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

We’re always keeping our eyes peeled and our ears tuned for new news on eosinophilic esophagitis (also EoE or EE). This matters to us because many children with EoE  use Neocate products, as part of their special, healthy diet.


The Study

Dr. Charles DeBrosse and Dr. James Franciosi at the Cincinnati Children’s Hospital, where there is a Center for Eosinophilic Disorders, recently published a new research study about the long-term effects of EoE.  If you’re interested in reading the study here are links to the study abstract as well as a great summary.


The Results

The research team looked at over 100 patients with esophagitis; some had EoE, while others had chronic esophagitis, and compared them to patients who had no esophagitis. On average, this was about 15 years after the patients developed esophagitis. EoE research was in its early stages back then, and many patients went undiagnosed or were misdiagnosed. The participants answered questions about their symptoms and quality of life. The researchers then compared the results of each of the groups to see what differences really stood out.

Patients with EoE reported a lower quality of life and experienced more trouble swallowing and had food become stuck in their esophagus more often. Those patients with higher eosinophil counts in childhood had more trouble swallowing as adults. Also, patients with a diagnosed food allergy were more likely to have trouble swallowing and to have food become stuck in their esophagus.


The Bottom Line

As the researchers concluded, EoE “is associated with reduced quality of life and persistent symptoms 15 years after presentation.” They also noted that both increased eosinophil counts and the presence of food allergy in childhood increase the rate of trouble swallowing in young adulthood. It doesn’t sound very positive, but it’s what many of us expected: there is a strong link between food allergies and symptoms among patients with EoE, and high eosinophil levels can have a lasting impact.


What Can We Take Away from This?

Sure, the results and conclusion don’t sound great at first, but there are a few things to keep in mind. For one, a HUGE amount of research has been conducted on EoE in the last 15 years, and we’ve learned a lot! Patients who had EoE 15 years ago had a much different experience than patients with EoE today have. For instance, the way that EoE is diagnosed and treated has improved in that time. Also, many more of today’s health care teams can recognize, diagnose, and treat EoE, which is more widely known. And many teams also include allergy testing as part of the care process for EoE.

There are also options for managing EoE that are now in wide use. For instance, elimination diets and elemental diets (which we’ll blog about in a few weeks – stay tuned) have come a long way. Elemental diets (or amino acid-based formulas) can be especially helpful in getting EoE under control and are useful in diagnostic phases. These formulas can help improve trouble swallowing when EoE isn’t under control, which can mean better outcomes. They can also provide key nutrients when added to a very limited diet.

Children on elemental diets have lots of options these days in the Neocate family of products. We have Neocate Junior, which is available in several flavors. We also have E028 Splash, which not only comes in multiple flavors, but is also in drink box form, so it’s just as ready-to-go as your child! And for children who miss solid textures on an elemental diet, Neocate Nutra can provide a change of scenery, especially prepared in one of our recipes.


What did you learn from the new research that was published in June?

- Rob 


[Photo: Microsoft Images]

We get questions related to starting solid foods from parents pretty often, and have blogged on topics such as how to start and some specific tips for infants with allergies. Most questions about starting solids are best answered by your little one’s health care team, since there isn’t always consensus in the medical community. Today we want to share an interesting study that was published recently in the Journal of the Academy of Nutrition and Dietetics that may be helpful.


The Article and the Study

The title of the article is “Associations of Infant Feeding Practices and Picky Eating Behaviors of Preschool Children.” We can simplify it to “how feeding infants might add to picky eating later on.” The authors looked into the way that feeding patterns in infancy, when eating patterns start to develop, affect picky eating behavior later in life. We know that every child will exhibit picky eating at some point; what we don’t know is how picky they will be and how long it will last. We don’t know any parent who wouldn’t do whatever they could to lower the risk of picky eating!

The authors of the study looked at data from 129 mothers of preschool children. The focus was on how early the moms started solid foods. They compared this with how willing the children were later in life to try new foods and how much variety their diets had.


The Results

The authors found that children in the study who were exclusively breastfed for the first 6 months of life were less likely to be picky about how their food was prepared, less likely to reject food, and less likely to be afraid of new foods. By waiting until 6 months to introduce solid foods, their children were less likely to be picky eaters later in childhood.


What the Results Mean

While it’s tempting to take the results of this study at face value, waiting until 6 months to introduce solids will not guarantee no picky eating. For starters, the authors admit that picky eating is hard to define, and each parent sees picky eating differently. This study also relied on parents’ memories about feeding their infants, and the small study group may not represent the whole population.

What we should take away from this study is that infant feeding practices, particularly the age when solids are started, can have an impact on picky eating behavior later in childhood. This study presents evidence that waiting until 6 months may be a good start, and that further studies could be useful. Introducing solids at 6 months is in line with the recommendations of the Academy of Nutrition and Dietetics (AND) and the American Academy of Pediatrics (AAP). For infants with documented allergy or risk of allergy, an expert panel has also suggested that it’s best to wait until 6 months to introduce solids. This is part of the reasoning behind why we suggest waiting until 6 months to introduce Neocate Nutra, the only hypoallergenic, amino acid-based semi-solid designed specifically for infants and children with allergies.

Would you change the age that you introduce solids based on the results of this study?

- Rob

[Image Source– http://www.babybites.info/2012/03/08/forgo-the-food-fight/]