Are We Meeting the Needs? A Systematic Review of Nutritional Gaps and Growth Outcomes in Children with Multiple Food Allergies

Abstract

Background/Objectives: Food allergies represent a growing public health challenge, showing an alarming increase in prevalence over the past few decades. Children with multiple food allergies face not only allergic reaction risks but also nutritional gaps, affecting diet, nutrition, and growth. This review summarizes the impact on nutrient intake and growth, highlighting key challenges and strategies to improve clinical care. Methods: The literature search was conducted using a structured search strategy in PubMed up to 31 January, using MeSH terms with Boolean operators (AND, OR) to combine searches (food hypersensitivity AND growth, food hypersensitivity AND nutrition, food hypersensitivity AND micronutrient, food hypersensitivity AND vitamin, food hypersensitivity AND trace element, and soy hypersensitivity) for human studies meeting pre-defined PICOS criteria that simultaneously assessed the reproducibility and validity. Results: Nearly 2000 studies were identified in the literature search, with 31 articles selected for full-text evaluation and 11 articles included in the final review. Dietary restrictions imposed by the need to avoid multiple allergens can lead to a reduced intake of essential nutrients, particularly proteins, calcium, iron, zinc, iodine, folate, vitamin B12, and vitamin D. Children with multiple FAs appear to be at an increased risk of impaired growth, as evidenced by the lower height-for-age, weight-for-age, head-circumference, and weight-for-length Z-scores compared to non-allergic peers. Conclusions: Evidence from the studies reviewed suggests that children with multiple FAs may be at increased risk for growth impairments and nutritional inadequacies, especially where dietary management does not adequately compensate for nutrient losses, and highlights that tailored dietary counseling is crucial.