Alimentação no primeiro ano de vida e prevenção de doenças alérgicas: evidências atuais
Feeding in the first year of life and prevention of allergic diseases: current evidence
Marina Neto Rafael; Heloiza C. T. Esteves; Glauce Hiromi Yonamine
Resumo
A prevalência de doenças alérgicas aumentou significantemente nos últimos anos. Devido a este rápido aumento, surgiu o interesse em se identificar estratégias de prevenção ou redução do risco de se desenvolver alergia. Acredita-se que esta alta prevalência seja consequência de mudanças ambientais modernas, como o desenvolvimento industrial, mudanças climáticas e de hábitos alimentares que poderiam afetar a função imunológica, independente do seu caráter genético. O presente estudo tem como objetivo discutir o papel da alimentação no primeiro ano de vida sobre a prevenção de doenças alérgicas, através de revisão bibliográfica com base em artigos publicados entre 2003 e abril de 2014, disponíveis nos bancos de dados PubMed, SciELO e LILACS. Com relação ao aleitamento materno, existem poucas evidências do seu efeito protetor para o desenvolvimento de alergia. A recomendação de manter o aleitamento materno exclusivo por período de 4 a 6 meses deve-se a outros benefícios associados a esta prática. Há dados suficientes para a indicação da utilização de fórmulas parcialmente ou extensamente hidrolisadas, com alergenicidade reduzida comprovada, para aqueles com alto risco de desenvolvimento de atopia, quando a amamentação exclusiva não for possível. O início da alimentação complementar é recomendado após 4-6 meses, com atenção à variedade dos alimentos. A alimentação no primeiro ano de vida parece ser importante para a modulação do desenvolvimento do sistema imunológico e prevenção de alergias.
Palavras-chave
Abstract
The prevalence of allergic diseases has significantly increased in recent years. Such rapid increase has stimulated research into strategies to prevent or reduce the risk of allergy. It is believed that this high prevalence may be due to recent environmental changes, including industrial development, climate change, and dietary habits, all of which may affect immune function, regardless of genetic background. The aim of the present study was to discuss the role played by feeding in the first year of life in the prevention of allergic diseases. In order to do that, the literature was browsed for articles published between 2003 and April 2014 and available in the PubMed, SciELO, and LILACS databases. With regard to breastfeeding, there is little evidence of a protective effect of this practice against the development of allergy. The recommendation of maintaining exclusive breastfeeding for 4-6 months is based on other associated benefits. Conversely, there is sufficient evidence to recommend the use of partially or extensively hydrolyzed formula, with proven low allergenic activity, in infants at high risk of developing atopy when exclusive breastfeeding is not possible. The initiation of complementary feeding is recommended after 4-6 months, and the variety of foods should be selected with care. Feeding in the first year of life appears to be important to modulate the development of the immune system and to prevent allergies.
Keywords
Referências
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Submetido em:
16/06/2014
Aceito em:
12/04/2015
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