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What Food Allergies Can Teach Our Kids

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Every now and again, I like to write about my personal experience as a mom managing food allergies. Parenting is no easy feat, but it’s especially tough when you're raising a child that could stop breathing if accidentally exposed to certain foods.   

Although peanut and tree nut allergies are not something I would have chosen for my daughter, there has been an upside to her having food allergies. For one, our family has to look more carefully at the ingredients we put into our bodies, which has made us healthier eaters. The greatest gifts, however, have come in the form of life skills and values my daughter has learned at a young age.

Below are a few that immediately come to mind. 

Diligence. Now that my daughter is entering kindergarten, she’s starting to take charge of carrying emergency medicines to and from activities and storing them appropriately. Increasingly, she’s having to brave the world without me. Whether at school, summer camp, or a birthday party, she knows it’s her responsibility to ask if a food is safe when I’m not there to help her read the label. 

What has she learned? To be detail oriented and persistent—qualities that will help her in countless facets of life. 

Compassion. We talk to our daughter often about things that make her unique, like food allergies and wearing glasses. I find these talks help her relate to the differences between people both physically and situationally. Last year we saw a homeless family outside of a local store asking for money. After she asked me a few questions to better understand the situation, she decided we should give them the snacks we brought in the car so that they wouldn’t be hungry. Cue my proud mama heart swelling! 

Compassion is one of those life skills that will serve her well as a child AND as an adult. 

Time Management. It takes time managing food allergies! Label reading and meal planning take a lot longer when you have to think about a food allergy. Our daughter completed OIT for her nut allergies in 2017, and while it’s now been a year since we finished, she still has a daily maintenance dose of several nuts and a mandatory hour-long rest period afterward. It can be hard to find time to squeeze in her maintenance dose and rest time each day (today it was sandwiched between summer school and a T-ball game!).

Showing her how we map out each day and carve out time to manage her food allergies has been a great lesson in time management that will serve her well as she enters “big kid school” this fall. 

Bravery. It can be hard to stand up for yourself, let alone when you’re a small child! Food allergies have nudged her to become her own self-advocate (and a food allergy advocate!). I’d like to think we’ve led by example as her champion and guardians all these years and I’m proud to see her now standing up for herself (and her health). 

I hope her bravery goes beyond self-advocacy. I hope her newfound courage leads her to try new things, persevere through adversity, and stand up for others in need.

We all have moments when food allergies feel defeating, inconvenient, and stressful. But for all the woes allergies bring, they can also be a gift. It all boils down to perspective. Adversity breeds strength, and I see that strength in my daughter more and more each day.

-      Meg and the Allergy Amulet Team

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FPIES: Not As Delicious As It Sounds

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From time to time, we like to write about the rarer forms of food allergy. We’ve covered  Eosinophilic EsophagitisOral Allergy Syndrome, and allergies to red meat and water! Today’s blog topic will cover another lesser-known, but very serious food allergy: Food Protein-Induced Enterocolitis Syndrome (FPIES for short). 

What is it?

FPIES is a non-IgE immune system reaction to food that affects the gastrointestinal (GI) tract. IgE stands for the antibody immunoglobulin E, and most allergic reactions (think top eight most common food allergies) involve this antibody. FPIES is cell-mediated, which results in a delayed allergic reaction.

Notably, unlike typical food allergies, FPIES does not show up on standard allergy tests.

Who does it affect?

FPIES reactions often show up in the first weeks or months of a child’s life. Sometimes the child may be a little bit older if they’ve been exclusively breastfed. First reactions often occur when introducing solid foods, such as infant formulas or cereals, which are typically made with dairy or soy.

What are the common trigger foods?

For infants that experience FPIES from solid foods, rice and oats are the most common triggers. Other reported triggers include, but are not limited to: milk, soy, barley, sweet potato, squash, green beans, peas, and poultry. 

Any food protein can be a trigger and some infants may be sensitive to other foods as well. As with any food allergy, some children may only react to 1-2 foods, while others may react to several. 

What are the symptoms?

FPIES can cause severe symptoms following ingestion of a trigger food. Classic FPIES symptoms include diarrhea, severe vomiting, and dehydration. These can lead to changes in body temperature, blood pressure, and lethargy. Upon ingestion of a trigger food, there is a characteristic delay of 2-3 hours before the onset of symptoms. 

Symptoms can range from mild (such as an increase in reflux and several days of runny stools) to life-threatening (shock). In several cases, after repeated vomiting, children often begin to vomit bile. Diarrhea typically follows and can last up to several days. It’s important to note that each child is unique and may experience their own range and severity of symptoms. 

Importantly, many infants who are eventually diagnosed with FPIES are initially suspected to have a severe infection or sepsis based on their symptoms. 

How is it diagnosed?

FPIES cannot be detected with traditional allergy testing methods, such as skin prick or blood tests that measures IgE antibodies. It is accordingly tough to diagnose.

Researchers are currently looking to atopy patch testing (APT) for its effectiveness in diagnosing FPIES. APT involves placing the trigger food in a metal cap, which is left on the skin for around 48 hours. The skin is then observed for symptoms in the days following removal.

Additionally, the outcome of APT may determine if the child is a potential candidate for an oral food challenge: the gold standard for food allergy diagnosis. A medical doctor, often an allergist and/or gastroenterologist, should be involved in the diagnosis of FPIES.

Is there a silver lining?

The good news is that FPIES usually resolves with time! Many children outgrow FPIES by age 3, allowing kids to introduce the offending foods back into their diet over time. With proper medical attention and a personalized dietary plan, children with FPIES can grow and thrive! 

- Meg and the Allergy Amulet Team

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A Brief History of Molecularly Imprinted Polymers: The Heart of Allergy Amulet’s Technology

 Dr. Joseph BelBruno, Scientific Advisor at Allergy Amulet.

Dr. Joseph BelBruno, Scientific Advisor at Allergy Amulet.

If you’ve been following our blog for a while, you’ve probably heard us talk about our scientific approach to detecting food allergens: molecularly imprinted polymer (MIP) films. These films lie at the technological heart of the Allergy Amulet. 

In a previous post, we covered the basics of how the technology works. Quick review: an MIP is a polymer (plastic) formed in the presence of target template molecules to create molecular molds. Once the templates are removed from our films, they leave behind trillions upon trillions of plastic molded “locks” that bind when in the presence of our molecular “keys.” In our films, these keys represent allergenic ingredients.

Today’s post looks at the history of MIP technology. While our science team has made considerable breakthroughs in the MIP field, we didn’t pull the foundation technology out of thin air. In fact, the body of work on MIPs dates back almost 100 years!

The first scientific mention of MIPs was back in 1931: a scientist named M. V. Polyakov discovered that when he made polymers out of silica in the presence of another molecule, the polymers would selectively absorb that molecule.

Some say the origins of MIP technology started with Jean Dickey at Cal Tech. He tried imprinting silica with organics back in 1949. The modern approach to imprinting began in Europe in the seventies and eighties with Klaus Mosbach in Sweden, Günter Wulff in Germany, Borje Sellegren in Amsterdam, and Karsten Haupt in France. These and other scientists developed many of the classic methods for creating imprinted polymers. Importantly, some studies found that in select circumstances, MIPs could imitate the functions of receptors, enzymes, and other biological molecules. 

After these initial discoveries, scientists identified new applications throughout the 20th century—mostly in drug separation—and you can currently buy MIP resins from leading science manufacturers like Sigma Aldrich. Yet, as with any nascent technology, development progressed slowly. Only in the past ten years have MIPs finally hit their stride: nearly half of all MIP papers were written in the past decade. Over time, researchers have optimized the conditions and techniques for developing MIPs, which has expanded the types of molecules MIPs are capable of imprinting. This has dovetailed with advancements in nanotechnology and communications technology. For example, the nanomaterials we use in our sensors were prohibitively expensive ten years ago. With these advancements, diverse commercial applications of MIP technology are finally becoming a reality.

For a detection device, successfully imprinting an allergenic ingredient (or any other target) is only half the battle.

Why is that? Well, even if an MIP can selectively bind the target molecule, it does so on a nanoscopic scale—we would have no way of knowing that binding occurred. Creating an MIP sensor accordingly requires a system that can translate that imprinting into something comprehensible (what scientists would call a transducer). While there has been significant research into different types of transducers for MIPs, a common approach has been electrical conductivity: an easily measured property that is already widely used in sensor technology.

There are several methods that convert successful imprinting to an electrical response. Two of the most popular methods involve using either conductive polymers or combining the MIPs with conductive nanomaterials.

Some of the first successes in creating conductive MIPs originated with Dr. Joseph BelBruno: a world-renowned chemist, Dartmouth chemistry professor, and Scientific Advisor at Allergy Amulet. Dr. BelBruno’s research laid the foundation for developing conductive MIP sensors. His work spawned the first commercial application of MIP sensors.

Allergy Amulet is positioned to become the second company to commercialize MIP sensors, and the first to create MIP sensors for detecting allergenic ingredients. Our sensors combine MIPs with an electrical response to create sensors for detecting molecular tracers of allergenic ingredients in food.

As with any novel application of an existing technology, it is important to recognize and pay tribute to the work of those before us. Learning and studying from the successes and failures of our predecessors is how we will advance as a scientific community, and advance as a society.    

-      Nazir and the Allergy Amulet Team

 

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Spokin’s Susie Hultquist: A Fearless Food Allergy Mama!

 Susie and her food-allergic daughter, Natalie.

Susie and her food-allergic daughter, Natalie.

If you’ve followed Allergy Amulet for a while, you know our team was founded by a female and that we love to support female entrepreneurs!

Unsurprisingly, we’re big fans of Susie Hultquist and the team she’s assembled at Spokin. This Chi-town team has built an app to help make managing food allergies easier! We recently sat down with Susie and asked her a few questions.

1. We understand you left your financial career on Wall Street to start Spokin. When did the “light bulb” moment happen?

It happened when my co-worker was selling girl scout cookies. I wanted to buy some, but in order to do that, I had to get ahold of a package to check the label and ensure they were safe for my family. I then went to their website to make sure the cookies were also available in our area. It took me 15 minutes to track down all the information I needed! That’s when I realized I was probably not the only person managing food allergies searching for this same information, and that there was a clear need to streamline and consolidate food safety information for the food allergy community.

At the time I was managing my company’s consumer internet portfolio and saw how different businesses were managing pain points. No one was solving this one, and I felt I was uniquely positioned to do so.

2. How long did it take to launch the app? 

It was two years in the making. I started by meeting with a lot of people who have food allergies. From there, we developed a content strategy and hired a graphic designer to work on app designs. We just celebrated the app’s first birthday!

3. What is your “why”?

My daughter Natalie. She’s allergic to peanuts and several tree nuts. I am determined to make her life easier and to help her live the fullest life possible. That’s what gets me up every day. 

A food allergy diagnosis often comes with a lot of no’s when it comes to food, and I want to be able to say yes as often as I can!

4. Spokin has a lot of new features and capabilities on the app. What are you most excited about?

Far and away is the map functionality! If you’re in the app and search within the “eateries” category you can choose any city in the US and see in seconds all the restaurants, bakeries, and ice cream shops others in the Spokin community have recommended. We now have 2.7 million reviews on the app and reviews span across 18 countries! 

To find in seconds all these yes’s after so many no’s is amazing. And it’s built by the food allergy community! This community is so generous. 

5. What does Spokin mean?

It’s a play on the word spoken. I had so many amazing interactions with people in the food allergy community that gave me advice verbally (where to eat in London, what chocolate chips to bake with, what to take with us on an airplane, etc.) but once spoken, that advice then vanished into thin air. All of this knowledge needed to be captured and shared with everyone. The idea was that if we built this platform, we could harness and share all of this great food wisdom with the food allergy community at large. 

6. When do you plan to release the Android version of the app?

We have started an Android waiting list and it’s on our product roadmap. We’re currently assessing demand, so please add your email to the Android list on our website, if interested! 

7. When you’re not focused on helping the food allergy community, what do you enjoy doing?

Spending time with my girls and my husband! We love to cook together, run together, and travel when we can. My girls all have very different interests so it’s fun to watch them pursue their passions. 

8. Since Spokin is based in Chicago, we have to know: do you cheer for the White Sox or the Cubs?

I love the Cubs, but I applaud the White Sox for offering peanut-free ballgames!

9. What’s your long-term vision for Spokin?

If everyone in the US with food allergies shared five recommendations we could build a database of 75 million data points that everyone can access! We’ve estimated that if it takes you 15 minutes a day to manage food allergies, then you can save a year of your life by having all of this information accessible to you. 

If you haven’t downloaded the Spokin app we recommend you check it out ASAP! Both Susie (Susie in the Spokin app) and Allergy Amulet’s founder, Abi Barnes, (allergy_amulet_abi in the Spokin app) have provided lots of recommendations!

-      Meg and the Allergy Amulet Team

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FOMO: Fear of Missing Out… On Nutrients

Part II: Wheat, Soy, Peanuts, and Tree Nuts

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Welcome to Part II of our FOMO series! Here we’re discussing how to replace nutrients lost from eliminating wheat, soy, peanuts, or tree nuts from your diet. You can find Part I here covering dairy, eggs, fish, and shellfish.

If you’re used to eating toast, cereal, pancakes, or other baked goods for breakfast, avoiding foods that contain wheat will likely be a hard adjustment. Or maybe you fed peanut butter and jelly sandwiches to your first child with no issue and your second child cannot eat peanut butter. It is an adjustment, to say the least! 

As a pediatric nutritionist, my work focuses on making sure kids with special dietary needs are getting the nutrients their growing bodies need. As you can imagine, many of my patients have multiple food allergies and have a fairly limited diet. The silver lining for these patients is that these children tend to have healthier diets because they’re avoiding lots of processed foods! 

I like to start by looking at each food that’s avoided and its corresponding nutrients side by side. As we discussed in Part I, this approach can make it less intimidating to identify other food sources for those lost nutrients.  

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Let’s take a closer look at a few of the nutrients needed when avoiding wheat, soy, peanuts, and tree nuts.

Wheat products in America are fortified with B vitamins, thiamin, riboflavin, and niacin. 

Thiamin is important for maintaining a healthy metabolism and key function of cells. The major thiamin food sources are whole grains, meat, and fish. In the US, breads, cereals, and infant formulas are enriched with thiamin as well as other B vitamins. If you’re avoiding wheat and most breads and cereals, you may want to ensure your wheat-free products are enriched with these key nutrients as well!

Niacin is another B vitamin—B3 to be specific. Niacin helps our bodies use fat, protein, and carbohydrates to create energy. This vitamin is also enriched in processed wheat products and can be found naturally in most meats as well as mushrooms, avocados, and sunflower seeds, to name a few. 

If you’re a meat eater and wheat-avoider, I’m not typically concerned that you’re missing out on B vitamins (thiamin, riboflavin, and niacin) or iron. However, you may want to think about how much fiber is in your diet. Many people substitute rice, potatoes, and corn-based products for wheat. However, these are mostly low in fiber.

Fiber is a carbohydrate that your body does not digest. There are two types of fiber: soluble fiber and insoluble fiber. Soluble fiber dissolves in water and helps to regulate blood cholesterol and glucose levels. Insoluble fiber does not dissolve in water and works to move food through the digestive tract. Many people experience symptoms like constipation after making a change in their diet. In these cases, I tell my patients to increase their fiber intake and add fruits, vegetables, legumes, brown rice, and other whole grains like oatmeal and quinoa. 

If you are not a meat eater, and you’ve eliminated wheat or soy, this next one is for you.

Iron is found in red meat, fish, and poultry, but there are many plant-based sources of iron outside of wheat and soy, including spinach, beans, lentils, nuts, seeds (e.g., pumpkin, chia, sunflower, and hemp), dried fruits, quinoa, and some fortified breakfast cereals. Iron is better absorbed with vitamin C, so I recommend adding an orange alongside your trail mix for your next snack. Calcium inhibits iron absorption, so whether you get your calcium from dairy or a dairy substitute, try to avoid eating them together. 

Avoiding soy is not easy because it is in so many foods. Both peanuts and soy belong to the legume family and contain many of the same nutrients such as B vitamins, protein, magnesium, and phosphorus. 

Magnesium helps normalize blood pressure and keeps our bones strong. Phosphorus also helps to keep our bones strong and helps our bodies make energy and move our muscles. Both of these minerals are found in abundance in beans, seeds, and tree nuts. Phosphorus is also found in dairy, eggs, in meat products, whole grains, potatoes, and dried fruit.

The goal for everyone should be to expand their diet and add more variety! A more diverse diet will lead to greater nutrient intake, and hopefully more delicious meals. If you feel like you’re in a food rut, take a chance and add something new to your routine. Your body (and likely your taste buds) will thank you!   

 

Tara McCarthy is a Registered Dietitian Nutritionist who has a passion for pediatrics. She has worked at Boston Children’s Hospital for over 15 years as well as a private practice and specializes in nutrition for children with special dietary needs such as food allergies, celiac disease, FPIES, EoE, allergic colitis, and sucrose isomaltose deficiency. 

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Food Allergy Awareness Week! Things I’d Like People to Know… And a Little Dr. Seuss

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It’s almost here, food allergy awareness week 2018! The official dates for this year are May 13-19.

I’m currently sitting in my office looking at a recent picture of my daughter and me at our state capitol with the governor to advocate for food allergy awareness. If you’ve followed Allergy Amulet for a while, you know I’m a passionate food allergy mom!

One of the greatest things about food allergy awareness week is that it’s a conversation starter. I LOVE that statistics are being shared left and right to paint the picture of how many people are affected! Heck, even buildings around the country are “turning teal” in recognition!

However, it’s important that the conversation not just be about how MANY people are affected, but HOW they are affected. So in the spirit of awareness and conversation, I wanted to share 10 things I’d like other parents to understand about food allergies!

1.    Food allergies are not a choice. We don’t know why our family has food allergies, and we have to manage them diligently every day. Please don’t feel sorry for us, help advocate for us!

2.    Food allergies can be life threatening and they’re a serious health issue, not simply an inconvenience—trace amounts of a food allergy protein can be deadly.

3.   Food allergies require planning. We can’t often join spur-of-the-moment outings, so please make sure to give us a heads up so we can plan ahead!

4.    If we ask questions about your food multiple times, it’s not because we don’t trust you, it’s because there’s no room for error. It’s not personal, it’s precautionary.

5.   Food allergies can be draining—mentally, emotionally, and financially. We can’t let our guard down and our vigilance level is always in “on” mode. We want to experience the same events and activities as everyone else, but it’s not always easy.

6.   We’re not germ freaks if we ask you to wash your hands after eating, or if you see us wiping down an airplane seat with disinfectant wipes. It’s simply that we are trying to keep the risk of allergen exposure to a minimum.

7.    Activities don’t have to involve food to be fun! If you know that someone with food allergies will be joining an activity or celebration that you’re organizing, try to be mindful of the foods they avoid (and give them a heads up if their allergen will be present so they can plan accordingly)!  

8.    Always feel free to ask questions. We will never get annoyed if you ask us a million questions about our allergies. Education is the first step to understanding!

9.   We’re just parents doing what we have to do to keep our kids safe. Please realize we’re not trying to inconvenience you, and that we’d do the same for your child!

10.  It helps to have a village of support so you don’t feel like you’re isolated on an island—if you are part of someone’s village, THANK YOU. It’s not an easy task!

Lastly, I leave you with some brilliant words from Dr. Seuss’s Horton Hears a Who. It seems appropriate for food allergy awareness week. ☺️

Don’t give up! I believe in you all!

A person’s a person, no matter how small!

And you very small persons will not have to die

If you make yourselves heard! So come on, now, and TRY!

 

The Mayor grabbed a tom-tom. He started to smack it.

And, all over Who-ville, they whooped up a racket.

They rattled tin kettles! They beat on brass pans,

On garbage pail tops and old cranberry cans!

They blew on bazookas and blasted great toots

On clarinets, oom-pahs and boom-pahs and flutes!

Great gusts of loud racket rang high through the air.

They rattled and shook the whole sky!

 

When they got to the top,

The lad cleared his throat and he shouted out, “Yopp!”

And that Yopp...

That one small, extra Yopp put it over!

Finally, at last! From that speck on that clover

Their voices were heard! They rang out clear and clean.

 

And the elephant smiled. “Do you see what I mean?”...

They’ve proved they ARE persons, no matter how small.

And their whole world was saved by the Smallest of ALL!

 

- Meg and the Allergy Amulet Team 

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My Child Doesn’t Have a Food Allergy... But Her Friends Do

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When my family moved to a new neighborhood five years ago, we quickly learned that our new neighbors’ oldest son had a severe peanut allergy. Our children became fast friends, and the kids went back and forth between the two houses all the time. None of our three children have food allergies, so this was very new to us. To ensure that he was safe while under our care, we knew we had to get up to speed on how to keep him out of harm’s way (and well fed!).

Here are the top 10 tips we’ve learned, in case you find yourself in a similar situation:

1)    Ask the Question. Inviting a new friend over for a play date or sharing snacks at the park? Always ask the other parent or caregiver if their child has any food allergies. Allergy parents are often grateful if you bring it up!

2)    Read Labels. Get to know the ingredients of the snack foods you regularly buy. Which granola bars contain tree nuts? Which crackers are made in a facility that processes peanuts? At a minimum, know where to look on the packaging to find allergen info. I’m often surprised when a food I would have considered to be nut-free actually isn’t. We’ve created a cheat sheet for you to learn the rules of label reading!

3)    Keep the Original Packaging. It’s so much easier to check the ingredient list on a box of crackers if it is still in the original packaging. Often, similar products made by different companies have different allergy warnings and ingredients. 

4)    Have Allergen-Free Snacks on Hand. Consider offering fresh fruits, veggies, or cheese for kids who can eat dairy. We’ve found that parents of kids with allergies are happy to make suggestions for healthy and safe snacks that everyone can enjoy. As an added bonus, minimally processed foods are healthier anyway!

5)    Think About Cross-Contact. When you make a PB&J for your child, does the knife go in both jars? If so, that jam may contain peanuts. I try to use two different knives, but if we have a friend over with a peanut allergy, I open a new jar of jam rather than risk an allergic reaction.

6)    Keep Up the Hand Washing. We all know we should have kids wash hands before eating, but what about afterwards? If your kids eat a peanut butter sandwich, be mindful that their hands may have peanut residue on them, which could pose a risk to those with peanut allergies! Post-meal hand washing also helps keep those toys clean! 🙌  

7)    Think Outside the House. When we carpool with the neighbor that has a peanut allergy, I wipe down the car handles and other surfaces that our kids touch, especially since our family often eats in the car! Let’s be honest, don’t we all? 😉

8)    Make Birthday Parties Inclusive. Ask about food allergies on the invitation. For an electronic invite, you can list what you are planning to serve. We have a child in one of my kids’ friend groups with an egg allergy. His mom is always willing to bring alternative snacks and treats, so a heads up is appreciated in case she needs to plan ahead! 

9)    Know and Support Your School’s Rules. Our elementary school has some classrooms that are nut free, so we always pack nut-free snacks. The lunchrooms are generally nut friendly, with designated nut-free tables. If my child wants to eat with a friend who sits at the nut-free table, he also needs a nut-free lunch. It’s important to avoid undermining the school’s allergen policies. There are plenty of delicious food options for your child that will also keep their friends safe!

10)   Make it Easy on Older Kids. Older kids don’t want you hyper-managing their food choices, especially when they aren’t your children. Make it easy for teens and tweens to self-manage their food allergies by offering plenty of safe options and letting them choose. 

With these guidelines in place, we have been able to successfully navigate the food allergy terrain while keeping our children’s friends safe (and bellies full!).

- Susannah and the Allergy Amulet Team

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FOMO: Fear of Missing Out… On Nutrients

Part I: Milk, Eggs, Fish, and Shellfish

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FOMO, or the fear of missing out, is a source of anxiety for many. For some, it means missing out on social engagements with friends. For others (likely many of our Allergy Amulet followers), it means missing out on certain foods. If you’re in the latter category, this post is for you.

There are many reasons people avoid certain foods: elimination diets, food allergies, or food intolerances, to name a few. In these cases, you’re not only removing the food from your diet, you’re also removing important nutrients (especially if we are talking about growing children!). As a pediatric dietitian, my job is to identify the foods that need to be eliminated, and then figure out how to ensure those lost nutrients remain in my client's diet.

This two-part series will focus on the nutrient implications of eliminating one or more of the top eight most common food allergens from your diet. Whether because of a food allergy or intolerance, or for diet or religious reasons, we’ve got you covered. This first part will focus on milk, eggs, fish, and shellfish. Next month, we’ll cover wheat, soy, peanuts, and tree nuts. Let’s get started.

Personally, I find it helpful to first look at each food and its corresponding nutrients side by side. This approach can make it less intimidating to then find other food sources for those lost nutrients.

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As you can see, some of the foods listed above have overlapping nutrients, vitamins, and minerals. For example, if you are eliminating eggs from your diet, you can find substitutes for protein and vitamin B12 in fish and shellfish.

Where can you find these nutrients and how do they affect your health? Let’s take a closer look.

Protein: Is my child getting enough protein? This question comes up frequently in my practice. First, it’s important to keep in mind that the majority of Americans eat plenty of protein! To see how much daily protein you should be consuming, these Dietary Reference Intake standards provide helpful guidelines. On average, a child should consume approximately .8 - 1.2 gram/kg of protein per day, depending on their age. For example, a 4-year-old child who weighs 35 pounds would need about 16 grams of protein per day. For perspective, a glass of soy milk at breakfast and a turkey sandwich at lunch would be about 24 grams.  

Of course, protein doesn’t just come from animals. There are many plant-based sources that can help you meet your daily protein needs. Most non-dairy milks and yogurts are rich in plant-based protein, for example, as well as beans, legumes, seeds, and nuts.

Has anyone noticed the ever-growing number of milk substitutes hitting grocery aisles? I certainly have! If you’re wondering which one might be best for you, the below table shows common milk substitutes and their approximate nutritional values.

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Calcium: Most parents worry about protein, but I find I’m more focused on calcium intake - especially for those that don’t eat dairy! Calcium is important because it helps maintain the strength of our bones and teeth. It also supports our body structure and helps our muscles, heart, and nervous system function properly. Calcium can be found in vegetables like bok choy, broccoli, Chinese cabbage and collards, beans (black, garbanzo, pinto), and almonds. Several milk substitutes and some orange juices and cereals are also fortified with calcium. Calcium needs range from 700mg - 1300mg/day, depending on a person’s age.

Vitamin D: Vitamin D also plays a role in bone health and the absorption of calcium. Your vitamin D intake depends mostly on sunlight exposure. That said, if you’re not getting much sunlight (read: grey winter weather), it helps to supplement your diet with this important nutrient. You may also routinely have your blood checked to determine whether you’re deficient in this vitamin, as you may need more than the recommended daily dose. If you can’t eat dairy or eggs (a major source of vitamin D), you should look to foods enriched with vitamin D as substitutes.

B Vitamins (B12, B2/Riboflavin, and B5/Pantothenic acid): B vitamins are important multitaskers. They are involved in everything from cognitive function and mood, to energy production and heart health.

B12: The best sources of vitamin B12 are eggs, milk, meat, fish, and poultry. I most often worry about B12 intake in my patients that are vegetarian or vegan. If you fall in either of those camps, plant-based milk substitutes and fortified beverages are great ways to help you meet your daily B12 needs while avoiding animal products.

B2/Riboflavin: Foods high in riboflavin include eggs, dairy, lean meats, green vegetables, and fortified grains (think cereals and breads).

B5/Pantothenic acid: Vitamin B5 (pantothenic acid in scientific terms) plays an important role in turning carbohydrates, fats, and proteins into energy. It removes strain, or stress on the body. Good sources of B5 include mushrooms, cheese, fish, avocados, eggs, lean meats, sunflower seeds, and sweet potatoes.

Expert tip: focus on the foods that you CAN eat. If certain foods are off limits, create a list of the foods you can safely eat, and separate them into different categories (see below).

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Ultimately, the more variety in your diet, the more likely you are to meet your nutritional needs. Plus, it makes eating that much more interesting! Nobody should have FOMO when it comes to food—even if cutting out certain foods is a necessary part of your diet. The solution, in my opinion, is expanding your palate.

 

Tara McCarthy is a Registered Dietitian Nutritionist who has a passion for pediatrics. She has worked at Boston Children’s Hospital for over 15 years as well as a private practice, and specializes in nutrition for children with special dietary needs such as food allergies, celiac disease, FPIES, EoE, allergic colitis, and sucrose isomaltose deficiency. 

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The Secret is Out: Transparency is In

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Last fall, Kellogg’s acquired a protein bar startup called RXBAR for $600M dollars. The significance of that deal is twofold. First is the story behind the company: two childhood friends built the business out of their kitchen with $5,000 each and no outside funding. Second, their brand was built on transparency and candor: each bar neatly lists a handful of ingredients on the front packaging followed by their signature motto: “No B.S.”

The market took notice.

In an era where food labels list hard-to-pronounce ingredients like “tartrazine” and “disodium inosinate” and include vague statements like “may contain” (which we wrote a separate blog post about), consumers are unsurprisingly gravitating towards products like RXBAR.

But the trend isn’t limited to food. Increasingly, shoppers are looking to company values—including a company’s commitment to transparency—when making purchase decisions. More consumers are looking beyond price tag and factoring in product origin, reputation, and quality and ethical standards. The rise of fair trade, organic, and Certified B Corporations (“B Corps”) is a testament to shifting consumer preferences. Consumers are also looking at where companies donate politically: with a new app from startup Goods Unite Us, consumers can run political background checks on products to see what political party their purchase indirectly supports.

Corporate candor is a hot commodity right now. That much is clear.

A Label Insight study looking at consumer behavior around food and personal care products found that nearly 40% of consumers would switch from their preferred brand to one that offered more product transparency. A quarter of respondents indicated that transparency was the leading reason they remained loyal to brands.

We live in a digital age where consumers have access to unprecedented levels of information. In turn, they are using that information to scrutinize company decision-making and hold companies accountable for those decisions. The businesses that are quickest to adapt will likely outperform and outlive their peers.

Investors see the appeal.

Investors routinely evaluate the risk of any potential deal or transaction. Transparency helps mitigate these risks by identifying blind spots, which can in turn reduce reputational, compliance, and financial risk. Transparency also fosters trust: the foundation of any business relationship.

The metrics of business success do not always account for intangibles like transparency and trust—but they should. Facebook is learning that the hard way this month, as user numbers drop and #DeleteFacebook becomes a trending hashtag.

Trust is hard to earn, difficult to quantify, and easily lost. For these reasons, trust is arguably the most valuable commodity a company holds. The precursor to trust is transparency.

- Abi and the Allergy Amulet Team

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Invest In Women

 Female leadership at Allergy Amulet from left to right: Susannah Gustafson (VP of Operations), Abi Barnes (CEO), and Meg Nohe (CMO).

Female leadership at Allergy Amulet from left to right: Susannah Gustafson (VP of Operations), Abi Barnes (CEO), and Meg Nohe (CMO).

While the Chinese zodiac sign for 2018 is the dog, a more appropriate symbol for this year is the woman.

Across the US, women are running for office in record numbers. France announced that it will begin imposing fines on companies that fail to eliminate unjustified gender pay gaps within the next three years. And in the US, movements like #MeToo and #TimesUp have forced our nation to address gender inequality, misogyny, and harassment.

One area where the gender disparity is particularly stark is the startup and venture capital space. In 2017, only 2% of all venture capital was invested in women-led startups, even though women own nearly 40% of the nation's businesses. That same year, the average financing round for women-led companies was less than half that of their male counterparts.

Why the glaring gender gap? While there’s no clear answer, many blame “mirrorocracy”: the idea that the VC community, lacking in diversity, tends to invest in individuals that look like them. Indeed, only ~8% of partners at the top 100 VC firms are women. A recent Harvard study further revealed bias in the line of questioning venture capitalists pose to female and male entrepreneurs. The study found that women were generally asked about the potential for losses, or what the study called “prevention” questions, whereas men were asked about the potential for gains, or “promotion” questions. For every additional prevention question posed to an entrepreneur, the startup raised an average $3.8M less.

Looking back at our own company’s fundraising trajectory, these figures are unsurprising. It took Allergy Amulet nearly three years to secure its first investment: a convertible note in 2016. And the vast majority of our current investors are men.

There’s a strong business case for investing in women. According to Credit Suisse, companies with female CEOs generate a 19% higher return on equity and a 10% higher dividend payout. A study by the Peterson Institute for International Economics found that companies with women in at least 33% of senior management roles accounted for higher annualized stock returns. The study also found that Fortune 500 companies with the greatest proportion of female board members significantly outperformed those with the lowest proportion.

We need to invest more in women, and we need more women investors.

Several VC firms are proactively seeking to address the problem. In a two-part series, Forbes identified several investors and VC funds committed to bridging the gender gap either by ensuring female representation among their partners, portfolio companies, or both.

As with any ecosystem, diversity breeds strength. The startup and venture capital worlds are no exception.  

- Abi and the Allergy Amulet Team

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