{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,30]],"date-time":"2026-09-30T06:24:32Z","timestamp":1790749472976,"version":"4.1.0"},"reference-count":57,"publisher":"MDPI AG","issue":"2","license":[{"start":{"date-parts":[[2023,1,13]],"date-time":"2023-01-13T00:00:00Z","timestamp":1673568000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Nutrients"],"abstract":"<jats:p>Background: Dietary and environmental factors may influence tolerance acquisition in food protein-induced allergic proctocolitis (FPIAP). This retrospective observational study explored the role of maternal diet during pregnancy and breastfeeding in tolerance acquisition in infantile FPIAP. Methods: Breastfed infants with FPIAP from six diverse regions in Greece were divided into two groups, based on development of tolerance to the trigger food: Group A (n = 43), before, and Group B (n = 53), after, the 6th month of age. Maternal diet during pregnancy and breastfeeding was elicited using the Mediterranean Diet Score Questionnaire and the Mediterranean Oriented Culture Specific Semi-Quantitative Food Frequency Questionnaire. Results: Mean age at diagnosis of FPIAP (1.5 months) and weaning (5.5 months) were the same in both groups. The main trigger was cow\u2019s milk. Group A received infant milk formula earlier than Group B. Group B had a higher incidence of asthma\/wheeze, siblings with milk allergy, maternal smoking and rural residence. On multivariate analysis, earlier resolution of FPIAP was associated with higher maternal education and with salt intake and consumption of goat\/sheep cheese during pregnancy and olive oil during breastfeeding. Consumption of multivitamins during pregnancy and meat, winter fruits, green vegetables, butter, salt, \u201cready-to-eat\u201d meals and pastries during breastfeeding were correlated with longer duration of symptoms. Conclusions: Mothers of children with FPIAP to cow\u2019s milk protein can be advised to eat more yogurt, cheese and olive oil during subsequent pregnancies, and avoid multivitamins, grilled food, \u201cready-to-eat\u201d meals, pastries, meat and alcohol during breastfeeding, to reduce the duration of FPIAP presenting in future infants.<\/jats:p>","DOI":"10.3390\/nu15020425","type":"journal-article","created":{"date-parts":[[2023,1,16]],"date-time":"2023-01-16T04:06:47Z","timestamp":1673842007000},"page":"425","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":11,"title":["Dietary Factors May Delay Tolerance Acquisition in Food Protein-Induced Allergic Proctocolitis"],"prefix":"10.3390","volume":"15","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-9026-2597","authenticated-orcid":false,"given":"Gavriela","family":"Feketea","sequence":"first","affiliation":[{"name":"Department of Hematology, \u201cluliu Hatieganu\u201d University of Medicine and Pharmacy, 400337 Cluj-Napoca, Romania"},{"name":"\u201cKaramandaneio\u201d Children\u2019s Hospital of Patra, 26331 Patra, Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"John","family":"Lakoumentas","sequence":"additional","affiliation":[{"name":"Department of Nutritional Sciences and Dietetics, International Hellenic University, 57400 Thessaloniki, Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1371-6764","authenticated-orcid":false,"given":"George N.","family":"Konstantinou","sequence":"additional","affiliation":[{"name":"Department of Allergy and Clinical Immunology, 424 General Military Training Hospital, 56429 Thessaloniki, Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4037-4421","authenticated-orcid":false,"given":"Nikolaos","family":"Douladiris","sequence":"additional","affiliation":[{"name":"Allergy Department, 2nd Pediatric Clinic, National and Kapodistrian University of Athens, 11528 Athens, Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4448-3468","authenticated-orcid":false,"given":"Nikolaos G.","family":"Papadopoulos","sequence":"additional","affiliation":[{"name":"Allergy Department, 2nd Pediatric Clinic, National and Kapodistrian University of Athens, 11528 Athens, Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1769-3005","authenticated-orcid":false,"given":"Maria","family":"Petrodimopoulou","sequence":"additional","affiliation":[{"name":"Department of Nutritional Sciences and Dietetics, International Hellenic University, 57400 Thessaloniki, Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ioannis","family":"Tasios","sequence":"additional","affiliation":[{"name":"Department of Nutritional Sciences and Dietetics, International Hellenic University, 57400 Thessaloniki, Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2346-1531","authenticated-orcid":false,"given":"Mina","family":"Valianatou","sequence":"additional","affiliation":[{"name":"Allergy Department, 2nd Pediatric Clinic, National and Kapodistrian University of Athens, 11528 Athens, Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Vasiliki","family":"Vourga","sequence":"additional","affiliation":[{"name":"Department of Nutritional Sciences and Dietetics, International Hellenic University, 57400 Thessaloniki, Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2665-5908","authenticated-orcid":false,"given":"Emilia","family":"Vassilopoulou","sequence":"additional","affiliation":[{"name":"Department of Nutritional Sciences and Dietetics, International Hellenic University, 57400 Thessaloniki, Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2023,1,13]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"360","DOI":"10.1111\/j.1399-3038.2007.00561.x","article-title":"Educational clinical case series for pediatric allergy and immunology: Allergic proctocolitis, food protein-induced enterocolitis syndrome and allergic eosinophilic gastroenteritis with protein-losing gastroenteropathy as manifestations of non-IgE-mediated cow\u2019s milk allergy","volume":"18","author":"Maloney","year":"2007","journal-title":"Pediatr. 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