We thank Mohiuddin et al for their comments about the value of our finding that vitamin D insufficiency (VDI) increases the risk of food allergy and that this appears to be independent of the risk of eczema and read with interest their confirmatory findings in their own cohort of eczematous children. We strongly support their conclusions that more work in this field is warranted, in particular that randomized controlled trials on the use of vitamin D for the prevention of food allergy would be timely. Vitamin D supplementation and food chain fortification are already universal in Europe and North America, which poses significant feasibility issues for supplementation trials in these settings. Thus there is an urgent need to evaluate the effect of vitamin D supplementation in countries that are yet to implement routine vitamin D supplementation, food chain fortification, or both (eg, Australia). Our own findings also demonstrate the importance of using challenge-proved food allergy (as opposed to proxy measures) as the primary outcome.
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