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food intolerance

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Humans Are Pooping Plastic

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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 

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Cross-Contact or Cross-Contamination: What’s the Difference?

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I’ll be honest with you: distinguishing between cross-contact and cross-contamination used to throw me off. Many people in the food allergy community (my past-self included) often mistakenly use the terms interchangeably.  

The confusion is so widespread that even food manufacturers and allergists mix up the two. In fairness, cross-contact is a new(ish) term, so some have gotten into the habit of labeling everything involving inadvertent food exposure as cross-contamination. “I’ll be the first to admit that I don’t always use the terms correctly,” says allergist Dr. Jordan Scott. “Many of us were trained to use cross-contamination to refer to allergens inadvertently getting into another food source.”

To help clear up some of the confusion, we’re breaking down the difference between the two terms in this post.

Let’s start with some examples.

Cross-contact: This occurs when a food allergen in one food (let’s say milk protein in cheese) touches another food (let’s say a hamburger), and their proteins mix, transferring the allergen from one food to another. These amounts are often so small that they can’t be seen!

In this example, let’s assume I have a severe milk allergy. If the cheese touches the burger, cross-contact has occurred. Even if the cheese is removed from the burger, trace amounts of the milk allergen likely remain on the burger making it unsafe to eat and posing the risk of an allergic reaction.

It’s important to note that most food proteins (with few exceptions, like heat labile proteins) CANNOT be cooked out of foods, no matter how high the temperature. When our daughter underwent oral immunotherapy for her peanut allergy, we were given the option to bake the peanut flour into muffins for her to consume. We were told that the high oven temperature would not affect the protein structure of the peanut flour.

Cross-contamination: Cross-contamination occurs when a bacteria or virus is unintentionally transferred from one food product to another, making the food unsafe. The key mark of distinction is that cross-contamination generally refers to food contamination, not food allergens.

A couple examples: you cut raw chicken on a cutting board before you put it on the grill. You then cut peppers on that same cutting board. The raw chicken juice touches the peppers, therefore posing a risk for bacteria. Or say you purchase a cantaloupe that unknowingly has listeria. The knife used to dice up the melon is now a vehicle for cross-contamination. Unlike cross-contact, properly cooking contaminated foods generally CAN eliminate the food-borne offender.

Is it all making sense now? In short, when referring to food allergens, use cross-contact, and when referring to food-borne bacteria or viruses, use cross-contamination. Easy peasy.

We hope our explanation cleared up any confusion. Now that you’re a cross-contact pro, here’s a guide with tips on how to avoid cross-contact.

Want to discuss this topic further? Still confused? Feel free to reach out to me at mnohe@allergyamulet.com. I’m always game for a good food allergy chat!  :)

-       Meg and the Allergy Amulet Team

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Food Allergies Today: An Expert Q & A

There are many unknowns in the food allergy world today. Why are food allergies on the rise? What can I do to prevent my child from developing a food allergy? How do I find out if I have a food allergy or intolerance, or if my child has one? With the help of two of our medical advisors, Dr. Jordan Scott and Dr. John Lee, we have answered some of these common food allergy questions to help you dine with confidence! Let’s get started.

1) What is a food allergy and how does it differ from a food intolerance?

A food allergy is an immune system reaction. Your immune system is comprised of five different types of immunoglobulins/antibodies (IgA, IgD, IgE, IgG, and IgM). If you have a food allergy, IgE is the responsive antibody. When exposed to a food allergen, IgE attaches to the allergen, mistaking it as a foreign intruder. This IgE-allergen compound then binds to immune cells, triggering a release of histamine and other chemicals that produce an allergic reaction. Symptoms can affect the central nervous, respiratory, and gastrointestinal systems, and produce epidermal symptoms such as hives, rashes, or eczema. In the most extreme cases, a food-allergic reaction produces anaphylaxis, a life-threatening response that requires immediate medical treatment.

Food intolerances often affect gastrointestinal function, but they can also impact the central nervous system, respiratory health, and skin. The main difference between a food allergy and intolerance is that, although intolerance symptoms can be severe, they are not life threatening and will not produce anaphylaxis.

2) What are the leading theories for the significant increase in food allergies? 

Between 1997 and 2011, food allergies among children increased approximately 50 percent, according to the CDC. Unfortunately, there is no clear answer as to why. Below are some of the leading theories, in no particular order.

Theory One: Changes in our food system

Over the past few decades, our agricultural system has undergone a considerable transformation, including the introduction of GMOs (genetically modified organisms), increased pesticide application, and the addition of numerous chemicals to our foods. This theory suggests that these chemicals and modified foods are affecting our bodies and immune systems, particularly our gut health, thereby increasing our susceptibility to food allergies and intolerances.

Theory Two: Hygiene hypothesis

The second theory is the “hygiene hypothesis,” suggesting that our modern world is too clean, and our reduced exposure to bacteria is weakening our immune systems. Some research also suggests that the overuse of antibiotics in animals and the rise of prescription medication is killing the good bacteria in our gut alongside the bad.

Theory Three: Epigenetics

Some research indicates epigenetics are responsible for the rapid increase in food allergies—heritable changes in gene expression that don’t change the underlying DNA sequence. Epigenetic changes can be the product of environmental or other external factors, like diet or smoking, or the result of natural occurrence. Research is continuing to uncover the role of epigenetics in a variety of human disorders and fatal diseases.

Theory Four: Delayed allergen exposure

In the past few years, a growing body of research is suggesting that we may not be introducing children early enough to common allergens. In February 2015, the LEAP Study results came out, debunking the previously accepted practice of discouraging exposure to peanut among high-risk infants. This misguided approach may have contributed to the rise of peanut allergies and other food allergies.

3) What are the current methods for diagnosing a food allergy? How have they changed in the past several years? 

To diagnose a food allergy, an allergist performs one of two tests (or both): a blood test (such as an ImmunoCAP test) and/or a skin prick test. The blood test measures the level of allergen-specific IgE antibodies present in the blood. Skin prick tests are exactly as they sound: the allergists pricks the patient’s arm or back with a sterile small probe containing a tiny amount of the food allergen. A food allergy diagnosis is confirmed if a wheal (a raised white bump surrounded by a small circle of red irritated skin) develops around the contact area.

In some cases, an allergist may suggest a food elimination diet to pinpoint the offending food. They may also recommend an oral food challenge.

In an oral food challenge, an allergist administers tiny amounts of the potential allergen in gradually increasing doses over a set period of time (usually 1-3 hours). The patient is closely monitored in the event the food produces an allergic reaction, and epinephrine is always on hand in case of a reaction.

To date, oral food challenges are considered the gold standard for food allergy diagnosis. Skin prick and blood tests aid in diagnosis, but they are prone to error—false positives are not uncommon. For this reason, many allergists avoid blanket food allergy screening, and carefully choose which foods to test. Skin prick tests and blood tests have been standard practice for aiding in allergy diagnosis for the past two decades.

4) What are some common allergic reaction symptoms?

It’s first important to note that no two allergic reactions are the same, and just because you have a mild reaction to a small bit of sesame one day, doesn’t mean symptoms will present in the same way the next time you ingest that same small amount. Below are the most common symptoms to an allergic reaction.  

Mild symptoms include: itchy or runny nose, sneezing, itchy mouth, a few hives or mild itch, and mild nausea or discomfort.

Severe symptoms include: shortness of breath, wheezing, repetitive cough, pale or bluish skin, faintness, weak pulse, dizziness, tight or hoarse throat, trouble breathing or swallowing, significant swelling of the tongue or lips, hives or widespread redness, repetitive vomiting or severe diarrhea, anxiety or confusion, or some combination thereof.

It’s important that food-allergic individuals also be aware of biphasic anaphylaxis. A biphasic allergic reaction is a second episode of anaphylaxes that typically occurs within the first several hours after the initial anaphylactic event. The symptoms of biphasic anaphylaxis can be more severe than the initial reaction. Due to the risk of biphasic anaphylaxis, a doctor may require that you remain in the hospital for several hours after an anaphylactic event for monitoring.

5) What are the most common misconceptions about food allergies? 

There are several misconceptions about food allergies. Below are a few that we hear most frequently:

Food allergies aren’t real—False. Food allergies are real. They are a response to the body’s immune system upon exposure to an allergen. The immune system misinterprets the food as a harmful invader and releases histamine and other chemicals to protect the body from perceived harm.

Food allergies aren’t life threatening—False. If an allergic reaction becomes severe, it can lead to anaphylaxis—a potentially fatal allergic reaction that involves the rapid onset of swelling which can obstruct air passageways. Symptoms of an allergic reaction may be isolated to one major system in the body (e.g., wheezing or difficulty breathing), or can involve multiple systems (e.g., lungs, heart, throat, mouth, skin, or gut), and typically present within minutes after a person ingests the offending food.

Each allergic reaction becomes increasingly worse—Not necessarily. Allergic reactions can be unpredictable. The severity of a reaction is based on a number of factors, including: the amount of the allergenic food ingested, the person’s degree of sensitivity to that food, if exercise is involved, if they are sick, if alcohol is present in their body, and if certain medications are being used (for example, NSAIDS may increase the severity of a reaction). A person with food allergies might not always experience the same symptoms each time.

A food can be made less allergenic by cooking it—Partially true. Because a food allergy is an immune system response to a protein in a food, the protein remains in the food during heating, so it cannot be cooked out. The exception to this rule is sometimes seen in highly processed foods, and with milk and egg allergies—some people are able to consume these foods after heating, such as baked goods. Ask your allergist before trying this at home.

Adults don’t develop food allergies—False. Though most food allergies start in childhood, they can develop at any age.

Peanuts are the only food that cause severe reactions—False. While peanuts are the leading trigger of food-related anaphylaxis, any food can elicit a severe reaction—other common foods include seafood, milk, wheat, eggs, and sesame seeds.

One small bite is ok—If someone has a severe food allergy, and is highly sensitive to small amounts, even a tiny bite can trigger anaphylaxis. It is well documented that allergic individuals can experience severe reactions to trace amounts of an allergen in their food.

6) What are the three most important things a food-allergic individual can communicate to their friends, family, and co-workers?

First, alert your “tribe” (friends, family, work colleagues, caregivers) of your food allergies and their accompanying health risk. Also note the various ways you can be exposed (e.g., ingestion, touch, and inhalation).

Second, let them know what symptoms to watch for in case of a reaction.

Finally, tell them where you keep your emergency medications and teach them how to use an epinephrine auto-injector. Share your doctor-provided food allergy action plan, if you have one. Often parents with food-allergic children have one to serve as a guide for caregivers. The American Academy of Pediatrics recently published a customizable Allergy and Anaphylaxis Emergency Plan.

7) What role do you see technology playing in the lives of individuals with food allergies and how they manage them now, and in future? 

Food allergies have increased at an alarming rate over the past two decades. The silver lining is that we’re putting more research dollars and efforts into allergy education, management, and prevention. Numerous start-ups are spearheading this effort with cutting-edge technologies and innovation. This Spokin article published in January highlights several. Until we find a cure, technology is going to become a necessary part of how we manage food allergies.

8) What will be important for future food allergy diagnoses and treatment?

With food allergy diagnoses at an all-time high, it will become increasingly important to have improved diagnostic tools available to better understand who is at risk for severe reactions. New therapies to help people better manage their allergies are being developed every day. One example is oral immunotherapy, or OIT. OIT is a method of food desensitization that involves re-introducing the immune system to the allergenic food via oral ingestion in gradually increasing amounts over time, with the goal of eventual tolerance. Another example is the Viaskin® patch, otherwise known as the peanut patch. This approach uses epicutaneous immunotherapy. After applying the patch to your skin, the allergen is concentrated in the top layers of the skin, where it activates the immune system by targeting antigen-presenting cells without passage of the antigen into the bloodstream. The peanut patch recently entered Phase III clinical trials. Products are also currently being developed for milk and egg.

Is desensitization the future of food allergies? Or is a cure on the horizon? Only time will tell. Until then, innovation, research, heightened awareness, and education are paving the way for a brighter food allergy future.

If you have additional questions you’d like our experts to answer, please send them to Meg at mnohe@allergyamulet.com. We’d love to hear from you!

- The Allergy Amulet Team

 

These questions, and their corresponding responses, were written by the Allergy Amulet team and reviewed by Allergy Amulet advisors, Dr. Jordan Scott and Dr. John Lee.

Dr. Scott is an allergist/immunologist and operates several private allergy clinics throughout the Boston area. He is on the board of overseers at Boston Children’s Hospital, and the past president of the Massachusetts Allergy and Asthma Society. Dr. Scott is an allergy/immunology instructor at the University of Massachusetts.

Dr. Lee is the clinical director of the food allergy program at Boston Children’s Hospital. Dr. Lee is widely recognized for his work in food allergy, and his commitment to patient health.

 

 

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Should I Go Gluten-Free? Break it Down for Me

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Google “gluten free” and you get roughly 150,000,000 results.

Clearly, the topic of gluten is trending.  You probably know at least one person that has cut gluten from their diet.  This begs the question: Is eating gluten-free a fad?  Will it pass by us eventually à la fat-free diets?  And what about the choice of whether or not you should go gluten-free?  Friends, that question is one we hear a lot.  And we want to help you find the answer.

Without having a severe gluten intolerance or celiac disease, it can be tough to know if it’s worth it, right?  How do you know if you have a gluten intolerance, celiac disease, or a sensitivity?  Well, while there is a test that can identify whether or not you have celiac disease, the only surefire way to know if you have a sensitivity is by eliminating gluten from your diet and seeing how your body responds after gradually reintroducing it thereafter.

To start, it’s important to understand the different types of gluten sensitivities.  These varying sensitivities can have different OR similar symptoms—and it’s often much more than just a bad stomachache.  Here’s a deeper look at the different sensitivities so you can better identify how gluten may be impacting you:

1. Gluten is a BIG problem for you (e.g., celiac disease)

Celiac disease is on the rise.  The condition, also called celiac sprue, coeliac, and gluten-sensitive enteropathy, once considered rare now affects more people than ever: 1 in 100.  Many physicians believe it is a grossly undiagnosed disease, and some doctors now regularly screen anyone with severe digestive complaints for the troubling illness.  The reality is that celiac is more than an uncomfortable condition—it can be life threatening, and is characterized by autoimmune antibodies.  It’s important to understand that celiac CANNOT cause anaphylaxis—a severe and potentially life-threatening allergic reaction—unlike a wheat allergy, for example.  Most people will not die from the immediate symptoms of celiac disease. However, left untreated, it can lead to several other conditions, some of which can be fatal.

●      Common symptoms: Stomach pain, chronic diarrhea, bloating, fatigue, floating or foul smelling stool, depression, fatigue, infertility, and weight loss.

●      Associated symptoms & conditions: Itchy rash, peripheral neuropathy, ataxia, osteoporosis, behavioral changes, irregular menstrual cycle, infertility, Addison’s disease, fibromyalgia, autism, anxiety/depression, chronic fatigue syndrome, inflammatory bowel disease, irritable bowel syndrome, severe headaches/migraines, rheumatoid arthritis, Hashimoto’s thyroiditis, Graves disease, type 1 diabetes, pancreatic disorders, and multiple sclerosis.

●      Diagnosis: To diagnose celiac disease, your doctor will administer a blood test called a Tissue Transglutaminase Antibodies (tTG-IgA), and you must have gluten in your system at the time of the test—if you’re on a gluten-free diet the test may produce false negative results.  This test is 98% accurate in patients with celiac disease.

2. You don’t have celiac disease, but something is way off (e.g., gluten intolerance/sensitivity)

Many people experience symptoms like those of celiac disease, despite negative tTG-IgA test results and intestinal biopsies revealing no tissue damage. It is unclear what the underlying cause is for a gluten intolerance or sensitivity, and is often diagnosed based on a patient’s response to a gluten-free diet.

●      Common symptoms: Often the same as celiac, and primarily digestive distress.

●      Dietary Recommendations: Having a severe gluten intolerance is becoming increasingly common, and it can be very frustrating because it’s difficult to obtain a clear diagnosis.  Gluten sensitivity can manifest in the same way as celiac disease, but with greater variability in severity and duration.  Your best bet may be to try an elimination diet, which you can find in many of our programs!  We recommend eliminating for two months for best results.  Determining if you’re gluten sensitive is just as important as determining if you have celiac disease, because over time, the integrity of your gut health can be compromised.  Gastrointestinal health is the cornerstone of optimal health—it plays a major role in the balance of hormones, mood, cognitive function, and other aspects of overall health and well-being.

3.  Gluten doesn’t make you feel too sexy

For those that don’t have celiac disease or a diagnosed intolerance, you may just not feel so hot after you eat gluten-containing foods.  Low energy, less endurance, and overall “slowness” are common words used to describe these feelings.  By removing gluten from your diet, many in this category see a positive change in their appearance, and many professional athletes have gone gluten-free to improve athletic performance!

●      Common symptoms: Digestive distress, fatigue, energy loss, and overall blah.

●      Dietary Recommendations: We recommend eliminating gluten from your diet for two months.  Why?  Gluten is pesky and can linger in the blood stream for a long time.  Add it back into your diet gradually over time and see you how feel.

4.  Gluten ain’t no thang

You feel absolutely fine with gluten.  No cramping or chronic side effects.  Perhaps you have headaches, digestive issues, or some joint pain.  You’ve tried going gluten-free for two months and noticed zero difference.  You’re realizing maybe something else is to blame.

Our feelings?  Being gluten-free is not a fad.  We have worked with too many people who notice legitimate improvements by removing it from their diet.  With that said, it’s important to consider a few things—when you cut out gluten, you are often cutting out a lot of unhealthy food too.  You will not be able to eat most fast food, many packaged items, and other foods that simply aren’t healthy.  So you have to ask yourself, was it the gluten or was it the crummy food?  One way to determine the difference is to eat healthy sources of gluten as a trial: wheat berries, farro, and couscous are just a handful of naturally gluten-filled whole grains.  On the flip side, going gluten-free and replacing those packaged foods with gluten-free versions may not necessarily improve your health, as they’re often laden with added sugars and fats to improve flavor.  The ticket is to try removing it from your diet and trying a healthy whole foods diet (with gluten grains) to see if gluten is the cause!

SO, what do you think? 

We hope this information helps guide you in making the decision of whether to go gluten-free.  Ultimately, the best way to find out whether a gluten-free diet is right for you is to remove it from your diet, then gauge how your body responds upon reintroduction.  We help people explore this in our 20-day nutrition program: Prescribe 20.  Because going at these things alone is never easy, and rarely successful, we believe that community is the key to success.  With our programs, we’re with you every step of the way, offering recipes, educational materials, and professional guidance.  With this support system in place, the process of discovering how to feed YOUR body isn’t so bad. Not one bit.

 Megan Morris is a certified nutritionist, Co-Founder & CEO of Prescribe Nutrition, and Founder of The Root of Health: an online digestive health resource. 

 

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