Food Allergy Survival Guide

Food Allergies

Food Allergies

Peanuts can leave you breathless. Cat dander can lead to itchy eyes, a stuffy nose, coughing and sneezing. And most of us have suffered through those seasonal allergies with horrible pollen counts. Learn more...

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Milk Intolerance Lactose Intolerance

The majority of children can tolerate lactose during a diarrheal episode. A small proportion of children with diarrhea may not be able to digest lactose and are therefore not tolerant of milk- and lactose-containing formulas. This is more likely to occur among young children who only receive animal milk or formula in their diet and who have persistent diarrhea, and it rarely occurs in children on a diet of breast milk. In a lactose-intolerant child, milk- and lactose-containing formulas result in a significant increase in stool output. Stool output reduces dramatically when the milk- or lactose-containing formula is stopped. The warning signs of lactose intolerance include deterioration of the child's clinical condition, signs of dehydration, and an increase in the stool volume when milk feedings are given. However, only when the child is not gaining weight, eating less, and not fully alert is this a real cause for concern. This condition can be managed by continuing breast feeding....

Definition of Food Intolerance

Food intolerance can be defined as a reproducible adverse reaction to a specific food or food ingredient, and it is not psychologically based. Although this appears straightforward, there are a number of One problem with our definition of food intolerance is the lack of definition of what constitutes an adverse reaction. All eating causes reactions, which include satiety, feeling warm, the urge to defecate (due to the gastrocolic reflex), and weight gain. The definition above does not take into account dosage. Large quantities of certain foods may result in disease in certain individuals, although such disorders are not usually included in the category of food intolerance. Any food, however harmless, can be harmful if taken in excess. Notable examples of this are 3. In those who are genetically predisposed, ingestion of an excess of purine-rich foods contributes to hyperuricemia, leading to gout, a disorder which is not usually regarded as a form of food intolerance.

Principal Mechanisms and Pathophysiology of Food Intolerance

The principal mechanisms resulting in food intolerance and the pathophysiology (where this is understood) are discussed below. Food Allergy Lactase deficiency An example of an enzyme defect causing food intolerance is lactase deficiency. In this condition, which is primarily a disorder that affects infants and young children, there is a reduced or absent concentration of the enzyme lactase in the small intestinal mucosa. Affected individuals are unable to break down ingested lactose, the main sugar found in milk, and which if unabsorbed passes into the large intestine, where there are two consequences. One is an osmotic diarrhea. The other is that some of the unabsorbed lactose is broken down by intestinal bacteria, accompanied by the production of gas (hydrogen) leading to abdominal distension and flatus and the production of organic acids that cause perianal soreness or excoriation. The production of hydrogen, its absorption into the bloodstream, and its excretion in the breath lead...

Food Allergy Clinical Presentation and Diagnosis

Health problems associated with food allergies can involve the gastrointestinal system, the respiratory system, the skin, and the eyes. Persons with a food allergy may have difficulty breathing, or they may have problems with itching, rashes, swelling, nausea, or vomiting. A food allergy may also be a cause of asthma. The symptoms of food allergy vary widely from person to person. Food allergies can also cause a severe clinical reaction known as anaphylaxis, which can result in death. Anaphylaxis may be characterized by throat and lip swelling, shortness of breath, sweating, itching, and feeling very faint. Diagnosis of a food allergy usually involves a careful examination of the patient's symptom history. Other causes of symptoms must be ruled out, and in some instances the suspected food or foods will be eliminated from the diet to see if symptoms stop. Blood tests or skin tests may also be performed. One test sometimes used to diagnose food allergy is the doubleblind,...

Classification of Food Allergy Disorders

Food allergy disorders may be classified based on the role of IgE antibody as IgE-mediated, non-IgE-mediated (cell-mediated) and mixed-IgE- and cellmediated (table 4). outgrew their milk allergy 25 decapeptides of a(s1)-casein, a(s2)-casein, K-casein, a-lactalbumin, and P-lactoglobulin, comprising the core epitopes, synthesized on a SPOTs membrane sera from individual patients were used for immunolabeling white children with persistent egg allergy Both groups had a comparable range of egg-specific IgE levels, but none of the patients with transient egg allergy had IgE antibodies against these epitopes of ovomucoid AA 1-10, 11-20, 47-56, and 113-122. In contrast, all 7 patients with persistent egg allergy recognized at least 4 of these immunodominant epitopes AA Amino acid CMA cow milk allergy DBPC double-blind placebo-controlled OFC oral food challenge. Oral allergy syndrome, immediate gastrointestinal food allergy IgE-Mediated Food Allergy Anaphylaxis represents the most severe form...

Food Intolerance Clinical Presentation and Diagnosis

Health problems caused by food intolerance vary depending upon the food and chemical involved. The amount of a food eaten may also play a role. Lactose intolerance is usually characterized by gastrointestinal problems such as bloating and diarrhea. Sulfite intolerance is typically characterized by difficulty in breathing. Those sensitive to MSG may experience a variety of symptoms, such as headache, numbness, and rapid heartbeat. Tyramine, found in pickled herring, soy sauce, red wine, and other foods, has been linked to migraine headache. Capsaicin can cause a burning pain in the mouth and other problems, such as nausea and vomiting. Myristicin has been associated with anxiety, chest pressure, hallucinations, fever, and skin redness. Diagnostic techniques for food intolerances vary depending upon the specific intolerance suspected. Symptom history and elimination diets are tools that are used, and the double-blind, placebo-controlled food challenge may also be helpful. Diagnosis of...

Specific Immunotherapy for Food Allergy with Mutated Proteins

Currently the only treatment for food allergy is strict avoidance of the offending food. In the past years much effort has been made to develop new treatment methods. Specific immunotherapy using injections is commonly used for the treatment of inhalant allergies. However, for food allergy it is As traditional immunotherapy has been largely impractical for the treatment of food allergies, several novel therapies are currently being explored 18, 19 . One of the most promising approaches is the immunotherapy with mutated proteins. Within the last couple of years food allergens have been better characterized 2, 20 . IgE-binding sites have been identified for many of these food allergens 21-26 . With this knowledge attempts to alter IgE antibody binding through alteration of the amino acid sequences of the IgE-binding sites have started (fig. 3). Mutation through single amino acid substitution resulted in reduced to complete loss of IgE binding 26-29 . For the major peanut allergens Ara h...

Drug Treatment in the Management of Food Allergy

At present, drug treatment has little part to play in the management of food allergies. There are two exceptions. First, there are a very small number of cases in which the reaction to a food is exclusively gastrointestinal, and in whom the reaction can be blocked by taking the drug sodium cromoglycate by mouth 20 min before the trigger food is swallowed. Second, there are a small number of individuals who develop the life-threatening reaction, of anaphylactic shock when exposed to a trigger food. There are three ways in which anaphylactic shock may prove fatal. First, rapid swelling of the soft tissues in the pharynx may completely obstruct the airway the treatment is to bypass the obstruction, either by passing an endotracheal tube, or by performing a tracheostomy. Another mechanism is severe shock, with a profound drop in blood pressure the life- A number of new approaches to the treatment of IgE-mediated food allergy are being examined. In a double-blind placebo-controlled study...

Documenting Possible Food Allergies

The diagnosis of food allergy is made from the history, supported by investigations and by responses to avoidance of specific food triggers. Since the value of investigations is limited, it is especially important to obtain a clear history. There are a number of practical points to be made Failure to seek inconsistencies such as these is one factor that is responsible for the overdiagnosis of food allergy.

Unreliability of Self Reported Food Allergy

Reports of food allergy from individuals or parents of children are notoriously unreliable. Such reports have to be treated with scepticism. It is common for parents to believe that foods are responsible for a variety of childhood symptoms. Double-blind provocation tests in children with histories of reactions to food only confirm the story in one-third of all cases. In the case of purely behavioral symptoms, the proportion that could be reproduced under blind conditions was zero. The same is true of adults' beliefs about their own symptoms. If unnecessary dietary restrictions are to be avoided, one has to be sceptical, and it may be necessary in some cases to seek objective confirmation of food intolerance. The gross overreporting of food allergy has to be borne in mind when examining data on prevalence that are based on unconfirmed subjective reports.

Hypoallergenic Formulas for Cows Milk Allergy

Cow's milk allergy is the most common cause of food allergy in the first years of life, affecting approximately 2-3 of children 7 . The majority of children outgrow their cow's milk allergy by 3-4 years of age 3 . Currently, the only treatment is strict avoidance however, a hypoallergenic substitute is necessary at this young age. Milk of another animal source such as goat or sheep cannot be recommended as a general substitute in cow's milk allergy. For example, many proteins in goat milk show a high similarity with cow's milk proteins resulting in a cross-reactivity of 92 8 . Therefore, patients might react severely at first exposure. In contrast, cross-reactivity with mare's milk occurs only in about 4 8 . Furthermore, soy formula may provide a safe and growth-promoting alternative for children with cow's milk allergy 9 . However, soy is a potent allergen itself and sensitization resulting in allergic reactions might occur. For many years hypoallergenic formulas have been used in...

Management of Food Allergy

Management of food allergy currently focuses on avoidance, prompt recognition and treatment of food-allergic reactions, and nutritional support. Children with food allergy, particularly those with multiple food allergies, are at risk of nutritional protein and calorie deficiency due to restricted diets and may require a hypoallergenic formula. Hypoallergenic formulas available in the US are either based on extensively hydrolyzed casein derived from cow's milk (Pregestimil, Nutramigen, Mead & Johnson Alimentum, Ross) or on a mixture of single amino acids (Neocate, SHS Elecare, Ross). Hypoallergenic formulas are well tolerated by children with IgE-mediated and with cell-mediated food allergy 25, 27 . Hypoallergenic formulas are also recommended for prophylaxis of food allergy in infants at risk of atopy. Based on the observation that children with IgE-mediated immune responses directed predominantly at conformational epitopes are more likely to outgrow egg and cow's milk allergy,...

Treatment of Food Allergies and Intolerances

The major mode of treatment for food allergies and intolerances is for the person to avoid consuming the food or foods that seem to cause health problems. This involves a high degree of dietary awareness and careful food selection. When foods are eliminated from the diet, it is important to ensure the nutritional adequacy of the diet, and some individuals may need to take dietary supplements. There are some food intolerances, such as lactose intolerance, where individuals may be able to reduce the amount of the food consumed and not totally eliminate it from the diet. People with lactose intolerance do not have to completely eliminate milk products, though they must reduce their intake of lactose (milk sugar) to a manageable level. SEE also Additives and Preservatives. Koerner, Celide B., and Munoz-Furlong, Anne (1998). Food Allergies. Minneapolis, MN Chronimed. Metcalfe, Dean D. Sampson, Hugh A. and Simon, Richard A. (1997). Food Allergy Adverse Reactions to Foods and Food Additives....

Controversies Related to Food Allergies and Intolerances

Controversial issues in this area include the diagnosis of brain allergy, the diagnosis of environmental illness related to food allergy, and the diagnosis of yeast allergy. The connection of these problems to food allergies is not universally recognized. Some have also linked hyperactivity to food allergy or intolerance. Hyperactivity in children, in some instances, may be related to eating large amounts of food additives, but it is not accepted to be an allergic condition by the majority of the scientific community. Other controversies relate to testing for food allergies. One controversial test is cytotoxic testing, which involves testing blood in the presence of the suspected food allergen to see if the blood cells are killed.

Common Foods Associated with Food Allergy

Almost any food can cause an allergy, though the foods most commonly associated with an allergic reaction are those frequently consumed by a population. For example, an allergy to rice is common in Southeast Asia, while fish allergy is a problem in the Scandinavian countries, where fish is frequently consumed (even at breakfast). Age is also a factor influencing the types of foods to which a person might be allergic. In the United States, common foods to which adults are allergic include eggs, shrimp, lobster, peanuts, other nuts, and fish. U.S. children who have food allergies find their problems are most frequently linked to milk, soy, eggs, and peanuts. Infants may be allergic to cow's milk or soy formulas. Some food allergies may be outgrown, but allergies to peanuts, shrimp, and fish tend to last throughout life. In addition, some individuals are only allergic to one food, whereas some are allergic to several foods. An allergic reaction can be triggered by a very small amount of...

Economic Impact Of Food Allergy

Very little is known regarding the economic impact of food allergy. However, it is evident that food allergy induces a cost related to individual health expenses, as well as indirect costs to families and the community. A recent study by a British and Dutch team reported on a questionnaire to measure the cost of food allergy in Europe. They compared the answers given in questionnaires from households with or without a food-allergic member. Annual direct costs were 1000 higher, indirect costs 2500 higher, and health costs 274 higher for households with a food-allergic member (Fox et al., 2009).

Food intolerance

Lactose intolerance Patients with lactose intolerance should avoid milk and milk products, including cheeses and butters. Some sufferers are able to tolerate small amounts of milk without symptoms. Food allergies Food allergies are immune-mediated disorders due to antibodies and hypersensitivity reactions. Up to 20 of the population perceive themselves to suffer from food allergy but only 1-2 of adults have genuine food allergies (Heaney 2000). The most common culprits are peanuts, milk, eggs and shellfish. The diagnosis of food allergy is difficult to prove or refute. Skin prick tests and measurements of antigen-specific IgE antibodies in serum have limited predictive value. Treatment of proven food allergy consists of detailed patient education and awareness, strict elimination of the offending antigen and in some cases antihistamines. Anaphylaxis should be treated as a medical emergency with resuscitation, airway support and intravenous adrenaline. Subsequently patients should wear...

Food Allergies

Considering that the gut microflora is an important factor in regulating both the intestinal and systemic immune system, probiotics are used to promote endogenous barrier mechanisms, reduce gut permeability and alleviate intestinal inflammation in patients with atopic dermatitis and food allergy (Majamaa & Isolauri 1997). A 1 -month study of 10 breastfed infants who had atopic eczema and cow's milk allergy found that L GG reduced certain faecal inflammatory markers. More specifically, the hygiene hypothesis suggests that improved hygienic conditions and vaccinations, which reduce early-life exposure to microbes, are associated with a heightened risk of allergic disease and other immune disorders. This is because reduced exposure may result in reduced stimulation of the immune system. As a result, lymphocytes that would normally differentiate to become Th1 type, differentiate to Th2-type cells and produce inflammatory cytokines in the allergic response in much greater quantities. As...

Lactose Intolerance

Because Amy has a form of lactose intolerance, she cannot digest milk unless it is in the form of yogurt, hard cheese, or cottage cheese. Drinking any milk products that contain lactose, such as the chocolate shake, will result in discomfort. Anyone with lactose intolerance should avoid milk, milk solids, whey (the liquid from milk), and casein, which is milk protein. Lactose is also found in breads, cereals, instant soups, instant potatoes, salad dressings, and nondairy powdered creamers. Drinking acidophilus milk or taking a pill containing lactase can also help avoid the digestive problems. In addition, about 20 of prescription drugs and 5 of over-the-counter drugs contain lactose. People with lactose intolerance need to be careful not to become deficient in calcium or riboflavin, a B vitamin.

Food Allergy

Food allergy is an adverse reaction to food in which the reaction is immune mediated. The immunological response comprises food-specific antibodies (IgE mediated), immune complex production, and muco-sal T cell-mediated reactions. Food allergy can be serious and lead to anaphylactic shock. This must be distinguished from food intolerance, which is a reproducible adverse reaction to a specific food or food ingredient, either as a result of abnormal absorption of a sugar due to an enzyme deficiency (e.g. lactose intolerance) or because of an exaggerated pharmacological response to chemicals in food, such as tyramine in cheese. Food allergy is most common in infants and tends to become less of a problem as children age. Foodstuffs implicated are cows' milk (2.5 of infants reducing to approximately 0.5 after 3 years) and egg allergy, which usually disappear after the age of 5 years. Fish legumes, peanuts, soy, and cereals can all cause food allergies. True food allergy is relatively...

Digestion and Nutrition

Amy is in a hurry and she knows the meal will be served fast and she knows the food is safe. The food may not be the tastiest in the world, or very good for her, but it will get her through lunch. Amy has eaten in this kind of place hundreds of times before. She orders a burger, fries, and a chocolate shake. She knows the burger and fries have lots of fat and salt that she does not need. She also knows the shake is risky for her. She has a form of lactose intolerance that sometimes results in abdominal cramping and diarrhea after ingesting milk products. But she is in a hurry, and at least she knows what she gets here besides, she has been thinking about the chocolate shake all morning. As you read through the chapters, you will follow Amy's lunch. You will read about what is really in her lunch, how it is digested, or broken down, and how it is absorbed into the body. The hamburger and fries she eats contain a lot of fat and salt, and the milkshake will most...

Dietary Management of Diarrhea Including Persistent Diarrhea

Data suggest that continued feeding during diarrhea is generally well tolerated and it minimizes the nutritional cost associated with diarrhea. A child should receive the same type of food during an episode of diarrhea as when the child is healthy. Feeding is usually tolerated, with the occasional exception of lactose intolerance. A small subgroup of children exclusively receiving nonhuman milk may have a higher rate of complications. These children should be closely supervised and provided with alternatives if needed. Full feedings will help to minimize growth faltering and a decline in nutritional status. Growth faltering may still occur, especially in severely undernourished children, due to poor nutrient absorption.

Adverse Effects And Reactions Allergies And Toxicity

Coconut can be a food allergen (Fries & Fries, 1983). It is a top-five food allergy in India, where coconut is a common food source (Teuber & Peterson, 1999). On the other hand, food allergies to coconut are considered rare in Australia, the UK, and the USA. As a result, commercial extracts of coconut are not currently available for skin-prick testing in Australia or New Zealand. Coconut-derived products can cause contact dermatitis (de Groot etal., 1987). They can be present in cosmetics, including some shampoos, moisturizers, soaps, cleansers, and handwashing liquids (Pinola et al., 1993).

What about overall satisfaction A year after surgery how do people feel about their decision to have gastric bypass

When food intolerances were assessed, milk and red meat stood out as the most frequent intolerances, occurring in 23 percent and 14 percent respectively. In the case of milk the intolerance is generally lactose intolerance manifested as abdominal bloating and cramping, whereas with red meat the intolerance is simply an acquired aversion.

Lactase Nonpersistence

Lactase persistence in the human population is inherited as a dominant genetic trait. It has been observed that lactose intolerance is 'ancient and globally distributed,' predating the appearance of a persistent lactase variant that was naturally selected in dairying regions. Hollox et al. report, ''the continued adult production of lactase results from the persistent expression of the protein lac-tose-phlorizin hydrolase which is encoded by the lactase gene (LCT) on chromosome 2.'' Swallow notes, ''the distribution of different lactase pheno-types in human populations is highly variable and is controlled by a polymorphic element cis- acting to the lactase gene. A putative causal nucleotide change

Lactose Digestion and Gastrointestinal Function

Lactose maldigestion and intolerance are influenced by age, infection, size of the lactose bolus, gastric emptying time, intestinal transit time, individual sensitivities, eating habits, genetics, environment, food ideologies, and cultural patterns. Furthermore, symptoms of lactose malabsorption may also be the result of bacterial fermentation of undigested carbohydrate in the colon. The type and extent of the colonic bacterial profile and the absorption of hydrogen and the volatile fatty acids will influence individual reports of symptoms associated with lactose intolerance. Clearly, lactose malabsorption is not a homogeneous event. Neither is it an all-or-none phenomenon having its origins in a single etiology. Clinical expressions of lactose malabsorption, lactose intolerance, and milk rejection find their origins in one or more of the causes outlined previously (Table 1).

Secondary Lactase Deficiency

Secondary lactase deficiency is distinct from genetically determined loss of lactase with age. Secondary lactase deficiency is frequently associated with diseases of the small intestine. Enteric viruses, such as rotavirus and Norwalk agent, can induce lactase deficiency by penetration of the enterocyte in the small intestine Rotaviruses are a principal cause of diarrhea and lactose intolerance in infancy. Denudation of the brush border of the jejunal mucosa associated with diarrhea can lead to the loss of the other two disaccharides, maltase and sucrose. Continued diarrhea may also lead to severe complications such as monosaccharide intolerance. Giardiasis have also

Lactose Digestion and Diet Calcium

Dietary calcium is an important element in skeletal development. Dairy products can account for up to three-fourths of dietary calcium in some populations. Milk is a rich source of calcium. Nevertheless, many minorities in the United States and population groups throughout the world drink decreasing amounts of milk after early childhood and little milk as adults. Given the high prevalence of lactose intolerance, alternatives to cow's milk should be identified for those who need them. Lactose-intolerant individuals ultimately attribute their discomfort to lactose-containing foods and voluntarily reduce or eliminate their milk intake. Data from national studies in the United States indicate that African American and Hispanic women have lower intakes of calcium compared to non-Hispanic women. An Institute of Medicine report concludes that the disparity in calcium intake ''may be explained in part by the much higher prevalence of lactose intolerance among African Americans and Hispanics,...

Nutrition Influences Mutation Risk

Inborn Errors of Metabolism Classification and Biochemical Aspects. Iron. Lactose Intolerance. Nutrient-Gene Interactions Molecular Aspects. Obesity Definition, Etiology and Assessment. Vitamin D Rickets and Osteomalacia. Zinc Physiology Deficiency in Developing Countries, Intervention Studies.

Eosinonophilc Gastroenteritis

In patients with mucosal layer disease (i.e., no involvement of muscle or serosal layer), food intolerance should be looked for. A trial of sequential elimination of milk, pork, beef, eggs, or gluten may be tried. Enteral elemental diets have been tried in some patients with success. Patients with mucosal layer disease who do not respond to dietary measures or patients with deeper layer involvement should try a course of steroids. Any patient who has traveled to the tropics should be considered for antihelminth therapy. See also Celiac Disease. Colon Disorders Nutritional Management of Disorders. Lactose Intolerance. Small Intestine Structure and Function. Stomach Disorders.

My Chronic Fatigue Story

There were some strong clues with the yeast theory. Eliminating all forms of sugar, and testing myself for food allergies helped to stabilize my situation. Some stool tests and we were convinced that somehow yeast had taken over my body chemistry. My illness gained a focus, it became a pitched battle with chronic yeast infection. The center of my yeast problem was my lower intestine. I became an expert on how to kill those little buggers in my gut, and it helped. My energies increased a little, and my symptoms eased somewhat.

The Chinese Contribution To The Inspection Of The Outer

Point 3 surely gives interesting indications for a general evaluation of the patient based on TCM syndromes. For example, desquamation of the lung area, as demonstrated also by Nogier, may direct the physician's attention to possible skin disorders a telangiectasia of the liver zone may orient his diagnostic intuition also toward depression and insomnia (see p. 97). Seborrhea of the cavum con-chae instead may orient the acupuncturist's diagnosis to metabolic disorders associated with food intolerance and diabetes if the pancreatic area is sensitive to pressure.

Migraine And Tensiontype Headache

Acupuncture Nodes

It is interesting to note the fourfold sensitization of the liver-gallbladder, the threefold sensitization of the elbow and the bigger area of the large intestine compared to the TTH group (on the right of Fig. 5.27). These three areas may be considered correlated, assuming that some of the patients have allergies or food intolerance negatively influencing the normal functions of the liver and the colon.

Diagnostic Tests Skin Prick Tests

False-positive results skin prick test reactivity may persist after clinical evidence of intolerance has subsided. For example, in a study of children with egg allergy, it was noted that 5 out of 11 who grew out of egg allergy had persistently positive skin prick tests after the allergy had disappeared. 6. False-negative tests skin prick tests are negative in some subjects with genuine food allergies. Skin prick tests are mainly used in research studies. The results of skin tests cannot be taken alone, and standard textbooks on allergy acknowledge that ''the proper interpretation of results requires a thorough knowledge of the history and physical findings.'' The problems in clinical practice are, for example, whether or not a subject with atopic disease (eczema, asthma, or hay fever) or symptoms suggestive of food intolerance will benefit from attempts to avoid certain foods or food additives. However, skin prick test results are unreliable predictors of response to such measures....

Trigeminal Neuralgia On The

Trigeminal Nerve Posterior Auricular

In the composite world of allergic conditions, the most frequently occurring are rhinoconjunctivitis, asthma, atopic eczema and food allergy, which represent a burden all over the world. In the UK, for example, the rates reported for allergic rhinitis and asthma in the 6th report of the House of Lords were, respectively, 9.4 and 5.5 in an estimated population of 60.6 million. Very close to the rate of asthma was that of atopic eczema and far from negligible was the incidence of infants and adults suffering with food allergy (respectively 5-7 and 1-2 ). The incidence of multiple allergies (asthma, eczema and allergic rhinitis together) was also significant (3.7 ) and showed an increase of 48.9 between 2001 and 2005.50

La Crosse encephalitis See encephalitis la crosse

Lactose intolerance The inability to digest milk sugar (lactose) because of a lack of the digestive enzyme lactase normally produced in the cells lining the small intestine. Lactase breaks down milk sugar into simpler forms that can then be absorbed into the bloodstream. When there is not enough lactase to digest the amount of lactose consumed, the results are gas, bloating, and abdominal pain. It is more common in African Americans than Caucasians. While not all children deficient in lactase have symptoms, those who do are considered to be lactose intolerant. Even though lactose intolerance is widespread, it need not pose a serious threat to good health. Children who have trouble digesting lactose can learn which dairy products and other foods they can eat without discomfort and which ones they should avoid. Many will be able to enjoy milk, ice cream, and other such products if eaten in small amounts or eaten with other food. Lactase liquid or tablets may also help digest the lactose.

Fasting and Vegetarian Diets

Several possible mechanisms have been proposed to explain the impact of elimination diets on clinical symptoms in RA. One possibility is that RA might be the result of hypersensitivity to environmental toxins or specifically to foods or food-related products, resulting in a food allergy of sorts that exacerbates symptoms of RA. However, true food intolerance, involving a systemic humoral immune response against food items, appears to be relatively uncommon among patients with RA. Another possible mechanism that has been proposed includes an alteration in the fatty acid content of the diet. Vegetarian diets contain more linoleic acid, but less AA, EPA, and DHA than omnivorous diets. Therefore, the eicosanoid precursors (AA, EPA, and DHA) must be produced endogenously from linoleic and a-linolenic acid (see Figure 1). It has been hypothesized that if this endogenous production cannot

Hypertension High Blood Pressure

Blood pressure is considered high at a reading of 140 90. There are no symptoms of the illness and it is recommended individuals over 40 be checked. Hypertension can be controlled by permanent diet and lifestyle changes this includes reducing stress, maintaining proper weight (not more than 5 lb overweight), and eating foods containing compounds that reduce blood pressure such as celery, garlic, and fresh fruits and vegetables. Having a home monitor is helpful. Smoking, alcohol, refined sugar, food allergies, and high-sodium foods can contribute to hypertension. Some people may need extra calcium to stabilize blood pressure. Some individuals are salt sensitive which causes a rise in their blood pressure. Daily exercises and various stress reduction techniques lower systolic and diastolic blood pressure.

Falsepositive And Falsenegative Auricular Diagnosis

Identified auricular areas may be the representation of parts of the body which have been injured in the past, leaving almost no after-effects. A second possibility is the detection of a tendency to allergy or food intolerance, or a predisposition to diabetes and hypertension, when these disorders are shared by other members of the patient's family. A third possibility is that of indicating hitherto unexpressed stress-related symptoms or somatization disorders in apparently healthy subjects.

Infant eHF and pHF in Clinical Studies

Most of the pHFs available today are based on 100 whey (pHF-W). The pHFs fulfill 2 of 3 criteria for the definition to be 'hypoallergenic' as recommended by the American Academy of Pediatrics 5 they have a reduced antigenicity of the protein and induce limited immunological reactions. However, they are not suitable for the therapy of cow's milk allergy intolerance. Nevertheless, in several clinical studies pHF has demonstrated a potential for prevention of allergic disease, and here mainly with regard to atopic dermatitis and food allergy 8, 28, 34-36 . Taking together the results of the intervention studies with hydrolysates, a preventive effect with regard to the prevalence and the cumulative incidence of allergic manifestations, mainly atopic dermatitis and food allergy could be demonstrated for both eHF and pHF 28 . A direct comparison between eHF and pHF was performed only in two studies, showing that, with regard to the reduction of atopic dermatitis and food allergy, mainly...

Abnormal Immune Response

Protein enterocolitis syndrome is a cell-mediated hypersensitivity disorder that typically occurs in infants within the first 3 months of life, most commonly in reaction to ingested dairy or soy protein 15 . The disease process is often restricted to the distal colon and is the most common cause of bloody stool in infants in developed countries following enteric Salmonella infection. Involvement of the small bowel as well as colon typically manifests as watery or bloody diarrhea, vomiting, and failure to thrive if diagnosis is delayed. Food protein-induced enteropathy (excluding CD) is an uncommon condition that occurs within the first several months of life and is manifested by persistent diarrhea and malabsorption clinical presentation is the same as classical CD but usually with vomiting. Histological changes can be very similar to that found in CD, but less severe 16 . There is patchy distribution of mucosal damage, some degree of villous atrophy, crypt hyperplasia, and increased...

Immunological Inflammatory Diarrheal Disorders

Regulator Cell Activation

If a child presents with an AIE, the onset is often within the first 3 or 4 months in the form of severe diarrhea which can be bloody 15 . The majority of boys with AIE present in addition with severe atopic skin disease, hema-tological abnormalities along with endocrinopathy, such as insulin-dependent diabetes mellitus or thyroiditis. This association was described as IPEX (immune dysregulation, polyendocrinopathy, autoimmune enteropathy, X-linked) syndrome 15, 17, 18 . It is interesting to note that boys with IPEX also show severe immunoallergic symptoms with a strong Th2 response and hyper-IgE syndrome having some similarities with extremely severe food allergy. Isolated or oligosymptomatic forms of severe AIE exist in both, boys and girls. Prior to the onset of AIE IPEX, these children develop completely normal, and no antenatal or neonatal particularities exist 19 . It is important to stress that the family history is most often positive for various autoimmune diseases. This...

Other Seed Allergies Sunflower Mustard Quinoa Buckwheat

Quinoa, which has long been a staple food in the Andean regions, has now reached Europe, and is largely available in grocery shops. In 2009 the first case of food allergy to quinoa was described in France (Astier et al., 2009), and more can be expected as this food is increasingly consumed in Europe.

Foods for special uses

Dairy products have long been known to be a functional food, as a good source of calcium. Additionally, fermented dairy products such as yogurt and kefir are a source of probiotics, live microbial food ingredients that are beneficial to human health (Roberfroid, 2000). Some probiotics are not part of a fermented milk product but are added to the milk as freeze-dried cultures. Intestinal microflora play an important role in the maintenance of health. Consumption of these live bacterial cultures are thought to affect the microbial ecology of the intestinal tract by colonization and replacement of non-beneficial bacteria (see also Chapter 8). Proposed benefits of the consumption of high levels of certain exogenous bacteria such as strains of Lactobacillus and Bifidobacterium include resistance to enteric pathogens, anti-colon cancer effect, strengthening of the immune response and alleviation of lactose intolerance (Sanders, 1999). Prebiotics are inulin-type fructans, i.e. carbohydrates...

The Registered Dietitian RD

The RD is helpful in FM because many people's quality of life will improve through dietary change. The RD can help people learn not only what foods to avoid or minimize but how to introduce new foods into the diet and how to really enjoy those new foods. In FM, obesity is often a problem, especially due to the sporadic nature of FM flare cycles and the resulting disruption of an exercise routine. The RD can individualize an eating plan based on each patient's food preferences. In general, they discourage diets and emphasize healthier eating for the long run. They also try to strip away moral value from food by discouraging naming certain foods good or bad. Instead, they focus on which foods to eat often and which foods to enjoy less frequently or in smaller amounts. Another role of the RD is to help people with concurrent celiac disease since gluten and its related products are so prevalent in the food supply. Lactose intolerance is a bit easier to negotiate, but an RD will have tips...

Carbohydrate Malabsorption

Lactose intolerance Lactose intolerance is defined by the occurrence of symptoms due to the inability to digest lactose, the main carbohydrate in milk. These symptoms may include abdominal pain, bloating, diarrhea, or flatulence. Lactose malabsorption is attributed to a relative deficiency of the di-saccharidase lactase. Primary lactase deficiency is a condition in which lactase activity declines after weaning. Secondary lactose intolerance is usually due to mucosal injury associated with a condition or disease such as infectious diarrhea, Crohn's disease, or short bowel syndrome. symptoms of lactose malabsorption, including the amount of lactose in the diet, the mixture of lactose with other foods, gastric emptying rate, colonic scavenge of malabsorbed carbohydrate, ethnic origin, and age. Primary lactose intolerance is prevalent in African American, Hispanic, Native American, and Asian populations. Nutritional management of lactose intolerance consists largely of the removal of...

Medication generictrade Alprazolam Xanax

Patient example Lucinda is a 32-year-old woman with long-standing constipation-prone IBS. Recently she was diagnosed with FM. Interestingly, she has tried no medication for either her IBS or FM. After a history, physical exam, and laboratory tests ruled out both IBD (inflammatory bowel disease) and lactose intolerance, her provider asked if she was more concerned about the IBS or the FM. Lucinda reported she felt IBS limited her life more than FM. The provider prescribed Dicyclomine and peppermint oil and referred her to a registered dietitian who helped Lucinda start a gradual dietary program to reduce food additives, especially MSG and aspartame. They gradually have added fiber and increased her water intake. After six months, Lucinda's IBS is at least 50 percent improved. She says she was not aware how much she relied on fast foods and now cooks at home 90 percent of the time. She states she is now ready to explore treatment options for her FM.

The indirect effect of anticariogenic substances on body except for tooth

A-glucosidase) provides many beneficial effects. However, if a large amount of sucrose and a-glucosidase are ingested simultaneously, transient diarrhea is caused because of an increase in osmotic pressure in the large intestine. This mechanism is thought to identical to that of lactose intolerance.

Probiotics and Prebiotics

Lactobacilli and bifidobacteria, sometimes combined with Streptococcus thermophilus, are the main bacteria used as probiotics in fermented dairy products. Most probiotic research has been done with nutra-ceutical preparations, but yogurt has been shown to alleviate lactose intolerance, prevent vaginal can-didosis in women with recurrent vaginitis, and reduce the incidence or severity of gastrointestinal infections.

Indications Milk Thistle

HHB) Fibrosis (1 CGH) Food Allergies (1 WAM) Gallstones (1 HHB MAB SKY HC020444-262 NP9(2) 6) Gastrosis (f APA) Hematuria (f HC020444-262 NP9(2) 6) Hemoptysis (f BIB) Hemorrhage (f KAB MCK) Hemorrhoid (f BIB HHB MAB WOI) Hepatosis (f12 KOM PH2 SHT WAM) Hepatosis A (1 BGB) High Blood Pressure (1 MCK HC020444-262) High Cholesterol (1 MAB) High Triglycerides (1 CGH X15177299) Hydrophobia (f BIB GMH) Hypereme-sis (f1 NP9(2) 6) Hypotonia (f HH3) Infection (f HHB) Inflammation (f1 APA HC020444-262 X15617879) Intoxication (1 FAD) Insulin Resistance (1 SYN) Itch (1 MAB) Jaundice (f2 BIB HH3 MAB PH2 PNC WAM) Leukemia (f1 HC020444-262 NP9(2) 6) Leukorrhea (f BIB) Malaria (f1 BIB HHB PHR PH2 HC020444-262) Menopause (f HHB) Metastasis (1 X15224346) Metrorrhagia (f HHB) Migraine (f HH3) MS (f ACT9 251) MS (1 HC020444-262) Mushroom Poisoning (2 FAD SHT) Myalgia (1 HC020444-262) Nausea (f1 MAB Cyto-protective (1 NP9(2) 6) Nephrosis (f12 BGB NP9(2) 6) Neurosis (f ACT9 251) Obesity (1 PNC) Oligolactea...

Dairy wW s Up with That

Robert Hatherill, a research scientist at the University of California at Santa Barbara, indicates that we can set ourselves up for serious disease by exposing the body to dairy products. Infants with milk allergies make antibodies to fight milk proteins that are linked to destroying cells in the pancreas. In the case of cataracts, milk sugar can build up in the lens of the eye, causing irreversible clouding or cataract. Dr. Hatherill, whose field is environmental toxicology, also points out that cow's milk enhances the uptake of lead, cadmium, mercury, and other metals.

Hydrolyzed Infant Formulas

Hydrolyzed infant formulas as a milk substitute, primarily invented for infants with cow's milk allergy, have later been adapted for primary allergy prevention. The concept of introducing hydrolysates in an attempt to prevent allergic diseases focuses on the reduction of the antigenicity and allergenicity of milk proteins 19 . The residual allergenicity of an infant formula, defined as the capacity of the molecules (allergens) to initiate an allergic response, is affected by molecular weight, chemical complexity, 'foreignness', dose and other factors such as route of exposure and yet unknown species-specific genetic factors 20 . Different processing of foods can alter its antigenicity. Heat treatment of cow's milk protein does affect the conformational epitopes and facilitates their hydrolysis. To produce the least allergenic formulas, cow's milk protein can be modified by enzymatic hydrolysis with progressive destruction of sequential epitopes 21 . Dependent on the degree of...

Flattened head syndrome See positional plagio

Food allergy An immune system response to a food that the body mistakenly believes is harmful. once the immune system decides that a particular food is harmful, it creates specific antibodies to it in an attempt to protect the body. The next time the child eats that food, the immune system releases massive amounts of chemicals (including hista-mine) in order to protect the body. These chemicals trigger a cascade of allergic symptoms that can affect breathing, the heart, the skin, or the gastrointestinal tract. Most food allergies trigger reactions such as itching, hives, and swelling, but in some cases a more serious response known as ana-phylactic shock can occur. This leads to a loss of consciousness or even death. Scientists estimate that between six and seven million Americans suffer from true food allergies. Many food allergies disappear as the child gets older about a third of cases disappear in one to two years if the child carefully avoids the offending item. However,...

Examples of Specialist Roles in Dietetics Renal Dietetics

The pediatric dietitian has a unique role in that they have to combine the metabolic requirements of the disease process or condition with the normal requirements for growth and development. With the advances in early diagnosis of many complex metabolic conditions, children may require complicated diets that are very different from those of the rest of their family and peers, need constant modification as the child grows, and may be lifelong. The dietitian is responsible for modifying the diet as necessary to take account of the patient's metabolic requirements, any feeding difficulties, mechanical or physiological, and the patient's food preferences and dislikes as he or she grows. The dietitian is an essential part of the support system for children with inborn errors of metabolism such as phenylketo-nuria and cystic fibrosis, conditions such as renal or heart disease, food allergies, diabetes, and many others, being able to tailor the diet to the patient's specific needs and having...

General Nutritional Management of Malabsorption

Review include duration of symptoms, underlying etiology of malabsorption, ability to meet nutritional needs by mouth, the presence of food allergies, and concurrent medical and surgical problems. The patient's nutritional status (weight, height, body mass index, and their respective percentiles) should

What about allergies and allergy tests

You will probably already know if you have any 'classical' allergies to foods because the effects will be very quick and probably quite dramatic. However, it's possible to have some delayed or hidden food allergies or sensitivities which are less obvious but which, nonetheless, can be detrimental to your health. The good news is that unlike 'classical' food allergies, which tend to stay, this type of sensitivity can be improved and need not be a severe or life-long condition. Tests for classical food allergies are unlikely to identify the foods associated with delayed or hidden allergies or sensitivities. Private allergy testing may do so, but this is often expensive. Another option is a special diet called the elimination and challenge diet. This is when you cut out a food(s) completely (substituting something nutritionally similar) for about two weeks - the elimination stage - and then reintroduce it in the challenge stage. A strong reaction to a food that you have been avoiding...

Food Dependent Exercise Induced Anaphylaxis

In this unusual condition, attacks only occur when the exercise follows within a couple of hours of the ingestion of specific foods, such as celery, shellfish, squid, peaches, or wheat. The mechanisms that result in food-dependent exercise-induced anaphy-laxis are obscure. This disorder, although rare, is important in the interpretation of dietary challenge studies of food intolerance because in these patients a simple double-blind food challenge without exercise will fail to validate a history of food intolerance.

Lupus Systemic Lupus Erythematosus SLE

The type of fat in the diet is important saturated fats and polyunsaturated fats including sunflower, corn, and safflower oils are inflammatory and can exacerbate the condition. In studies, improvement has been shown when omega-3 fatty acids are included in the diet. Alfalfa seeds and sprouts aggravate the disease and food allergies may precipitate an inflammation.

Enteropathy Caused by Food Hypersensitivity

Food Allergy In food allergy, duodenal, ileal and colonic lymphonodular hyperplasia may be detected 15 as a consequence of immune activation. Histological abnormalities are variable from total to patchy or even absent villous atrophy, mild to moderately increased intraepithelial CD8 cells, lymphoid follicles, activated lamina propria CD4 cells (with increased IFN-7 with or without IL-4 or TNF-a) and decreased regulatory cytokines (especially TGF-p) 16 . Different from CD, enteropathy caused by food allergy presents a thin mucosa, a prominent patchy distribution, only moderate crypt hyperplasia and less intraepithelial lymphocyte infiltration. The infiltration of eosinophils and mast cells is frequent and related to antigen-induced dysmotility and enteric neural dysfunction. The mucosal lesions may cause reduction in brush border disaccharidase expression and secondary exocrine pancreatic impairment, caused by decreased duodenal CCK production, with mild-to-moderate steat-orrhea and...

Practical Aspects of Meeting the Nutrient Needs of Infants

The introduction of complementary foods, especially solids and eventually finger foods, is important for infants to develop normal oral and motor skills related to eating and to attain adequate intakes of nutrients that may be low in breast milk (e.g., protein or iron). In a report by the March of Dimes, three common inappropriate complementary feeding practices were delineated (i) introducing foods too early or too late, (ii) introducing foods of low nutrient density, and (iii) feeding contaminated foods. It is noted in the report that early introduction of foods may reduce the intake of breast milk due to limited gastric capacity of very young infants or precipitate an allergic reaction in infants with a family history of food allergy or atopy. By delaying introduction of foods beyond 6 months, there is increasing risk of deficiencies of nutrients known to be relatively low in breast milk and yet essential to support rapid growth of infants, such as iron and zinc. The choice of...

Management Dietary Elimination

The management of food allergy consists largely of elimination from the diet of the trigger food or foods. Elimination diets are used either for the diagnosis or the treatment of food intolerance, or for both. A diet may be associated with an improvement in symptoms because of intolerance to the food, a placebo effect, or the improvement may have been a coincidence. The degree of avoidance that is necessary to prevent symptoms is highly variable. Some patients are intolerant to minute traces of food, but others may be able to tolerate varying amounts. Strict avoidance and prevention of symptoms are the aims in certain instances, but in many cases it is unknown whether allowing small amounts of a food trigger could lead to either enhanced sensitivity or to the reverse, increasing tolerance. The duration required for dietary avoidance varies. For example, intolerance to food additives may last only a few years, whereas intolerance to peanuts is usually lifelong. Although food allergy is...

Immunological and Molecular Mechanisms

And potent response against foreign substances, develop tolerance to ingested food antigens. The means by which tolerance develops is poorly understood, but it is believed that failure to develop tolerance leads to food allergy. The relatively low salivary secretory IgA concentrations, together with the large amount of ingested protein, contributes to the large amount of food antigens confronting the immature GALT. In genetically predisposed infants, these food antigens may stimulate the excessive production of IgE antibodies or other abnormal immune responses.

Hydrolyzed Infant Formulas for Therapy and Prevention

However, by the definition of the American Academy of Pediatrics a hypoallergenic formula needs to fulfill three criteria (1) the antigenicity of the protein must be reduced, (2) it should be successfully used in patients with documented cow's milk allergy and (3) the immunogenicity of the product must be reduced 5 . Following this definition, eHFs have a higher potential of being classified as hypoallergen than pHFs, because they can be successfully used in children with cow's milk allergy. A formula suitable for being classified as a 'formula for therapy' of cow's milk allergy intolerance has to fulfill several clinical and preclinical criteria. This includes a double-blind, placebo-controlled food challenge, followed by 7 days' feeding with the respective formula to prove that 90 (with 95 confidence) of children with documented cow's milk allergy intolerance can tolerate the formula without developing allergic symptoms 5 . eHFs, primarily intended for the therapy of cow's milk...

Chronic Fatigue Syndrome

Chronic fatigue syndrome is characterized by profound fatigue that is not alleviated by sleep, and a myriad of other symptoms including impairment of memory and concentration, muscle pain, and swollen lymph nodes. There is no single cause of the illness and a physician should be consulted to explore all possibilities. Causes may be a viral infection, adrenal gland dysfunction, chemical sensitivity, autonomic nervous system disorder, or food allergy.

Triggers for Loss of Tolerance

The mechanism of response to gluten in celiac disease is quite different from that of IgE-mediated food allergies. IFN-7, a potent inflammatory cytokine, is characteristically produced in celiac disease as well as TNF-a. IL10 and TGF-0, which are both counter-inflammatory regulatory cytokines for the intestine, are also expressed in celiac disease, although they are apparently inadequate to prevent the substantial inflammation that occurs.

Can Early Exposure to Infections Be Protective

Intervention studies are needed to demonstrate the relevance of these findings and to examine the effect of adding probiotics to infant formulas. In one recently published study from Finland, which unfortunately was not blinded, infants with milk allergy and atopic dermatitis had milder symptoms and fewer markers of intestinal inflammation if their milk formula was fortified with lactobacilli.

Hyperactivity and Antisocial Behavior

In children, there is an increasing frequency of the diagnosis of ADHD, a condition characterized by inattention, impulsive and disruptive behavior, learning difficulties, and increased levels of gross motor activity and fidgeting. Also, the prevalence of food allergies and intolerances has been increasing. Perhaps it is not surprising that dietary explanations and treatments for ADHD have been sought regularly for several decades, given theories of allergic reactions or intolerance to food additives, ingredients in chocolate, and even refined sugar (often grouped as the 'Feingold theory', after an early instigator of unproven dietary intervention). There has also been a long-standing interest in the possibility that antisocial behavior in children and adults might in part result from poor nutrition, although early studies were poorly designed. Behavioral effects of sugar and of many additives have by and large not been supported by controlled studies however, determining...

Food and Chemical Allergies and Depression

The connection between food allergies and depression was a revelation to me. I was treating a young woman who was both alcoholic and depressed. I expected to find some food or chemical sensitivities because she had a terrible withdrawal hangover when she stopped drinking, indicating an allergic addicted response to alcohol. But I was not prepared for the Jekyll and Hyde changes that I witnessed.

Avoiding Foods to Prevent Allergy

Food allergy has been estimated to affect approximately 1 or 2 of infants and young children in Western Europe and is assumed to be increasing in line with other forms of atopic disease, although evidence to support this is limited. Some food allergies (e.g., peanut allergies) can persist into adulthood and in severe cases can be life threatening. Most confirmed food allergies are associated with a relatively limited range of foods, including cow milk, eggs, tree nuts, peanuts, soybeans, wheat, fish, and shellfish. The development of food allergy depends on several factors, including genetic factors and early exposure to allergenic proteins in the diet, food protein uptake and handling, and the development of tolerance. However, it remains uncertain whether sensitization occurs in utero and, if so, whether this occurrence is restricted to specific stages of gestation. There is little evidence to support any benefit of avoiding specific foods during pregnancy to reduce the risk of...

Allergenic Aspects of Egg Proteins

Eggs are one of the most common causes of food allergies in infants and young children. Although the majority of egg allergies are caused by egg-white protein, proteins in both the egg white and the yolk are associated with allergies. The egg white contains 50 ovalbumin, which is the major allergen. Other egg-white allergenic proteins are ovomu-coid, ovotransferrin, and lysozyme. Most egg allergies in young children are outgrown by the age of 5 years following an elimination diet.

Allergies and Intolerances

Food allergies affect approximately 3 percent of children and 1 percent of adults in the United States. It is estimated that an even larger percentage of the population experiences problems with food intolerance. Worldwide, adverse reactions to food constitute a significant public health issue. lactose intolerance inability to digest lactose, or milk sugar

What Is An Allergic Reaction

Food-induced allergy may present with various symptoms. In 90 of reactions the skin is involved, with either acute urticaria (hives) or angioedema. These symptoms usually appear within minutes of ingesting the triggering food. Conjunctival and nasal symptoms are also common in acute systemic food reactions, but occur infrequently as isolated manifestations. Gastrointestinal symptoms are also very common, usually starting within minutes to 2 hours after the food has been ingested. Symptoms are various, and include nausea, vomiting, abdominal pain or cramping, and diarrhea. Respiratory reactions manifest as acute wheezing, respiratory distress, dysphonia, and dysphagia. The symptoms of food allergy can range from very mild, to life-threatening reactions with multisystemic severe shock. A reaction involving several organs is known as anaphylaxis, which is generally graded in four stages. The degree of reaction determines the emergency Pollen allergy is very common. Up to 25 of the...

Prevalence Of Allergy

Allergies, and in particular food-related allergies, are a growing entity in the industrialized population. The true prevalence and risk factors are still not well known. Prevalence has different patterns in different age groups, and recent meta-analysis reported occurrences varying from 3 to 35 (Rona et al., 2007). Of note, the number of correctly diagnosed food allergies largely differs from the number of perceived reactions to any food in population-based studies (Zuidmeer et al., 2008). Since 2005, a large prospective birth cohort study (EuroPrevall) has been running in nine countries across Europe. This study will provide helpful results regarding the prevalence, patterns, and associated factors of food challenge-diagnosed food allergies in European children (Keil et al., 2009). A study in the United States has shown that 5.3 of adults reported a doctor-diagnosed food allergy and 9.1 reported a self-perceived food allergy. The prevalence of food allergy to the eight most common...

Selection of Enteral Formulas for Malabsorption

Patients who have carbohydrate malabsorption from lactose intolerance should use lactose-free formula. Fat malabsorption calls for MCT-enriched formula. In cases of protein malabsorption or severe enteropathy, a formula that is a protein hydrolysate or amino acid-based would be most appropriate. Since many malabsorption syndromes overlap in terms of the macronutrient affected, as in cases of

Potential Adverse Effects

Cereals do not have any intrinsic non-specific toxins. However, acrylamide, a carcinogen and potential neuro-toxin, has recently been found at levels up to 120 mg 100 g_1 in baked and fried foods, including breads and processed cereals. Research is ongoing, but the early indications are that acrylamide from these sources is unlikely to increase cancer risk. Detrimental effects may be caused by antinutrients in cereals and, in susceptible individuals, by adverse immune responses (celiac disease, food allergies). Cereals may also be a source of toxins of fungal origin (mycotoxins) or of toxic environmental, agricultural, or industrial contaminants.

Modulation by Probiotics

Specific probiotic bacteria can modulate both the intestinal microflora and local and systemic immune responses. Activation of immunological cells and tissues requires close contact of the probiotic with the immune cells and tissue on the intestinal surface. Interestingly, both lactobacilli and bifidobacteria, which colonize mainly the small and large intestine respectively, when given as probiotic supplements were able to modify immunological reactions related to allergic inflammation, whereas lactobacilli were ineffective in protection against cows' milk allergy. In this respect, preferential binding of probiotics on the specific antigen-processing cells (macrophages, dendritic, and epithelial cells) may be even more important than the location of adhesion. It is also known that the cytokine stimulation profiles of

Inability to Predict Outcome

In many situations (e.g., atopic disease), the subject wants to know whether there will be any benefit from food avoidance (e.g., not drinking cows' milk or not eating apples). Even if there were valid tests for the diagnosis of food intolerance, the outcome of avoidance measures depends on a number of other variables. Allergen avoidance may succeed for the following reasons 2. The period of elimination was too short. For example, where a child has an enteropathy (damage to the small intestine) due to food allergy, it may take a week or more for improvement in symptoms to occur.

Cows Milk Protein Avoidance

Butter, margarine, cream, cheese, ice cream, and yogurt all need to be avoided. Fats that can be used instead include margarines made from pure vegetable fat (e.g., Tomor) and lard. Caution is required with baby foods, as a large number of manufactured products, e.g., rusks, contain milk protein. A common trap is so-called 'vegetarian' cheese, often wrongly believed to be safe for subjects with cows' milk allergy. In fact, it differs from ordinary cheese only in the use of nonanimal rennet and is unsuitable for people with cows' milk allergy. Meat, game, and poultry are all allowed, but sausages and pies should be avoided unless it is known that they are milk free. Intolerance to cows' milk protein is not a reason to avoid beef. Eggs are allowed, but not custard or scrambled egg which may contain milk. Fish is permitted, unless it is cooked in batter (which unless otherwise stated should be assumed to contain milk) or milk. Lemon curd, chocolate spread, chocolate (unless stated to be...

Concerns about Food Production

Some concerns about the use of biotechnology for food production include possible allergic reactions to the transferred protein. For example, if a gene from Brazil nuts that produces an allergen were transferred to soybeans, an individual who is allergic to Brazil nuts might now also be allergic to soybeans. As a result, companies in the United States that develop genetically engineered foods must demonstrate to the U.S. Food and Drug Administration (FDA) that they did not transfer proteins that could result in food allergies. When, in fact, a company attempted to transfer a gene from Brazil nuts to soybeans, the company's tests revealed that they had transferred a gene for an allergen, and work on the project was halted. In 2000 a brand

Common Foods Associated with Intolerance

Foods associated with intolerance include preserved foods, foods containing monosodium glutamate (MSG, a flavor enhancer), and specific foods such as milk, pickled herring, soy sauce, chili peppers, and nutmeg. Intolerance to lactose is a major problem for many populations. In the United States, lactose intolerance is common among those of African and Asian descent. The Native American population also has a high prevalence of lactose intolerance. For many food intolerances, including those listed above, specific chemicals or enzyme abnormalities have been identified as being associated with the intolerance. Lactose intolerance is associated with problems with the enzyme lactase. Chemicals associated with food intolerance include sulfite (in preserved foods), tyramine (in pickled herring and soy sauce), capsaicin (in chili peppers), and myristicin (in nutmeg).

Nutrient Gene Interactions in Chronic Disease

A further refinement for recommended nutrient intakes is to include consideration of the relationship of one or more nutrients to the development of chronic disease. Many chronic diseases are the result of an interaction between the genetic heritage or genotype of the individual and the lifestyle choices that individual makes. Conditions such as heart disease, diabetes mellitus, and obesity are in this category. There are also a number of genetic conditions that can be managed by diet. One of the most common of these is lactose intolerance. Approximately 75-80 of the adult population in the world today is lactose intolerant. That is, they cannot consume quantities of milk and some milk products without experiencing gastrointestinal distress. Table 2 lists some genetic disorders that are amenable to dietary management. There are also some relatively rare genetic diseases that affect genes involved in key nutritionally relevant biological processes. For example, mutations in the gene...

Specific Nutrients Calcium

In the 1997 DRIs, Als of calcium were raised from 800 to 1300 mg in 9-18 year olds. Only a small percentage of the population takes in the RDA for calcium. The estimated average calcium intake in American women is only about 500-600 mg a day, and is much lower in the developing world (as low as 200 mg a day). From calcium tracer studies performed since the 1950s, intestinal calcium absorption ranges from 10 to 40 of ingested calcium, with a higher percentage absorption with lower calcium intakes. A large percentage (usually 7080 ) of dietary calcium is from milk and dairy products, which provides about 250 mg calcium per 8 oz (240 ml) glass of milk, and most studies show better absorption from dairy products than from vegetable sources. However, many people, especially non-Caucasians, develop relative lactose intolerance after childhood, and are reluctant to increase their dairy food intake.

Dietary Management

Food intolerance There is much controversy surrounding the role of food in the development and onset of asthma. Evidence suggests that atopic or asthmatic parents, whose children have a high risk of developing asthma, should be advised to avoid smoking during pregnancy avoid cigarette smoke exposure after the child is born undertake house dust mite control strategies exclusively breast-feed their infants for 6 months and subsequently provide their child with a nutritious, balanced diet. In contrast, there is little to suggest that a low allergen diet for high-risk women during pregnancy is likely to reduce the risk of having an atopic child. Generally, the incidence of food intolerance in asthma is thought to be small, although there is evidence that intolerance to foods may act as a trigger for some cases of asthma. Common food allergens identified include milk, eggs, nuts, orange See also Cancer Epidemiology of Lung Cancer. Cystic Fibrosis. Food Intolerance. Malnutrition Primary,...

Eat nonfat or low fat 1 dairy products in moderation if you tolerate them well

Lactose is a naturally occurring simple sugar you can eat in moderation if you tolerate it well. Lactose intolerance is the inability to digest dairy products. People who are lactose intolerant don't have the enzyme necessary to digest lactose, so they get gas, bloating, water retention, abdominal cramps and diarrhea when they eat dairy products. The degree of lactose intolerance can vary greatly. In those with severe intolerance, the symptoms are very pronounced. In those with a minor intolerance, the symptoms can be as subtle as a bloated and puffy appearance. Although it's not fat, bloat makes you look fat, which is exactly what someone seeking muscle definition doesn't want


Some researchers believe that poor diet, or, more specifically, food allergies, malnutrition, and hypoglycemia, can provoke criminal behaviors. Food allergies and malnutrition in particular have been linked to mental imbalances, such as abnormal serotonin activity, which have been linked to violent behavior. Examples of this include a twelve-year-old who, after eating a banana, tried to hit another patient with a stick and a fifty-two-year-old woman who, after having wheat, said she wanted to punch someone (Schellhardt 1977 1). Hypoglycemia, or having low blood sugar, has also been linked to irrational behavior that is controllable through diet.

Peanut Allergies

Peanut allergies, which are among the most widespread food allergies, affect more than 1.5 million people in the United States. Symptoms of an allergic reaction may include a flushed face, hives, difficulty breathing or swallowing, vomiting, dizziness, chills, and loss of consciousness. The reaction of an allergic person to peanuts can be rapid and dramatic, sometimes causing death within minutes. The incidence of peanut allergies among children doubled in the United States between 1997 and 2002, prompting some schools to consider banning peanuts and peanut products from


Koletzko Thank you for a very stimulating and fascinating talk. I was particularly impressed by your observation that early specific sensitization to food allergens is a strong predictor of later respiratory disease. Is this related to your choice of putting IgE on top of your list of atopic phenotypes From the clinical point of view, IgE is a rather frustrating molecule because we see a lot of patients with allergy who don't have elevated IgE, particularly if they have food allergy or GI manifestations. Moreover, we see a lot of patients with elevated IgE that don't have disease. In your MAS data you found that the frequency of IgE sensitization to food allergens was pretty stable between age 1 and 13 years, even though point prevalence of food allergy varies markedly during this age range. Thus I wonder whether you might be able to offer any better perspective for the future Would there be an opportunity to develop a better algorithm where IgE may act as one factor, and the...


Food allergy is defined as an immune system-mediated adverse reaction to food proteins. Class 1 food allergens are represented by peanut, egg white, and cow's milk they are heat- and acid-stable glycoproteins that induce allergic sensitization via gastrointestinal tract and cause systemic reactions. Class 2 food allergens are homologous to proteins in birch tree pollen and class 2 food allergy develops as a consequence of respiratory sensitization to the cross-reactive pollen. Class 2 food allergens are very heat-labile and tend to induce reactions limited to oral allergy symptoms. In contrast, plant nonspecific lipid transfer proteins are resistant to heating and tend to induce systemic reactions. Analysis of IgE-binding epitopes with SPOT membranes revealed that cow's milk-, egg- and peanut-allergic subjects without IgE antibodies against certain sequential epitopes of the major allergens were more likely to achieve tolerance than subjects whose IgE antibodies were directed against...


A number of laboratory immune assays (RAST, CAP system) have been developed for the detection of allergen-specific IgE antibody in the bloodstream. These assays have a similar performance to skin tests in that a negative test (specific IgE antibody < 0.35kIU l measured by Pharmacia CAP system) has a high negative predictive value > 95 . Clinical decision points indicating > 95 likelihood of reaction were established for the most common food allergens, including milk, egg, peanut, tree nuts, and fish 36 . For example, a child older than 2 years with milk IgE antibody level > 15kIU l is highly (> 95 ) likely to react during an oral milk challenge. Food-specific IgE antibody levels below the decision points indicate a decreasing likelihood of reaction that needs to be determined with OFC. Currently available diagnostic tests for IgE-mediated food allergy do not predict severity of reactions and chances of resolving food allergy with time. Considering data from studies in...

Food Habits

There exists great diversity in language, socioeconomic status, religion, age, education, social class, location, length of time in the United States, and country of origin among Asian Americans. Hence, caution needs to be taken not to generalize or imply that food habits are similar for all individuals of this group. For example, Chinese meals consist mainly of four food groups grains, vegetables, fruit, and meat. Because of lactose intolerance, most Chinese do not consume large amounts of dairy products, substituting soymilk and tofu as sources of protein and calcium. Some Asian food, such as Thai food, is generally spicy, hot, and high in sodium. Hot peppers are used daily. The Japanese are very concerned about the visual appeal of food and the separateness of the foods and tastes. Garlic and hot pepper, commonly used among Asian Americans, are not common ingredients in the Japanese cuisine. Korean Americans eat kimchi with each meal. Kimchi is cabbage marinated in salt water,...

Oral Food Challenges

OFCs remain the most accurate method for diagnosing food allergy, for both IgE-mediated as well as for non-IgE-mediated food allergy and for determining the threshold dose of food. Many protocols were developed in one approach, during an OFC for an IgE-mediated food allergy, a premeasured amount of food (typically 8-10 g of dry food or 80-100 ml of liquid food) mixed with a masking food is administered in small increments every 10-15 min over 90min. In a placebo-controlled challenge, two sessions (one with real food, one with placebo food) are separated by a 90-min break and completed on a single day or each session may be done on separate days. Double-blind, placebo-controlled food challenge is considered a gold standard for the diagnosis of food allergy and is preferred in the research setting. OFCs are stopped at the first sign of an objective reaction such as hives, rhin-orrhea, sneezing, coughing, or vomiting. OFCs are always conducted under physician supervision in a controlled...


Too little fiber and fluids are the most likely cause of constipation others are drugs such as painkillers, antidepressants, antihistamines, and heart medications lack of exercise, stress, anxiety, laxative overuse dull intestinal nerve reflexes pregnancy, and aging due to the loss of muscle tone. If constipation develops suddenly, see a physician as it may be an indication of colon cancer or impaction. Chronic constipation may be triggered by food allergies.


Cystitis is a bacterial infection of the lining of the bladder affecting mainly women. It is usually caused by E. coli which travels from the anus through the urethra and into the bladder. Food allergies, vaginal yeast infections, chemical sensitivities, tissue abrasion from friction during intercourse, and a too large diaphragm may increase exposure to bacteria. Stress and oral contraceptives can lower resistance to infection.

Population Studies

In the European Community Respiratory Health Survey administered to 17280 adults in 15 countries covering the period 1991-1994, 12 of respondents reported a food allergy or intolerance, ranging from 4.6 in Spain to 19.1 in Australia. The foods most commonly reported to cause shortness of breath were peanut in the United States fruit in Iceland, Belgium, Ireland, and Italy and hazelnut in Norway, Sweden, and Germany. The reason for the variation in the reported food triggers is unknown. A population-based study of 33110 people in France defined food allergy on the basis of self-reported typical allergic symptoms only and found a rate of 3.5 . In adults, the main foods reported to trigger allergic reactions were seafood, fruit, and The parents of 866 children from Finland were asked to provide a detailed history of food allergy, and for certain foods the diagnosis was further investigated by elimination and open challenge at home. Food allergy was reported in 19 by the age of 1 year, 22...

Provocation Tests

To confirm a history (parents' observations of alleged food allergy are notoriously unreliable, as are adults' beliefs about their own allergies) 3. to see if a subject has grown out of a food intolerance and Open food challenges are the simplest approach, but open food challenges run the risk of bias influencing the parents' (or doctors') observations. Often this is unimportant. But in some cases belief in food intolerance may be disproportionate, and where this is suspected there is no substitute for a double-blind placebo-controlled challenge. An open challenge may be an open invitation to the overdiagnosis of food intolerance. For example, in the UK parents widely believe that there is an association between food additives and bad behavior, but in one series, double-blind challenges with tartrazine and benzoic Effect of dose In some cases of food intolerance, minute quantities of food (e.g., traces of cows' milk protein) are sufficient to provoke florid and immediate symptoms. In...

Dietary Treatments

Some professionals have advocated the use of special diets, vitamin supplements, or both to manage some symptoms associated with autism spectrum disorders. In recent years, a theory has been formed that some cases of autism are caused by food allergies, specifically severe allergic reactions to gluten, a protein found in flour, and casein, a protein found in milk products, that irritate or damage the brain and lead to the unusual behaviors associated with the autism spectrum disorders. So far this hypothesis is based on clinical observations and parent reports rather than well-controlled scientific studies. As with understanding the potential risks and benefits associated with medications, future research investigations are very much needed. Some parents report improvement of their child's behavior when certain prod

Other Conditions

Glutamine is a popular supplement in naturopathic practice and sometimes used for conditions that may be associated with compromised intestinal permeability such as food allergies, leaky gut syndrome and malabsorption syndromes, including diarrhoea. It may also be used for conditions such as dermatitis and general fatigue based on the theory that compromised intestinal permeability provides the opportunity for undigested food particles (especially proteins) to enter the systemic circulation and gives rise to an unwanted immune response that manifests as a skin reaction or lethargy.

Gallbladder Disease

Active in producing bile acids which keep cholesterol dissolved. Some individuals may be deficient in HCl (stomach hydrochloric acid). Obesity and constipation are risks for forming stones. Food allergies have been shown to precipitate gallbladder inflammation but not stones eggs, onions, and pork are the most common offenders.


Severe infections increase mucosal permeability and induce local expression of co-stimulatory molecules allowing antigen penetration in the mucosa, T cell activation and possible disruption of oral tolerance. In the last decades, rapid realimentation in acute gastroenteritis has reduced the incidence of postenteritis syndrome with food intolerance and persistent diarrhea. Complex carbohydrates, probiotics and prebiotics, such as maize, green banana fibers and pectin, have been hypothesized to enhance epithelial gut repair and absorption. L-Glutamine, the 'fuel' for the intestine, nucleotides, causing proliferation of enterocytes, growth factor(s) with trophic effects on the intestinal mucosa, bovine colostrum and bovine serum concentrate have also been evaluated, without evidence of any substantial benefit 2 .

Altering Gut Flora

Prevention and treatment of diarrhea (particularly rotaviral and antibiotic associated), improved lactose digestion, enhanced gut immune function, and, most recently, prevention and treatment of food allergy and its systemic effects (atopic dermatitis and possibly gastrointestinal allergic disease). Use of probiotics to beneficially alter flora composition and its effects will be elaborated on in a separate chapter.