Food Allergy Survival Guide

Food Allergies

Food Allergies

Peanuts can leave you breathless. Cat dander can lead to itchy eyes, a stuffy nose, coughing and sneezing. And most of us have suffered through those seasonal allergies with horrible pollen counts. Learn more...

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Pathophysiology Of Food Allergy

Food allergies in infancy can be conceptualized as a failure or impairment in developing oral tolerance. The pathological mechanisms involved in the development of oral tolerance and factors leading to food antigen sensitization are not completely understood.89 The dose and frequency of exposure as well as biological characteristics of antigens are likely to affect the development of oral tolerance. Oral tolerance involves predominantly the down-regulation of T helper-1 (Th1) responses and of cell-mediated immunity. CD4+ lymphocytes have been shown to play an integral part in the induction and maintenance of oral tolerance.90 The deviation from a Th1- to Th2-predominant immune response is believed to be mediated by cytokines such as TGF-P, which is derived from Th3 lymphocytes in the gut. IL-4 and IL-10 are also of likely importance in the mediation of oral tolerance.91 Factors that may predispose to impaired oral tolerance include increased antigen uptake, decreased production of...

Lactose Intolerance and Malabsorption

Lactose malabsorption describes a physiological situation. It is the basis for lactose intolerance. The inability to digest lactose is a quantitative phenomenon related to the enzyme lactase and its amount and activity in the intestine. Lactose intolerance, then, is a clinical definition. It involves the concept that the individual is unable to tolerate physiologically the lactose present in milk and other dietary products because of an inability to digest the carbohydrate, due to insufficient activity of the lactase enzyme. Intolerance to lactose as a clinical entity has been recognized for some time. Early in this century, Abraham Jacoby hinted at the existence of lactose intolerance in speeches to the American Pediatric Society later, in 1926, John Howland, in his presidential address to that same organization, was somewhat more explicit when he indicated that many of the infantile diarrheas were the result of a lack of ferments necessary for the digestion of carbohydrate (Flatz...

Dietary prevention of food allergies and atopic dermatitis

Elimination diets have long been an integral part in the treatment and secondary prevention of food allergies and AD.30,123 There may also be a role for the delayed introduction of high-risk weaning foods, such as egg and peanut, as part of the primary prevention of food sensitization. However, while these dietary interventions may reduce the frequency of manifestations of food allergy during the period of diet exclusion, there is no conclusive evidence they prevent the development of food allergy or hasten the induction of tolerance.124

Understanding Food Allergies

A true food allergy is a hypersensitive reaction that occurs when your immune system responds abnormally to harmless proteins in food. That is, your body misinterprets something good as an intruder and produces antibodies to halt the invasion. Remember the episode of Three's Company when Jack sneaked in late one night, and Chrissy and Janet mistook him for a robber and clobbered him over the head It's the same thing with food allergies, only you're the one who gets clobbered. Food allergy is an overreaction by the body's immune system, usually triggered by protein-containing foods (such as cow's milk, nuts, soybeans, shellfish, eggs, and wheat). Food intolerance is an adverse reaction that generally does not involve the immune system (such as lactose intolerance).

Diagnosing a True Food Allergy

Many folks view this whole food-sensitivity business as faddism and quackery, and unfortunately, we have earned this mindset. Did you know that out of the gazillions of people who think they have a food allergy, less than 2 percent of the American adult population actually have one Why does the idea of a food allergy get so recklessly thrown around One reason may be that people are often quick to blame physical ailments on food. Another aggravating reason for all the misdiag-noses are those so-called allergy quacks that grab your hard-earned money and diagnose you with the allergy of the month. In today's world, a true food allergy can be properly diagnosed with scientific sound testing. If you think you might suffer from an allergic response to certain foods, get it checked out. The first step is to find a qualified and reputable physician who has been certified by the American Board of Allergy and Immunology. Ask your primary doctor for a referral, or call the American Academy of...

Treating a True Food Allergy

What's the treatment once you're diagnosed with a true food allergy Avoid the offending food Although this list is not a substitute for consulting a registered dietitian, it can provide a pretty good idea of which food ingredients to avoid after you've been diagnosed with one of the following food allergies For further information and a free newsletter on food allergies, send a self-addressed stamped envelope to The Food Allergy and Anaphylaxis (FAAN) 10400 Eaton Place, Suite 107 Fairfax, VA 22030 1-800-929-4040 Some people have such severe food allergies that they can even exhibit symptoms from the following

Whats Lactose Intolerance All About

If you can't stomach milk and you experience bloating, nausea, cramping, excessive gas, or a bad case of the runs after eating a dairy food, you are not alone. In fact, an estimated 30 to 50 million Americans suffer from some degree of lactose intolerance, which is the inability to digest the milk sugar lactose. In fact, I once had a client tell me he visited so many restrooms while touring through Europe he was ready to write The Complete Idiot's Guide to European Bathrooms. Up to 70 percent of the entire world's population does not produce enough of the enzyme lactase and therefore has some degree of lactose intolerance. In the United States alone, the following groups experience some or all symptoms of lactose intolerance Don't confuse a lactose intolerance with a milk allergy. A lactose intolerance involves difficulty digesting the milk sugar lactose a milk allergy involves an allergic reaction from the protein components in cow's milk. Folks who suffer from milk allergies cannot...

Living with a Lactose intolerance

The following tips are helpful for people who have difficulty digesting lactose. As mentioned earlier, the degree of lactose intolerance can vary from person to person therefore, not everyone will be able to handle all of the suggestions. Give them each a shot, but be sure that you're in a comfortable place if some seem a bit risky. Keep in mind that lactose-containing foods are generally your best sources for the mineral calcium, so children and women with increased calcium requirements should load up on the nondairy sources and speak with a registered dietitian about the possibility of calcium supplementation. For further information and a free brochure on lactose intolerance, call 1-800-LACTAID. For further information and a free brochure on lactose intolerance, call 1-800-LACTAID. Some people with lactose intolerance can tolerate yogurt because the bacteria in the yogurt actually metabolizes the milk sugar lactose for you.

Prevalence Of Food Allergy

In recent years, the prevalence of atopic diseases and food allergies appears to have increased in many Western countries. Food allergy has its greatest incidence in infancy and early childhood.55 It is estimated that about 8 of children will develop adverse reactions to food, most of them in the first year of life.51 The prevalence of food allergy varies between regions and appears to be influenced by cultural and genetic fac-tors.3 For example, hypersensitivity to cow's milk and egg is uncommon in Southeast Asia, whereas peanut hypersensitivity is uncommon in Malaysia, Japan and the Philippines.54 Conversely, shellfish hypersensitivity is common in children from the Philippines and Singapore where it is part of the diet from early infancy, but it is uncommon in Western children. Despite the overall increase in the incidence of food allergies in Western countries, the spectrum of food allergens has remained relatively unchanged over the past decade, and sensitization to minor food...

Marc J Buehner Patricia W Cheng

We see that even when there is temporal information so one can reliably predict an event from an earlier observation (e.g., sunrise from a rooster's crowing, a storm from a drop in the barometric reading), correlation need not imply causation. One might think that intervention (i.e., action, manipulation) is what differentiates between covariation and causation When the observations are obtained by intervention, by oneself or others, the covariations are causal otherwise, they are not necessarily causal. A growing body of research is dedicated to the role of intervention in causal learning, discovery, and reasoning (e.g., Gopnik et al., 2004 Lagnado & Sloman, 2004 Steyvers, Tenen-baum, Wagenmakers, & Blum, 2003). Indeed, the general pattern reported is that observations based on intervention allow causal inferences that are not possible with mere observations. However, although intervention generally allows causal inference, it does not guarantee it. Consider a food allergy test...

Foodallergic skin disease

In rare cases the animal may actually be allergic to the protein within the diet. This is true food allergy, but the term food allergy is often misused. Many pet owners refer to the reaction their pet had to a particular food as an 'allergic' reaction when it may have just been food intolerance. A true food allergy must involve the pet's immune system and takes many months or even years to develop. A dog or cat that reacts to a new food the first time it is exposed to it probably has food intolerance. Food allergy or hypersensitivity is an immunological response to one or more dietary proteins. It is considered the third most common skin hypersensitivity disease in dogs and the second most common in cats, accounting for up to 5 of all canine dermatoses and 6 of feline. The prevalence and severity of food hypersensitivity reactions is greatest in younger animals. Signs are predominantly associated with the skin and or gastrointestinal tract. A high proportion of food allergies produce...

Does the taste of any particular food or combination of foods play any part in your eating disorder

You don't have the chance to let your personal sense of taste influence what you eat. Have people in your family always eaten their food cooked with certain spices or to a certain degree of doneness and given you no choice in the matter Are you particularly sensitive to sweet, salt, sour, or bitter tastes Do you have food allergies Do certain tastes repulse you and make it impossible for you to eat anything at all It's important to explore these questions because your solution may be a simple one substitute similarly nutritious foods for the ones you can't stand.

Nutritional Support Awful Dophilus and More

Diet is incredibly important in treating persistent pediatric diarrhea. Food allergies such as wheat gluten, sugar malabsorption, or deficient pancreatic enzymes are the most common causes of this condition. Try cutting out wheat products for several weeks. (And check your labels wheat is in everything ) Next, give sugary foods and juices some time off. Children often become addicted to sugar, so this may not be easy, but their improved health will strengthen your resolve.

Medical Overview and Epidemiology

Hood and greater female symptom reporting in adolescence. Most children with chronic or recurrent abdominal pain, probably over 90 , do not suffer from explanatory physical disease, such as peptic ulcer or Crohn's disease (American Academy of Pediatrics Subcommittee on Chronic Abdominal Pain 2005), and are considered to suffer generically from functional abdominal pain (FAP). Traditional physical disease, with demonstrable structural, infectious, inflammatory, or biochemical findings, is especially unusual in the absence of red flags such as weight loss, gastrointestinal bleeding, fever, anemia, or persistent vomiting. Helicobacter pylori infection and celiac disease are not etiological in most cases, and despite suspicions about food allergies, lack of dietary fiber, and lactose malabsorption, results of dietary intervention such as fiber supplementation and lactose-free diets have been disappointing (Huertas-Ceballos et al. 2008a).

Clinical Manifestations

The clinical manifestations of lactose intolerance include increasing abdominal discomfort, borboryg-mus, flatulence, and finally fermentative diarrhea. Although an inordinate amount of any carbohydrate in the diet will produce a similar symptomatology, intolerance to lactose is the most prominent of these clinical syndromes. The basis of this phenomenon is primarily the activity of the lactase relative to dietary lactose. The lower the activity, the less the capacity for the hydrolysis of the lactose, although other factors - such as intestinal motility and the presence of other nutrients also play a role in this phenomenon.

Role Of Food Allergens In Atopic Dermatitis

Food allergy is usually the earliest manifestation of atopy and may affect both breast- and formula-fed infants.54,92 Early sensitization to food allergens is typically transient and followed by inhalant sensitization, as demonstrated by the appearance of specific serum IgE antibodies to inhalant allergens or positive skin prick tests (SPT).104,105 This chapter will focus predominantly on the role of food allergens in AD, as the role of inhalant allergens will be discussed in Chapter 9. Several studies have examined the relationship between AD and food hypersensitivity. In an early study by Sampson and McCaskill,38 children with AD were evaluated for the presence of food allergies by double-blind placebo-controlled food challenges (DBPCFC) 85 (84 ) children developed skin symptoms of 113 children (median age 6 years, range 4 months to 24 years), 63 (56 ) developed either skin, gastrointestinal, or respiratory symptoms in response to food challenge. Egg, peanut, and cow's milk...

Foodspecific IgE antibodies

Food antigen-specific IgE antibodies have been shown to be a useful tool in the assessment of immediate-type food allergy.41> 71> 111-113 Sampson et al41 measured food-specific IgE antibodies in serum samples from 196 Table 8.4 Frequency of IgE-mediated food allergy in infants with atopic dermatitis (AD). (Reproduced from Hill DJ, Hosking CS, Heine RG. Clinical spectrum of food allergy in children in Australia and South-East Asia identification and targets for treatment. Ann Med 1999 31 272-81.) Table 8.4 Frequency of IgE-mediated food allergy in infants with atopic dermatitis (AD). (Reproduced from Hill DJ, Hosking CS, Heine RG. Clinical spectrum of food allergy in children in Australia and South-East Asia identification and targets for treatment. Ann Med 1999 31 272-81.) patients with AD, allergic rhinitis or asthma, and challenge-proven food allergies. In that study, food-specific IgE cut-off levels for cow's milk, egg, peanut, and fish were determined that predicted the...

Hypoallergenic formulae

Soy formula is often used as a cow's milk substitute. However, a significant proportion of infants with CMA may also be sensitized to soy protein.81,139 Soy protein may be associated with gastrointestinal or skin manifestations of food allergy. Soy allergy may manifest in infants with vomiting or worsening of eczema. In infants with soy hypersensitivity an extensively hydrolysed or amino acid-based formula should be considered, particularly if the infants are also allergic to cow's milk.140 Extensively hydrolysed formulae are commonly used in the treatment of infants with cow's milk or soy allergy. The value of partially and extensively hydrolysed formulae in preventing infants food allergy is still an area of debate.141-143 It has been estimated that about 10-20 of infants with CMA may be intolerant of extensively hydrolysed formulae.139,144-147 In these infants, amino acid-based formula (AAF) has proved effective and AAF the allergic manifestations usually remit within days. Infants...

Eczema Ditch the Itch

Common culprits that often contribute to eczema include wheat, dairy, sugar, eggs, processed foods, peanuts, strawberries, shrimp, and -fried foods. Watch what your child eats and observe his or her symptoms for 24 hours to see if there's a connection. Food allergies can escalate eczema. Common culprits that often contribute to eczema include wheat, dairy, sugar, eggs, processed foods, peanuts, strawberries, shrimp, and -fried foods. Watch what your child eats and observe his or her symptoms for 24 hours to see if there's a connection.

Oriental Medicine Makes the Connection

Acupuncture can significantly reduce the itching and eruptions of eczema. I will frequently employ the use of nutrition to weed out food allergies and herbs to keep the whole body balanced. Since most of these patients have a family history of eczema or allergies, we work to balance or correct deep-seated deficiencies in your overall health. Be patient the results are worth it.

Keep on Drinking Sipping Gulping and Guzzlin

Pregnant women with lactose intolerance should eat plenty of nondairy calcium-fortified foods, along with the special lactose-reduced products. Also, speak with your physician about calcium supplementation. (For further information on lactose intolerance, see Chapter 20.)

The clinical manifestations of atopic dermatitis

Dennie Morgan Fold

Skin is pruritic and erythematous patches can be seen covered with crusts, which are often secondarily infected (Figure 1.2). Because the rash is scaly and crusted and resembles burnt milk the disease has also been called milk scale. The rash can also develop on the extensor surfaces of the extremities and on the trunk (Figure 1.3). Children with AD often have troubles with sleeping due to pruritus (Figure 1.4). Food allergies are rather common (Figure 1.5). neck, and hands (Figure 1.8). The lips can be dry and scaly. The lesions are usually symmetric erythematous papules with excoriations, small crusts, and lichenifica-tion (Figure 1.9). Food allergies are less common than in infants. Children from 4 to 16 years usually develop symmetric eczema on the flexural areas (Figure 1.10), on the hands (Figure 1.11), and feet. The so-called horseback area on the back of the thighs can also be affected (Figures 1.12-13). During the winter months the children can develop eczema on their hands...

Genetic dissection of eczema

Treatment Genetic Diseases Strategies

Eczema is commonly the first clinical manifestation of allergic disease. Onset of disease is observed during the first year of life in 57 and during the first 5 years in 87 of patients.3 For the majority of affected children eczema heralds a lifetime of allergic disease. The development of atopic disease often follows an age-dependent pattern that is known as the 'atopic march'.4 A susceptible child commonly passes a characteristic sequence of transient or persistent disease stages that begins with eczema and food allergy in the young infant and continues with the development of respiratory airways disease later in childhood and adulthood. The close familial and intra-individual association of these disease entities strongly suggests shared genetic determinants. However, additional epi-demiological studies show that parental eczema confers a higher risk of eczema to offspring than parental asthma or allergic rhinitis,5 indicating the presence of eczema-specific genes. The localisation...

Animal Models Of Atopic Dermatitis

Several mouse models of food allergy and AD have been developed recently.106-108 These mouse models may be useful in exploring the pathophysiology of food allergy and developing new experimental treatments or vaccines. The first mouse model of IgE-mediated CMA successfully mimicked some of the clinical features observed in humans.106 In the following year, a model of peanut allergy and anaphylaxis was developed by the same group.108 This model successfully sensitized mice to the major peanut allergens, and specific IgE antibodies to Ara h 1 and Ara h 2 were induced.

Cholelithiasis and Cholecystitis

In the approach to the patient with symptomatic gallstones, clinicians should effectively rule out other potential causes of RUQ and epigastric abdominal pain, distinguishing biliary from nonbiliary etiologies as the primary source of disease (see Table 38-1). A gallstone blocking the cystic duct or common bile duct (CBD choledocholithiasis) results in acute biliary colic, which can evolve into acute suppu-rative cholecystitis or cholangitis. The onset of pain from biliary colic is rarely related to meals or the type of food consumed, contrary to popular opinion. Many patients with postprandial abdominal pain believe that they have gallbladder disease, but many of them suffer from dyspepsia or GERD. One meta-analysis found that heartburn, flatulence, regurgitation, and fatty food intolerance were not associated with gallstones, but that epigastric pain, nausea, and vomiting were associated with a higher odds ratio of having gallstones (Kragg et al., 1995).

Patient Encounter Part 1

Jessica is an 18-month-old female who is brought to her pediatrician because of difficulty gaining weight. Her mother states that Jessica has had four to five loose stools daily ever since I can remember. She was previously diagnosed with reflux and milk allergy. Oral ranitidine and elimination of cow's milk-based dairy products have not helped. Jessica is plotted on the growth chart at less than the third percentile for both height and weight. Mom also reports that she has been treated in the emergency de

Epidemiology And Etiology

Noninfectious causes of acute diarrhea include drugs and toxins (Table 21-3), laxative abuse, food intolerance, IBS, inflammatory bowel disease, ischemic bowel disease, lactase deficiency, Whipple's disease, pernicious anemia, diabetes mellitus, malabsorption, fecal impaction, diverticulosis, and celiac sprue.

History and Geography

Thus the present-day geographic distribution of peoples who can or cannot digest lactose fits with our historical knowledge of the distribution of ancient pastoral groups and the milking of their animals. Nonetheless, confusion arises over questions of levels of lactose intolerance among peoples with no history of pastoral activity. In the case of a native American population - the Pima-Papagos, for example - the inability to digest lactose has been reported at only 60 percent (see Tables VIII.75.1 and VIII.75.2). The 40

Irritable Bowel Syndrome

Although not completely understood, irritable bowel syndrome (IBS) seems to be more common these days than the sniffles. With symptoms ranging from excessive gas, cramping, bloating, and intermittent bouts of constipation and diarrhea, IBS (also called a spastic colon) usually has nothing to do with food allergies or intolerances. It's more likely a functional problem with the muscular movement of your intestines. In fact, it's generally diagnosed when the serious gastrointestinal ailments are ruled out. Some doctors say that people can even bring it on with anxiety or nerves.

Irritable Bowel Syndrome A Moving Experience

Common triggers of IBS include stress, food intolerances (such as high fat content), and hormonal changes. Your physician may schedule tests such as a proctosigmoidoscopy to examine the inside lining of the bowel to rule out conditions such as Crohn's disease, diverticulitis, lactose intolerance, and ulcerative colitis. There are few


Colitis means inflammation of the large intestine and the most common clinical signs are watery diarrhoea, often containing blood and mucus (jelly), with excessive straining and often a dramatic increase in the number of motions passed each day. The affected animal may be constantly trying to pass faeces, only achieving a small amount of blood-stained mucus. Animals with colitis often benefit from diets containing an increased amount of fibre. Some cases of colitis have been linked to food allergy and so a strict elimination diet trial with a single novel protein source is recommended in cases that fail to respond to higher fibre levels alone.

Secondary pyoderma

An elimination diet trial, for up to 10 weeks, is considered the only certain method of confirming food allergy and without it food allergy may remain undiagnosed. However, diet trials can present difficulties and they have been eliminated by the use of protein hydrolysate technology. Major food allergens are proteins with molecular weights between 10 000 and 70 000 daltons. Hydrolysate technology uses digestive enzymes to break down these proteins to their components (peptides and amino acids), reducing their antigenicity up to 66 times. Hydrolysed protein components have an average molecular weight less than 6000 daltons too small to trigger an immune reaction.

Dietary Intervention

The most useful diet for children with ASDs is the gluten-free casein-free (GF CF) diet. This diet was developed based on the observation that children with ASDs are more likely to have food allergies and higher levels of yeast, gastrointestinal problems, and an inability to break down certain proteins. There is evidence that children with ASDs have deficiencies in vitamins and minerals and cannot properly digest gluten and casein. Therefore, the proteins gluten and casein leak into the gut undigested and attach to the opiate receptors of the brain. As a result, children may have behavioral problems such as lack of focus and irritability, as well as digestive problems that may exacerbate their symptoms of ASD. The GF CF diet strives to eliminate peptides that may cross into the brain and alter typical brain activity so that these symptoms are alleviated. Thus, the GF CF diet removes all foods containing gluten, including wheat, oats, barley, and rye, and all dairy products a source of...

Infants and Toddlers

Recommended for infants with hereditary lactase deficiency or galactosemia and may be tried in infants intolerant to cow's milk, but soy formula should not be used in preterm infants. Because some infants allergic to cow's milk protein will develop an allergy to soy protein, it is advisable to use an extensively hydrolyzed protein formula in cases of true milk allergy or malabsorption. These are lactose free and may contain medium-chain triglycerides to improve fat absorption (AAP, 2009).

In This Chapter

Breast- and formula-fed babies seem to have the same amount of colic. Certainly if you are using formula, it's a good idea to switch to another brand, or try a nondairy variety to see if food intolerance is part of your baby's discomfort. You may also vary the amount you feed your baby. Overfeeding is another common cause of colic. Feeding on demand is controversial with child-rearing experts, but it's an easy experiment to try scheduled feedings of a set amount of food and see if the colic improves.


Peanuts are one of the most allergenic foods and are often implicated in food-induced anaphylaxis73 that may, rarely, be fatal.74 Unlike other food allergies, peanut hypersensitivity usually persists into adult life.75-77 The main peanut allergens were first discovered in sera from patients with AD.78> 79 Ara h 1, one of the seed storage proteins in peanut, is considered the major allergen.78 Ara h 1 has been sequenced, and at least 23 specific IgE binding epitopes identified. Two other major peanut allergens, Ara h 2 and Ara h 3, have also been characterized.79,80

Skin prick test

SPT in the diagnosis of food allergy is said to be unreliable in infancy. Hill et al studied the 'diagnostic' weal diameter to cow's milk, egg, and peanut that was 100 predictive of a positive open food challenge.115 The cutoff weal diameter was defined as the diameter above which all children presenting with suspected food allergy reacted on food challenge (Figures 8.2 a-c). All children over 2 years with an SPT weal diameter to cow's milk > 8 mm, and those under 2 years with an SPT > 6 mm, were challenge-positive. These 'diagnostic'

Atopy patch test

Non-IgE mediated hypersensitivity reactions to food are difficult to diagnose as they are not reliably detected by antibody or skin prick testing.32 The APT is an epicutaneous test that was originally developed to diagnose sensitization to aeroallergens.117 Patch test skin reactions appear to be mediated by T-cell responses.118 Several studies have assessed the diagnostic accuracy of the APT in relation to skin prick and serum IgE testing.29,119,120 Isolauri et al found that the combined use of skin prick and patch testing increased the accuracy in the diagnosis of food allergies in children with AD, suggesting that IgE- and T-cell mediated phenomena can be detected independently by both tests.29 Majamaa et al found the APT more sensitive than skin prick and IgE testing in detecting CMA in infancy.119 A study of 75 German children (age range 4 months to 12 years) examined the diagnostic accuracy of

Allergen avoidance

The treatment of food allergies follows the general principles of allergen avoidance. In breast-fed infants, maternal elimination diets have successfully been employed to reduce the food antigen exposure to the infant. Besides dietary interventions, treatment of the dermatological manifestations usually relies on topical corticosteroids and moisturizers.131 However, in young children AD will usually relapse as soon as the topical corticosteroids are discontinued, unless the offending allergens are eliminated from the children's diet. In order to avoid unnecessary dietary restrictions,132 the diagnosis of food allergies should be based on established diagnostic guidelines.53 A broad elimination diet should only be maintained for a short period of time in order to reduce the risk of growth impairment and nutritional deficiencies. In infants on therapeutic elimination diets, growth parameters need to be closely monitored, as energy and micronutrient intakes may be reduced compared with...


In most infants and young children, dietary management of food allergies and topical treatment with corticosteroids will successfully control the manifestations of AD. The severity of food allergy-related AD usually decreases towards the end of the second year. Elimination diets can be progressively relaxed as the infant develops tolerance to the offending food item. About 85 of infants with CMA and about 50 of egg allergies will develop tolerance by 3 years of age.55,58 In contrast, only about 20 of children with allergy to peanut or tree nuts will become tolerant.153 Although allergen avoidance appears to hasten the subsequent development of antigen tolerance it remains unclear to what extent dietary manipulations alter the course of food allergies.143,154 Persistence of AD may be associated with sensitization to inhalant and environmental allergens, particularly to house dust mite. Infants with AD may therefore be at increased risk of other atopic manifestations in relation to...


AD affects between 10-21 of young infants and often represents the first clinical manifestation of food allergies and atopy.3-5 Infants with clinically significant AD should therefore be investigated for the presence of food allergies. IgE-mediated food allergies may coexist with T-cell-mediated manifestations. Although the definitive test for food allergies remains the DBPCFC, the need for these resource-consuming challenges can be reduced by measurement of food-specific IgE antibodies, in combination with skin prick and atopy patch testing. In the majority of cases, food allergies remit spontaneously by 3 years of age, with the exception of peanut allergy. Persistence of AD beyond early childhood is commonly associated with sensitization to inhalant and environmental allergies, particularly to house dust mite, cat, and rye grass. Treatment of AD in infancy relies on topical cortico-steroids, immunomodulatory agents, and dietary antigen elimination. In breast-fed infants, maternal...


Nutrigenomics is expected to have a wide effect on the food market in affluent countries over the next 10-20 years (Oliver, 2005) and will provide both opportunities and challenges for the food manufacturer using dairy, and most other ingredients. While there are a few known SNPs that are likely to lead to effects from milk consumption (most notably those affecting the ability to metabolize lactose, leading to lactose intolerance), there is little or no specific information relating to milk proteins, apart from the A2 milk case discussed below.

Subject Index

Heart-related diseases, 160 herpes simplex, 161 hookworm infection, 166-167 infectious hepatitis, 172 infectious mononucleosis, 174 influenza, 180 lactose intolerance, 183 Lassa fever, 184-185 atrial fibrillation, 104 Australia and New Zealand AIDS, 1 beriberi, 46 bubonic plague, 63 cirrhosis, 79 dengue, 86 echinococcosis, 110 encephalitides, 36 filariasis, 127 gout, 155-156 heart-related diseases, 160 hookworm infection, 167 infectious hepatitis, 173 inflammatory bowel disease, 176 influenza, 180 lactose intolerance, 183 lead poisoning, 188 leprosy, 193 leptospirosis, 196 Lyme disease, 201 measles, 213 meningitis, 216 multiple sclerosis, 221-222 ophthalmia, 230 osteoporosis, 238 Paget's disease of bone, 238 poliomyelitis, 260 Q fever, 267, 269-270 in Argentine hemorrhagic fever, 39 ascariasis and, 42 in bacillary dysentery, 44 in cholera, 74-75 in clonorchiasis, 81 Cochin-China, 306 in colchicum, 154 in cystic fibrosis, 83 enteric, 340 in fasciolopsiasis, 123 in giardiasis, 93, 144...