Tag Archives: food allergy

Technical University of Munich study: Allergy potential of strawberries and tomatoes depends on the variety

21 Jul

Moi wrote about allergies in Food allergies can be deadly for some children:

If one is not allergic to substances, then you probably don’t pay much attention to food allergies. The parents and children in one Florida classroom are paying a lot of attention to the subject of food allergies because of the severe allergic reaction one child has to peanuts. In the article, Peanut Allergy Stirs Controversy At Florida Schools Reuters reports:
Some public school parents in Edgewater, Florida, want a first-grade girl with life-threatening peanut allergies removed from the classroom and home-schooled, rather than deal with special rules to protect her health, a school official said.
“That was one of the suggestions that kept coming forward from parents, to have her home-schooled. But we’re required by federal law to provide accommodations. That’s just not even an option for us,” said Nancy Wait, spokeswoman for the Volusia County School District.
Wait said the 6-year-old’s peanut allergy is so severe it is considered a disability under the Americans with Disabilities Act.
To protect the girl, students in her class at Edgewater Elementary School are required to wash their hands before entering the classroom in the morning and after lunch, and rinse out their mouths, Wait said, and a peanut-sniffing dog checked out the school during last week’s spring break….
Chris Burr, a father of two older students at the school whose wife has protested at the campus, said a lot of small accommodations have added up to frustration for many parents.
“If I had a daughter who had a problem, I would not ask everyone else to change…. http://www.reuters.com/article/2011/03/22/us-peanut-allergy-idUSTRE72L7AQ20110322

Researchers are trying to discover the reason for the allergies.

Active Beat described allergies in the 10 Most Common allergies in Adults:

1. Nuts
Even though we’re most sensitive about nut exposure in schools and around our children, peanut allergies make up 3.3 million allergy cases in the U.S. Plus, reactions to peanut allergies are typically the most severe, resulting in the highest rates of anaphylactic shock compared to other types of allergies. So beware of seemingly nut-free foods and beauty products—moisturizer (which often uses peanut oil) and chili and stews (which often add peanut butter as a thickener).
2. Pollen
Pollens are another common allergy trigger for North Americans. And pollen allergies can act up if you share an environment with trees, grass, and flowering plants. Pollen allergens are airborne so they’re particularly challenging from spring to autumn when plant life is blooming and pollen can be inhaled.
3. Shellfish
Shellfish allergy is one of the more common food allergies for adults—with more than 2-percent of American adults affected. Shellfish allergies also typically develop later in life, unlike many others. So not only do sufferers have to say no to shrimp, oysters, lobster, clams, mussels, and crab; they also have to beware of coming into contact with things like vitamins (i.e., Glucosamine), pet foods, and cross contamination from restaurants.
4. Pet Hair
Sure you love Fido and Fluffy, but as soon as they crawl up on your lap, you’re left with a runny nose and watery eyes. Allergies to pet hair stem from the oil that animal’s secrete from their coats as well as from the protein in their hair.
5. Eggs
Even though more kids are affected by egg allergies, they are still a concern for 20-percent who take the reaction with them into adulthood. Eggs are often hidden in the sneakiest of places as well—including in immunizations, medications, anesthetics, and baked goods.
6. Dust mites
Dust mites are stubborn allergens because they can’t be seen by the naked eye, and they live in dust, which is present in just about every home and workplace setting. And the allergen is kind of gross—dust mites feed on our bacteria, fungi and dead skin cells in dust balls, and we experience allergic reactions to their waste. Yuck!
7. Soy
Although soy is less of an allergen issue for adults than it is for children, soy beans are a common hidden ingredient in packaged foods, hair, baby formula, stuffed toys, and skin products, so it can be rather dangerous even though it may not be listed on the label.
8. Insect bites
An insect stings or bites as part of its defensive mechanism. However, when an insect bites, it leaves proteins in the skin that are also allergy triggers for some people. The allergy can manifest as mild swelling and itchiness, but it can also be life-threatening for some people.

9. Milk
Cow’s milk is the most common food allergy, with 80-percent of U.S. children suffering from exposure to dairy products, many taking the allergy into adulthood. A milk allergy differs from “lactose intolerance” (the body’s inability to digest milk sugars) in that it’s an immune response to milk proteins, including lactose-free products.
10. Wheat
Wheat is a challenging food allergy because it’s found in so many things—including soy sauce, most beers, deli meats, moisturizing lotions, and even shampoos. A wheat allergy differs from Celiac disease (an autoimmune disorder), and oftentimes can cause anaphylaxis in combination with physical exertion. https://www.activebeat.com/your-health/women/10-most-common-allergies-in-adults/?streamview=all

The Technical University of Munich studied whether the variety of the allergen has an impact on the specific allergy.

Science Daily reported in Allergy potential of strawberries and tomatoes depends on the variety

The incidence of food allergies has increased in recent decades: It affects three to four percent of the adult population and five percent of children. Tomatoes (Solanum lycopersicum) and strawberries (Fragaria x ananassa) can cause allergic reactions due to the presence of various allergenic proteins. Of particular note are proteins that resemble the primary allergen in birch pollen and due to this similarity can lead to birch pollen-associated food allergy. About 1.5 percent of the population in Northern Europe and up to 16 percent in Italy are affected by tomato allergies. And around 30 percent of those who are allergic to birch pollen also report allergenic reactions to strawberry fruits….
Previous studies have found that there are several proteins in both strawberries and tomatoes, which can cause allergic reactions. The aim of the two recently published studies was to quantify an important allergenic protein in the various strawberry and tomato varieties. In order to analyze a broad spectrum, varieties were selected in both cases, which differed in size, shape, and color. Furthermore, the influence of organic and conventional cultivation conditions as well as various processing methods ranging from sun-drying and oven-drying to freeze-drying of the fruits, were investigated. It was assumed that the concentration of the allergenic protein varies with the color of the ripe fruit, the state of growth, and the processing method.
The specific variety makes all the difference
Twenty-three different-colored tomato varieties and 20 strawberry varieties of different sizes and shapes were examined to analyze the genetic factor for the expression of the allergenic protein in the fruits.
The concentration of the allergen in both types of fruit varied greatly between varieties. In addition, the heat sensitivity of the proteins could be confirmed: If the fruits were exposed to heat during the drying process, their allergy potential was lower. However, the influence of cultivation conditions (conventional and ecological) on the allergy content was minor….
https://www.sciencedaily.com/releases/2018/07/180713111957.htm

Citation:

Allergy potential of strawberries and tomatoes depends on the variety
Approach for cultivation of strawberry and tomato varieties with reduced allergy potential
Date:
July 13, 2018
Source:
Technical University of Munich (TUM)
Summary:
Strawberries and tomatoes are among the most widely consumed fruits and vegetables worldwide. However, many people are allergic to them, especially if they have been diagnosed with birch pollen allergy. A team has investigated which strawberry or tomato varieties contain fewer allergens than others and to what extent cultivation or preparation methods are involved.
Journal References:
1. Elisabeth Kurze, Roberto Lo Scalzo, Gabriele Campanelli, Wilfried Schwab. Effect of tomato variety, cultivation, climate and processing on Sola l 4, an allergen from Solanum lycopersicum. PLOS ONE, 2018; 13 (6): e0197971 DOI: 10.1371/journal.pone.0197971
2. Elisabeth Kurze, Vanessa Kock, Roberto Lo Scalzo, Klaus Olbricht, Wilfried Schwab. Effect of the Strawberry Genotype, Cultivation and Processing on the Fra a 1 Allergen Content. Nutrients, 2018; 10 (7): 857 DOI: 10.3390/nu10070857

Here is the press release from the Technical University of Munich:

Approach for cultivation of strawberry and tomato varieties with reduced allergy potential
Allergy potential of strawberries and tomatoes depends on the variety
13.07.2018, Research news
Strawberries and tomatoes are among the most widely consumed fruits and vegetables worldwide. However, many people are allergic to them, especially if they have been diagnosed with birch pollen allergy. A team from the Technical University of Munich (TUM) has investigated which strawberry or tomato varieties contain fewer allergens than others and to what extent cultivation or preparation methods are involved.
The incidence of food allergies has increased in recent decades: It affects three to four percent of the adult population and five percent of children. Tomatoes (Solanum lycopersicum) and strawberries (Fragaria x ananassa) can cause allergic reactions due to the presence of various allergenic proteins. Of particular note are proteins that resemble the primary allergen in birch pollen and due to this similarity can lead to birch pollen-associated food allergy. About 1.5 percent of the population in Northern Europe and up to 16 percent in Italy are affected by tomato allergies. And around 30 percent of those who are allergic to birch pollen also report allergenic reactions to strawberry fruits.

Symptoms of an immunological reaction to strawberries or tomatoes can affect the skin (urticaria or dermatitis), irritate mucous membranes and trigger a runny nose, and can also lead to abdominal pain. Food allergy sufferers develop symptoms after eating fresh fruit or vegetables, while processed products are often tolerated.

Previous studies have found that there are several proteins in both strawberries and tomatoes, which can cause allergic reactions. The aim of the two recently published studies under the direction of Prof. Dr. Wilfried Schwab from the Chair of Biotechnology of Natural Products was to quantify an important allergenic protein in the various strawberry and tomato varieties. In order to analyze a broad spectrum, varieties were selected in both cases, which differed in size, shape, and color.
Furthermore, the influence of organic and conventional cultivation conditions as well as various processing methods ranging from sun-drying and oven-drying to freeze-drying of the fruits, were investigated. It was assumed that the concentration of the allergenic protein varies with the color of the ripe fruit, the state of growth, and the processing method.
THE SPECIFIC VARIETY MAKES ALL THE DIFFERENCE
Twenty-three different-colored tomato varieties and 20 strawberry varieties of different sizes and shapes were examined to analyze the genetic factor for the expression of the allergenic protein in the fruits.

The concentration of the allergen in both types of fruit varied greatly between varieties. In addition, the heat sensitivity of the proteins could be confirmed: If the fruits were exposed to heat during the drying process, their allergy potential was lower. However, the influence of cultivation conditions (conventional and ecological) on the allergy content was minor.

Consequently, the proteins investigated in the studies (Sola l 4.02 in tomatoes and Fra a 1 protein in strawberries) may in future serve as markers for the cultivation of hypoallergenic tomato and strawberry varieties.
PUBLICATIONS:
Kurze, Elisabeth, Lo Scalzo, Roberto, Campanelli, Gabriele; Schwab, Wilfried: Effect of tomato variety, cultivation, climate and processing on Sola l 4, an allergen from Solanum lycopersicum, PLOS ONE 2018. DOI: 10.1371/journal.pone.0197971.

Kurze, Elisabeth; Kock, Vanessa; Lo Scalzo, Roberto; Olbricht, Klaus and Schwab, Wilfried: Effect of the strawberry genotype, cultivation and processing on the Fra a 1 allergen content, Nutrients 2018 10, 857. DOI: 10.3390/nu10070857..
CONTACT:
Prof. Dr. Wilfried Schwab
Technical University of Munich
Chair of Biotechnology of Natural Products
Phone: +49 8161 71 2912
Mail: wilfried.schwab@tum.de
Desk: Sabine Letz https://www.tum.de/en/about-tum/news/press-releases/detail/article/34818/

A physical examination is important for children to make sure that there are no health problems. The University of Arizona Department of Pediatrics has an excellent article which describes Pediatric History and Physical Examination http://www.peds.arizona.edu/medstudents/Physicalexamination.asp The article goes on to describe how the physical examination is conducted and what observations and tests are part of the examination. The Cincinnati Children’s Hospital describes the Process of the Physical Examination http://www.cincinnatichildrens.org/health/p/exam/
If children have allergies, parents must work with their schools to prepare a allergy health plan. See, Journal of American Medical Association study: Consumption of nuts by pregnant woman may reduce nut allergies in their children https://drwilda.com/tag/peanut-allergy/

Resources:

Micheal Borella’s Chicago-Kent Law Review article, Food Allergies In Public Schools: Toward A Model Code

Click to access Borella.pdf

USDA’s Accomodating Children With Special Dietary Needs

Click to access SpecialDietaryNeeds.PDF

Child and Teen Checkup Fact Sheet
http://www.health.state.mn.us/divs/fh/mch/ctc/factsheets.html

Video: What to Expect From A Child’s Physical Exam https://www.aol.com/video/view/what-to-expect-from-a-childs-physical-exam/325661948/

Where information leads to Hope. © Dr. Wilda.com

Dr. Wilda says this about that ©

Blogs by Dr. Wilda:

COMMENTS FROM AN OLD FART©
http://drwildaoldfart.wordpress.com/

Dr. Wilda Reviews ©
http://drwildareviews.wordpress.com/

Dr. Wilda©
https://drwilda.com/

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Mercy Children’s Hospital study: Children with asthma often have undiagnosed peanut allergy

17 May

More children seem to have peanut allergies. Ross Brenneman wrote in the Education Week article, How Peanuts Became Public Health Enemy #1:

Researchers aren’t sure why, but over the past several years, the number of children reported to have allergies has doubled, to 5 percent of children in the United States. Yet at the same time, in schools and elsewhere, allergies have drawn what some see as an oversized amount of attention. A new paper out of Princeton University explores why that may have happened.

Allergy attacks are awful. I’ve been there plenty of times. Eyes swollen shut, coughing, hacking, sneezing—and that’s just garden-variety pollen. But severe allergic reactions, also known as anaphylaxia, can cause death, even for the constantly vigilant. That’s why the U.S. House of Representatives voted unanimously last week in favor of a bill that would incentivize states, through a pre-existing grant program, to make sure their schools have a supply of epinephrine (usually an EpiPen) on hand, as well as staff members trained in using it…

One percent. That’s it. One estimate pegs it closer to 1.4 percent for children, but only .6 percent for adults. Either way, it’s small. Not all of those affected are seriously allergic, either. One percent isn’t nothing, but it’s not the kind of number that would suggest a strong cultural reaction, either.
Why, then, have peanut allergies become such a well-known public health menace? Maybe it’s partly from the mystery surrounding all allergies; scientists don’t know why allergies exist and why some people grow out of them. It’s also not clear how much an allergy attack may be exacerbated by asthma; the two often go hand in hand….
http://blogs.edweek.org/edweek/rulesforengagement/2013/08/how_peanuts_became_public_health_enemy_number_one.html?intc=es

Kids With Food Allergies has some excellent resources.
http://www.kidswithfoodallergies.org/resourcespre.php?id=62&title=Peanut_allergy_avoidance_list&gclid=CJTC7sfLuLICFWdxQgodxHcAJQ

Science Daily reported in Many children with asthma have reaction to peanuts, but do not know it:

A new study has shown that many children who have asthma have a sensitivity to peanuts, but did not know it. Conducted by researchers in the U.S., the study specifically looked at pediatric asthma patients at a pediatric pulmonary clinic.

The study will be presented at the ATS 2015 International Conference.

“Many of the respiratory symptoms of peanut allergy can mirror those of an asthma attack, and vice versa. Examples of those symptoms include shortness of breath, wheezing and coughing,” said study lead author Robert Cohn, MD, MBA. “This study aimed to evaluate the proportion of asthmatic children who also demonstrated a sensitivity to peanuts.”

For the study, the researchers looked at 1,517 children from the pediatric pulmonary clinic at Mercy Children’s Hospital in Toledo, Ohio. They determined if the children’s charts had a documented peanut allergy and if they had undergone a blood test for antibodies demonstrating a potential reaction to peanuts, known as IgE. Children were considered positive if they had a documented history of peanut allergy or a specific IgE blood test that showed a level higher than normal.

What they found was that of the 1,517 charts that were reviewed, 163, or about 11%, had a documented history of peanut allergy. Nearly 44% (665) had specific IgE testing at some point to test for peanut allergy. Out of that group, 148, or approximately 22%, had a positive test to peanut sensitivity. However, more than half of these children and their families did not suspect there was any sensitivity to peanuts. The prevalence of positive tests varied across age groups but the prevalence of known peanut allergy was strikingly similar across age groups…

Citation:

Many children with asthma have reaction to peanuts, but do not know it

Date: May 17, 2015

Source: American Thoracic Society (ATS)

Summary:

In recent years and months, peanut allergies in children have been in the news frequently, as scientists reveal new insights into why more and more children are developing them and what can be done to avoid them. However, until now, few have studied the connection between peanut allergy and childhood asthma.
http://www.sciencedaily.com/releases/2015/05/150517143400.htm

Here is the press release:

Public Release: 17-May-2015 Many children with asthma have reaction to peanuts, but do not know it

American Thoracic Society

ATS 2015, DENVER – In recent years and months, peanut allergies in children have been in the news frequently, as scientists reveal new insights into why more and more children are developing them and what can be done to avoid them. However, until now, few have studied the connection between peanut allergy and childhood asthma.
A new study has shown that many children who have asthma have a sensitivity to peanuts, but did not know it. Conducted by researchers in the U.S., the study specifically looked at pediatric asthma patients at a pediatric pulmonary clinic.

The study will be presented at the ATS 2015 International Conference.

“Many of the respiratory symptoms of peanut allergy can mirror those of an asthma attack, and vice versa. Examples of those symptoms include shortness of breath, wheezing and coughing,” said study lead author Robert Cohn, MD, MBA. “This study aimed to evaluate the proportion of asthmatic children who also demonstrated a sensitivity to peanuts.”

For the study, the researchers looked at 1,517 children from the pediatric pulmonary clinic at Mercy Children’s Hospital in Toledo, Ohio. They determined if the children’s charts had a documented peanut allergy and if they had undergone a blood test for antibodies demonstrating a potential reaction to peanuts, known as IgE. Children were considered positive if they had a documented history of peanut allergy or a specific IgE blood test that showed a level higher than normal.

What they found was that of the 1,517 charts that were reviewed, 163, or about 11%, had a documented history of peanut allergy. Nearly 44% (665) had specific IgE testing at some point to test for peanut allergy. Out of that group, 148, or approximately 22%, had a positive test to peanut sensitivity. However, more than half of these children and their families did not suspect there was any sensitivity to peanuts. The prevalence of positive tests varied across age groups but the prevalence of known peanut allergy was strikingly similar across age groups.
“This study demonstrates children with asthma might benefit from a test for peanut sensitivity, especially when control of wheezing and coughing is difficult to achieve. If a physician is having this problem, or if a parent notices it in his or her asthmatic child, they should consider testing, even if they believe their child is not sensitive to peanuts,” said Dr. Cohn. “There should be continued investigation to learn more about the connection between asthmatic children and peanut sensitivity.”
###
* Please note that numbers in this release may differ slightly from those in the abstract. Many of these investigations are ongoing; the release represents the most up-to-date data available at press time.
Abstract 61468
Prevalence of Peanut Sensitivity Among Children with Asthma
Type: Scientific Abstract
Category:01.21 – Pediatric Epidemiology: Risk Factors, Outcomes and Management (PEDS)
Authors: R.C. Cohn, A. Al-Yazji; Mercy Children’s Hospital/University of Toledo – Toledo, OH/US

Abstract Body
Introduction: The prevalence of childhood asthma in the US is increasing. Coexistence of peanut allergy with asthma could be a risk factor for increased morbidity and mortality. Also some asthma medications should be avoided in children with peanut allergy. Few studies are available assessing the relationship between peanut allergy and asthma. In this study we set out to determine the prevalence of peanut sensitivity among children with asthma who were active patients in a large pediatric pulmonary clinic.
Methods: All charts of children who carried the diagnosis of asthma and who were actively seen in the pediatric pulmonary clinic at Mercy Children’s Hospital in Toledo, Ohio were retrospectively reviewed for documented peanut allergy and the presence or absence of peanut IgE testing. Children were considered positive if they had a documented history of peanut allergy or a specific IgE blood test >0.35 ku/l. Children who had a positive test and who did not report a peanut allergy before testing were labeled as”unsuspected”. Data were analyzed collectively and by age groups.

Results: 1517 charts of children diagnosed with asthma were reviewed; 163 (10.7%) had a documented h/o peanut allergy. 665 patients of the 1517 (43.8%) had specific IgE testing at some point. Of the 665, 148 (22.3%) had a positive test to peanut. 53% of these children and their families did not suspect peanut sensitivity. The prevalence of positive tests varied across age distributions but the prevalence of known peanut allergy was strikingly similar across age groups.

Conclusion: In this select group of asthma patients the prevalence of peanut sensitivity was high. Many children/families did not suspect a peanut sensitivity. We speculate that children with asthma might benefit from peanut sensitivity screening especially when control is difficult to achieve.
Disclaimer: AAAS and EurekAlert! are not responsible for the accuracy of news releases posted to EurekAlert! by contributing institutions or for the use of any information through the EurekAlert system.

Media Contact
Nathaniel Dunford
ndunford@thoracic.org

@atscommunity
http://www.thoracic.org

A physical examination is important for children to make sure that there are no health problems. The University of Arizona Department of Pediatrics has an excellent article which describes Pediatric History and Physical Examination http://www.peds.arizona.edu/medstudents/Physicalexamination.asp The article goes on to describe how the physical examination is conducted and what observations and tests are part of the examination. The Cincinnati Children’s Hospital describes the Process of the Physical Examination http://www.cincinnatichildrens.org/health/p/exam/
If children have allergies, parents must work with their schools to prepare a allergy health plan. See, Journal of American Medical Association study: Consumption of nuts by pregnant woman may reduce nut allergies in their children https://drwilda.com/tag/peanut-allergy/

Resources:

Micheal Borella’s Chicago-Kent Law Review article, Food Allergies In Public Schools: Toward A Model Code

Click to access Borella.pdf

USDA’s Accomodating Children With Special Dietary Needs

Click to access SpecialDietaryNeeds.PDF

Child and Teen Checkup Fact Sheet
http://www.health.state.mn.us/divs/fh/mch/ctc/factsheets.html

Video: What to Expect From A Child’s Physical Exam
http://on.aol.com/video/what-to-expect-from-a-childs-physical-exam-325661948

Where information leads to Hope. © Dr. Wilda.com

Dr. Wilda says this about that ©

Blogs by Dr. Wilda:

COMMENTS FROM AN OLD FART©
http://drwildaoldfart.wordpress.com/

Dr. Wilda Reviews ©
http://drwildareviews.wordpress.com/

Dr. Wilda ©                                                                                                                                                                                https://drwilda.com/
https://drwilda.com/

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Journal of American Medical Association study: Consumption of nuts by pregnant woman may reduce nut allergies in their children

24 Dec

Moi wrote about allergies in Food allergies can be deadly for some children:
If one is not allergic to substances, then you probably don’t pay much attention to food allergies. The parents and children in one Florida classroom are paying a lot of attention to the subject of food allergies because of the severe allergic reaction one child has to peanuts. In the article, Peanut Allergy Stirs Controversy At Florida Schools Reuters reports:

Some public school parents in Edgewater, Florida, want a first-grade girl with life-threatening peanut allergies removed from the classroom and home-schooled, rather than deal with special rules to protect her health, a school official said.
“That was one of the suggestions that kept coming forward from parents, to have her home-schooled. But we’re required by federal law to provide accommodations. That’s just not even an option for us,” said Nancy Wait, spokeswoman for the Volusia County School District.
Wait said the 6-year-old’s peanut allergy is so severe it is considered a disability under the Americans with Disabilities Act.
To protect the girl, students in her class at Edgewater Elementary School are required to wash their hands before entering the classroom in the morning and after lunch, and rinse out their mouths, Wait said, and a peanut-sniffing dog checked out the school during last week’s spring break….
Chris Burr, a father of two older students at the school whose wife has protested at the campus, said a lot of small accommodations have added up to frustration for many parents.
“If I had a daughter who had a problem, I would not ask everyone else to change…. http://www.reuters.com/article/2011/03/22/us-peanut-allergy-idUSTRE72L7AQ20110322

More children seem to have peanut allergies. Researchers are trying to discover the reason for the allergies, but also asking the question of whether the number of nut allergies in children can be reduced.

Michael Pearson of CNN reported in the story, Study: Eating nuts during pregnancy may reduce baby’s allergy risk:

The children of women who regularly ate peanuts or tree nuts during pregnancy appear to be at lower risk for nut allergies than other kids, according to a new study published Monday.
The study, published in the Journal of the American Medical Association, is the first to demonstrate that a mother who eats nuts during pregnancy may help build up a baby’s tolerance to them after birth, its lead author, Dr. Michael Young, told CNN.
The effect seemed to be strongest in women who ate the most peanuts or tree nuts — five or more servings per week, according to the study, which controlled for factors such as family history of nut allergies and other dietary practices.
Peanut and tree nut allergies tend to overlap, according to the researchers.
What food allergies are costing families — and the economy
Earlier studies indicated that nut consumption during pregnancy either didn’t have any effect or actually raised the risk of allergies in children.
However, the authors of the latest study say those studies were based on less reliable data and conflict with more recent research suggesting that early exposure to nuts can reduce the risk of developing allergies to them.
There is currently no formally recognized medical guidance for nut consumption during pregnancy or infancy. http://www.cnn.com/2013/12/23/health/nut-allergy-study/

Citation:

Original Investigation | December 23, 2013 JOURNAL CLUB
Prospective Study of Peripregnancy Consumption of Peanuts or Tree Nuts by Mothers and the Risk of Peanut or Tree Nut Allergy in Their Offspring FREE ONLINE FIRST
A. Lindsay Frazier, MD, ScM1,2; Carlos A. Camargo Jr, MD, DrPH2,3,4; Susan Malspeis, MS2; Walter C. Willett, MD, DrPH4,5,6; Michael C. Young, MD7
[+] Author Affiliations
JAMA Pediatr. Published online December 23, 2013. doi:10.1001/jamapediatrics.2013.4139
Article
Tables
References
Comments
ABSTRACT
ABSTRACT | METHODS | RESULTS | DISCUSSION | CONCLUSIONS | ARTICLE INFORMATION | REFERENCES
Importance The etiology of the increasing childhood prevalence of peanut or tree nut (P/TN) allergy is unknown.
Objective To examine the association between peripregnancy consumption of P/TN by mothers and the risk of P/TN allergy in their offspring.
Design, Setting, and Participants Prospective cohort study. The 10 907 participants in the Growing Up Today Study 2, born between January 1, 1990, and December 31, 1994, are the offspring of women who previously reported their diet during, or shortly before or after, their pregnancy with this child as part of the ongoing Nurses’ Health Study II. In 2006, the offspring reported physician-diagnosed food allergy. Mothers were asked to confirm the diagnosis and to provide available medical records and allergy test results. Two board-certified pediatricians, including a board-certified allergist/immunologist, independently reviewed each potential case and assigned a confirmation code (eg, likely food allergy) to each case. Unadjusted and multivariable logistic regression analyses were used to evaluate associations between peripregnancy consumption of P/TN by mothers and incident P/TN allergy in their offspring.
Exposure Peripregnancy consumption of P/TN.
Main Outcomes and Measures Physician-diagnosed P/TN allergy in offspring.
Results Among 8205 children, we identified 308 cases of food allergy (any food), including 140 cases of P/TN allergy. The incidence of P/TN allergy in the offspring was significantly lower among children of the 8059 nonallergic mothers who consumed more P/TN in their peripregnancy diet (≥5 times vs <1 time per month: odds ratio = 0.31; 95% CI, 0.13-0.75; Ptrend = .004). By contrast, a nonsignificant positive association was observed between maternal peripregnancy P/TN consumption and risk of P/TN allergy in the offspring of 146 P/TN-allergic mothers (Ptrend = .12). The interaction between maternal peripregnancy P/TN consumption and maternal P/TN allergy status was statistically significant (Pinteraction = .004).
Conclusions and Relevance Among mothers without P/TN allergy, higher peripregnancy consumption of P/TN was associated with lower risk of P/TN allergy in their offspring. Our study supports the hypothesis that early allergen exposure increases tolerance and lowers risk of childhood food allergy.
Peanut allergy affects 1% to 2% of the population in most Western countries,1- 3 and in the United States, the prevalence of childhood peanut allergy has more than tripled, from 0.4% in 1997 to 1.4% in 2010.4 Typically, the onset of peanut allergy is in early childhood; 70% of reactions occur during the first known exposure.5 These IgE-mediated hypersensitivity reactions require prior allergen exposure and sensitization, implying that prior exposure to peanut had already occurred in utero or through unknown exposures in the diet or environment, such as through skin or respiratory routes.6 Because of frequent overlap between peanut allergy and tree nut allergy and their similar natural history, with 80% to 90% persistence of the food allergy into adulthood,7 these 2 allergies are often considered together as peanut or tree nut (P/TN) allergy.
For many years, pediatric guidelines have recommended the avoidance of P/TN for at least the first 3 years of life, with some experts also recommending that P/TN be avoided during pregnancy.8 These recommendations were rescinded recently when literature reviews showed little support for them.9,10 For decades, many investigators have posited that modifications of the maternal diet during pregnancy might prevent food allergies.11- 14 However, some studies on maternal avoidance of peanut during pregnancy actually demonstrated an increase in peanut sensitization in the child,15- 17 while other studies found no association.5,14,18,19 In related research, early exposure to allergenic foods in infant diets may decrease sensitization and increase oral tolerance to those foods.20- 24
Given the lack of clarity in the current literature, an important quandary exists: should the pregnant mother include or exclude P/TN in her diet? The goal of our investigation was to clarify the association between peripregnancy consumption of P/TN by mothers and the subsequent development of P/TN allergy in their offspring…. http://archpedi.jamanetwork.com/article.aspx?articleid=1793699

Resources:

Micheal Borella’s Chicago-Kent Law Review article, Food Allergies In Public Schools: Toward A Model Code

Click to access Borella.pdf

USDA’s Accommodating Children With Special Dietary Needs http://www.k12.wa.us/ChildNutrition/pubdocs/SpecialDietaryNeeds.PDF

Child and Teen Checkup Fact Sheet http://www.health.state.mn.us/divs/fh/mch/ctc/factsheets.html
Video: What to Expect From A Child’s Physical Exam
http://on.aol.com/video/what-to-expect-from-a-childs-physical-exam-325661948

Related:
New federal guidelines for schools regarding student allergies
https://drwilda.com/2013/11/04/new-federal-guidelines-for-schools-regarding-student-allergies/

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New federal guidelines for schools regarding student allergies

4 Nov

Moi wrote about allergies in Food allergies can be deadly for some children:
If one is not allergic to substances, then you probably don’t pay much attention to food allergies. The parents and children in one Florida classroom are paying a lot of attention to the subject of food allergies because of the severe allergic reaction one child has to peanuts. In the article, Peanut Allergy Stirs Controversy At Florida Schools Reuters reports:

Some public school parents in Edgewater, Florida, want a first-grade girl with life-threatening peanut allergies removed from the classroom and home-schooled, rather than deal with special rules to protect her health, a school official said.
“That was one of the suggestions that kept coming forward from parents, to have her home-schooled. But we’re required by federal law to provide accommodations. That’s just not even an option for us,” said Nancy Wait, spokeswoman for the Volusia County School District.
Wait said the 6-year-old’s peanut allergy is so severe it is considered a disability under the Americans with Disabilities Act.
To protect the girl, students in her class at Edgewater Elementary School are required to wash their hands before entering the classroom in the morning and after lunch, and rinse out their mouths, Wait said, and a peanut-sniffing dog checked out the school during last week’s spring break….
Chris Burr, a father of two older students at the school whose wife has protested at the campus, said a lot of small accommodations have added up to frustration for many parents.
“If I had a daughter who had a problem, I would not ask everyone else to change…. http://www.reuters.com/article/2011/03/22/us-peanut-allergy-idUSTRE72L7AQ20110322

More children seem to have peanut allergies.
See, More school battles about peanut allergies https://drwilda.com/tag/allergy/

Mike Stobbe of AP reported in the article, Feds post food allergy guidelines for schools:

ATLANTA (AP) — The federal government is issuing its first guidelines to schools on how to protect children with food allergies.
The voluntary guidelines call on schools to take such steps as restricting nuts, shellfish or other foods that can cause allergic reactions, and make sure emergency allergy medicine — like EpiPens — are available.
About 15 states — and numerous individual schools or school districts — already have policies of their own. “The need is here” for a more comprehensive, standardized way for schools to deal with this issue, said Dr. Wayne Giles, who oversaw development of the advice for the Centers for Disease Control and Prevention.
Food allergies are a growing concern. A recent CDC survey estimated that about 1 in 20 U.S. children have food allergies — a 50 percent increase from the late 1990s. Experts aren’t sure why cases are rising.
Many food allergies are mild and something children grow out of. But severe cases may cause anaphylactic shock or even death from eating, say, a peanut.
The guidelines released Wednesday were required by a 2011 federal law.
http://www.huffingtonpost.com/2013/10/30/school-allergy-guidelines_n_4177867.html?utm_hp_ref=email_share

Here is information from the Centers for Disease Control about the guidelines:

Food Allergies in Schools
Food allergies are a growing food safety and public health concern that affect an estimated 4%–6% of children in the United States.1, 2 Allergic reactions can be life threatening and have far-reaching effects on children and their families, as well as on the schools or early care and education (ECE) programs they attend. Staff who work in schools and ECE programs should develop plans for preventing an allergic reaction and responding to a food allergy emergency.
Voluntary Guidelines for Managing Food Allergies In Schools and Early Care and Education Programs [PDF – 10MB]
Food Allergy Guidelines FAQs [PDF – 163KB]
What is a Food Allergy?
A food allergy occurs when the body has a specific and reproducible immune response to certain foods.3 The body’s immune response can be severe and life threatening, such as anaphylaxis. Although the immune system normally protects people from germs, in people with food allergies, the immune system mistakenly responds to food as if it were harmful.
Eight foods or food groups account for 90% of serious allergic reactions in the United States: milk, eggs, fish, crustacean shellfish, wheat, soy, peanuts, and tree nuts.3
Symptoms of Food Allergy in Children
Symptoms Communicated by Children with Food Allergies4
• It feels like something is poking my tongue.
• My tongue (or mouth) is tingling (or burning).
• My tongue (or mouth) itches.
• My tongue feels like there is hair on it.
• My mouth feels funny.
• There’s a frog in my throat; there’s something stuck in my throat.
• My tongue feels full (or heavy).
• My lips feel tight.
• It feels like there are bugs in there (to describe itchy ears).
• It (my throat) feels thick.
• It feels like a bump is on the back of my tongue (throat).
The symptoms and severity of allergic reactions to food can be different between individuals, and can also be different for one person over time. Anaphylaxis is a sudden and severe allergic reaction that may cause death.5 Not all allergic reactions will develop into anaphylaxis.
Food Allergies in Schools
• Children with food allergies are two to four times more likely to have asthma or other allergic conditions than those without food allergies.1
• The prevalence of food allergies among children increased 18% during 1997–2007, and allergic reactions to foods have become the most common cause of anaphylaxis in community health settings.1,6
• In 2006, about 88% of schools had one or more students with a food allergy.7

Treatment and Prevention of Food Allergies in Children
There is no cure for food allergies. Strict avoidance of the food allergen is the only way to prevent a reaction. However, since it is not always easy or possible to avoid certain foods, staff in schools and ECE programs should develop plans to deal with allergic reactions, including anaphylaxis. Early and quick recognition and treatment of allergic reactions that may lead to anaphylaxis can prevent serious health problems or death.
Voluntary Guidelines for Managing Food Allergies In Schools and Early Care and Education Programs
In consultation with the U.S. Department of Education and a number of other federal agencies, CDC developed the Voluntary Guidelines for Managing Food Allergies in Schools and Early Care and Education Centers [PDF – 10MB] in fulfillment of the 2011 FDA Food Safety Modernization Act to improve food safety in the United States. Download Food Allergy Guidelines FAQs [PDF – 163KB].
The Voluntary Guidelines for Managing Food Allergies provide practical information and planning steps for parents, district administrators, school administrators and staff, and ECE program administrators and staff to develop or strengthen plans for food allergy management and prevention. The Voluntary Guidelines for Managing Food Allergies include recommendations for each of the five priority areas that should be addressed in each school’s or ECE program’s Food Allergy Management Prevention Plan:
1. Ensure the daily management of food allergies in individual children.
2. Prepare for food allergy emergencies.
3. Provide professional development on food allergies for staff members.
4. Educate children and family members about food allergies.
5. Create and maintain a healthy and safe educational environment.
References
1. Branum AM, Lukacs SL. Food allergy among U.S. children: trends in prevalence and hospitalizations. NCHS Data Brief. 2008;10:1-8.
2. Liu AH, Jaramillo R, Sicherer SH, et al. National prevalence and risk factors for food allergy and relationship to asthma: results from the National Health and Nutrition Examination Survey 2005-2006. J Allergy Clin Immunol. 2010;126(4):798-806.e13.
3. Boyce JA, Assa’ad A, Burks AW, et al; NIAID-Sponsored Expert Panel. Guidelines for the diagnosis and management of food allergy in the United States: report of the NIAID-sponsored expert panel. J Allergy Clin Immunol. 2010;126(suppl 6):S1-S58.
4. The Food Allergy & Anaphylaxis Network. Food Allergy News. 2003;13(2).
5. Sampson HA, Munoz-Furlong A, Campbell RL, et al. Second symposium on the definition and management of anaphylaxis: summary report—Second National Institute of Allergy and Infectious Disease/Food Allergy and Anaphylaxis Network Symposium. Ann Emerg Med. 2006;47(4):373-380.
6. Decker WW, Campbell RL, Manivannan V, et al. The etiology and incidence of anaphylaxis in Rochester, Minnesota: a report from the Rochester Epidemiology Project. J Allergy Clin Immunol. 2008;122(6):1161-1165.
7. O’Toole TP, Anderson S, Miller C, Guthrie J. Nutrition services and foods and beverages available at school: results from the School Health Policies and Programs Study 2006. J Sch Health. 2007;77:500-521.
Voluntary Guidelines for Managing Food Allergies In Schools and Early Care and Education Programs [PDF – 10MB]
Food Allergy Guidelines FAQs [PDF – 163KB]
http://www.cdc.gov/healthyyouth/foodallergies/

It requires a great deal of tact and give and take on the part of parents and the school to produce a workable situation for students, the child with the allergy, and parents.
A physical examination is important for children to make sure that there are no health problems. The University of Arizona Department of Pediatrics has an excellent article which describes Pediatric History and Physical Examination http://www.peds.arizona.edu/medstudents/Physicalexamination.asp The article goes on to describe how the physical examination is conducted and what observations and tests are part of the examination. The Cincinnati Children’s Hospital describes the Process of the Physical Examination http://www.cincinnatichildrens.org/health/p/exam/
If children have allergies, parents must work with their schools to prepare a allergy health plan.

Resources:

Micheal Borella’s Chicago-Kent Law Review article, Food Allergies In Public Schools: Toward A Model Code http://www.cklawreview.com/wp-content/uploads/vol85no2/Borella.pdf

USDA’s Accommodating Children With Special Dietary Needs http://www.k12.wa.us/ChildNutrition/pubdocs/SpecialDietaryNeeds.PDF

Child and Teen Checkup Fact Sheet http://www.health.state.mn.us/divs/fh/mch/ctc/factsheets.html

Video: What to Expect From A Child’s Physical Exam http://on.aol.com/video/what-to-expect-from-a-childs-physical-exam-325661948

Where information leads to Hope. © Dr. Wilda.com

Dr. Wilda says this about that ©

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COMMENTS FROM AN OLD FART© http://drwildaoldfart.wordpress.com/

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