Vaccination can lower children’s risk of allergy. Cathleen Muche-Borowski and her coauthors present a clinical practice guideline for allergy prevention in the current issue of Deutsches Ärzteblatt International (Dtsch Arztebl Int 2009; 106[39]: 625-31).

Allergic diseases are becoming increasingly common in Western industrialized countries. As there is still no etiologically based treatment of allergic asthma, hay fever, or atopic eczema, the prevention of these diseases is a matter of special importance.

The majority of the 217 studies that the authors analyzed documented a protective effect of fish consumption in the diet of both the mother and the child. Soy-based baby food, in contrast, has no protective effect. In fact, because preparations of this type contain phytoestrogens, the authors even express concern about a potential harmful effect on health. Furthermore, delaying the introduction of solid food in the child’s diet was not shown to have any beneficial effect on the development of allergy in the German cohort studies that the authors reviewed.

The reduction of dust mite allergens in the home as a single primary preventive measure has been removed from the guideline. A further change is that the updated version by Dr. Muche-Borowski et al. no longer contains any statement about specific immune therapy.

Vaccination, however, can lower the risk of allergy, in the authors’ expert opinion. Recent studies indicate, too, that overweight in childhood is associated with asthma, although dietary measures for either mothers or children cannot be considered indicated at present, because relevant data are lacking. The updated clinical guideline enables physicians to give recommendations about allergy prevention based on the current state of the evidence.

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