Food Allergy Living Blog Tagged Results

In food allergy circles, we usually think of symptoms and side effects as results of food allergies, not the other way around. In most cases that’s true. Science has shown a strong link between food allergy and atopic dermatitis, a form of eczema. Last month Dr. Jon Hanifin, a respected dermatologist, gave a talk to colleagues discussing the link between atopic dermatitis and food allergies. The research he presented suggests that for some patients it may actually be atopic dermatitis that comes first and acts as a precursor to food allergies.

Atopic dermatitis is often one of the first signs that a parent or caregiver notices in their child which helps lead to the diagnosis of food allergy. As Dr. Hanifin explained, about 6-10% of children are diagnosed with atopic dermatitis, and of those about a third will be diagnosed with a food allergy. Which begs the question: If parents notice signs of atopic dermatitis first, and an allergy diagnosis comes later, couldn’t atopic dermatitis be causing some instances of food allergy?

What We Know:

-In cases of food allergy, offending foods cause reactions in the body which involve the immune system

-Immunoglobulin E antibodies (IgE) are immune substances which are normally in our bodies at low levels, but are higher with food allergy

-Allergy symptoms often involve the skin (including our digestive tract, which is like an inside skin), an important barrier that keeps most outside “things” from getting inside

-One factor of atopic dermatitis is “holes” in the barrier our skin provides

What Dr. Hanifin Proposed:

In the past it was assumed that food allergies came first, causing both high IgE levels and atopic dermatitis. Dr. Hanifin suggested that in some patients atopic dermatitis is caused by “gaps” in the skin (likely due to genetics), which means that foreign substances can enter the skin and cause adverse reactions. He thinks it may be proteins that get through these gaps which allows the body to become sensitive to certain foods, leading to a food allergy.

What does all of this mean? The biggest message here is that patients with atopic dermatitis, especially those under five years, should be tested for food allergies. While avoiding food allergens may not help improve atopic dermatitis, it could certainly prevent or improve other serious side effects of allergies. The second message is that more research needs to be done into the causes of atopic dermatitis and its relationship to food allergies. Any research that leads to better health, through reducing instances of atopic dermatitis and/or food allergies, is good research! Tell us about your experience: Was atopic dermatitis the first sign that you saw of your child’s food allergy?

- Rob

This weekend, March 18 – 22, we will be joining the best and brightest allergy and immunology experts at the American Academy of Allergy Asthma & Immunology (AAAAI) annual meeting in San Francisco, California.

AAAAI was established in 1943 and is the largest professional allergy and immunology medical organization in the United States. With nearly 6,500 members, AAAAI is made up of asthma specialists, clinical immunologists, allied health professionals and many others, all of who have a special interest in researching and treating allergic diseases.

Presenting new advancements and findings for allergy, asthma and immunology patients is the main goal of AAAAI and the annual meeting and we are looking forward to learning from the presentations at the conference. Some of the food allergy-related topics this year include:

• The Food Allergy Guidelines: From Controversy to Consensus
• What is New in Pediatric Allergy
• Activation of the Innate Immune System by Allergens: How Allergic Reactions get Started
• Living with Risk: Quality of Life for Families with Food Allergies

We’ll be sure to keep you posted on all of the fun and exciting things we hope to learn this weekend!

- Sarah

Not so many years ago, it was pretty common for kids to give classmates valentines with candy, bring in baked goods to share, and have a Valentine’s Day party at school. While a lot of classrooms have cut back on such activities, it’s still a great idea to play it safe this Valentine’s Day and avoid the risk of allergic reactions.

Preparing

Since Valentine’s Day falls on a school day this year, the best thing you can do is to remind your child’s teacher(s) of allergies ahead of time. If valentines are going to be exchanged or a party is planned, the teacher can help share information with other parents to ensure that everyone remains safe from potential allergens. Feel free to offer to send a “safe” treat in with your child if they won’t be able to enjoy other foods.

If your child is going to a friend’s house for a Valentine’s Day party, make sure to check in with the host parents to make sure they are aware your little one has a food allergy and ask what will be served ahead of time. Remind your child that they should keep an eye out for allergens: even if a party has a menu, there’s no guarantee other parents won’t send unplanned treats.

Hosting

Are you a teacher? If so, remember that the safest valentine for a child with an allergy is one that doesn’t include candy. You may find it easiest to institute a “cards only” rule if valentines are exchanged. A Valentine’s Day party can be great without the snacks by involving fun games or crafts. You could also keep the food and ensure it’s safe by purchasing or preparing snacks yourself that you know are safe and instituting a “no treats” rule for parents.

If you’re a parent who’s hosting a get-together for some of your child’s playmates, it’s best to check ahead of time with other parents to ask about allergies. Other parents may be more than happy to contribute allergen-free foods to the menu, or you can forgo food altogether and host the party away from mealtime with some fun activities instead.

Giving

Whether your child has an allergy or not, make sure he/she is giving valentines that are safe for other students in their class who may have an allergy of their own. Lots of valentine multi-packs include candy, which most kids enjoy. However, to keep the valentines your child hands out safe, you might consider sprucing up a “traditional” card-only valentine. You can add to the “cool factor” by including valentine-themed tattoos, stickers, or other approved favors in place of edible gifts.

Have a child that can’t enjoy chocolate or the usual treats? Try out our recipe for a knock-out knock-off of chocolate pudding. Also consider family-friendly activities that don’t involve food. Finally, a t-shirt, CD, game or even small vase of flowers could be the surprise gift your child wasn’t expecting!

What tips do you have to keep Valentine’s Day worry free?

- Rob

The American Academy of Pediatrics (AAP) doesn’t recommend the use of multivitamins for all children because eating a balanced diet (with iron-fortified foods) is usually sufficient to meet a child’s vitamin and mineral requirements. However, for a child with a restricted diet, a multivitamin may be necessary. We’ve been getting a lot of inquiries about Phlexy Vits, our powdered micronutrient supplement, so I wanted to use this blog post to provide some more information on it.

Phlexy Vits are a powdered micronutrient supplement containing vitamins, minerals and trace elements. They were designed to meet the nutritional needs of older children (11+) and adults. Occasionally Phlexy Vits are used in children but the dosage must be adjusted and this should only be done under the direction and supervision of a healthcare professional.

Phlexy Vits were actually originally developed for patients with Phenylketonuria or PKU, who require a restrictive, low protein diet. However, they may be useful for anybody with a medical condition that requires them to follow a restrictive diet. We have received inquiries about the use of Phlexy Vits for patients with multiple food allergies because many popular multivitamin brands contain hidden allergens.

Hidden Allergens in Children’s Vitamins

Below is a list of popular children’s multivitamins and the food allergens that they contain:

• Centrum Children’s: contains milk, soy and wheat (as well as lactose)
• Flintstones Complete and Flintstones Plus Immunity: contain soy
• Flintstones Gummies: contains wheat and tree nuts
• One-A-Day Scooby Doo Gummies: contains wheat and tree nuts

Vitamins for Children 11 and Older with Food Allergies

For older children (11+) with food allergies, Phlexy Vits may be a great option because they are free of milk and soy proteins, gluten and the sugars lactose, sucrose and fructose. There are no corn proteins in Phlexy Vits; however, certain nutrients are derived from corn so discuss this with your health care provider if your child is very sensitive to corn derivatives. Keep in mind that Phlexy Vits were developed for individuals over 11 years of age so do not use for younger children unless advised by your health care professional. The daily intake will have to be adjusted for a younger child.

For those of you with children on Neocate products, a multivitamin probably isn’t necessary. Neocate products are nutritionally-complete and were designed to meet all nutrient needs: protein, fat, carbohydrates, vitamins and minerals.

- Mallory

You may have noticed that allergies and asthma often go hand in hand. Roughly, 70% of children with asthma have some type of allergy[1]. So do allergies cause asthma? Or does asthma cause allergies? The answer to both questions is no; one does not cause the other but the two conditions do have a strong connection.

Inflammation & Your Immune System

Allergies and asthma are both inflammatory conditions caused by dysfunction of the immune system. Sometimes they are referred to as “atopic diseases”. The immune system is the body’s defense to foreign invaders, such as bacteria, viruses, pathogens, fungi, etc. When the immune system detects these foreign invaders, it releases cells that seek out and destroy them. Inflammation is one of the first responses of the immune system to infection. Usually, the immune system keeps us healthy; however, a malfunctioning immune system can lead to illness. This is what happens with allergies and asthma.

Asthma vs. Allergies

With allergies, the immune system is hyperactive and produces an unnecessary inflammatory response to a traditionally harmless substance (such as a food protein). Asthma is a chronic lung disease characterized by episodes of inflammation and narrowing of the airway in response to certain "triggers." These triggers vary from patient to patient and may include infectious agents, exercise, stress, pollutants such as cigarette smoke, and common allergens such as cat dander, dust mites, and pollen.

Is there a link?

There are approximately 9 million kids in the US who have asthma[2]. Of this 9 million, about ¾ have asthma that is triggered by allergies. Remember, we talked about different triggers for asthma symptoms (exercise, pollen, allergens, etc.). Patients whose asthma is triggered by allergens are often said to have “allergic asthma”. [3] According to the Asthma and Allergy Foundation of America, allergic asthma is the most common type of asthma, affecting around half of asthma patients.

Does Genetics Play a Role?

Atopy refers to the genetic tendency to develop allergic diseases, such as eczema, allergies and asthma[4]. Someone with “atopy” produces certain antibodies associated with allergic disease. Genetics and environmental factors both contribute to whether a patient does or doesn’t develop atopic diseases. Not all people with atopy (that genetic predisposition) go on to develop allergic diseases because environmental factors play a role too; However, they are significantly more likely to. Likewise, not all people with atopic disease have atopy (but most do).

Genetics obviously plays a big role in the development of allergic diseases. If one parent has an atopic condition, their child has a 1 in 4 chance of having some form of atopic disease (not necessarily the same one as the parent)[5]. If both parents have an atopic condition, the child is more than 50% likely to develop an atopic disease.

Hopefully, this information gives you a better understanding of why asthma and allergies are so often seen together. While neither one causes the other, some people have a genetic predisposition which puts them at a greater risk for developing all forms of allergic disease (such as allergy, eczema and asthma). So if you have one allergic disease, you have a higher risk for developing other types of allergic conditions in comparison to the general population.

Have you found this to be true with your little ones? Be sure to share your experiences with us in the comments!

- Mallory

[1] World Health Organization. Global surveillance, prevention and control of chronic respiratory disease: a comprehensive approach, 2007.
[2] The Nemours Foundation/KidsHealth^®© 1995- 2010. http://kidshealth.org/.
[3] American Academy of Allergy Asthma & Immunology.
[4] Atopic Diseases in Childhood. Gold MS and Kemp AS. MJA 2005; 182 (6):298-304. [5] The National Eczema Association. http://www.nationaleczema.org/.

It’s a new year and it seems not much has changed in the news department — it’s still all about allergies! I just came across an article in Time magazine on allergies and Americans.

The article, called “Have Americans Gone Nuts Over Nut Allergies?” is very similar to the article from the US News & World Report that I blogged about a few weeks ago. This article is a bit different, however, because it covers both sides of the allergy argument: doctors that feel people are too worried about allergies and parents who feel there is never enough attention paid to allergies.

To read the entire article, click here. T

he way I look at it is the more articles that are written about allergies, the more people that are aware of them. And that is always a good thing!

Have you read any interesting allergy news articles lately?

- Nita

Parents often ask us if their second child has an increased risk of allergies if their older sibling has them.  So, in today’s post, we’ll discuss the genetics of allergies.

The exact cause of allergies is unknown, but researchers suspect that they are most likely caused by a combination of both genetics and environmental factors.

Genetic Factors:

“Atopy” is a term used to describe the genetic predisposition to develop allergies or allergic diseases.  Allergies and allergic disease may include eczema, asthma, food allergies, etc.  

Studies show that if one parent is “atopic”, at least 30% of their children will have allergies[i]. If both parents are atopic, this value goes up to 50%.  Although a familial history of allergy puts you at an increased risk of developing allergy, you will not necessarily develop the same type of allergy or allergic disease as your family member[ii].  Atopy describes a predisposition for allergic disease in general.  The presentation and type of allergic disease may vary from family member to family member (for example, a parent has an allergy to pet dander and their child has an allergy to milk protein).

Environmental Factors:

Not all individuals with a genetic predisposition for allergies will go on to develop them because the environment plays an important role too.  It is difficult to know how much is determined by genetics and how much is determined by environmental factors because family members are often exposed to the same environmental factors.  Research on identical twins raised in different environments has shown that there is some discrepancy in the development of allergies despite a shared genetic predisposition.  This suggests that although there is a strong genetic component, environmental exposure is quite influential as well[iii].

What can you do?

You cannot modify a genetic predisposition for developing allergies (at least not yet!), you can alter the environmental exposures, which influence the development of allergies.  External environmental factors like smog, car exhaust, pollen, etc are difficult to alter unless you move to a different location. However, it is possible to reduce the indoor environmental  factors in your home. Whether or not this is effective in preventing allergies in those predisposed to them is still unclear but it certainly couldn’t hurt.  There is also a great deal of interest in whether dietary modifications, both for the mother during pregnancy and for the infants during the first year or life, can protect infants predisposed to developing allergic disease.  At this point, there is not enough  evidence to make a strong recommendation on preventive practices. However, research shows that introducing foods (anything other than breast milk or formula) during the first 4 months of life is associated with the development of allergies so refraining from this is one more way you may be able to protect your little one from developing allergies.

-Mallory

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