Preprint Article Version 1 Preserved in Portico This version is not peer-reviewed

The Need for Culturally Appropriate Food Allergy Management Strategies: The Indian Milk Ladder

Somashekara Hosaagrahara Ramakrishna
ORCID logo ,
Neil Shah
,
Bhaswati C Acharyya
,
Emmany Durairaj
,
Lalit Verma
,
Srinivas Sankaranarayanan
,
Nishant Wadhwa
,
Carina Venter
*
Version 1 : Received: 4 August 2023 / Approved: 4 August 2023 / Online: 7 August 2023 (10:11:59 CEST)

A peer-reviewed article of this Preprint also exists.

Hosaagrahara Ramakrishna, S.; Shah, N.; Acharyya, B.C.; Durairaj, E.; Verma, L.; Sankaranarayanan, S.; Wadhwa, N.; Venter, C. The Need for Culturally Appropriate Food Allergy Management Strategies: The Indian Milk Ladder. Nutrients 2023, 15, 3921. Hosaagrahara Ramakrishna, S.; Shah, N.; Acharyya, B.C.; Durairaj, E.; Verma, L.; Sankaranarayanan, S.; Wadhwa, N.; Venter, C. The Need for Culturally Appropriate Food Allergy Management Strategies: The Indian Milk Ladder. Nutrients 2023, 15, 3921.

Abstract

Abstract: Background: Cow’s milk allergy (CMA) is one of the most common and complex food allergies affecting children worldwide and with few exceptions, presents in the first few months of life. Baked milk containing diets are well tolerated in the majority of milk allergic children and allow dietary restrictions to be relaxed. In addition, the early introduction of tolerated forms of allergenic foods to the infant’s diet in small amounts may enhance the outgrowth of milk allergy through oral tolerance induction. The methods of milk introduction vary widely across the globe. Methods: We convened an expert group to develop a comprehensive milk ladder based on calculated milk protein content using Indian foods. To validate the milk ladder, foods chosen for the ladder were analyzed and the ladder was re-evaluated based on amount cooked milk protein content. Results: Combining expert consensus and validation of milk protein content, we created the world’s first milk ladder containing Indian foods. This is the first ladder that provides information on timing and temperature of cooking, with validated milk protein content. Conclusions: This is the first milk ladder based on unique features of Indian food habits built by consensus of Indian experts along with international collaboration with quantified of milk protein in each step. We believe the “The Indian Milk Ladder” will be a very helpful tool for pediatricians helping manage CMA in children as well as their parents and caregivers, not only in India but in countries world-wide where these foods are commonly consumed.

Keywords

Cow’s Milk allergy; CMA; Milk ladder; Tolerance acquisition; Baked food

Subject

Medicine and Pharmacology, Immunology and Allergy

Copyright: This is an open access article distributed under the Creative Commons Attribution License which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

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