The role of diet and nutrition in allergies

Allergies and nutrition

Food allergies are affecting a growing number of individuals around the world, particularly young children. From cow’s milk allergy to severe anaphylactic reactions, the burden on patients, families, and healthcare systems is substantial. Beyond symptom management, nutrition plays a powerful role in immune system regulation, and long-term care. At Danone Research & Innovation , we explore how targeted nutritional interventions—backed by microbiome science and decades of immunology research—can support the management of food allergies and improve quality of life for those affected.

A quick overview of food allergies and allergic reactions

A food allergy is an immune-mediated reaction to certain dietary proteins that the body mistakenly identifies as harmful. These reactions can range from mild digestive discomfort to severe systemic reactions like anaphylaxis.

The major food allergens

Food allergies are commonly triggered by a specific group of foods known as the "major allergens". These include: Cow’s milk, eggs, peanuts and tree nuts, wheat and soy, fish and shellfish and sesame

Symptoms and degrees of allergic reactions

When someone has an allergy, their immune system responds excessively to a normally harmless substance, known as an allergen, by producing Immunoglobulin E (IgE) antibodies. These IgE antibodies attach to certain immune cells, which then release chemicals like histamine. This chain reaction leads to allergy symptoms, typically affecting the respiratory tract, skin, or throat. The symptoms of food allergies vary widely depending on the individual and the allergen involved. They can be categorized into mild, moderate, or severe reactions:

Mild to moderate symptoms:

  • Skin reactions such as eczema.

  • Gastrointestinal issues like nausea, vomiting, or diarrhea.

  • Respiratory symptoms including nasal congestion or allergic rhinitis.

  • General irritability in infants with cow’s milk protein allergy (CMA)3.

Severe Symptoms (Anaphylaxis):

This is a life-threatening reaction that requires immediate medical attention. Symptoms include:

  • Difficulty breathing.

  • Swelling of the tongue or throat.

  • Rapid drop in blood pressure.

  • Persistent vomiting or diarrhea4-5. 

Proper diagnosis and management are crucial for all types of allergic reactions. For instance, CMA  can severely impact growth and nutritional status if left untreated7.

The rising prevalence of food allergies

Global data indicates that the number of people affected by allergies worldwide continues to grow, with current estimates suggesting that 30 to 40% of the global population experiences at least one allergic condition7.

Among children, food allergies are particularly concerning. For instance, CMA affects up to 5% of infants and young children globally, with prevalence rates varying between 1.8% and 7.5% depending on the region and diagnostic criteria8-9.

In addition to the physical symptoms, such as the gastrointestinal distress and skin reactions mentioned above, allergies impose a significant socio-economic burden. For example, in the United States alone, the 2013 annual economic impact of direct medical costs of food allergies exceeds $4 billion and indirect costs related to lost productivity adding billions more10.

Furthermore, untreated or poorly managed allergies can lead to severe complications like anaphylaxis, which accounts for thousands of emergency room visits annually. The financial strain extends to families managing conditions like CMA, where specialized hypoallergenic formulas  can cost significantly more than regular infant formulas9.

5%
of infants and young children globally are affected by CMA

30 - 40%
of the global population experiences at least one allergic condition

The immune system, gut microbiome, and allergies: a key interplay

The human immune system and the intestinal microbiome have a close relationship. The human intestine, which is home to around 100,000 billion microorganisms, hosts between 70 and 80% of the immune cells, forming a complex network that integrates innate immunity (the one we have from birth) and adaptive immunity (the one we acquire later).

In early life, infants' microbiome is developing, which has a strong effect on their immune systems. For example, a microbial imbalance (dysbiosis) negatively affects immune function, increasing susceptibility to allergies. This dysbiosis is characterized by a decrease in beneficial bacteria such as bifidobacteria, in favor of potentially pathogenic microorganisms.

Studies have shown that:

  • Low microbial diversity in infants is associated with the development of allergic conditions or asthma later in life11.

  • Children diagnosed with CMA or multiple food allergies generally show signs of intestinal dysbiosis, which can persist even after the allergic symptoms have resolved12-13.

  • Disruptions to the intestinal barrier, alterations in microbial diversity and immune cell dysregulation are strongly correlated with an increased risk of allergies14.

Nutrition as a strategy for allergy prevention and management

Strategically designed nutrition, especially in early life, significantly influences allergy risk and severity.

Breastfeeding provides optimal nutrition and immune protection, but when breastfeeding is insufficient or impossible, appropriate formula selection becomes vital. Clinical evidence highlights that partially hydrolyzed protein-based formulas and extensively hydrolyzed formulas can significantly reduce CMA symptoms and improve tolerance development15.

Specific nutrients such as vitamins, minerals, prebiotics (dietary fibers that promote beneficial bacteria), probiotics (live beneficial bacteria), and synbiotics (combination of both)16-17 can effectively modulate the gut microbiome, positively influencing immune function. Research demonstrates that early introduction and consistent consumption of these ingredients can lead to significant reductions in allergy incidence and improved tolerance to potential allergens18.

R&I at Danone: innovative nutritional solutions for managing allergies

Our decades of experience in the field

With over 40 years of expertise in immunology and more than 600 publications in this area, we collaborate extensively with international research institutions.

Within the allergy field, we focus on how the right nutrition during early life can have an impact on allergy development, allergy management and overall immune health.

This extensive scientific collaboration plays a decisive role in the development of evidence-based nutritional solutions that translate into tangible health outcomes for allergy sufferers.

Innovations that benefit allergy sufferers

In our specialized centers, we develop nutritional solutions that will help children and adults manage and potentially prevent their allergies, whether food-related or not.

For example, our specialized hypoallergenic formulas , such as extensively hydrolyzed formulas (eHF) or amino acid-based formulas, offer crucial support to infants with severe CMA, providing them with complete nutrition while reducing allergic risks. These formulas have been clinically proven to promote normal growth, reduce allergic symptoms and help induce tolerance over time19.

In addition, we are focusing on formulas designed to restore a healthy intestinal microbiota in allergic patients. Products enriched with prebiotics, probiotics or synbiotics have shown promising results in clinical trials, improving microbiome diversity, strengthening the integrity of the intestinal barrier and improving the regulation of the immune system20.

The clinical studies we are conducting and the partnerships we are forging underscore our commitment to cutting-edge science, providing healthcare providers and families with the most advanced tools to manage allergies effectively and safely.

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  3. https://www.msdmanuals.com/home/immune-disorders/allergic-reactions-and-other-hypersensitivity-disorders/food-allergy#Symptoms_v780141

  4. https://acaai.org/allergies/allergic-conditions/food/

  5. https://www.hopkinsmedicine.org/health/conditions-and-diseases/food-allergies

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  12. Yang Yudie , Li Xiaoqi , Yang Ying , Shoaie Saeed , Zhang Cheng , Ji Boyang , Wei Yongjun. Advances in the Relationships Between Cow’s Milk Protein Allergy and Gut Microbiota in Infants. Frontiers in Microbiology. Volume 12 - 2021. DOI=10.3389/fmicb.2021.716667. ISSN=1664-302X

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  14. Niewiem M, Grzybowska-Chlebowczyk U. Intestinal Barrier Permeability in Allergic Diseases. Nutrients. 2022 Apr 30;14(9):1893. doi: 10.3390/nu14091893. PMID: 35565858; PMCID: PMC9101724.

  15. Wilsey MJ, Florio J, Beacker J, Lamos L, Baran JV, Oliveros L, Sriaroon P, Brown JM, Vanderhoof JA. Extensively Hydrolyzed Formula Improves Allergic Symptoms in the Short Term in Infants with Suspected Cow's Milk Protein Allergy. Nutrients. 2023 Mar 30;15(7):1677. doi: 10.3390/nu15071677. PMID: 37049517; PMCID: PMC10096968.

  16. Sestito S, D'Auria E, Baldassarre ME, Salvatore S, Tallarico V, Stefanelli E, Tarsitano F, Concolino D, Pensabene L. The Role of Prebiotics and Probiotics in Prevention of Allergic Diseases in Infants. Front Pediatr. 2020 Dec 22;8:583946. doi: 10.3389/fped.2020.583946. PMID: 33415087; PMCID: PMC7783417.

  17. Liu Yue , Wang Jiaqi , Wu Changxin. Modulation of Gut Microbiota and Immune System by Probiotics, Pre-biotics, and Post-biotics. Frontiers in Nutrition. Volume 8 - 2021. DOI=10.3389/fnut.2021.634897. ISSN=2296-861X

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  19. Vandenplas Y, Dupont C, Eigenmann P, Heine RG, Høst A, Järvi A, Kuitunen M, Mukherjee R, Ribes-Koninckx C, Szajewska H, von Berg A, Zhao ZY; Mosaic Study Investigator Group. Growth in Infants with Cow's Milk Protein Allergy Fed an Amino Acid-Based Formula. Pediatr Gastroenterol Hepatol Nutr. 2021 Jul;24(4):392-402. doi: 10.5223/pghn.2021.24.4.392. Epub 2021 Jul 5. PMID: 34316474; PMCID: PMC8279827.

  20. Van der Aa LB, van Aalderen WM, Heymans HS, Henk Sillevis Smitt J, Nauta AJ, Knippels LM, Ben Amor K, Sprikkelman AB; Synbad Study Group. Synbiotics prevent asthma-like symptoms in infants with atopic dermatitis. Allergy. 2011 Feb;66(2):170-7. doi: 10.1111/j.1398-9995.2010.02416.x. PMID: 20560907.
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