Anthropometric parameters and nutritional status in children with severe atopic dermatitis and food allergy

Abstract

Objective. To assess the nutritional status and factors affecting it in children with severe atopic dermatitis (AD) and food allergy (FA). Patients and methods. This single-center, observational, cross-sectional, uncontrolled, retrospective study enrolled 315 children aged between 1 month and 17 years 11 months with severe AD and FA. Standard anthropometric parameters were measured and calculated, including WAZ (weight-for-age Z-score), HAZ (height-for-age Z-score), and BAZ (BMI-for-age Z-score). Patients’ medical histories were examined, and the levels of total IgE and specific IgE to food allergens, hemoglobin, ferritin, iron, and vitamin D were evaluated. Results. On average, anthr opometric parameters in the examined patients were below the reference values. Failure to thrive of mild degree was detected in 27.6% of children, moderate degree in 13.7%, and severe degree in 2,2%. The frequency of overweight and obesity was 9.5% and 3.8%, respectively. A correlation was found between HAZ and children’s age (r = 0.21, p = 0.015) and the number of excluded food groups (r = -1.66, p = 0.031), and between BAZ and the number of excluded food groups (r = -1.39, p = 0.019). HAZ (p = 0.014) and BAZ (p = 0.017) values were lower in children following a dairy-free diet than in children on other types of elimination diets. At the same time, BAZ was higher in children who did not strictly follow the diet than in those who did (p = 0.011). There was a correlation between BAZ and vitamin D levels (r = 0.29, p = 0.012). Formulas based on extensive hydrolyzed protein and free aminoacides reduced severity and frequency of failure to thrive in management children with CMPA. Conclusion. Children with severe AD and FA require careful planning of their diets to reduce the risk of failure to thrive. It is necessary to study the influence of dietary composition and eating behavior of patients on their nutritional status. Key words: children, atopic dermatitis, nutritional status, elimination diet, food allergy, physical development, vitamin D