods are introduced alongside other solids. Research generally reports that early introduction of allergenic foods, particularly nuts and egg, is associated with lower risk of allergic disease 18 and it has been suggested that high-risk children should be introduced to peanut-containing foods as early as 4–6 months of age 67 . In this sample, most highly allergenic foods were introduced to infants at around 6–9 months. However, some allergenic foods were introduced much later, for example a fifth (21%) of children had not been exposed to egg and over a third of infants (35%) had not been exposed to nuts by 12 months. This suggests that a significant proportion of parents are delaying the introduction of allergenic foods to their infants. Similarly, between 10–16% of infants had diets that avoided foods due to allergy at each wave of data collection. In this sample, parents of the infants, both those with and without a family history of allergy did not appear to be following advice to introduce nuts and eggs alongside other solids, and nuts and eggs were introduced late, with a large proportion of infants not being exposed to either of these foods by one year of age. Delaying the introduction of nut and egg in the population and the avoidance of highly allergenic foods in high risk infants might affect the development of allergies in infants. However, these dietary decisions could be a modifiable risk factor for allergy development: in countries, such as Australia, where a national strategy has been implemented to communicate the recommendations to introduce allergenic foods earlier to infants, early introduction to allergenic foods has been well accepted by the population (see for example the Nip Allergies in the Bub strategy 19 and the Early Nuts Study 20 ). From the current study, it is not clear why parents are not following the current guidance to introduce allergenic foods alongside other foods during weaning, or why parents of infants with a family history of allergy choose to avoid certain foods due to allergy, future qualitative research would help to understand the factors underpinning these decisions. However, it may be that these behaviours are contributing to the high prevalence of allergic disease in the UK. Furthermore, in the current study, although infants with a family history of allergy were introduced to allergenic foods at similar times to other infants, they were more likely to have diets that avoided particular foods than infants without a family history of allergy. The foods that were reported to be avoided by infants were most commonly dairy, soya, egg and nuts but also included a variety of fruits. This is likely to reflect that infants with a family history of allergy are introduced to allergenic foods at a similar time as other infants, but that their parents later decide to avoid these foods in their infants’ diets. Many of the foods being avoided in the infants’ diets are not highly allergenic foods, for example at each wave of data collection a number of parents reported avoiding fruits such as banana, which is uncommonly associated with allergy One of the strengths of the current study was its longitudinal design, this ensured that the parents were less affected by recall bias in their reports of when they introduced foods to the infants as the parents were sent the questionnaires to completed when their infants were of an appropriate age. However, limitations of the study include reliance of parental-report measures, for example about the timing of introductions of highly allergenic foods required parents to understand the ingredients in pre-prepared infant foods. Furthermore, the participants involved in the study were more likely to be highly educated than the typical XXXXXX population. The response rate to the questionnaires ranged from 36–55%, and older, more highly educated mothers from the initial cohort were more likely to respond. These findings may not be replicable in younger, less well-educated populations. In conclusion, in this sample, although most highly allergenic foods were introduced to infants along with other solid foods, many parents delayed the introduction of egg and nuts beyond one year of age. Furthermore, infants with a family history of allergy were more likely to have diets that avoided foods due to allergy. These behaviours may contribute to the development of allergic disease. Declarations Financial Support The study was funded by the University of XXXXXX Ethical Approval: This study was conducted according to the guidelines laid down in the Declaration of Helsinki and all procedures involving research study participants were approved by the South Central Berkshire B Research Ethics Committee (REC ref: 15/SC/0008). Written informed consent was obtained from all participants Competing Interests: None Author Contribution Statement : All authors were involved in the study design, SH, and GM were involved in data collection. SH wrote the first draft of the paper and conducted the analyses, all authors contributed to further drafts. Acknowledgements: The authors would like to thank the families who participated in this study and the Research Midwives at XXXXXX Hospital - Zoe Garner, Linda Lishman, Jess Madgwick, Gilly Stephens and Carole Hoyland. The authors also thank Professor Sasee Pallikadavath for all of his advice towards the Birth Cohort registry and the research-based learning students who assisted with the project References Dierick BJH, van der Molen T, Flokstra-de Blok BMJ, Muraro A, Postma MJ, Kocks JWH, et al. Burden and socioeconomics of asthma, allergic rhinitis, atopic dermatitis and food allergy. 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Timing of allergenic food introduction to the infant diet and risk of allergic or autoimmune disease a systematic review and meta-analysis. Vol. 316, JAMA - Journal of the American Medical Association. 2016. Vale S, Said M, Joshi P, Smith J, Salter S, Loh R. P18: NIP ALLERGIES IN THE BUB - AN INITIATIVE OF THE NATIONAL ALLERGY STRATEGY. Intern Med J. 2018;48. Soriano VX, Peters RL, Ponsonby AL, Dharmage SC, Perrett KP, Field MJ, et al. Earlier ingestion of peanut after changes to infant feeding guidelines: The EarlyNuts study. Journal of Allergy and Clinical Immunology. 2019;144(5). Additional Declarations There is NO conflict of interest to disclose. Cite Share Download PDF Status: Published Journal Publication published 30 Apr, 2025 Read the published version in European Journal of Clinical Nutrition → Version 1 posted Editorial decision: revise 19 Jul, 2024 Review # 1 received at journal 15 Jul, 2024 Review # 2 received at journal 05 Jul, 2024 Reviewer # 2 agreed at journal 24 Jun, 2024 Reviewer # 1 agreed at journal 20 Jun, 2024 Reviewers invited by journal 07 Feb, 2024 Editor assigned by journal 17 Nov, 2023 Submission checks completed at journal 17 Nov, 2023 First submitted to journal 16 Nov, 2023 You are reading this latest preprint version Research Square lets you share your work early, gain feedback from the community, and start making changes to your manuscript prior to peer review in a journal. As a division of Research Square Company, we’re committed to making research communication faster, fairer, and more useful. We do this by developing innovative software and high quality services for the global research community. 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Also discoverable on Platform About Our Team In Review Editorial Policies Advisory Board Help Center Resources Author Services Accessibility API Access RSS feed Manage Cookie Preferences © Research Square 2026 | ISSN 2693-5015 (online) Privacy Policy Terms of Service Do Not Sell My Personal Information {"props":{"pageProps":{"initialData":{"identity":"rs-3621004","acceptedTermsAndConditions":true,"allowDirectSubmit":false,"archivedVersions":[],"articleType":"Article","associatedPublications":[],"authors":[{"id":250438419,"identity":"5c34f38b-2d1b-426d-bd7c-ac29b0b94b54","order_by":0,"name":"Suzannah Helps","email":"data:image/png;base64,iVBORw0KGgoAAAANSUhEUgAAAZAAAAAyAQMAAABI0h/eAAAABlBMVEX///8AAABVwtN+AAAACXBIWXMAAA7EAAAOxAGVKw4bAAABEUlEQVRIiWNgGAWjYBAC+QYIncAgwcB4gIHBBiElgUOLwQGEFgYgOw3IZiaghQFVy2EitEikP/xcuMMuj0G6+cDhgj/n8/ilzx9g+FHDkDizAYdfZiQkS888k1zMIHMs4fDMttvFkn3JDIw9xxgSZ+OwheFGwgFp3jbmxAaJHIPDvA23EzecATqMt4EhcR5OLYnNv3nb6oFa8j8c5vlzDqyF8S9eLclsQFsOg2xhOMzDdgCshRlkCy6HGZx5xmbN23Y8sU0izQDol+RiyR5mg8MyxySMcXq/Pf3xbd626sR+ieSHjwv+2OXx8zA+fPimxkZ2xgFcLoMCNgZIhCSAOAdwxwoagGsZBaNgFIyCUYAMANm8W+pmQfuaAAAAAElFTkSuQmCC","orcid":"https://orcid.org/0000-0002-8033-1752","institution":"University of Portsmouth","correspondingAuthor":true,"prefix":"","firstName":"Suzannah","middleName":"","lastName":"Helps","suffix":""},{"id":250438420,"identity":"3dc89771-ba73-4664-9433-64ad11d84631","order_by":1,"name":"Gilly Mancz","email":"","orcid":"","institution":"University of Southampton","correspondingAuthor":false,"prefix":"","firstName":"Gilly","middleName":"","lastName":"Mancz","suffix":""},{"id":250438421,"identity":"eb76c1a7-0819-43a1-b04b-f4c3bf6922a3","order_by":2,"name":"Taraneth Dean","email":"","orcid":"","institution":"London South Bank University","correspondingAuthor":false,"prefix":"","firstName":"Taraneth","middleName":"","lastName":"Dean","suffix":""}],"badges":[],"createdAt":"2023-11-16 14:56:07","currentVersionCode":1,"declarations":"","doi":"10.21203/rs.3.rs-3621004/v1","doiUrl":"https://doi.org/10.21203/rs.3.rs-3621004/v1","draftVersion":[],"editorialEvents":[{"content":"https://doi.org/10.1038/s41430-025-01617-x","type":"published","date":"2025-04-30T04:00:00+00:00"}],"editorialNote":"","failedWorkflow":false,"files":[{"id":50925747,"identity":"00379a05-06f9-4e28-8f49-0d7bdb19cca4","added_by":"auto","created_at":"2024-02-09 17:08:38","extension":"png","order_by":1,"title":"Figure 1","display":"","copyAsset":false,"role":"figure","size":1366289,"visible":true,"origin":"","legend":"\u003cp\u003eData Collection and Participation Flow Chart\u003c/p\u003e","description":"","filename":"1.png","url":"https://assets-eu.researchsquare.com/files/rs-3621004/v1/210bf33711a55b5e2bcd26cb.png"},{"id":81752010,"identity":"aa64c818-8d2e-4eb7-ba22-5d43fce38ed1","added_by":"auto","created_at":"2025-05-01 07:12:49","extension":"pdf","order_by":0,"title":"","display":"","copyAsset":false,"role":"manuscript-pdf","size":2600573,"visible":true,"origin":"","legend":"","description":"","filename":"manuscript.pdf","url":"https://assets-eu.researchsquare.com/files/rs-3621004/v1/6126dad4-5b68-413a-b3c4-47b3ae76111c.pdf"}],"financialInterests":"There is \u003cb\u003eNO\u003c/b\u003e conflict of interest to disclose.","formattedTitle":"The introduction of allergenic foods to the infant diet in a UK cohort: the impact of family history of allergy","fulltext":[{"header":"Introduction","content":"\u003cp\u003eAllergic disease is highly prevalent in the UK and worldwide.\u003csup\u003e1\u003c/sup\u003e\u0026nbsp; \u0026nbsp;Observational studies which reported an association between allergy and early exposure to allergenic foods, initially led to recommendations to introduce allergenic foods later into children\u0026rsquo;s diets as a method of preventing food allergies. However more recent, well controlled RCTs have failed to support food avoidance as a method of allergy prevention and these studies, including Learning About Peanut (LEAP\u003csup\u003e2\u003c/sup\u003e) and Early Introduction of Food to Avoid Intolerance (EAT\u003csup\u003e3\u003c/sup\u003e) have instead shown that early introduction of allergenic foods is associated with lower incidence of food allergies. Simons et al. \u003csup\u003e4\u003c/sup\u003e demonstrated that in a population cohort study, children who were introduced to peanut after 1 year of age, were more likely to have a peanut allergy at 3 years of age than children who were introduced to peanut earlier.\u0026nbsp;\u003c/p\u003e\n\u003cp\u003eIn 2008, global allergy prevention guidelines were updated to remove the recommendation to delay the introduction of allergenic foods\u003csup\u003e5\u003c/sup\u003e. In 2017, the National Institute of Allergy and Infectious Disease (NIAID) recommend that high-risk children should be introduced to peanut-containing foods as early as 4-6 months of age\u003csup\u003e6\u003c/sup\u003e, and the Scientific Advisory Committee on Nutrition (SACN) report in the UK suggests that the introduction of peanut and egg should start along with other solids\u003csup\u003e7\u003c/sup\u003e.\u0026nbsp;\u003c/p\u003e\n\u003cp\u003eThere is limited evidence of the extent to which these updated recommendations have been accepted by the UK population. However, a recent study showed that they are not being followed in Saudi Arabia, where highly allergenic foods such as peanut and fish were typically not introduced until infants were older than one year\u003csup\u003e8\u003c/sup\u003e. Furthermore, there has been limited research investigating whether infants at higher risk of allergic disease (those with a first degree relative with allergy) are introduced to foods, including highly allergenic foods in a different manner. Van Odijk et al.\u003csup\u003e9\u003c/sup\u003e reported that families with a history of allergic disease did not differ in the timing of foods, including allergenic foods, however Schoetzau et al.\u003csup\u003e10\u003c/sup\u003e reported that mothers with a family risk of eczema delayed introducing solid foods compared to mothers without a family history or eczema, and Venter et al.\u003csup\u003e11\u003c/sup\u003e reported that mothers with a family history of allergy were more likely to breastfeed exclusively for longer, and to avoid the introduction of peanuts for longer than women without a family history of allergy. Grimshaw \u003csup\u003e12,13\u003c/sup\u003e reported that up until one year, the diet of children with and without food allergies were similar but by 2 years of age the two groups had significantly different diets and the non-allergic children were more likely to be eating a diet richer in fruit, vegetables and home-prepared foods. Different diets or delayed introduction of allergenic foods in high risk infants might affect the development of allergies in infants and could be a modifiable risk factor for allergy development.\u003c/p\u003e\n\u003cp\u003eThis paper describes the introduction of highly allergenic foods in a population sample at approximately 6, 12 and 24 months of age. It also examines these factors in high risk infants with family history of allergy.\u0026nbsp;\u003c/p\u003e\n\u003cp\u003eThe study aimed to investigate:\u003c/p\u003e\n\u003col start=\"1\" type=\"a\"\u003e\n \u003cli\u003eThe time and type of foods introduced into infants\u0026rsquo; diets in a population cohort\u003c/li\u003e\n \u003cli\u003eThe association between family history of allergy and time and type of foods introduced to infants\u0026rsquo; diet\u003c/li\u003e\n\u003c/ol\u003e\n\u003cp\u003e\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e\u0026nbsp;\u003c/p\u003e"},{"header":"Methods","content":"\u003cdiv id=\"Sec2\" class=\"Section2\"\u003e \u003ch2\u003eRecruitment and eligibility\u003c/h2\u003e \u003cp\u003eParticipants were part of a longitudinal population-based cohort study, the XXXXXX Birth Cohort Project in XXXXXX, UK. Pregnant women were screened to check their eligibility for the registry whilst attending an antenatal ultrasound clinic appointment at XXXXXXX\u0026rsquo;s main hospital between 21st May 2015 and the 24th July 2017.\u003c/p\u003e \u003cp\u003eIndividuals were eligible for the study if they met the following criteria: Pregnant women aged 16 or over, with a home address within the city\u0026rsquo;s eight postcodes, who had sufficient mental capacity to consent; booked to deliver their baby at the main hospital birthing centre, the midwifery led maternity centre or at home; planning to live in in the city for a year after the birth.\u003c/p\u003e \u003cp\u003eTo reduce selection bias, eligible women were approached and screened, rather than using a volunteer approach. Interpreter services were available for non-English speakers, however no women required this service.\u003c/p\u003e \u003cp\u003e Full ethical approval for the Birth Cohort registry was given by XXXXXXX Research Ethics Committee (REC ref: XX/XX/XXXX) and all mothers gave informed consent. The Birth Cohort Registry was designed to gather data on a wide range of factors impacting on the health and development of babies, although this article is specifically focusing on the areas of the questionnaire related to allergy and diet.\u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec3\" class=\"Section2\"\u003e \u003ch2\u003eParticipants\u003c/h2\u003e \u003cp\u003eA total of 390 participants consented to take part in the registry, with one participant joining twice with two different pregnancies, see Fig.\u0026nbsp;1 for data collection and participation flowchart. This article covers all waves of data collection to date; antenatally (Wave 0), at birth (Wave 1) when the baby was around 6 months (Wave 2), around 12 months (Wave 3), and around 24 months (Wave 4). Only live births were included in the registry for subsequent follow ups.\u003c/p\u003e \u003cp\u003eWave 0 data was collected by an interview conducted by a research midwife with the mother in a private area of the antenatal clinic. Wave 1 data were collected by a research midwife from the mother\u0026rsquo;s medical information. Wave 2, 3 and 4 data were collected using self-completed questionnaires. Paper versions of the questionnaires were sent with self-addressed stamped envelopes and reminder questionnaires were sent after one month to parents who had not responded.\u003c/p\u003e \u003cp\u003e[Insert Fig.\u0026nbsp;1 here]\u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec4\" class=\"Section2\"\u003e \u003ch2\u003eMeasures\u003c/h2\u003e \u003cdiv id=\"Sec5\" class=\"Section3\"\u003e \u003ch2\u003eSocio-demographic and environmental characteristics\u003c/h2\u003e \u003cp\u003eParental socio-demographic data was collected from the mother antenatally, through the Wave 0 questionnaire, including maternal age, marital status, maternal \u0026amp; paternal education level, maternal \u0026amp; paternal employment status, ethnicity and parity of pregnancy. Wave 1 collected data at birth including the infant\u0026rsquo;s sex and date of birth.\u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec6\" class=\"Section3\"\u003e \u003ch2\u003eFamily History of Allergy\u003c/h2\u003e \u003cp\u003eIn Wave 0 mother self-report of family history of allergy was collected (maternal, paternal and sibling history of asthma, hay fever, itchy rash, wheeze, runny nose and food allergies).\u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec7\" class=\"Section3\"\u003e \u003ch2\u003eInfant dietary intake\u003c/h2\u003e \u003cp\u003eA parent reported food frequency questionnaire was completed in Waves 2, 3 and 4. This was an amended version of the Southampton Women\u0026rsquo;s Survey FFQ at 6 months which has been shown to be a valid measure of energy and nutrient intake in infants\u003csup\u003e14\u003c/sup\u003e. At Wave 2 the questionnaire consisted of a list of 28 foods and 10 drinks, at Waves 3 and 4, the questionnaire consisted of a list of 77 foods and 10 drinks, reflecting the greater range of foods likely to be consumed by an older child. For each food, the frequency of consumption over the previous month of each food and drink was recorded using a multiple response grid. Variety in the infant\u0026rsquo;s diet was calculated as the number of different food items consumed over the previous month.\u003c/p\u003e \u003cp\u003eIn Waves 2 and 3 parents were also asked to report the age at which their infant was introduced to solid food and was first introduced to highly allergenic foods (including wheat, egg, milk, fish, nuts and sesame). For these responses, a single variable was created which considered replies to this question at either wave. If the parent had indicated a different answer in the two Waves e.g. reported that their infant was introduced to solid food from 20 weeks when asked at Wave 2 but reported 22 weeks when asked at Wave 3, the answer from Wave 2 was used as it was considered less affected by recall bias.\u003c/p\u003e \u003cp\u003eIn Waves 2, 3 and 4, parents were asked whether they were avoiding any food in their child\u0026rsquo;s diet due to allergy and if yes, they were asked to specify which foods\u003c/p\u003e \u003c/div\u003e \u003c/div\u003e \u003cdiv id=\"Sec8\" class=\"Section2\"\u003e \u003ch2\u003eData Analysis\u003c/h2\u003e \u003cp\u003eOnly questionnaires with complete responses were included in each analysis, those with missing data were excluded from analysis. SPSS (IBM, version 26) was used to analyse the data. Categorical variables were expressed as frequency and percentage and the χ\u003csup\u003e2\u003c/sup\u003e test was used to test these relationships. Repeated measures ANOVA was used to test the change in continuous variables (e.g. variety of foods eaten) over time. Binary logistic regressions were used to determine the effects of family history of allergy on the likelihood that infants\u0026rsquo; introduction to each allergenic food was delayed (9 months or later, compared to before 9 months)\u003c/p\u003e \u003c/div\u003e"},{"header":"Results","content":"\u003cdiv id=\"Sec10\" class=\"Section2\"\u003e \u003ch2\u003eDemographic characteristics of parents and infants\u003c/h2\u003e \u003cp\u003e[Insert Table\u0026nbsp;\u003cspan refid=\"Tab1\" class=\"InternalRef\"\u003e1\u003c/span\u003e]\u003c/p\u003e \u003cp\u003e \u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab1\" border=\"1\"\u003e \u003ccaption language=\"En\"\u003e \u003cdiv class=\"CaptionNumber\"\u003eTable 1\u003c/div\u003e \u003cdiv class=\"CaptionContent\"\u003e \u003cp\u003eParental and infant demographic characteristics of sample\u003c/p\u003e \u003c/div\u003e \u003c/caption\u003e \u003ccolgroup cols=\"5\"\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c4\" colnum=\"4\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c5\" colnum=\"5\"\u003e\u003c/div\u003e \u003cthead\u003e \u003ctr\u003e \u003cth align=\"left\" colspan=\"3\" nameend=\"c3\" namest=\"c1\"\u003e \u003cp\u003eParental demographics\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/th\u003e \u003cth align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/th\u003e \u003c/tr\u003e \u003c/thead\u003e \u003ctbody\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eTotal Population\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003eWave 2 Population\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003eWave 3 Population\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003eWave 4 Population\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eN\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e390\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e216\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e193\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e139\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cem\u003eMaternal Age\u003c/em\u003e\u0026nbsp;Mean (SD) [Range]\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e31 years (4.85)\u003c/p\u003e \u003cp\u003e[18\u0026ndash;43]\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e33 years* (4.38)\u003c/p\u003e \u003cp\u003e[19\u0026ndash;44]\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e34 years* (4.25)\u003c/p\u003e \u003cp\u003e[22\u0026ndash;44]\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e35 years* (3.87)\u003c/p\u003e \u003cp\u003e[24\u0026ndash;45]\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eHigher level of Maternal Education**\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e223 (57%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e151 (70%)*\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e138 (72%)*\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e102 (73%)*\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eHigher level of Paternal Education**\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e164 (42%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e113 (52%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e99 (51%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e83 (60%)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cem\u003eMaternal Ethnicity\u003c/em\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eWhite British\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e318 (82%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e174 (81%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e161 (83%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e114 (82%)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eWhite other\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e44 (11%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e31 (14%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e26 (13%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e19 (14%)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eMixed/multiple ethnic groups\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e6 (2%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e2 (1%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e1 (1%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e1 (1%)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eAsian/Asian British\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e13 (3%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e6 (3%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e4 (2%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e3 (2%)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eBlack/African/Caribbean/Black British\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e6 (1.5%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e2 (1%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e1 (1%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e1 (1%)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eOther ethnic group\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e2 (1%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e-\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e-\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e-\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eNot specified\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e1 (1%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e1 (1%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e-\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e1 (1%)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colspan=\"5\" nameend=\"c5\" namest=\"c1\"\u003e \u003cp\u003eInfant Demographics\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eN\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e220\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e199\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e145\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eSex: Male N (%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e191 (49%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e113 (51%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e97 (49%)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eAge (SD) [range] months\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e6 (0.91)\u003c/p\u003e \u003cp\u003e[5\u0026ndash;10]\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e13 (1.1) [11\u0026ndash;17]\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e25 (0.99) [23\u0026ndash;30]\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eBirth Order: First born (no siblings)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e165 (42%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e108 (50%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e98 (51%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e67 (48%)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eVariety of food eaten in previous month\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e12.1 (5.94)*\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e46.6 (9.32)*\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e48.2 (8.77)*\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eConsulted GP about any allergic symptoms\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e53 (24%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e79 (40%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e42 (29%)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eAvoiding any foods due to allergy\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e32 (15%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e32 (16%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e15 (10%)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cem\u003eFamily History of Allergy\u003c/em\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"4\" nameend=\"c5\" namest=\"c2\"\u003e \u003cp\u003e(Any close family history)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eAsthma\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e149 (38%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e69 (32%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e59 (31%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e38 (27%)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eHay fever\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e208 (53%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e114 (53%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e102 (53%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e71 (51%)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eItchy Rash\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e117 (30%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e65 (30%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e60 (31%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e40 (29%)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eWheeze\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e140 (36%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e25 (12%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e63 (33%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e34 (24%)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eRunny Nose\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e183 (47%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e106 (49%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e97 (50%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e66 (47%)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eFood Allergy\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e110 (28%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e60 (28%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e56 (29%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e41 (29%)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003c/tbody\u003e \u003c/colgroup\u003e \u003ctfoot\u003e \u003ctr\u003e\u003ctd colspan=\"5\"\u003e\u003cem\u003eNote\u003c/em\u003e. *\u003cem\u003ep\u003c/em\u003e\u0026thinsp;\u0026lt;\u0026thinsp;.05, **Higher level of education refers to having obtained a higher education qualification (normally beyond age 18) which includes bachelor degrees, as well as degree apprenticeships, and foundation degrees.\u003c/td\u003e\u003c/tr\u003e \u003c/tfoot\u003e \u003c/table\u003e\u003c/div\u003e \u003c/p\u003e \u003cp\u003eDemographic characteristics of participants who responded to each wave of data collection are shown in Table\u0026nbsp;\u003cspan refid=\"Tab1\" class=\"InternalRef\"\u003e1\u003c/span\u003e, as well as the prevalence of allergy among close family members (biological mother, father or siblings) of the infant. Participants were predominately white British (\u0026gt;\u0026thinsp;80%) which is representative of XXXXXX city (79%). However, respondents to Waves 2\u0026ndash;4 were typically highly educated (\u0026gt;\u0026thinsp;70% Higher Education), which is higher than average for XXXXXXX\u0026rsquo;s population (35% Higher Education).\u003c/p\u003e \u003cp\u003eRespondents to the questionnaire were older, and more likely to have attended higher education compared to non-respondents. However, there was no difference in the percentage of mothers of white British ethnicity for respondents compared to non-respondents\u003c/p\u003e \u003cp\u003eIn all waves of data collection, hay fever was the most commonly reported allergy and more than 50% of infants had at least one close family member with hay fever. Around 28% of infants had a close family member with a food allergy, and 38% of infants had a close family member with asthma.\u003c/p\u003e \u003cp\u003e15% of parents reported that they were avoiding giving their infants certain foods due to allergy at Wave 2, 16% at Wave 3 and 10% at Wave 4 (see Table\u0026nbsp;\u003cspan refid=\"Tab1\" class=\"InternalRef\"\u003e1\u003c/span\u003e). The most commonly reported foods that were being avoided due to allergy at Wave 2 were: dairy (n\u0026thinsp;=\u0026thinsp;14, yogurt n\u0026thinsp;=\u0026thinsp;1), soya (n\u0026thinsp;=\u0026thinsp;6), egg (n\u0026thinsp;=\u0026thinsp;5), nuts (n\u0026thinsp;=\u0026thinsp;5) and fruits (banana, n\u0026thinsp;=\u0026thinsp;2; strawberries, n\u0026thinsp;=\u0026thinsp;1; orange, n\u0026thinsp;=\u0026thinsp;1). At Wave 3 commonly avoided foods were dairy (n\u0026thinsp;=\u0026thinsp;14, milk and cheese, n\u0026thinsp;=\u0026thinsp;2), egg (n\u0026thinsp;=\u0026thinsp;8), nuts (n\u0026thinsp;=\u0026thinsp;8), soya (n\u0026thinsp;=\u0026thinsp;6) and fruits (banana n\u0026thinsp;=\u0026thinsp;1; blueberries, n\u0026thinsp;=\u0026thinsp;1; watermelon, n\u0026thinsp;=\u0026thinsp;1; cucumber, n\u0026thinsp;=\u0026thinsp;1; and strawberries, n\u0026thinsp;=\u0026thinsp;1). And at Wave 4 the most commonly avoided foods were dairy (n\u0026thinsp;=\u0026thinsp;6), nuts (n\u0026thinsp;=\u0026thinsp;4), egg (n\u0026thinsp;=\u0026thinsp;3), soya (n\u0026thinsp;=\u0026thinsp;3) and fruits (banana, n\u0026thinsp;=\u0026thinsp;2; raspberries, n\u0026thinsp;=\u0026thinsp;1; tomato, n\u0026thinsp;=\u0026thinsp;2; kiwi, n\u0026thinsp;=\u0026thinsp;1; blueberries, n\u0026thinsp;=\u0026thinsp;1; apricot, n\u0026thinsp;=\u0026thinsp;1).\u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec11\" class=\"Section2\"\u003e \u003ch2\u003eTime and Type of Foods Introduced into Infants\u0026rsquo; Diets\u003c/h2\u003e \u003cp\u003eThe mean age for introduction of solid foods was 22.7 weeks (SD\u0026thinsp;=\u0026thinsp;3.40, range 6\u0026ndash;36 weeks). Most highly allergenic foods were introduced to infants at around 6\u0026ndash;9 months. Wheat was introduced earlier than the other allergenic foods: 31% of infants were introduced to wheat before they reached 6 months, and nearly all infants had been introduced to wheat by the time they were 9 months (97%). Nuts were introduced latest with only 38% of infants being introduced to nuts by the time they were 9 months old, and 35% of infants never having exposure to nuts by Wave 3 (around 12 months). Egg and sesame were also introduced to infants later, and 21% of infants had not been exposed to eggs and 16% had not been exposed to sesame by Wave 3 (around 12 months) see Table\u0026nbsp;\u003cspan refid=\"Tab2\" class=\"InternalRef\"\u003e2\u003c/span\u003e.\u003c/p\u003e \u003cp\u003e \u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab2\" border=\"1\"\u003e \u003ccaption language=\"En\"\u003e \u003cdiv class=\"CaptionNumber\"\u003eTable 2\u003c/div\u003e \u003cdiv class=\"CaptionContent\"\u003e \u003cp\u003eNumber of children who were introduced to highly allergenic foods at each age (in months)\u003c/p\u003e \u003c/div\u003e \u003c/caption\u003e \u003ccolgroup cols=\"7\"\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c4\" colnum=\"4\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c5\" colnum=\"5\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c6\" colnum=\"6\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c7\" colnum=\"7\"\u003e\u003c/div\u003e \u003cthead\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/th\u003e \u003cth align=\"left\" colspan=\"6\" nameend=\"c7\" namest=\"c2\"\u003e \u003cp\u003eAge (months) N (%)\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003c/thead\u003e \u003ctbody\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e\u0026lt;\u0026thinsp;3\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e3 to \u0026lt;\u0026thinsp;6\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e6 to \u0026lt;\u0026thinsp;9\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e9 to \u0026lt;\u0026thinsp;12\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e12+\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003eNever\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eWheat\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e2 (1%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e70 (30%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e154 (66%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e4 (2%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e-\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e2 (1%)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eEgg\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e-\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e9 (5%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e120 (60%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e22 (11%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e7 (4%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e41 (21%)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eMilk\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e1 (\u0026lt;\u0026thinsp;1%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e34 (16%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e158 (73%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e12 (6%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e4 (2%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e7 (3%)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eFish\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e-\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e9 (4%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e134 (63%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e52(25%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e5 (2%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e12 (6%)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eNuts\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e1 (\u0026lt;\u0026thinsp;1%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e3 (2%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e69 (35%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e41 (21%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e12 (7%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e69 (35%)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eSesame\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e1 (\u0026lt;\u0026thinsp;1%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e5 (3%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e91 (46%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e52 (26%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e18 (9%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e32 (16%)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003c/tbody\u003e \u003c/colgroup\u003e \u003c/table\u003e\u003c/div\u003e \u003c/p\u003e \u003cp\u003e[Insert Table\u0026nbsp;\u003cspan refid=\"Tab2\" class=\"InternalRef\"\u003e2\u003c/span\u003e]\u003c/p\u003e \u003cp\u003eRepeated measure ANOVA showed that the variety of foods eaten by infants increased as they aged (see Table\u0026nbsp;\u003cspan refid=\"Tab1\" class=\"InternalRef\"\u003e1\u003c/span\u003e). Both the increase in variety of foods eaten from Wave 2 to Wave 3, and the increase in Wave 3 to Wave 4, were statistically significant.\u003c/p\u003e \u003cp\u003e \u003cem\u003eThe association between family history of allergy and time and type of foods introduced to infants\u0026rsquo; diet\u003c/em\u003e \u003c/p\u003e \u003cp\u003eThere was no difference in the age of introduction of solid food between the infants with any family history of any allergy and infants without a family history of these allergies (\u003cem\u003et\u003c/em\u003e(135)\u0026thinsp;=\u0026thinsp;1.47, \u003cem\u003ep\u003c/em\u003e\u0026thinsp;=\u0026thinsp;.144, \u003cem\u003ens\u003c/em\u003e).\u003c/p\u003e \u003cp\u003eAs shown in Table\u0026nbsp;\u003cspan refid=\"Tab3\" class=\"InternalRef\"\u003e3\u003c/span\u003e, none of the binary logistic regression models which assessed the effects of family history of allergy on the likelihood that infants\u0026rsquo; introduction to each allergenic food was delayed, were statistically significant. Family history of allergy did not make a significant contribution to delayed introduction (9 months or later compared to before 9 month) of any of these allergenic foods.\u003c/p\u003e \u003cp\u003e \u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab3\" border=\"1\"\u003e \u003ccaption language=\"En\"\u003e \u003cdiv class=\"CaptionNumber\"\u003eTable 3\u003c/div\u003e \u003cdiv class=\"CaptionContent\"\u003e \u003cp\u003ePercentage of infants introduced late (9 months or later) to highly allergenic foods by family history of allergy\u003c/p\u003e \u003c/div\u003e \u003c/caption\u003e \u003ccolgroup cols=\"7\"\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c4\" colnum=\"4\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c5\" colnum=\"5\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c6\" colnum=\"6\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c7\" colnum=\"7\"\u003e\u003c/div\u003e \u003cthead\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/th\u003e \u003cth align=\"left\" colspan=\"6\" nameend=\"c7\" namest=\"c2\"\u003e \u003cp\u003eLate introduction of:\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003c/thead\u003e \u003ctbody\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eWheat\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003eEgg\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003eMilk\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003eFish\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003eNuts\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003eSesame\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eAsthma\u003c/p\u003e \u003cp\u003eNo Asthma\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e1%\u003c/p\u003e \u003cp\u003e4%\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e22%\u003c/p\u003e \u003cp\u003e27%\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e7%\u003c/p\u003e \u003cp\u003e11%\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e27%\u003c/p\u003e \u003cp\u003e34%\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e60%\u003c/p\u003e \u003cp\u003e62%\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e45%\u003c/p\u003e \u003cp\u003e53%\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eHayfever\u003c/p\u003e \u003cp\u003eNo Hayfever\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e3%\u003c/p\u003e \u003cp\u003e2%\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e28%\u003c/p\u003e \u003cp\u003e22%\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e12%\u003c/p\u003e \u003cp\u003e7%\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e30%\u003c/p\u003e \u003cp\u003e34%\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e58%\u003c/p\u003e \u003cp\u003e65%\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e51%\u003c/p\u003e \u003cp\u003e49%\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eRash\u003c/p\u003e \u003cp\u003eNo Rash\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e4%\u003c/p\u003e \u003cp\u003e3%\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e31%\u003c/p\u003e \u003cp\u003e23%\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e14%\u003c/p\u003e \u003cp\u003e8%\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e27%\u003c/p\u003e \u003cp\u003e34%\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e60%\u003c/p\u003e \u003cp\u003e62%\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e44%\u003c/p\u003e \u003cp\u003e53%\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eWheeze\u003c/p\u003e \u003cp\u003eNo Wheeze\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e1%\u003c/p\u003e \u003cp\u003e3%\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e22%\u003c/p\u003e \u003cp\u003e27%\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e5%\u003c/p\u003e \u003cp\u003e12%\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e25%\u003c/p\u003e \u003cp\u003e35%\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e58%\u003c/p\u003e \u003cp\u003e63%\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e47%\u003c/p\u003e \u003cp\u003e52%\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eItch\u003c/p\u003e \u003cp\u003eNo Itch\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e3%\u003c/p\u003e \u003cp\u003e3%\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e28%\u003c/p\u003e \u003cp\u003e22%\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e8%\u003c/p\u003e \u003cp\u003e11%\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e29%\u003c/p\u003e \u003cp\u003e35%\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e59%\u003c/p\u003e \u003cp\u003e63%\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e53%\u003c/p\u003e \u003cp\u003e47%\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eFood Allergy\u003c/p\u003e \u003cp\u003eNo Food Allergy\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e5%\u003c/p\u003e \u003cp\u003e2%\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e24%\u003c/p\u003e \u003cp\u003e26%\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e8%\u003c/p\u003e \u003cp\u003e10%\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e37%\u003c/p\u003e \u003cp\u003e30%\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e69%\u003c/p\u003e \u003cp\u003e58%\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e47%\u003c/p\u003e \u003cp\u003e51%\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003csup\u003e\u003cb\u003e1\u003c/b\u003e\u003c/sup\u003e\u003cb\u003eModel χ\u003c/b\u003e\u003csup\u003e\u003cb\u003e2\u003c/b\u003e\u003c/sup\u003e\u003c/p\u003e \u003cp\u003e\u003cb\u003ep\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e4.058\u003c/p\u003e \u003cp\u003eP\u0026thinsp;=\u0026thinsp;.669\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e4.430\u003c/p\u003e \u003cp\u003eP\u0026thinsp;=\u0026thinsp;.619\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e10.949\u003c/p\u003e \u003cp\u003eP\u0026thinsp;=\u0026thinsp;.090\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e4.866\u003c/p\u003e \u003cp\u003eP\u0026thinsp;=\u0026thinsp;.561\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e4.414\u003c/p\u003e \u003cp\u003ep\u0026thinsp;=\u0026thinsp;.658\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e4.466\u003c/p\u003e \u003cp\u003eP\u0026thinsp;=\u0026thinsp;.614\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003c/tbody\u003e \u003c/colgroup\u003e \u003ctfoot\u003e \u003ctr\u003e\u003ctd colspan=\"7\"\u003e\u003cem\u003eNote.\u003c/em\u003e The model (binary logistic regression) assessed the impact of family history of all allergies on late introduction of each type of allergenic food.\u003c/td\u003e\u003c/tr\u003e \u003c/tfoot\u003e \u003c/table\u003e\u003c/div\u003e \u003c/p\u003e \u003cp\u003eHowever, as shown in Table\u0026nbsp;\u003cspan refid=\"Tab4\" class=\"InternalRef\"\u003e4\u003c/span\u003e, at Wave 2, infants with a family history of every type of allergy were more likely to have diets avoiding certain foods due to allergy compared to infants without a family history of that allergy. At Wave 3, infants with a family history of asthma, hay fever, itchy rash or food allergy were more likely to have diets avoiding foods due to allergy and at Wave 4, infants with a family history of asthma or hay fever were more likely to have diets avoiding foods due to allergy, than infants without a family history of these allergies.\u003c/p\u003e \u003cp\u003e \u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab4\" border=\"1\"\u003e \u003ccaption language=\"En\"\u003e \u003cdiv class=\"CaptionNumber\"\u003eTable 4\u003c/div\u003e \u003cdiv class=\"CaptionContent\"\u003e \u003cp\u003eThe percentage of infants with diets that avoid food due to allergy in infants with compared to without a family history of allergy.\u003c/p\u003e \u003c/div\u003e \u003c/caption\u003e \u003ccolgroup cols=\"4\"\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c4\" colnum=\"4\"\u003e\u003c/div\u003e \u003cthead\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/th\u003e \u003cth align=\"left\" colspan=\"2\" nameend=\"c3\" namest=\"c2\"\u003e \u003cp\u003ePercentage of infants with diets that avoid foods due to allergy\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c4\"\u003e \u003cp\u003eχ\u003csup\u003e2\u003c/sup\u003e (\u003cem\u003ep\u003c/em\u003e value)\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003c/thead\u003e \u003ctbody\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eFamily History of Asthma\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003eNo family history of Asthma\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eWave 2\u003c/p\u003e \u003cp\u003eWave 3\u003c/p\u003e \u003cp\u003eWave 4\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e27%\u003c/p\u003e \u003cp\u003e24%\u003c/p\u003e \u003cp\u003e23%\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e10%\u003c/p\u003e \u003cp\u003e13%\u003c/p\u003e \u003cp\u003e6%\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e7.68 (\u003cem\u003ep\u003c/em\u003e\u0026thinsp;=\u0026thinsp;.006)\u003c/p\u003e \u003cp\u003e11.05(\u003cem\u003ep\u003c/em\u003e\u0026thinsp;=\u0026thinsp;.001)\u003c/p\u003e \u003cp\u003e9.88 (\u003cem\u003ep\u003c/em\u003e\u0026thinsp;=\u0026thinsp;.002)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eFamily History of Hay Fever\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003eNo Family History of Hay Fever\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eWave 2\u003c/p\u003e \u003cp\u003eWave 3\u003c/p\u003e \u003cp\u003eWave 4\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e24%\u003c/p\u003e \u003cp\u003e25%\u003c/p\u003e \u003cp\u003e20%\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e8%\u003c/p\u003e \u003cp\u003e7%\u003c/p\u003e \u003cp\u003e1%\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e8.60 (\u003cem\u003ep\u003c/em\u003e\u0026thinsp;=\u0026thinsp;.003)\u003c/p\u003e \u003cp\u003e11.05 (\u003cem\u003ep\u003c/em\u003e\u0026thinsp;=\u0026thinsp;.001)\u003c/p\u003e \u003cp\u003e13.18 (\u003cem\u003ep\u003c/em\u003e\u0026thinsp;\u0026lt;\u0026thinsp;.001)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eFamily History of Itchy Rash\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003eNo Family History of Itchy Rash\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eWave 2\u003c/p\u003e \u003cp\u003eWave 3\u003c/p\u003e \u003cp\u003eWave 4\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e25%\u003c/p\u003e \u003cp\u003e25%\u003c/p\u003e \u003cp\u003e13%\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e12%\u003c/p\u003e \u003cp\u003e7%\u003c/p\u003e \u003cp\u003e10%\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e4.72 (\u003cem\u003ep\u003c/em\u003e\u0026thinsp;=\u0026thinsp;.030)\u003c/p\u003e \u003cp\u003e11.05 (\u003cem\u003ep\u003c/em\u003e\u0026thinsp;=\u0026thinsp;.001)\u003c/p\u003e \u003cp\u003e.277 (\u003cem\u003ep\u003c/em\u003e\u0026thinsp;=\u0026thinsp;.599) \u003cem\u003ens\u003c/em\u003e\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eFamily History of Wheeze\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003eNo Family History of Wheeze\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eWave 2\u003c/p\u003e \u003cp\u003eWave 3\u003c/p\u003e \u003cp\u003eWave 4\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e27%\u003c/p\u003e \u003cp\u003e23%\u003c/p\u003e \u003cp\u003e18%\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e11%\u003c/p\u003e \u003cp\u003e14%\u003c/p\u003e \u003cp\u003e8%\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e9.17 (\u003cem\u003ep\u003c/em\u003e\u0026thinsp;=\u0026thinsp;.002)\u003c/p\u003e \u003cp\u003e2.62 (\u003cem\u003ep\u003c/em\u003e\u0026thinsp;=\u0026thinsp;.106) \u003cem\u003ens\u003c/em\u003e\u003c/p\u003e \u003cp\u003e2.55 (\u003cem\u003ep\u003c/em\u003e\u0026thinsp;=\u0026thinsp;.116) \u003cem\u003ens\u003c/em\u003e\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eFamily History of Runny Nose\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003eNo Family History of Runny Nose\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eWave 2\u003c/p\u003e \u003cp\u003eWave 3\u003c/p\u003e \u003cp\u003eWave 4\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e23%\u003c/p\u003e \u003cp\u003e22%\u003c/p\u003e \u003cp\u003e12%\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e10%\u003c/p\u003e \u003cp\u003e12%\u003c/p\u003e \u003cp\u003e9%\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e6.75 (\u003cem\u003ep\u003c/em\u003e\u0026thinsp;=\u0026thinsp;.009)\u003c/p\u003e \u003cp\u003e3.15 (\u003cem\u003ep\u003c/em\u003e\u0026thinsp;=\u0026thinsp;.076) \u003cem\u003ens\u003c/em\u003e\u003c/p\u003e \u003cp\u003e.412 (\u003cem\u003ep\u003c/em\u003e\u0026thinsp;=\u0026thinsp;.521) \u003cem\u003ens\u003c/em\u003e\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eFamily History of Food Allergy\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003eNo Family History of Food Allergy\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eWave 2\u003c/p\u003e \u003cp\u003eWave 3\u003c/p\u003e \u003cp\u003eWave 4\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e30%\u003c/p\u003e \u003cp\u003e32%\u003c/p\u003e \u003cp\u003e10%\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e11%\u003c/p\u003e \u003cp\u003e11%\u003c/p\u003e \u003cp\u003e10%\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e11.18 (\u003cem\u003ep\u003c/em\u003e\u0026thinsp;=\u0026thinsp;.001)\u003c/p\u003e \u003cp\u003e12.04 (\u003cem\u003ep\u003c/em\u003e\u0026thinsp;=\u0026thinsp;.001)\u003c/p\u003e \u003cp\u003e.211(\u003cem\u003ep\u003c/em\u003e\u0026thinsp;=\u0026thinsp;.646) \u003cem\u003ens\u003c/em\u003e\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003c/tbody\u003e \u003c/colgroup\u003e \u003c/table\u003e\u003c/div\u003e \u003c/p\u003e \u003cp\u003e[Insert Table\u0026nbsp;\u003cspan refid=\"Tab4\" class=\"InternalRef\"\u003e4\u003c/span\u003e]\u003c/p\u003e \u003cp\u003eRepeated measures ANOVA showed that there was no significant difference in the variety of foods eaten by the infants who had a family history of allergy compared to infants without a family history of allergy (F(1)\u0026thinsp;=\u0026thinsp;.115, \u003cem\u003ep\u003c/em\u003e\u0026thinsp;=\u0026thinsp;.735 \u003cem\u003ens\u003c/em\u003e) and there was also not a significant Group X time interaction (F(2)\u0026thinsp;=\u0026thinsp;.428, \u003cem\u003ep\u003c/em\u003e\u0026thinsp;=\u0026thinsp;.652, \u003cem\u003ens\u003c/em\u003e).\u003c/p\u003e \u003c/div\u003e"},{"header":"Discussion","content":"\u003cp\u003eThis study aimed to investigate the time and type of foods introduced into infants\u0026rsquo; diets in this population cohort and whether this differed in infants with a family history of allergy compared to infants without a family history of allergy.\u003c/p\u003e \u003cp\u003eAlthough there is no specific guidance for the optimal age of timing of introduction of highly allergenic foods, current guidelines for primary prevention of food allergy does not advise late introduction of allergenic foods \u003csup\u003e15\u0026ndash;17\u003c/sup\u003e. And rather that highly allergenic foods are introduced alongside other solids. Research generally reports that early introduction of allergenic foods, particularly nuts and egg, is associated with lower risk of allergic disease\u003csup\u003e18\u003c/sup\u003e and it has been suggested that high-risk children should be introduced to peanut-containing foods as early as 4\u0026ndash;6 months of age \u003csup\u003e67\u003c/sup\u003e.\u003c/p\u003e \u003cp\u003eIn this sample, most highly allergenic foods were introduced to infants at around 6\u0026ndash;9 months. However, some allergenic foods were introduced much later, for example a fifth (21%) of children had not been exposed to egg and over a third of infants (35%) had not been exposed to nuts by 12 months. This suggests that a significant proportion of parents are delaying the introduction of allergenic foods to their infants. Similarly, between 10\u0026ndash;16% of infants had diets that avoided foods due to allergy at each wave of data collection.\u003c/p\u003e \u003cp\u003eIn this sample, parents of the infants, both those with and without a family history of allergy did not appear to be following advice to introduce nuts and eggs alongside other solids, and nuts and eggs were introduced late, with a large proportion of infants not being exposed to either of these foods by one year of age. Delaying the introduction of nut and egg in the population and the avoidance of highly allergenic foods in high risk infants might affect the development of allergies in infants. However, these dietary decisions could be a modifiable risk factor for allergy development: in countries, such as Australia, where a national strategy has been implemented to communicate the recommendations to introduce allergenic foods earlier to infants, early introduction to allergenic foods has been well accepted by the population (see for example the Nip Allergies in the Bub strategy\u003csup\u003e19\u003c/sup\u003e and the Early Nuts Study \u003csup\u003e20\u003c/sup\u003e). From the current study, it is not clear why parents are not following the current guidance to introduce allergenic foods alongside other foods during weaning, or why parents of infants with a family history of allergy choose to avoid certain foods due to allergy, future qualitative research would help to understand the factors underpinning these decisions. However, it may be that these behaviours are contributing to the high prevalence of allergic disease in the UK.\u003c/p\u003e \u003cp\u003eFurthermore, in the current study, although infants with a family history of allergy were introduced to allergenic foods at similar times to other infants, they were more likely to have diets that avoided particular foods than infants without a family history of allergy. The foods that were reported to be avoided by infants were most commonly dairy, soya, egg and nuts but also included a variety of fruits. This is likely to reflect that infants with a family history of allergy are introduced to allergenic foods at a similar time as other infants, but that their parents later decide to avoid these foods in their infants\u0026rsquo; diets. Many of the foods being avoided in the infants\u0026rsquo; diets are not highly allergenic foods, for example at each wave of data collection a number of parents reported avoiding fruits such as banana, which is uncommonly associated with allergy\u003c/p\u003e \u003cp\u003eOne of the strengths of the current study was its longitudinal design, this ensured that the parents were less affected by recall bias in their reports of when they introduced foods to the infants as the parents were sent the questionnaires to completed when their infants were of an appropriate age. However, limitations of the study include reliance of parental-report measures, for example about the timing of introductions of highly allergenic foods required parents to understand the ingredients in pre-prepared infant foods. Furthermore, the participants involved in the study were more likely to be highly educated than the typical XXXXXX population. The response rate to the questionnaires ranged from 36\u0026ndash;55%, and older, more highly educated mothers from the initial cohort were more likely to respond. These findings may not be replicable in younger, less well-educated populations.\u003c/p\u003e \u003cp\u003eIn conclusion, in this sample, although most highly allergenic foods were introduced to infants along with other solid foods, many parents delayed the introduction of egg and nuts beyond one year of age. Furthermore, infants with a family history of allergy were more likely to have diets that avoided foods due to allergy. These behaviours may contribute to the development of allergic disease.\u003c/p\u003e"},{"header":"Declarations","content":"\u003cp\u003e \u003ch2\u003eFinancial Support\u003c/h2\u003e \u003cp\u003eThe study was funded by the University of XXXXXX\u003c/p\u003e \u003c/p\u003e \u003cp\u003e \u003cstrong\u003eEthical Approval:\u003c/strong\u003e \u003cp\u003e This study was conducted according to the guidelines laid down in the Declaration of Helsinki and all procedures involving research study participants were approved by the South Central Berkshire B Research Ethics Committee (REC ref: 15/SC/0008). Written informed consent was obtained from all participants\u003c/p\u003e \u003c/p\u003e \u003cp\u003e \u003cstrong\u003eCompeting Interests:\u003c/strong\u003e \u003cp\u003eNone\u003c/p\u003e \u003c/p\u003e\u003ch2\u003eAuthor Contribution\u003c/h2\u003e \u003cp\u003e \u003cb\u003eStatement\u003c/b\u003e: All authors were involved in the study design, SH, and GM were involved in data collection. SH wrote the first draft of the paper and conducted the analyses, all authors contributed to further drafts.\u003c/p\u003e\u003ch2\u003eAcknowledgements:\u003c/h2\u003e \u003cp\u003e The authors would like to thank the families who participated in this study and the Research Midwives at XXXXXX Hospital - Zoe Garner, Linda Lishman, Jess Madgwick, Gilly Stephens and Carole Hoyland. The authors also thank Professor Sasee Pallikadavath for all of his advice towards the Birth Cohort registry and the research-based learning students who assisted with the project\u003c/p\u003e"},{"header":"References","content":"\u003col\u003e\n\u003cli\u003eDierick BJH, van der Molen T, Flokstra-de Blok BMJ, Muraro A, Postma MJ, Kocks JWH, et al. Burden and socioeconomics of asthma, allergic rhinitis, atopic dermatitis and food allergy. Vol. 20, Expert Review of Pharmacoeconomics and Outcomes Research. 2020. \u003c/li\u003e\n\u003cli\u003edu Toit G, Sayre PH, Roberts G, Lawson K, Sever ML, Bahnson HT, et al. Allergen specificity of early peanut consumption and effect on development of allergic disease in the Learning Early About Peanut Allergy study cohort. Journal of Allergy and Clinical Immunology. 2018;141(4). \u003c/li\u003e\n\u003cli\u003eNct. The EAT-On Study: sensitisation, Allergy and Child Health. https://clinicaltrials.gov/show/NCT03495583. 2018; \u003c/li\u003e\n\u003cli\u003eSimons E, Balshaw R, Lefebvre DL, Dai D, Turvey SE, Moraes TJ, et al. Timing of Introduction, Sensitization, and Allergy to Highly Allergenic Foods at Age 3 Years in a General-Population Canadian Cohort. Journal of Allergy and Clinical Immunology: In Practice. 2020;8(1). \u003c/li\u003e\n\u003cli\u003eAgostoni C, Decsi T, Fewtrell M, Goulet O, Kolacek S, Koletzko B, et al. Complementary Feeding: A Commentary by the ESPGHAN Committee on Nutrition. J Pediatr Gastroenterol Nutr. 2008 Jan;46(1):99\u0026ndash;110. \u003c/li\u003e\n\u003cli\u003eTogias A, Cooper SF, Acebal ML, Assa\u0026rsquo;ad A, Baker JR, Beck LA, et al. Addendum guidelines for the prevention of peanut allergy in the United States: Report of the National Institute of Allergy and Infectious Diseases\u0026ndash;sponsored expert panel. Journal of Allergy and Clinical Immunology. 2017;139(1):29\u0026ndash;44. \u003c/li\u003e\n\u003cli\u003eScientific Advisory Committee on Nutrition. Assessing the health benefits and risks of the introduction of peanut and hen \u0026rsquo; s egg into the infant diet before six months of age in the UK A Joint Statement from the Scientific Advisory Committee. 2017. \u003c/li\u003e\n\u003cli\u003eAlTuwayjiri A, Almutairi A. Knowledge, attitude, and practice of the parents regarding childhood vaccinations in Saudi Arabia 2021. International Journal of Medicine in Developing Countries. 2021; \u003c/li\u003e\n\u003cli\u003evan Odijk J, Hulth\u0026eacute;n L, Ahlstedt S, Borres MP. Introduction of food during the infant\u0026rsquo;s first year: A study with emphasis on introduction of gluten and of egg, fish and peanut in allergy-risk families. Acta Paediatrica, International Journal of Paediatrics. 2004;93(4). \u003c/li\u003e\n\u003cli\u003eSchoetzau A, Gehring U, Franke K, Gr\u0026uuml;bl A, Koletzko S, von Berg A, et al. Maternal compliance with nutritional recommendations in an allergy preventive programme. Arch Dis Child. 2002;86(3). \u003c/li\u003e\n\u003cli\u003eVenter C, Pereira B, Voigt K, Grundy J, Clayton CB, Higgins B, et al. Factors associated with maternal dietary intake, feeding and weaning practices, and the development of food hypersensitivity in the infant. Pediatric Allergy and Immunology. 2009;20(4). \u003c/li\u003e\n\u003cli\u003eGrimshaw KEC, Maskell J, Oliver EM, Morris RCG, Foote KD, Mills ENC, et al. Diet and food allergy development during infancy: Birth cohort study findings using prospective food diary data. Journal of Allergy and Clinical Immunology. 2014;133(2). \u003c/li\u003e\n\u003cli\u003eGrimshaw KEC, Bryant T, Oliver EM, Martin J, Maskell J, Kemp T, et al. Incidence and risk factors for food hypersensitivity in UK infants: Results from a birth cohort study. Clin Transl Allergy. 2016;6(1). \u003c/li\u003e\n\u003cli\u003eMarriott LD, Robinson SM, Poole J, Borland SE, Godfrey KM, Law CM, et al. What do babies eat? Evaluation of a food frequency questionnaire to assess the diets of infants aged 6 months. Public Health Nutr. 2008;11(7). \u003c/li\u003e\n\u003cli\u003eMuraro A, Halken S, Arshad SH, Beyer K, Dubois AEJ, Du Toit G, et al. EAACI Food Allergy and Anaphylaxis Guidelines. Primary prevention of food allergy. Allergy: European Journal of Allergy and Clinical Immunology. 2014;69(5):590\u0026ndash;601. \u003c/li\u003e\n\u003cli\u003eFleischer DM, Spergel JM, Assa AH, Pongracic JA. Primary Prevention of Allergic Disease Through Nutritional Interventions. J Allergy Clin Immunol Pract. 2013;1(1):29\u0026ndash;36. \u003c/li\u003e\n\u003cli\u003eChan ES, Cummings C, Atkinson A, Chad Z, Francoeur M jos\u0026eacute;e, Kirste L, et al. IMMUNOLOGY Dietary exposures and allergy prevention in high-risk infants : a joint position statement of the Canadian Society of Allergy and Clinical Immunology and the Canadian Paediatric Society. 2014;1\u0026ndash;6. \u003c/li\u003e\n\u003cli\u003eIerodiakonou D, Garcia-Larsen V, Logan A, Groome A, Cunha S, Chivinge J, et al. Timing of allergenic food introduction to the infant diet and risk of allergic or autoimmune disease a systematic review and meta-analysis. Vol. 316, JAMA - Journal of the American Medical Association. 2016. \u003c/li\u003e\n\u003cli\u003eVale S, Said M, Joshi P, Smith J, Salter S, Loh R. P18: NIP ALLERGIES IN THE BUB - AN INITIATIVE OF THE NATIONAL ALLERGY STRATEGY. Intern Med J. 2018;48. \u003c/li\u003e\n\u003cli\u003eSoriano VX, Peters RL, Ponsonby AL, Dharmage SC, Perrett KP, Field MJ, et al. Earlier ingestion of peanut after changes to infant feeding guidelines: The EarlyNuts study. Journal of Allergy and Clinical Immunology. 2019;144(5). \u003c/li\u003e\n\u003c/ol\u003e"}],"fulltextSource":"","fullText":"","funders":[],"hasAdminPriorityOnWorkflow":false,"hasManuscriptDocX":true,"hasOptedInToPreprint":true,"hasPassedJournalQc":"","hasAnyPriority":false,"hideJournal":false,"highlight":"","institution":"","isAcceptedByJournal":true,"isAuthorSuppliedPdf":false,"isDeskRejected":"","isHiddenFromSearch":false,"isInQc":false,"isInWorkflow":false,"isPdf":false,"isPdfUpToDate":true,"isWithdrawnOrRetracted":false,"journal":{"display":true,"email":"[email protected]","identity":"european-journal-of-clinical-nutrition","isNatureJournal":false,"hasQc":false,"allowDirectSubmit":false,"externalIdentity":"ejcn","sideBox":"Learn more about [European Journal of Clinical Nutrition](http://www.nature.com/ejcn/)","snPcode":"41430","submissionUrl":"https://mts-ejcn.nature.com/cgi-bin/main.plex","title":"European Journal of Clinical Nutrition","twitterHandle":"@ejcneditor","acdcEnabled":true,"dfaEnabled":true,"editorialSystem":"ejp","reportingPortfolio":"Nature AJ","inReviewEnabled":true,"inReviewRevisionsEnabled":false},"keywords":"","lastPublishedDoi":"10.21203/rs.3.rs-3621004/v1","lastPublishedDoiUrl":"https://doi.org/10.21203/rs.3.rs-3621004/v1","license":{"name":"CC BY 4.0","url":"https://creativecommons.org/licenses/by/4.0/"},"manuscriptAbstract":"\u003cp\u003e\u003cstrong\u003eBackground/Objective: \u003c/strong\u003eTo describe the introduction of highly allergenic foods in a UK population sample, and to determine whether the introduction of highly allergenic foods differed in infants with family history of allergy.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eSubjects/Methods: \u003c/strong\u003eA population birth cohort study recruited eligible pregnant women while they were attending an antenatal ultrasound clinic appointment at a UK city hospital. Parental-reported family history of allergy and infant diet was collected through structured interviews at recruitment and postal questionnaires. Parents reported on their infants’ diet at around 6 months (n = 216), around 12 months (n = 193) and around 24 months of age (n = 139).\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eResults\u003c/strong\u003e: Most highly allergenic foods were introduced to infants at around 6-9 months. However, nut and egg were introduced much later, and 21% of children had not been exposed to egg and 35% of infants had not been exposed to nuts by 12 months. Infants with a family history of allergy were introduced to highly allergenic foods at a similar time to other infants but were more likely to have diets that avoided foods due to allergy than other infants (most commonly dairy, soya, egg and nuts).\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eConclusions:\u003c/strong\u003e As many parents delayed the introduction of egg and nuts beyond one year of age and infants with a family history of allergy were more likely to have diets that avoided foods due to allergy, these behaviours might affect the development of allergies in infants and could be a modifiable risk factor for allergy development.\u003c/p\u003e","manuscriptTitle":"The introduction of allergenic foods to the infant diet in a UK cohort: the impact of family history of allergy","msid":"","msnumber":"","nonDraftVersions":[{"code":1,"date":"2024-02-09 17:08:33","doi":"10.21203/rs.3.rs-3621004/v1","editorialEvents":[{"type":"communityComments","content":0},{"type":"decision","content":"revise","date":"2024-07-19T10:06:19+00:00","index":"","fulltext":""},{"type":"editorInvitedReview","content":"This content is not available.","date":"2024-07-15T08:46:12+00:00","index":1,"fulltext":"This content is not available."},{"type":"editorInvitedReview","content":"This content is not available.","date":"2024-07-05T14:29:03+00:00","index":2,"fulltext":"This content is not available."},{"type":"reviewerAgreed","content":"This content is not available.","date":"2024-06-24T07:40:24+00:00","index":2,"fulltext":"This content is not available."},{"type":"reviewerAgreed","content":"This content is not available.","date":"2024-06-20T17:09:50+00:00","index":1,"fulltext":"This content is not available."},{"type":"reviewersInvited","content":"","date":"2024-02-07T06:24:42+00:00","index":"","fulltext":""},{"type":"editorAssigned","content":"","date":"2023-11-17T11:44:44+00:00","index":"","fulltext":""},{"type":"checksComplete","content":"","date":"2023-11-17T11:43:08+00:00","index":"","fulltext":""},{"type":"submitted","content":"European Journal of Clinical Nutrition","date":"2023-11-16T14:53:26+00:00","index":"","fulltext":""}],"status":"published","journal":{"display":true,"email":"[email protected]","identity":"european-journal-of-clinical-nutrition","isNatureJournal":false,"hasQc":false,"allowDirectSubmit":false,"externalIdentity":"ejcn","sideBox":"Learn more about [European Journal of Clinical Nutrition](http://www.nature.com/ejcn/)","snPcode":"41430","submissionUrl":"https://mts-ejcn.nature.com/cgi-bin/main.plex","title":"European Journal of Clinical Nutrition","twitterHandle":"@ejcneditor","acdcEnabled":true,"dfaEnabled":true,"editorialSystem":"ejp","reportingPortfolio":"Nature AJ","inReviewEnabled":true,"inReviewRevisionsEnabled":false}}],"origin":"","ownerIdentity":"070cfaaa-4693-4670-a0c6-bda7dcf5c772","owner":[],"postedDate":"February 9th, 2024","published":true,"recentEditorialEvents":[],"rejectedJournal":[],"revision":"","amendment":"","status":"published-in-journal","subjectAreas":[{"id":26452005,"name":"Health sciences/Risk factors"},{"id":26452006,"name":"Health sciences/Health care/Nutrition"},{"id":26452007,"name":"Health sciences/Health care/Public health/Epidemiology"},{"id":26452008,"name":"Health sciences/Health care/Disease prevention/Lifestyle modification"}],"tags":[],"updatedAt":"2025-05-01T07:12:43+00:00","versionOfRecord":{"articleIdentity":"rs-3621004","link":"https://doi.org/10.1038/s41430-025-01617-x","journal":{"identity":"european-journal-of-clinical-nutrition","isVorOnly":false,"title":"European Journal of Clinical Nutrition"},"publishedOn":"2025-04-30 04:00:00","publishedOnDateReadable":"April 30th, 2025"},"versionCreatedAt":"2024-02-09 17:08:33","video":"","vorDoi":"10.1038/s41430-025-01617-x","vorDoiUrl":"https://doi.org/10.1038/s41430-025-01617-x","workflowStages":[]},"version":"v1","identity":"rs-3621004","journalConfig":"researchsquare"},"__N_SSP":true},"page":"/article/[identity]/[[...version]]","query":{"redirect":"/article/rs-3621004","identity":"rs-3621004","version":["v1"]},"buildId":"qtupq5eGEP_6zYnWcrvyt","isFallback":false,"isExperimentalCompile":false,"dynamicIds":[84888],"gssp":true,"scriptLoader":[]}