Food Allergy and Dietitians

A new study by Jaffe Food Allergy Institute, at Mount Sinai School of Medicine concludes that pediatric dietitians self-reported their proficiency is only moderate when it comes to food allergy. Dietitians would prefer, and certainly benefit from, more training on food allergy.

Several years ago, our allergist's office hired a dietitian for individuals and families with food allergies. I set up an appointment looking for information on calcium and protein sources for our dairy, egg, nut allergic child. At the time we were also avoiding wheat, soy and corn and I was struggling with preparing balanced, nutritious meals and snacks. During the appointment, I was given hand-outs on specific food allergies. That's about it. She offered little helpful information and I felt like I educated her more than the other way around.

I'm not blaming the dietitian. I just think she was hired due to her credentials and wasn't given satisfactory training in food allergy. There is a need for dietitians who are food allergy savvy. Fortunately ELL and other organizations are stepping up to train dietitians.

Recent similar studies of school nurses and pediatricians have also shown they have limited, and sometimes incorrect, knowledge of food allergies. Those of us in the food allergy circle can help by educating our own school nurses and doctors. Rather than feel upset over their lack of knowledge, pass on relevant research, books and food allergy conference/workshop information. We can all play a role in education.

Food Allergy Back to School Guide

Yeah, yeah, I know it's still July, but it really is time to think about back to school if you're sending a food allergic child to school this fall. Here are some steps to take now:

• Contact the school to find out what paperwork is required for your child to have access to life-saving medication.
• Schedule a check-up with the allergist. Bring required school paperwork to the appointment for the allergist's signature. It's easiest if you fill out the portions pertaining to emergency contact information in advance. Many schools require the doctor to complete the treatment portion. Some doctor's offices charge a small fee to complete and sign forms.
• Get prescriptions for epinephrine as extra medications will stay at school.
• Meet with the school principal and nurse before school begins. Let them know what you need in terms of staff training, access to medications, lunchtime procedures and access to special foods for school celebrations or emergency situations.
• Use this time to make sure your child is educated about his/her food allergies. Review the rules of eating away from home and how to identify when extra help is needed. Make sure your child knows who to go to within the school if they need help dealing with their food allergy.

Have I missed anything? Do you have other ways to get ready for school?

So, get that paperwork, schedule those appointments and sit back and enjoy the rest of summer vacation with your kids!

Probiotics and Allergic Diseases

Results are out for a new study that had pregnant and breastfeeding moms drinking probiotic milk. Their babies were followed for 2 years. The results show a 40% drop in the incidence of eczema. At this point, there was no signifigant decrease in the rate of allergy and asthma rates, but these children will be followed to the age of six in a follow-up study.

As asthma, allergy and eczema are the triumvirate (like that big word? It's Latin for 3 things that go together) , this study gives some important clues into the role of probiotics and allergic disease. Probiotics are live lactic acid bacteria that can be added to milk and some foods. There are many types of probiotic bacteria strains, so check with your doctor if considering trying probiotics as a way to prevent eczema for newborns.

Reliable Tests for Food Allergy Diagnosis

Skin tests and blood tests are the standards for initial diagnosis of food allergy. Unfortunately, neither are very reliable. I don't know about you, but when the doctor calls and starts reading off blood test results to me, I hang up the phone feeling more confused than ever. If the "almond number" rose from 2 to 15 in the past year, is my child way more allergic to almonds now than last year? What does, "off the chart for dairy" mean?  I've never felt like these numbers give me helpful information.

While the "gold standard" for diagnosing food allergy is the food challenge, it is helpful to have accurate information going into the challenge.

Christopher Love, an MIT engineer, is on the trail of a more precise way to measure food allergies in a blood test. His new technology, recently reported in Lab on a Chip, can analyze individual immune cells. Instead of detecting antibodies, like the current blood test does, Love's system screens the patient’s immune cells for small proteins known as cytokines. Immune cells such as T cells produce cytokines when an allergic response is initiated, attracting other cells to join in the response. Those cells are then exposed to the potential allergen for a precise measurement.

Research continues and human trials are the next step, but I'm hopeful that Love's work will allow those of us who deal with food allergies the abilibty to make better ecisions based on helpful and accurate information.

Food Allergy Research Funded

Last Wednesday, the National Institutes of Health announced that the Consortium of Food Allergy Research (CoFAR), established in 2005, will be funded for five more years. This is a 29.9 million dollar grant and is great news for those affected by food allergy. From low allergy peanuts to polyphenol-enriched apple extract to desensitizing people to their allergens, there is incredible research happening in the area of food allergy right now.

"We are pleased to continue our support of CoFAR, NIAID’s major program dedicated to exploring the causes of food allergy and developing new treatment and prevention strategies," says Daniel Rotrosen, M.D., director of the Division of Allergy, Immunology and Transplantation at NIAID. CoFAR plans to expand research into the genetic components of food allergy and broaden research into disorders such as EoE.

This is much needed money for scientists to continue to unlock the puzzle of food allergy. After a LONG dry spell, food allergy is finally getting the attention and funds to address causes and treatment. That's great news for millions of people!

Allergy Medication: The EpiKey

Epipens® and Twinjects® are a wonderful medical device that save lives of those experiencing an anaphylactic reaction due to food, insect sting or latex allergy. I also find them to be bulky and I worry about my child carrying the medicine as a teen and young adult. It turns out someone else was worried about that too. TCB Medical Devices has developed the EpiKey, a small epinephrine device that fits on a key chain.

The EpiKey was created by Thomas C. Beller, MD., an allergist in South Carolina. Dr. Beller hopes this device will save lives with its small size and ease of use. It's on a fast-track for FDA approval.


I'll keep you posted.

Food Allergy App

Another helpful tool for people dealing with food allergies is on the horizon. Expected out in mid July 2010, NutriSleuth iphone App allows users to plug in dietary requirements for an instant "yes" or "no" reading within seconds of scanning a product's barcode. Individualized profiles allow users to determine if the food is allowed for each family member. It even offers alternative choices!

Aahhh...simplified grocery shopping...

Food Allergy Reseach

How about this grandma who burst into action when her grandson was diagnosed with food allergies?. Lita Indzel Cohen started a foundation, FARI (Food Allergy Research Initiative), basing it in the lab at Philadelphia College of Osteopathic Medicine, where she serves on the Board of Trustees.

The goal of FARI is to study food allergy and develop a treatment for it. They've been making progress using immune modulation to decrease the severity of allergic responses in peanut allergic mice.

 Hopefully FARI research will lead to treatment and a cure for Lita's grandson and many others who deal with food allergies.

As more pieces of the puzzle are added, hopefully appropriate food allergy treatments will emerge. Thanks for your contribution, Lita!

Food Allergy Cooking Show on Oprah Network?

Oprah begins her OWN TV debut in Jan. 2011. Her casting call brought in oodles of entries and millions of votes. In the cooking category, "Cooking Allergy Free with Dee", soared to the top with over a million votes. Dee is off to Hollywood to convince Oprah, and the other powers that be, that her show deserves a slot.

I'm thrilled to see so much interest in a show like this. Dee is a mother of four. Two of her kids have multiple food allergies. She's like many of us as she tries to find delicious meal, snacks and treats for her children, with the added challenge of avoiding many major food groups.

Good luck, Dee!

Common Sense for Food Allergies

I heard on the news this morning that a recent study in the Archives of Pediatrics & Adolescent Medicine shows that changing to a later start time for high school students is good for adolescents.

 Makes perfect sens to me. Years of research has shown that the body clock during the teen years shifts to going to bed later and getting up later. We know this and should use this information wisely.

What does this have to do with food allergies, you may ask?

Well, this study seems like common sense to me. I don't believe we've used common sense for food allergies. Allergic to pollen? Get regular injections of minute doses of pollen to desensitize the body to pollen. Allergic to milk? Avoid it forever.

I've never thought that made sense. We do it in our house because that's the doctor's orders, but it doesn't seem like good common sense. Since getting the blood test results for my allergic child last week, I'm even more convinced. After 10 years of strict avoidance of multiple foods, all numbers are up- by a lot. My child is not out-growing any of these allergies. As a matter of fact, things are heading in the wrong direction.

This isn't good enough any more. I'm hopeful about  a cow's milk immunotherapy study published recently in the Journal of Allergy and Clinical Immunology. This study involved placing cow's milk protein on unbroken skin in an effort to desensitize people.

Just yesterday, DBV Technologies got the go-ahead from the FDA to begin human clinical investigation of peanut desensitization. Trials begin this month in six medical centers in the U.S.

Avoidance isn't working. Desensitization makes common sense when it comes to food allergy. I recognize there are risks involved and I certainly do not recommend desensitization at home right now. But, let's all keep talking to our allergists and pushing for something better than "strictly avoid".

Stay tuned. We're starting to use common sense in food allergy treatment.

Food Allergy Support

Food Allergy Initiative has an extensive list of food allergy support groups in the U.S. as well as internationally. Helpful for those newly diagnosed, support groups also benefit those more experienced through expert speaker presentations and advocacy opportunities within the community. It is always helpful to learn from others with similiar experiences. Check out a local support group today.