Russian Journal of AllergyRussian Journal of AllergyРоссийский Аллергологический Журнал1810-88302686-682XPublishing House ABV Press151510.36691/RJA1515ReviewsНаучные обзорыReview ArticleThe problems of long-term adherence to elimination diets in children with food allergiesПроблемы длительного соблюдения элиминационных диет при пищевой аллергии у детейhttps://orcid.org/0000-0002-0995-42607018-6434EmelyashenkovEvgeny E.ЕмельяшенковЕвгений Евгеньевич
Russian Federation

Graduate Student

аспирант

dkswdsman@mail.ruhttps://orcid.org/0000-0002-3056-403X2094-2840MakarovaSvetlana G.МакароваСветлана Геннадиевна
Russian Federation

MD, Dr. Sci. (Med.), Professor

д.м.н., профессор

sm27@yandex.ruhttps://orcid.org/0000-0001-8586-79464397-6291FisenkoAndrei P.ФисенкоАндрей Петрович
Russian Federation

MD, Dr. Sci. (Med.), Professor

д.м.н., профессор

fisenko.ap@nczd.ruhttps://orcid.org/0000-0003-2252-85705906-9724MurashkinNikolay N.МурашкинНиколай Николаевич
Russian Federation

MD, Dr. Sci. (Med.), Professor

д.м.н., профессор

murashkin.nn@nczd.ruhttps://orcid.org/0000-0002-6701-38722960-6185GalimovaAlbina A.ГалимоваАльбина Альбертовна
Russian Federation

MD, Junior Research Associate

м.н.с.

albina86@yandex.ruhttps://orcid.org/0000-0002-1650-652X3893-9946EreshkoOksana A.ЕрешкоОксана Александровна
Russian Federation

MD, Cand. Sci. (Med.)

к.м.н.

ereshko.oa@nczd.ruNational Medical Research Center for Children’s HealthНациональный медицинский исследовательский центр здоровья детейLomonosov Moscow State UniversityМосковский государственный университет имени М.В. ЛомоносоваFirst Sechenov Moscow State Medical University (Sechenov University)Первый Московский государственный медицинский университет имени И.М. Сеченова (Сеченовский Университет)Central State Medical Academy of Department of Presidential AffairsЦентральная государственная медицинская академия Управления делами Президента Российской Федерации25052022060620221922222331701202207042022Copyright ©; 2022, Pharmarus Print MediaCopyright ©; 2022, Фармарус Принт Медиа2022Pharmarus Print MediaФармарус Принт Медиаhttps://rusalljournal.ru/raj/article/view/1515

In recent years, the challenge of the control and maintenance of nutritional status in patients on an elimination diet for food allergies has got a lot of attention. Due to the possibility of long-term elimination of important food groups without adequate replacement, the high efficiency of this treatment method has been linked with the risk of nutritional deficiency, impaired physical growth, and eating behavior disorders in children. This review takes into account physical growth disorders in children with food allergies due to insufficient intake of micronutrients (vitamins, fatty acids), as well as such behavioral disorders as a distortion of food and taste preferences and food neophobia. We also discuss the problems of artificial mixture choice in children who are in their first year of life, correction of the diet in children over one year of age with micronutrient supplementation, as well as the results of studies on the quality of life of both children with elimination diets and people from their families.

When prescribing an elimination diet, the doctor must constantly monitor the diet and growth indices of the child. It is necessary to take to into account the child’s age, his nutritional requirements, and possible deficiencies of nutrients while planning the diet, as well as determine the necessary and sufficient diet duration.

В последние годы всё больше внимания уделяют проблеме контроля и поддержания нутритивного статуса у пациентов с пищевой аллергией, находящихся на элиминационной диете. Высокая эффективность данного метода лечения сопряжена с риском дефицита нутриентов в питании, нарушением физического развития и пищевого поведения ребёнка из-за возможного длительного исключения важных групп продуктов без адекватной замены.

В обзоре рассматриваются проблемы нарушения физического развития детей с пищевой аллергией вследствие недостаточного поступления микронутриентов (витаминов, жирных кислот), в том числе такие особенности поведения, как искажение пищевых и вкусовых предпочтений, пищевая неофобия. Изучены вопросы, связанные с выбором искусственной смеси для детей первого года жизни, коррекцией рациона путём дотации микронутриентов у детей старше одного года, а также результаты исследований качества жизни как детей, находящихся на элиминационных диетах, так и их семей.

При назначении элиминационной диеты врач должен вести постоянный мониторинг рациона ребёнка и показателей его физического развития. Необходимо планировать рацион с учётом возраста ребёнка, его потребности в нутриентах и их возможного дефицита, а также определять необходимую и достаточную длительность диеты.

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