Could Functional Nutrition Address Africa’s Growing Prevalence of Food Allergies?

As Food Allergies (FAs) are on the increase across the developing world, Africa is in search of treatment and prevention methods.¹ Yet, interestingly, numerous studies have demonstrated an association between the microbiome and the development of FAs.²

Functional Nutrition (FN), with its individualised and flexible patient care approach³, presents a plausible tool for improved microbiome health (from skin to gut microbiota).

This then begs the question, could FN be used as a treatment and risk reduction method for FA diseases?

Adopting A Knowledge-Oriented System Approach

The deep impact of nutrition on all biochemical and physiological processes of the body (including the development of, and resistance to, FAs), must not be underestimated. It is proven that maintaining and strengthening human health is impossible when adequate nutrition is neglected.⁵It is this fundamental role of nutrition that motivates the use of therapeutic FN, much like Functional Medicine (FM), aiming to treat and reduce the risk of various diseases, including FAs.⁵

To develop an FN dietary recommendation, one can use what is called a “knowledge-oriented system of adequate nutrition”. This helps Health Care Practitioners (HCPs) to quickly and correctly create diet recommendations that consider the patient’s state of current nutrition, individual characteristics, and external factors.⁵ Furthermore, this helps identify the health of the skin, gastrointestinal tract and airway microbiota.

While developing an FN diet, HCPs can consider:

Biochemistry data (protein, carbohydrate, lipid statuses, immune parameters, & biochemical blood analysis)
Physiology data (weight deficit, activity factors, & injuries),
Food hygiene data (volume, weight, consistency, & temperature of food)

Yet, to deeply understand each patient and their disease management, HCPs should also consider individual parameters (age, anthropometric, & calliper measure data).⁵

Practically Applying the Knowledge-Oriented System

In the creation of a knowledge-oriented system HCPs can build their own, foundational knowledge base of their patient, which contains basic concepts and relations between them.⁵

To build this system for each patient, you can retrieve patient information such as: ⁵

- region of residence (environment plays a role in one’s microbiota health)²;
- activity factor;
- injury factor (operations, bone fractures, traumatic brain injuries, etc.);
- current state of nutrition;
- anthropometric data;
- calliper measure indicators;
- indicators of trophological status;
- indicators of micro- and macronutrient status;
- indicators of vitamin status;
- database on the chemical composition of food products;
- database of biomedical nutritional requirements depending on the disease

Such information presents a matrix of relations that include three main blocks: patient's physiological state, diet indicators, environmental factors, and the many relations within blocks, between blocks and creating groups of factors.⁵This ensures that the HCP gets a complete and wholistic understanding of each patient, including their FAs and allergic reaction triggers.

Although it can sometimes be difficult to retrieve all this information from a patient, immediately... Some alternative and more conversational questions can be asked to get to the same kind of FA information, or to ensure the patient is more comfortable when talking about their current context.

Conversational questions to enhance individual patient understanding:

(to understand your patients on an individual level)

What foods do you enjoy eating?
What foods do you avoid eating, not because you don’t enjoy them but because they have an adverse reaction (you experience a headache, itchy palate/throat or sudden post-nasal drip shortly after eating them, for example)?
What foods do you eat, not because you enjoy eating them, but because they make you feel energised?
Have you ever felt nauseous after a meal?
Do you ever crave a specific food?
Have you been enjoying more time at home, lately?
With winter kicking in, are you still finding the time and energy to stay active?
How is your work going?
- Would you say that it has been relatively busy lately?
- Have you found yourself working more hours?
What foods are you regularly buying?
- Are you buying these because they are cheaper, easier to source?
- Does the cost-factor make a big difference in choice of foods?

Pregnancy

Applying FN during Pregnancy

Pregnancy is a fundamental time to develop a healthy foetus microbiome. In a previous article, Nestlé Nutrition Institute of Africa investigated pregnancy and FN.

FN proved a holistic and wholesome option to support women and infants during pregnancy, as diet and lifestyle regimes are adaptable factors that can affect overall long-term health. Read more here.

Why HCPs Should Use a Functional Nutrition Approach

By conducting this in-depth knowledge of patients, HCPs can better understand what each patient needs, using an FN or FM stance - where each patient’s recommendations are completely unique.

Additionally, this kind of research into each patient’s history and environment helps to faster assess the role that the microbiota plays in FA development or management and faster develop therapeutics to alter such developments.²

There is no consensus on what defines a “healthy” gut microbiome that works for all, which means that future research must continually consider the unique and individual responses to diet.⁴

Leung, A.S.Y.; Wong, G.W.K.; Tang, M.L.K. Food allergy in the developing world. J. Allergy Clin. Immunol. 2018, 141, 76–78.
Aguilera, A., Dagher, I. and Kloepfer, K., 2020. Role of the Microbiome in Allergic Disease Development. Current Allergy and Asthma Reports, [online] 20(9). Available at: <https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7702839/> [Accessed 7 May 2021].
PCC Institute for Health Professionals., 2017. Why Functional Nutrition is a Future-Focused Field. [online] Climb.pcc.edu. Available at: <https://climb.pcc.edu/blog/why-functional-nutrition-is-a-future-focused-field#:~:text=Functional%20nutrition%2C%20a%20type%20of,person%20based%20on%20their%20needs> [Accessed 07 May 2021].
Frame, L., Costa, E. and Jackson, S., 2020. Current explorations of nutrition and the gut microbiome: a comprehensive evaluation of the review literature. Nutrition Reviews, [online] 78(10), pp.798-812. Available at: <https://academic.oup.com/nutritionreviews/article/78/10/798/5811361?login=true> [Accessed 11 May 2021].
Nikitina, M. and Chernukha, I., 2021, ‘Knowledge-Oriented System in the Development of Functional Nutrition’, V.M. Gorbatov Federal Research Center for Food System of RAS, 26TH CONFERENCE OF FRUCT ASSOCIATION, Moscow, Russia, 20 -24April. PDF available online at: <https://fruct.org/publications/acm26/files/Nik.pdf>