Viewing entries in
Nutrition

Comment

Intuitive Eating + Food Allergy

pablo-merchan-montes-772142-unsplash.jpg

Proper nutrition, much like medicine, does not have a one-size-fits-all approach. In fact, what works for one person may not work for another. This is also why fad diets often don’t work. 

One of the more recent nutrition concepts that extends into counseling practices is Intuitive Eating, which encourages us to steer away from the diet mentality, and instead embrace positive lifestyle behaviors. The authors and dietitians behind Intuitive Eating, Evelyn Tribole and Elyse Resch, first wrote about the concept in 1995, publishing what is today the best-known book for helping rebuild healthy body images and restoring normal healthy eating behaviors. 

When I hear diet talk from friends, family, and clients, I’m often conflicted. On the one hand, I applaud the perceived need to change. On the other hand, I know scientifically that diets don’t often work; behavior and lifestyle changes are what stick. There is an overwhelming body of scientific literature that offers insight as to why our bodies fight diets. So if diets don’t work, then how do we make healthier, long lasting, and positive lifestyle changes? Here’s where Intuitive Eating comes into play. 

I like to compare Intuitive Eating to your best self-care day—it’s listening exactly to what your body needs, accepting it, nourishing it, and moving on. It’s giving your body the nutrients it needs while listening to your internal cues. 

The following are the 10 main ideas behind Intuitive Eating: 

1.   Reject the diet mentality. Get rid of the ideas and materials (books, magazines, etc.) that encourage and offer false hope of quick weight loss. 

2.   Honor your hunger. Physically and biologically feed your body the adequate energy it needs to function properly. Build trust in yourself that your body will tell you exactly what it needs. 

3.   Make peace with food. Give yourself permission to eat and abolish food rules. No foods are forbidden (unless you have a food allergy, that is). More on that later!

4.   Challenge the food police. Don’t applaud yourself for only eating x number of calories or feel guilty for eating that piece of birthday cake. 

5.   Respect your fullness. Really listen to the body signals that tell you you’re full. 

6.   Discover the satisfaction factor. Savor the foods that bring you joy and pleasure. You’ll typically find you end up eating less of that “forbidden” food because you took the time to savor it. 

7.   Honor your feelings without using food. Stress, anxiety, and boredom are some of the feelings that are often responsible for triggering emotional eating. Instead, pay attention to your emotional responses. 

8.   Respect your body. Accept your genes. You would never force your feet into the wrong shoes. Give your body the respect it deserves. 

9.   Exercise. Focus on how you feel while working out. If you hate it, try something new. Look at the true motivation behind your workout—is it to lose weight? Feel an endorphin high? Reduce stress?

10.  Honor your health. Make food choices that honor your health, but that also make you feel good. You don’t have to have a perfect diet. Remember, it’s progress over time that matters, not any one meal or one day that will make the difference. 

Over time, I’ve grown curious as to how food allergies, intolerances, and other medical conditions might apply to a philosophy like Intuitive Eating, which challenges us to actively listen to our bodies’ dietary needs. Initially it seemed counterintuitive to combine the two: one teaches us that we should intuitively feed our body what it needs/wants, while the other requires us to avoid certain foods for medical purposes. 

But what if Intuitive Eating could unlock greater freedom, patience, and kindness towards their bodies for those with food allergies?

Intrigued? Let’s dig into the details. 

Diets don’t work for a variety of reasons. Scientifically, when you restrict food or are on a diet, your brain produces something called neuropeptide Y, which triggers your brain to crave carbohydrates. Familiar with that feeling you get at 11am because you skipped breakfast? Pay a little thank you to your brain. It’s physically reminding you that you haven’t eaten and that you need to feed it carbohydrates because they are our body’s primary and preferred source of energy. When the body is in a deficit, we are physically depriving it of the calories and nutrients it needs to function. 

This isn’t to say all diets are bad. In particular, medically-prescribed diets are often extremely helpful and medically necessary for those suffering from food allergies, intolerances, and other medical conditions. However, many diets end up depriving your body of the vital nutrients it needs to function properly. The more you deny your hunger and fight your natural biology, the stronger and more intense these food cravings can become. 

If you’re reading this, there’s a good chance you either suffer from a food allergy or intolerance, or care for someone who does. Food allergies force us to eliminate foods or food groups to keep us safe. Intuitive Eating encourages us to ditch all food-related rules. How do you reconcile the two? What about challenging the idea that food allergies are a limitation, and instead, thinking of your food allergy as part of your body’s intuition? By reframing the way you think about your food allergy, you acknowledge your food cravings and indulge in the foods that your body CAN tolerate. Craving ice cream but have a dairy allergy? Search out dairy-free ice cream alternatives—there are a lot of comparable ones out there that are delicious and will do the trick. This way you honor your cravings, while respecting your body’s intuitive dietary boundaries. 

If you’re curious to learn more about Intuitive Eating, here are a few resources:

1.     https://www.intuitiveeating.org

2.     10 principles explained in depth: https://www.intuitiveeating.org/10-principles-of-intuitive-eating/

3.    Additional resources: https://www.intuitiveeating.org/resources/articles/

Rebecca Noren is on the Allergy Amulet health advisory board and works with chef Ming Tsai. Rebecca holds a master's degree in nutrition and is a registered dietitian. She is dedicated to bringing her expertise in public relations, marketing, and culinary production to the intersection of food, health, and food allergies. 

Comment

Comment

Humans Are Pooping Plastic

karina-tes-1228178-unsplash.jpg

Got your attention? Thought so. 😉

If you’re thinking, What does poop have to do with food allergies? First, food allergies affect our health and diet, which implicates our digestive tract. Number two, research is increasingly looking to the gut for answers around the rise in food allergies. For these reasons, we thought the topic was a-poo-priate. 💩

This past summer, Austrian researchers reported that the deluge of plastic entering our environment is now entering our stool. That’s right—plastic has been discovered in 114 aquatic species90% of seabirds, and now, evidently, in us. 

As part of this first-of-its-kind study, researchers followed eight volunteers from a handful of European countries, tracked their consumption habits, and then sampled their stool. Small fibers of plastic—known as microplastics—were found in all participants’ feces to varying degrees, amounting to the first documentation of plastic in human feces to date. The findings confirmed what many scientists have long suspected: we’re eating plastic.

Scientists are now grappling with the health implications, which are largely unknown. Microplastics are capable of damaging the reproductive and gastrointestinal systems in sea life, but little is known about their impact on humans.

On average, 13 billion microplastic particles enter US waterways every day through the municipal water supply. An estimated 8 million tons of plastic enter the oceans each year. The latter bulk of plastic gets broken down into smaller bits, which are eaten by smaller organisms, and make their way up the food chain.

How does this relate to the food allergy and intolerance community? 

First, we know that immune health is closely tied to food allergies and intolerances. Experts have found that plastic in the gut can suppress the immune system and increase the likelihood of gastrointestinal diseases like inflammatory bowel disease. Second, research has shown that exposure to phthalates, which are found in many plastics, can increase childhood risk of allergies. According to the lead researcher of the study, Dr. Philipp Schwabi: “[my] primary concern is the human impact… especially [on] patients with gastrointestinal diseases.” He notes that “the smallest particles are capable of entering the bloodstream, the lymphatic system and may even reach the liver.”

While research on the human impact of plastic is still early, one thing is clear: plastic may be harming our immune systems, which could potentially implicate our body’s ability to tolerate and digest certain foods.

We’re eating our waste—that much is clear. Now the question is, what are we going to do about it? 

-      Abi and the Allergy Amulet Team 

Comment

Comment

Roses are Red, Violets are Blue, Sugar is Sweet, and Food Allergies Can Be Sweet Too

E01E40E3-5146-42B2-81DC-434C149C709C.JPG

Ah, Valentine’s Day. For some, this day provides a great excuse to press pause on the stressors of life and take time to celebrate the ones you love. For those with food allergies and intolerances, however, this day can bring about a lot of anxiety. 

If you’re a food allergy parent like me, here’s what probably goes through your head: Will my child be given a valentine that contains their allergen? What will be served at school? Will they feel comfortable speaking up to ensure the treat is safe? Why does this holiday have to center around food?!

If you are celebrating Valentine’s Day as a food-allergic adult, it can be just as stressful. Valentine’s Day often comes in the form of chocolates, or a splurge on a nice dinner and dessert (in our house that means sushi)!

We get it guys. This holiday can be hard. That’s why we’ve teamed up with our friend chef Ming Tsai to bring you a homemade sweet treat this Valentine’s Day. 

Easy? Check. Healthy? Check. Top eight allergen free AND gluten free AND sesame free? Check check check. 

Here’s Chef Tsai’s recipe for Strawberry Coconut Sorbet (note: this recipe contains coconut). 

Strawberry Coconut Sorbet (serves 2)

- 1/2 cup frozen strawberries

- 1/2 cup coconut milk

- 1/4 teaspoon lemon zest

- 2 tablespoons unsweetened coconut flakes

Add strawberries, coconut milk, and zest to a blender and blend until just smooth. Serve immediately and garnish with coconut flakes or cacao nibs (or whatever your heart desires 😍).  

Enjoy friends!

XOXO, 

Meg and the Allergy Amulet Team 

Comment

Comment

Food Allergies + Natural Disasters… A Different Kind of Storm

dominik-martin-100802-unsplash.jpg

As torrential floods from Hurricane Florence ripped through the Carolinas earlier this month, Madison, Wisconsin—home of the Allergy Amulet headquarters—was still reeling from record rainfall levels and flash floods. 

These events got us thinking: How should the food allergy community prepare for a natural disaster? 

First, there are great emergency kit checklists available through the American Red Cross and FEMA websites, which advise on supplies to have at the ready in case of an emergency. If you or your loved one has a food allergy, however, you have a few extra things to consider.

Tell me more.

At a minimum you should plan to have several days’ worth of allergy-friendly foods on hand that don’t require refrigeration, heating, and that don’t spoil easily. This might include canned vegetables, granola, or dried fruits and meats. Don’t forget several days’ worth of water, too! 

The American Red Cross recommends having a seven-day supply of any necessary medications. For food allergy families this could include your antihistamines as well as epinephrine, or any other doctor-recommended medications (e.g., inhaler). Depending on where you live, and what type of emergencies are most common, you may want to have these items already packed and stored in a convenient location. For example, if you live in an area prone to tornadoes, it’s likely that you have a basement, so you may want to store your emergency supplies down there.  

What if I need to evacuate?

Evacuating in the wake of a natural disaster can present unique challenges for those with food allergies. Shelters may not serve allergy-friendly meals, and even if they do, families may need to manage for cross-contact. Having allergy-friendly foods on hand and disinfectant wipes for hands and surfaces can help mitigate exposure risk. Make sure to also pack emergency action plans for children if you have them, insurance cards, and an emergency contact list with your medical providers!

Check expiration dates!

Don’t forget to review and update your emergency preparedness kit at least once a year, and make sure to check the expiration dates on your epinephrine and antihistamines. Spokin recently offered a feature on its app that helps you to manage epinephrine expiration dates.

We all hope that you never need your emergency supplies, but it’s a good idea to be prepared! 

- Susannah and the Allergy Amulet Team 

Comment

Comment

FPIES: Not As Delicious As It Sounds

jelleke-vanooteghem-381416-unsplash.jpg

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

Comment

Comment

FOMO: Fear of Missing Out… On Nutrients

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

brooke-lark-229136-unsplash.jpg

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.  

Screen Shot 2018-05-22 at 10.19.34 AM.png

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. 

Comment

Comment

FOMO: Fear of Missing Out… On Nutrients

Part I: Milk, Eggs, Fish, and Shellfish

rachel-park-366508-unsplash.jpg

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.

Screen Shot 2018-04-10 at 2.33.59 PM.png

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.

Screen Shot 2018-04-10 at 2.37.16 PM.png

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).

Screen Shot 2018-04-10 at 2.39.18 PM.png

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. 

Comment