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Published in: BMC Pediatrics 1/2013

Open Access 01-12-2013 | Research article

Duration of a cow-milk exclusion diet worsens parents’ perception of quality of life in children with food allergies

Authors: Luciana Indinnimeo, Luciano Baldini, Valentina De Vittori, Anna Maria Zicari, Giovanna De Castro, Giancarlo Tancredi, Giulia Lais, Marzia Duse

Published in: BMC Pediatrics | Issue 1/2013

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Abstract

Background

In Italy, rigorous studies obtained with specific and validated questionnaires that explore the impact of exclusion diets on health-related quality of life (HRQoL) in children with food allergies are lacking. In this cross-sectional study, we wished to validate the Italian version of a disease-specific quality of life questionnaire, and assess the impact of exclusion diets on the HRQoL in a cohort of Italian children with IgE-mediated food allergies.

Methods

Children on an exclusion diet for ≥1 food were enrolled consecutively, and their parents completed the validated Italian version of the Food Allergy Quality of Life Questionnaire–Parent Form (FAQLQ-PF) and Food Allergy Independent Measure (FAIM).

Results

Ninety-six parents of children aged 0–12 years answered the FAQLQ–PF. The validity of the construct of the questionnaire was assessed by correlation between the FAQLQ–PF and FAIM–PF (r = 0.85). The Italian version of the FAQLQ had good internal consistency (Cronbach's α >0.70). Factors that mainly influenced the HRQoL were older age, severity of food allergy, and the duration of the cow milk-exclusion diet.

Conclusions

The FAQLQ–PF, validated in Italian, is a reliable instrument. Worse QoL scores were observed among older children, those with severe systemic reactions, and those with a prolonged cow milk-free diet. It is very important to consider the QoL assessment as an integral part of food-allergy management. These results emphasize the need to administer exclusion diets only for the necessary time and the importance of assessment of the HRQoL in these patients.
Literature
1.
2.
go back to reference Rona RJ, Keil T, Summers C, Gislason D, Zuidmeer L, Sodergren E, Sigurdardottir ST, Lindner T, Goldhahn K, Dahlstrom J, McBride D, Madsen C: The prevalence of food allergy: a meta-analysis. J Allergy Clin Immunol. 2007, 120 (3): 638-646. 10.1016/j.jaci.2007.05.026.CrossRefPubMed Rona RJ, Keil T, Summers C, Gislason D, Zuidmeer L, Sodergren E, Sigurdardottir ST, Lindner T, Goldhahn K, Dahlstrom J, McBride D, Madsen C: The prevalence of food allergy: a meta-analysis. J Allergy Clin Immunol. 2007, 120 (3): 638-646. 10.1016/j.jaci.2007.05.026.CrossRefPubMed
3.
go back to reference Branum AM, Lukacs SL: Food allergy among children in the United States. Pediatrics. 2009, 124 (6): 1549-1555. 10.1542/peds.2009-1210.CrossRefPubMed Branum AM, Lukacs SL: Food allergy among children in the United States. Pediatrics. 2009, 124 (6): 1549-1555. 10.1542/peds.2009-1210.CrossRefPubMed
4.
go back to reference Caffarelli C, Coscia A, Ridolo E, Povesi Dascola C, Gelmetti C, Raggi V, Volta E, Vanelli M, Dall'aglio PP: Parents' estimate of food allergy prevalence and management in Italian school-aged children. Pediatr Int. 2010, Nov 24. doi:10.1111/j Caffarelli C, Coscia A, Ridolo E, Povesi Dascola C, Gelmetti C, Raggi V, Volta E, Vanelli M, Dall'aglio PP: Parents' estimate of food allergy prevalence and management in Italian school-aged children. Pediatr Int. 2010, Nov 24. doi:10.1111/j
5.
go back to reference Sicherer SH, Sampson HA: Food allergy: recent advances in pathophysiology and treatment. Annu Rev Med. 2009, 60: 261-277. 10.1146/annurev.med.60.042407.205711.CrossRefPubMed Sicherer SH, Sampson HA: Food allergy: recent advances in pathophysiology and treatment. Annu Rev Med. 2009, 60: 261-277. 10.1146/annurev.med.60.042407.205711.CrossRefPubMed
6.
go back to reference Epstein I, Stinson J, Stevens B: The effects of camp on health-related quality of life in children with chronic illnesses: a review of the literature. J Pediatr Oncol Nurs. 2005, 22 (2): 89-103. 10.1177/1043454204273881.CrossRefPubMed Epstein I, Stinson J, Stevens B: The effects of camp on health-related quality of life in children with chronic illnesses: a review of the literature. J Pediatr Oncol Nurs. 2005, 22 (2): 89-103. 10.1177/1043454204273881.CrossRefPubMed
7.
go back to reference Sawyer SM, Aroni RA: Self-management in adolescents with chronic illness. What does it mean and how can it be achieved?. Med J Aust. 2005, 183 (8): 405-409.PubMed Sawyer SM, Aroni RA: Self-management in adolescents with chronic illness. What does it mean and how can it be achieved?. Med J Aust. 2005, 183 (8): 405-409.PubMed
8.
go back to reference Youssef NN, Murphy TG, Langseder AL, Rosh JR: Quality of life for children with functional abdominal pain: a comparison study of patients’ and parents’ perceptions. Pediatrics. 2006, 117 (1): 54-59. 10.1542/peds.2005-0114.CrossRefPubMed Youssef NN, Murphy TG, Langseder AL, Rosh JR: Quality of life for children with functional abdominal pain: a comparison study of patients’ and parents’ perceptions. Pediatrics. 2006, 117 (1): 54-59. 10.1542/peds.2005-0114.CrossRefPubMed
9.
go back to reference Olsson C, Bond L, Johnson MW, et al: Adolescent chronic illness: a qualitative study of psychosocial adjustment. Ann Acad Med Singapore. 2003, 32: 43-50.PubMed Olsson C, Bond L, Johnson MW, et al: Adolescent chronic illness: a qualitative study of psychosocial adjustment. Ann Acad Med Singapore. 2003, 32: 43-50.PubMed
10.
go back to reference Juniper EF, Guyatt GH, Dolovich J: Assessment of quality of life in adolescents with allergic rhinoconjunctivitis: development and testing of a questionnaire for clinical trials. J Allergy Clin Immunol. 1994, 93 (2): 413-423. 10.1016/0091-6749(94)90349-2.CrossRefPubMed Juniper EF, Guyatt GH, Dolovich J: Assessment of quality of life in adolescents with allergic rhinoconjunctivitis: development and testing of a questionnaire for clinical trials. J Allergy Clin Immunol. 1994, 93 (2): 413-423. 10.1016/0091-6749(94)90349-2.CrossRefPubMed
11.
go back to reference Roberts G, Hurley C, Lack G: Development of a quality-of-life assessment for the allergic child or teenager with multisystem allergic disease. J Allergy Clin Immunol. 2003, 111 (3): 491-497. 10.1067/mai.2003.138.CrossRefPubMed Roberts G, Hurley C, Lack G: Development of a quality-of-life assessment for the allergic child or teenager with multisystem allergic disease. J Allergy Clin Immunol. 2003, 111 (3): 491-497. 10.1067/mai.2003.138.CrossRefPubMed
12.
go back to reference Passalacqua G, Canonica GW, Baiardini I: Rhinitis, rhinosinusitis and quality of life in children. Pediatr Allergy Immunol. 2007, 18 (Suppl): 40-45.CrossRefPubMed Passalacqua G, Canonica GW, Baiardini I: Rhinitis, rhinosinusitis and quality of life in children. Pediatr Allergy Immunol. 2007, 18 (Suppl): 40-45.CrossRefPubMed
13.
go back to reference Avery NJ, King RM, Knight S, Hourihane JO: Assessment of quality of life in children with peanut allergy. Pediatr Allergy Immunol. 2003, 14 (5): 378-382. 10.1034/j.1399-3038.2003.00072.x.CrossRefPubMed Avery NJ, King RM, Knight S, Hourihane JO: Assessment of quality of life in children with peanut allergy. Pediatr Allergy Immunol. 2003, 14 (5): 378-382. 10.1034/j.1399-3038.2003.00072.x.CrossRefPubMed
14.
go back to reference Marklund B, Ahlstedt S, Nordström G: Health-related quality of life in food hypersensitive schoolchildren and their families: parents' perceptions. Health Qual Life Outcomes. 2006, 4: 48-10.1186/1477-7525-4-48.CrossRefPubMedPubMedCentral Marklund B, Ahlstedt S, Nordström G: Health-related quality of life in food hypersensitive schoolchildren and their families: parents' perceptions. Health Qual Life Outcomes. 2006, 4: 48-10.1186/1477-7525-4-48.CrossRefPubMedPubMedCentral
15.
go back to reference Sicherer SH, Noone SA, Munoz-Furlong A: The impact of childhood food allergy on quality of life. Ann Allergy Asthma Immunol. 2001, 87 (6): 461-464. 10.1016/S1081-1206(10)62258-2.CrossRefPubMed Sicherer SH, Noone SA, Munoz-Furlong A: The impact of childhood food allergy on quality of life. Ann Allergy Asthma Immunol. 2001, 87 (6): 461-464. 10.1016/S1081-1206(10)62258-2.CrossRefPubMed
16.
go back to reference DunnGalvin A, de BlokFlokstra BM, Burks AW, Dubois AE, Hourihane JO: Food allergy QoL questionnaire for children aged 0–12 years: content, construct and crosscultural validity. Clin Exp Allergy. 2008, 38 (6): 977-986. 10.1111/j.1365-2222.2008.02978.x.CrossRefPubMed DunnGalvin A, de BlokFlokstra BM, Burks AW, Dubois AE, Hourihane JO: Food allergy QoL questionnaire for children aged 0–12 years: content, construct and crosscultural validity. Clin Exp Allergy. 2008, 38 (6): 977-986. 10.1111/j.1365-2222.2008.02978.x.CrossRefPubMed
17.
go back to reference DunnGalvin A, Cullinane C, Daly DA, Flokstra-de Blok BM, Dubois E, Hourihane JO: Longitudinal validity and responsiveness of the food allergy quality of life questionnaire - parent form in children 0–12 years following positive and negative food challenges. Clin Exp Allergy. 2010, 40 (3): 476-485. 10.1111/j.1365-2222.2010.03454.x.CrossRefPubMed DunnGalvin A, Cullinane C, Daly DA, Flokstra-de Blok BM, Dubois E, Hourihane JO: Longitudinal validity and responsiveness of the food allergy quality of life questionnaire - parent form in children 0–12 years following positive and negative food challenges. Clin Exp Allergy. 2010, 40 (3): 476-485. 10.1111/j.1365-2222.2010.03454.x.CrossRefPubMed
18.
go back to reference Host A, Andrae S, Charkin S, et al: Allergy testing in children: why, who when and how. Allergy. 2003, 58: 559-569. 10.1034/j.1398-9995.2003.00238.x.CrossRefPubMed Host A, Andrae S, Charkin S, et al: Allergy testing in children: why, who when and how. Allergy. 2003, 58: 559-569. 10.1034/j.1398-9995.2003.00238.x.CrossRefPubMed
19.
go back to reference Boyce JA, Assa'ad A, Burks AW, Jones SM, Sampson HA, Wood RA, Plaut M, Cooper SF, Fenton MJ, Arshad SH, Bahna SL, Beck LA, Byrd-Bredbenner C, Camargo CA, Eichenfield L, Furuta GT, Hanifin JM, Jones C, Kraft M, Levy BD, Lieberman P, Luccioli S, McCall KM, Schneider LC, Simon RA, Simons FE, Teach SJ, Yawn BP, Schwaninger JM, NIAID-Sponsored Expert Pane: Guidelines for the diagnosis and management of food allergy in the United States: report of the NIAID-sponsored expert panel. J Allergy Clin Immunol. 2010, 126 (6 Suppl): S1-58.PubMedPubMedCentral Boyce JA, Assa'ad A, Burks AW, Jones SM, Sampson HA, Wood RA, Plaut M, Cooper SF, Fenton MJ, Arshad SH, Bahna SL, Beck LA, Byrd-Bredbenner C, Camargo CA, Eichenfield L, Furuta GT, Hanifin JM, Jones C, Kraft M, Levy BD, Lieberman P, Luccioli S, McCall KM, Schneider LC, Simon RA, Simons FE, Teach SJ, Yawn BP, Schwaninger JM, NIAID-Sponsored Expert Pane: Guidelines for the diagnosis and management of food allergy in the United States: report of the NIAID-sponsored expert panel. J Allergy Clin Immunol. 2010, 126 (6 Suppl): S1-58.PubMedPubMedCentral
21.
go back to reference van der Velde JL, Flokstra-de Blok BM, Vlieg-Boerstra BJ, Oude Elberink JN, DunnGalvin A, Hourihane JO, Duiverman EJ, Dubois AE: Development, validity and reliability of the food allergy independent measure (FAIM). Allergy. 2010, 65 (5): 630-635. 10.1111/j.1398-9995.2009.02216.x. doi:10.1111/j.1398-9995.2009.02216.x.Epub 2009 Oct 21CrossRefPubMed van der Velde JL, Flokstra-de Blok BM, Vlieg-Boerstra BJ, Oude Elberink JN, DunnGalvin A, Hourihane JO, Duiverman EJ, Dubois AE: Development, validity and reliability of the food allergy independent measure (FAIM). Allergy. 2010, 65 (5): 630-635. 10.1111/j.1398-9995.2009.02216.x. doi:10.1111/j.1398-9995.2009.02216.x.Epub 2009 Oct 21CrossRefPubMed
22.
go back to reference Oude Elberink JN, de Monchy JG, Golden DB, Brouwer JL, Guyatt GH, Dubois AE: Development and validation of a health-related quality-of-life questionnaire in patients with yellow jacket allergy. J Allergy Clin Immunol. 2002, 109 (1): 162-170. 10.1067/mai.2002.120552.CrossRefPubMed Oude Elberink JN, de Monchy JG, Golden DB, Brouwer JL, Guyatt GH, Dubois AE: Development and validation of a health-related quality-of-life questionnaire in patients with yellow jacket allergy. J Allergy Clin Immunol. 2002, 109 (1): 162-170. 10.1067/mai.2002.120552.CrossRefPubMed
23.
go back to reference Cohen BL, Noone S, Munoz-Furlong A, Sicherer SH: Development of a questionnaire to measure quality of life in families with a child with food allergy. J Allergy Clin Immunol. 2004, 114 (5): 1159-1163. 10.1016/j.jaci.2004.08.007.CrossRefPubMed Cohen BL, Noone S, Munoz-Furlong A, Sicherer SH: Development of a questionnaire to measure quality of life in families with a child with food allergy. J Allergy Clin Immunol. 2004, 114 (5): 1159-1163. 10.1016/j.jaci.2004.08.007.CrossRefPubMed
24.
go back to reference Sampson HA: Anaphylaxis and emergency treatment. Pediatrics. 2003, 111: 1601-1608.PubMed Sampson HA: Anaphylaxis and emergency treatment. Pediatrics. 2003, 111: 1601-1608.PubMed
25.
go back to reference Sampson HA, Munoz-Furlong A, Campbell RL: Second symposium on the definition and management of anaphylaxis: summary report. Second national Institute of Allergy and Infectious disease/Food Allergy and Anaphylaxis Network Symposium. J Allergy Clin Immunol. 117 (2): 391-397. Sampson HA, Munoz-Furlong A, Campbell RL: Second symposium on the definition and management of anaphylaxis: summary report. Second national Institute of Allergy and Infectious disease/Food Allergy and Anaphylaxis Network Symposium. J Allergy Clin Immunol. 117 (2): 391-397.
26.
go back to reference Nowak-Wegrzyn A, Fiocchi A: Is oral immunotherapy the cure for food allergies?. Curr Opin Allergy Clin Immunol. 2010, 10 (3): 214-219. 10.1097/ACI.0b013e3283399404.CrossRefPubMed Nowak-Wegrzyn A, Fiocchi A: Is oral immunotherapy the cure for food allergies?. Curr Opin Allergy Clin Immunol. 2010, 10 (3): 214-219. 10.1097/ACI.0b013e3283399404.CrossRefPubMed
27.
go back to reference Nowak-Węgrzyn A, Muraro A: Food allergy therapy: is a cure within reach?. Pediatr Clin North Am. 2011, 58 (2): 511-530. 10.1016/j.pcl.2011.02.010.CrossRefPubMed Nowak-Węgrzyn A, Muraro A: Food allergy therapy: is a cure within reach?. Pediatr Clin North Am. 2011, 58 (2): 511-530. 10.1016/j.pcl.2011.02.010.CrossRefPubMed
28.
go back to reference Scurlock AM, Burks AW, Jones SM: Oral immunotherapy for food allergy. Curr Allergy Asthma Rep. 2009, 9 (3): 186-193. 10.1007/s11882-009-0028-z.CrossRefPubMed Scurlock AM, Burks AW, Jones SM: Oral immunotherapy for food allergy. Curr Allergy Asthma Rep. 2009, 9 (3): 186-193. 10.1007/s11882-009-0028-z.CrossRefPubMed
29.
go back to reference Cummings AJ, Knibb RC, King RM, Lucas JS: The psychosocial impact of food allergy and food hypersensitivity in children, adolescents and their families: a review. Allergy. 2010, 65: 933-945. 10.1111/j.1398-9995.2010.02342.x.CrossRefPubMed Cummings AJ, Knibb RC, King RM, Lucas JS: The psychosocial impact of food allergy and food hypersensitivity in children, adolescents and their families: a review. Allergy. 2010, 65: 933-945. 10.1111/j.1398-9995.2010.02342.x.CrossRefPubMed
30.
go back to reference Ostblom E, Egmar AC, Gardulf A: The impact of food ipersensitivity reported in 9- year-old by their parents on health related quality of life. Allergy. 2008, 63 (2): 211-218. 10.1111/j.1398-9995.2007.01559.x.CrossRefPubMed Ostblom E, Egmar AC, Gardulf A: The impact of food ipersensitivity reported in 9- year-old by their parents on health related quality of life. Allergy. 2008, 63 (2): 211-218. 10.1111/j.1398-9995.2007.01559.x.CrossRefPubMed
31.
go back to reference Wassemberg J, Cochard M, Dunn-Galvin A: Parent perceived quality of life is age dependent in children with food-allergy. Pediatr Allergy Immunol. 2012, 23 (5): 412-419. 10.1111/j.1399-3038.2012.01310.x.CrossRef Wassemberg J, Cochard M, Dunn-Galvin A: Parent perceived quality of life is age dependent in children with food-allergy. Pediatr Allergy Immunol. 2012, 23 (5): 412-419. 10.1111/j.1399-3038.2012.01310.x.CrossRef
32.
go back to reference Munoz-Furlong A: Daily coping strategies for patients and their families. Pediatrics. 2003, 111 (6 Pt 3): 1654-1661.PubMed Munoz-Furlong A: Daily coping strategies for patients and their families. Pediatrics. 2003, 111 (6 Pt 3): 1654-1661.PubMed
33.
go back to reference Cummings AJ, Knibb RC, Erlewyn-Lajeunesse M, King RM, Roberts G, Lucas JS: Management of nut allergy influences quality of life and anxiety in children and their mothers. Pediatr Allergy Immunol. 2010, 21 (4 Pt 1): 586-594.CrossRefPubMed Cummings AJ, Knibb RC, Erlewyn-Lajeunesse M, King RM, Roberts G, Lucas JS: Management of nut allergy influences quality of life and anxiety in children and their mothers. Pediatr Allergy Immunol. 2010, 21 (4 Pt 1): 586-594.CrossRefPubMed
34.
go back to reference Bollinger ME, Dahlquist LM, Mudd K: The impact of food allergy on the daily activities of children and their families. Ann Allergy Asthma Immunol. 2006, 96: 415-421. 10.1016/S1081-1206(10)60908-8.CrossRefPubMed Bollinger ME, Dahlquist LM, Mudd K: The impact of food allergy on the daily activities of children and their families. Ann Allergy Asthma Immunol. 2006, 96: 415-421. 10.1016/S1081-1206(10)60908-8.CrossRefPubMed
35.
go back to reference Longo G, Barbi E, Berti I, et al: Specific oral tolerance induction in children with very severe cow’s milk-induced reactions. J Allergy Clin Immunol. 2008, 121: 343-347. 10.1016/j.jaci.2007.10.029.CrossRefPubMed Longo G, Barbi E, Berti I, et al: Specific oral tolerance induction in children with very severe cow’s milk-induced reactions. J Allergy Clin Immunol. 2008, 121: 343-347. 10.1016/j.jaci.2007.10.029.CrossRefPubMed
36.
go back to reference Burks AW, Jones SM, Wood RA, et al: Oral immunotherapy for treatment of egg allergy in children. N Engl J Med. 2012, 367: 3-10.1056/NEJMp1204516.CrossRef Burks AW, Jones SM, Wood RA, et al: Oral immunotherapy for treatment of egg allergy in children. N Engl J Med. 2012, 367: 3-10.1056/NEJMp1204516.CrossRef
Metadata
Title
Duration of a cow-milk exclusion diet worsens parents’ perception of quality of life in children with food allergies
Authors
Luciana Indinnimeo
Luciano Baldini
Valentina De Vittori
Anna Maria Zicari
Giovanna De Castro
Giancarlo Tancredi
Giulia Lais
Marzia Duse
Publication date
01-12-2013
Publisher
BioMed Central
Published in
BMC Pediatrics / Issue 1/2013
Electronic ISSN: 1471-2431
DOI
https://doi.org/10.1186/1471-2431-13-203

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