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Development of a practice guideline for dietary counselling of children with IgE-mediated food allergy

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Summary

Purpose

The incidence of food allergy is increasing globally and whilst there is consensus that dietitians should be involved in its management, the roles that dietitians should fulfil differ between different guidelines and the description of tasks remains unclear. Currently, no Swiss guideline exists to assist dietitians in counselling children with food allergies. There is a need for recommendations that will guide dietitians through the counselling process. The aim of this project was to create a practice guideline for dietary counselling of children with food allergy.

Methods

Practice guidelines were developed following the Academy of Nutrition and Dietetics stepwise approach. The process consisted of six steps: (1) Determine the scope of the guideline. (2) Conduct a systematic review. (3) Draft the guideline recommendations using the Nutrition Care Process (NCP) as a framework. (4) Finalise the guideline during a face-to-face meeting. (5) Conduct internal and external review and revise accordingly. (6) Publish guideline.

Results

The process resulted in 25 recommendations for dietary counselling. Most recommendations are based on expert opinion only, due to the lack of studies in this field and showed similar levels of consensus between the expert group and external review by allergists. However, there were nine recommendations where the consensus differed.

Conclusion

This guideline provides a comprehensive guide to dietary counselling for food allergy by dietitians in Switzerland. It will inform best practice and improve patient-centred care and encourage a consistent approach, but it will need to be reviewed and updated as more robust evidence is produced.

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Abbreviations

CMA:

Cow’s milk allergy

NCP:

Nutrition Care Process

PICO:

Patient, Intervention, Comparison, Outcome

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Acknowledgements

The authors would like to thank all allergists for taking part in the external review and for providing their opinions and comments. Furthermore, they would also like to thank Klazine van der Horst (Bern University of Applied Sciences) and Helena Jenzer (Bern University of Applied Sciences) for providing support by allowing internship students to work on this project. In addition, they would like to thank the Ulrich Müller-Gierok Stiftung for their financial support of the project.

Funding

This study was partially funded by the Allergiestiftung Ulrich Müller-Gierok. The foundation did not have any influence on the content of the guideline.

Author information

Authors and Affiliations

  1. Division of Nutrition and Dietetics, Bern University of Applied Sciences, Berne, Switzerland

    Julia Eisenblaetter, Selina Bürklin, Ashley Gschwend & Claudia Relats

  2. Children’s Hospital St Gallen, St Gallen, Switzerland

    Caroline Roduit

  3. Christine Kuehne Center for Allergy Research and Education (CK-CARE), Davos, Switzerland

    Caroline Roduit

  4. University Children’s Hospital Zurich, Zurich, Switzerland

    Caroline Roduit, Isabel Fischer & Gabrielle Schütt

  5. aha! Swiss Allergy Centre, Berne, Switzerland

    Karin Stalder

  6. Department of Pediatrics, University Hospital Inselspital Bern, Berne, Switzerland

    Daniela Hofmann

  7. Hochgebirgsklinik Davos, Davos, Switzerland

    Regula Herzog & Daniel Gianelli

  8. Department of Children and Adolescent Medicine, Aarau Cantonal Hospital, Aarau, Switzerland

    Monique Mura

  9. Praxis für Ernaehrungsberatung, Blumenfeld, Switzerland

    Petra Martel

  10. University Children’s Hospital, Basel, Switzerland

    Andrea Werder & Lina Martin

  11. Institute of Health and Community, School of Health Professions, Plymouth University, Plymouth, UK

    Julia Eisenblaetter, Mary Hickson & Anne Payne

  12. Royal Brompton Hospital, London, UK

    Isabel Skypala

Authors
  1. Julia Eisenblaetter
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  2. Selina Bürklin
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  7. Isabel Fischer
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  10. Regula Herzog
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  11. Daniel Gianelli
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  14. Andrea Werder
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  15. Lina Martin
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  16. Mary Hickson
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  17. Isabel Skypala
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  18. Anne Payne
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Contributions

All authors contributed to the guideline development process. Literature search and analysis was done by Claudia Relats and Julia Eisenblaetter. The first draft of the guideline was written by Selina Bürklin and J. Eisenblaetter. The first draft of the manuscript was written by J. Eisenblaetter and A. Gschwend. All authors commented on previous versions of the manuscript and read as well as approved the manuscript.

Corresponding author

Correspondence to Julia Eisenblaetter.

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Conflict of interest

J. Eisenblaetter has received a research grant from the Swiss Federal Safety and Veterinary Office. S. Bürklin, A. Gschwend, C. Relats, C. Roduit, K. Stalder, I. Fischer, D. Hofmann, G. Schütt, R. Herzog, D. Gianelli, M. Mura, P. Martel, A. Werder, L. Martin, I. Skypala and A. Payne declare that they have no competing interests. M. Hickson has received a research grant from the General Education Trust of the British Dietetic Association and an honorarium for speaking at a symposium from Fresenius Kabi.

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Eisenblaetter, J., Bürklin, S., Gschwend, A. et al. Development of a practice guideline for dietary counselling of children with IgE-mediated food allergy. Allergo J Int 29, 155–164 (2020). https://doi.org/10.1007/s40629-020-00124-8

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  • DOI: https://doi.org/10.1007/s40629-020-00124-8

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