Soy Milk Doesn't Start Peanut Allergies

I hadn't heard that some researchers thought that giving soy products to children would trigger peanut allergies. In fact, if you had asked me, I'd had told you it was a nutty internet factoid that simply wasn't true.

Fortunately for me, it isn't true.

A recent study, Soy consumption is not a risk factor for peanut sensitization" published in the Journal of Allergy and Clinical Immunology by Jennifer Koplin et al. Volume 121, Issue 6, Pages 1455-1459 (June 2008) clears up the confusion.

Background
A recent cohort study suggested that intake of soy milk or soy formula was associated with peanut allergy. If this finding is confirmed, it suggests an avenue for modification of diet as a peanut allergy prevention strategy.

Objective
To investigate the relationship between soy consumption and peanut sensitization in a prospective cohort study of children.

Methods
A total of 620 babies with a family history of allergic disease were recruited. Dietary information was obtained from telephone interviews every 4 weeks from birth until 15 months and then again at 18 months and 2 years. Skin prick tests to peanut, milk, and egg were performed at 6, 12, and 24 months. A wheal size ≥3 mm was considered positive for sensitization.

Results
Children whose parents elected to introduce soy formula or soy milk into their children's diet were more likely to be sensitized to peanuts at 2 years (odds ratio, 2.02; 95% CI, 1.04-3.92; P = .039). However, this relationship was explained by feeding of soy to children who had siblings with milk allergy or were themselves sensitized to milk. After adjusting for these factors, there was no evidence of an association between soy consumption and peanut sensitization (odds ratio, 1.34; 95% CI, 0.64-2.79; P = .434).

Conclusion
The association between soy consumption and peanut sensitization is not causal but merely a result of preferential use of soy milk in infants with a personal or family history of cow's milk allergy. Future studies should take the confounding effects related to dietary modifications by parents into account when investigating the association between diet and childhood allergic diseases.

In simpler language, parents whose older children already had allergies gave their younger children soy in the hopes of preventing dairy allergies in them. This didn't always work. Some children developed peanut and other allergies anyway. Once those families were removed, the correlation vanished.

From now on, it is just a nutty internet factoid. Ignore it.

Different Allergy Tests: Different Results

When you go to your doctor for a blood test to see if you have allergies, the test the doctor picks may or may not give you the right answer.

That's the depressing news from a study published in the May issue of the Journal of Allergy and Clinical Immunology.
"Correlation of serum allergy (IgE) tests performed by different assay systems," by Julie Wang, James H. Godbold, and Hugh A. Sampson, Volume 121, Issue 5, Pages 1219-1224 (May 2008)

Methods
Fifty patients from the Mount Sinai Pediatric Allergy practice were prospectively enrolled. For each deidentified sample, specific IgE levels were measured to egg, milk, peanut, cat, birch, and Dermatophagoides farinae at different laboratories, each using a different assay system (Phadia ImmunoCAP, Agilent Turbo-MP, and Siemens Immulite 2000). Results were analyzed to determine whether IgE measurements were equivalent. Food allergen–specific IgE levels were correlated with clinical data and around empirically determined thresholds that predict probability of clinical disease in 50% or 95% of subjects.

Results
Variable degrees of agreement existed among the 3 assays. Immulite 2000 overestimated all specific IgE levels compared with ImmunoCAP. Turbo-MP overestimated for egg but underestimated for birch and D farinae. Differences for milk, peanut, and cat were observed, without a trend toward overestimation or underestimation. Furthermore, several values for the food allergens were discrepant around the 50% and 95% positive predictive values for clinical reactivity.

Conclusion
Discrepancies in specific IgE values from 3 different assays can potentially lead to altered management and treatment. The predictive values for clinical reactivity associated with food-specific IgE levels determined by ImmunoCAP should not be applied to results from other assays.

This is a fairly specialized result, aimed at practicing doctors rather than patients. While it implies that current results are not always as accurate as they could be - hardly news to many people with allergies judging from the complaints I hear about testing - being able to tell in the future which test works best for different allergies can help to improve the accuracy of diagnoses, so if these results hold up they would be good news for allergy sufferers.

Tips for Buying Allergy-Friendly Foods

I've written before about Enjoy Life, the fast-growing maker of gluten-free and allergen-free snacks. They had Gina Clowes, founder of the popular AllergyMoms.com blog, put together a list of tips for consumers buying allergy-friendly products.

• Have an unbreakable rule: no label = no thank you. Never eat a food that does not have a label.
  
  
• Always carefully read ingredient statements. Different versions of the same food can have different ingredients (for example, chewy Spree candy contains egg white while original Spree does not).
  
  
• Know that different sizes of the same foods can contain different ingredients. (For example, some “mini” versions of Laffy Taffy do not contain egg, but the large size does contain egg.)
  
  
• Don’t rely on common sense to determine if foods are safe. Tuna and flavored water can contain dairy, egg rolls and chili can contain peanut butter, licorice and soy sauce can contain wheat, and the list goes on.
  
  
• Take all precautionary warnings seriously. Manufacturers use different statements to warn consumers like “may contain” or “processed in a facility with.” However, the language used does not indicate the level of risk.
  
  
• Know that precautionary warnings are voluntary. If a product does not have a warning, it does not mean that the product is free of cross contamination. When in doubt, call the company to find out where and how the product was processed.
  
  
• Don’t play ingredient roulette. Even if you or your child once ate a product with a warning, that does not mean the next batch will be safe.
  
  
• Beware of hidden allergens. Potent allergens like sesame and mustard can hide behind the words “natural flavors” or “spices.”
  
  
• Know where the food is made. Seek out products that say they are made in a "dedicated peanut-free, nut-free, soy-free or allergy-free facility," depending on your diet restriction. This provides even further assurance of the food's safety.

International Study on Special Diets Published

Last year, many websites that promote a gluten-free or allergy-sensitive diet encourages their readers to take part in a survey of experiences while eating out or traveling.

The final study, titled Understanding Gluten and Allergen-Free Experiences of Guests & Hospitality Worldwide, summarizes the findings from over 2700 customers and businesses in 35 countries.

The reports states, not surprisingly, that 80% of of those with food allergies or celiac disease eat out less because of concerns with foods they haven't prepared or vetted themselves.

The full report will cost you $380. However you can get a free executive summary at www.allergyfreepassport.com or at www.glutenfreepassport.com. A related site, www.glutenfreeonthego.com, provides access to "the world's largest directory of gluten-free establishments."

The Two Types of Food Allergies

For some real facts, let's turn to a good summary article I found on MedicalNewsToday.com.

IgE-Mediated Food Allergies

The parts of the immune system responsible for immediate on-set reactions (the most dramatic example of which is food anaphylaxis) are IgE antibodies.

In allergic individuals (who are sometimes referred to as being "atopic") eating certain food proteins (such as whey and casein protein contained in cow's milk) results in the production of specific IgE antibody molecules directed against the protein. The second time the individual eats the food, these specific IgE molecules interact with each other, and the protein, to cause the release of harmful chemicals (such as histamine) from special mast cells. This causes the damage associated with the symptoms of food allergy. Damage may occur to the skin, respiratory system or gastrointestinal tract, where the symptoms of food allergy are almost exclusively seen.

Non-IgE-Mediated Food Allergy

"T-cells" are the components of the immune systems responsible for delayed-type food allergic reactions. In individuals with a predisposition for delayed on-set food allergy, initial ingestion of food protein leads to the production of specific types of "T-cell". When the food is subsequently ingested, the food protein is "processed" in a variety of ways and "presented" to the previously generated food-specific T-cells. These T-cells then "invade" the area of the body about to suffer damage, as the skin or the bowel. This processing, presenting and invasion can take 24-48 hours which explains the delayed response. T-cells release chemicals that, through a chain of events, lead to the damage associated with symptoms of food allergy.

IgE mediated reactions are sometimes referred to as "true" allergies, while non-IgE mediated reactions are sometimes called hypersensitivities. Unfortunately, these names are not consistently applied inside the medical profession or by the press.

You should also check out the entry on my website, Lactose Intolerance versus Milk Allergy, for a quick reference chart of the differences.

Our Greatest Weapon is Fear...

Parents, do you like being scared out of your shoes for no good reason at all? What about guilt trips? Do you prefer to make your purchasing decisions based on how horrible you'd feel if something happened to your child, no matter than the product has nothing useful to offer? Do the latest buzzwords slide down your brainstem to lubricate the pathway to your wallet?

If so, then you are the target audience for the BabyBam Collection.

The rest of us may be forgiven if we take a pass.

I'll just quote the one relevant section here, although the entire press release has a rising gorge factor of ten.

As the number of infants with gluten, soy, and lactose intolerance rises each year - so do severe skin allergies. Our exceptionally soft onesies, pants, pajamas, and towels are naturally hypoallergenic, anti-microbial, moisture wicking and anti-bacterial thus preventing odor and skin irritations," added [BabyBam Collection CEO Jody Graziano] Jonas.

No indication exists that the number of infants with lactose intolerance is rising. Probably the opposite is true. Lactose tolerance is a dominant mutation. If you receive the gene from either one of your parents you will become lactose tolerant. The number of adults with lactose tolerance increases every year.

Very few babies are naturally lactose intolerant. Only the tiniest handful are born lactose intolerant. Most of humanity - that's the four billion or so of us who are lactose intolerant - do not lose the ability to digest lactose until after the age of weaning. Some babies do become temporarily lactose intolerant because their intestines are affected by common "stomach flus" - really gastrointestinal ailments - and a much smaller number are affected by more serious problems that damage the delicate lining in their intestines. Even if you add them all up, the vast majority of infants - more than 99% - are not and never will be lactose intolerant.

But let's say that all the lies are truth. Say that lactose intolerance is a scourge that is ravaging our precious children. Say that lactose intolerance is, despite all medical evidence, increasing rather than decreasing.

Even in that upside-down, Bizarro world, where day is night and sweet is sour, nothing - repeat, nothing - that you could put onto your infant would make one particle of difference. Lactose intolerance is not an allergy. It comes solely because of the lack of an intestinal enzyme, lactose. Contact with milk, milk products, or milk byproducts has never produced a single case of lactose intolerance in the history of humanity.

Using lactose intolerance to sell onesies is pure pig ignorant fear-mongering.

The only thing we have to fear is fear itself. True. Still true. Always true.

Do not let your fear, your guilt, your hopes or dreams or nightmares, start you down the path to acting irrationally, to blindly blunder down the pathway to darkness, to imagine feverishly that you can avert the doom peddled by the ignorant or the cynical or the heartless, by swallowing their snake oil.

More Reactions to Allergy Reaction Reactions

On Sunday I wrote about the contentiousness of allergy issues in Our Reactions to Allergy Reaction Reactions. I noted that parents of children with serious food allergies have a legitimate sensitivity to the frequently disparaging comments made by those who have no stake in the issue while at the same time unnecessary fears have been generated by those who appear to feel that everything is a risk.

If I had waited one more day, The New York Times would have dropped a magnificent example into my lap.

Last week science writer John Tierney expounded on our culture of fear and what it is doing to our health in Living in Fear and Paying a High Cost in Heart Risk. His point is that worrying about fear may be costlier to our collective health than the actual risks posed by what we fear.

He started with what I would consider to be a perfectly innocuous sentence:

Although it’s impossible to calculate the pain that terrorist attacks inflict on victims and society, when statisticians look at cold numbers, they have variously estimated the chances of the average person dying in America at the hands of international terrorists to be comparable to the risk of dying from eating peanuts, being struck by an asteroid or drowning in a toilet.

He's quoting actual comments by statisticians concerning small risks rather than making these comments himself, note.

Yet Ellen Urich wrote a letter of complaint to the Times:

As the mother of a child with a life-threatening food allergy, I was greatly disheartened by John Tierney’s grouping the chances of dying from eating peanuts with being struck by an asteroid or drowning in a toilet. Public awareness and understanding of anaphylaxis and food allergies has grown enormously in the past decade, but it is my fear that this type of analogy trivializes a growing health condition that requires a serious attitude in order to save lives.

This may be taking a parent's concern way too far. Tierney trivializes nothing in his article. He properly quotes others as pointing out that the risks of death by terrorism is real by highly unlikely, as highly unlikely and as small in number as some other risks.

The statisticians are numerically right. The Center for Disease Control recorded only 12 deaths from food allergies in 2004. The Consumer Product Safety Commission warns parents that:

Toilets are often overlooked as a drowning hazard in the home. The typical scenario involves a child under 3-years-old falling headfirst into the toilet.

Yet that same page indicates the number of drowning victims is probably in the same range as the 14 that the CDC estimates for food allergy deaths.

The number of deaths from terrorism in the U.S. in recent years. Zero.

Any such avoidable death, especially the death of a child, is tragic and should never be trivialized. Everything reasonable that can be done to prevent such tragedies should be.

We've gone far beyond reasonable over the past six years. The world today is exactly as dangerous as it was on Sept 10, 2001, probably neither more so or less than. Nothing new there. The world has always been dangerous, from events both large and small. As Tierney notes, both public figures and the media have created a climate of fear. I'd go further, and accuse the Administration and its partisan toadys and the bootlickers in the media of doing so deliberately to further their aims and concentrate their power.

For all their crimes - and they are legion - even the Administration did not create a fear of peanuts. On that issue, both the fearmongers and the trivializers run rampant across the media and the internet. In a culture of fear fears will multiply and reason will flee.

The best thing we can collectively do is to break out of the culture of fear. In the next 10 months of a presidential race, you'll hear fear as a constant: fear of strangers, fear of change, fear of the future, fear of the unknown, fear of uncertainty, fear of "Them." Don't allow the fearmongers to triumph. More than that: don't allow their fearmongering to go unchallenged. Reason must triumph.

As Franklin D. Roosevelt said in his first inaugural speech, fighting against a climate of fear as deep and pervasive if not as deliberately created as the one today, "The only thing we have to fear is fear itself." If you've ever wondered what he meant by that, just look around you.

Nightmare Advice on Allergies

I write fantasy and science fiction professionally. Even so I swear I could never make anything up as wild as homeopathy.

Homeopathy is based on the ancient folklore of "like cures like." Practitioners take herbs that create symptoms superficially similar to those produced by a disease or ailment and then dilute them until nothing but water and a "memory" of the herb is left. This magically creates a cure.

You can therefore use homeopathy to cure just about anything that creates symptoms. Ricky Hussey in The American Chronicle want to cure eczema this way.

Treatment

Homeopathy Apis, Graphites, Pulsatilla, Rhus tox., and Sulfur may be helpful. Herbal Medicine Marigold tea, calendula ointment, or aloe vera gel are all helpful. Aromatherapy Add 12 drops of fennel, geranium, or sandalwood to 2fl oz/60ml of carrier oil.

Pulsatilla? It's "the weather cock among remedies." What? Huh? Even after reading this site I can't figure out what that's supposed to mean.

The disposition and mental state are the chief guiding symptoms to the selection of Pulsatilla. It is pre-eminently a female remedy, especially for mild, gentle, yielding disposition. Sad, crying readily; weeps when talking; Changeable, contradictory. The patient seeks the open air; always feels better there, even though he is chilly. Mucous membranes are all affected. Discharges thick, bland, and yellowish-green. Often indicated after abuse of Iron tonics, and after badly-managed measles. Symptoms ever changing. thirstless, peevish, and chilly. When first serious impairment of health is referred to age of puberty. Great sensitiveness. Wants the head high. Feels uncomfortable with only one pillow. Lies with hands above head.[bolding and punctuation as in original]

Wow. If this were the 60s, everybody would know what this guy was on, and they wouldn't think homeopathy.

What's even worse is that many, if not most, homeopathic pills are made out of lactose. The Organic Pharmacy dips its toe into the world of science.

Homeopathic products are very clean-meaning they have no binders, fillers or coatings. The soft molded lactose tablets are made to dissolve almost instantly when placed in the mouth. Because the remedies dissolve in the mouth, they are absorbed by the mucous membranes in the mouth and carried directly into your system. For this reason, the remedies work faster than conventional medicines because conventional medicines are usually coated and don't get absorbed into the system until the coating is dissolved by the stomach acid, and that generally takes about twenty minutes.

In standard, or allopathic, medicine, this is called sublingual administration. It can be very effective, but doctors and pharmacists will note that not every chemical works well this way, with some not mixing well with saliva or containing chemicals too large to be absorbed.

Besides, if lactose isn't a binder or filler, then what conceivable role does it play?

For even more evidence that homeopathists understand nothing of chemistry, here is another mind-busting statement from the pulsatilla site:

[Q.]Does anyone know if there can be a problem using the homeopathic tablets which are lactose tablets when a person is lactose intolerant?

[A.]Probably no problem. But if you wish you can disolve them in water further diluting any lactose content.

Dilution solves everything! Yay!

Lactose is lactose. The amount you take in counts. It doesn't matter if the amount is concentrated in a pill or spread through a glass of water. That same amount will enter your intestines.

This is absolutely the most basic chemistry of digestion. If the homeopaths don't know this, you shouldn't allow them or any of their products within a thousand feet of your intestines.

And I shouldn't have to tell you that people with serious dairy allergies will avoid any product that contains lactose in the first place.

Homeopathy is a nightmare of pseudoscience and its most ignorant peddlers are dangerous.

No Evidence That Avoiding Foods While Breastfeeding Prevents Allergies

Women whose infants have known milk protein allergies or whose families have known allergies are properly told to avoid drinking milk themselves while breastfeeding. Milk proteins from the food can travel through the bloodstream and enter the breast milk, triggering allergic responses in the infants.

This advice has been widely disseminated in recent years. Perhaps too widely. The American Academy of Pediatrics (AAP) is afraid that women whose infants have no such allergies may be denying themselves foods out of fear of triggering allergies, even when those are unlikely.

In fact, the AAP feels this is such a problem that it has issued updated guidelines that reassure nursing mothers that no good evidence exists that avoiding certain trigger foods will prevent allergies from occurring.

Carla Johnson of the Associated Press reported the new policy in a story that I'm glad to see was widely covered. (The link goes to the Houston Chronicle, which reprints more of the article than some other newspapers.)

In August 2000, the doctors group advised mothers of infants with a family history of allergies to avoid cow's milk, eggs, fish, peanuts and tree nuts while breast-feeding.

That advice, along with a recommended schedule for introducing certain risky foods, left some moms and dads blaming themselves if their children went on to develop allergies.

"They say, 'I shouldn't have had milk in my coffee,'" said Dr. Scott Sicherer of the Mount Sinai School of Medicine's Jaffe Food Allergy Institute in New York. "I've been saying, 'We don't really have evidence that it causes a problem. Don't be on a guilt trip about it.'"

Mothers of high risk infants should still breast feed exclusively for at least the first four months, though.

The study is in the journal Pediatrics. You can read the full text online at Effects of Early Nutritional Interventions on the Development of Atopic Disease in Infants and Children: The Role of Maternal Dietary Restriction, Breastfeeding, Timing of Introduction of Complementary Foods, and Hydrolyzed Formulas by Frank R. Greer, MD, Scott H. Sicherer, MD, A. Wesley Burks, MD and the Committee on Nutrition and Section on Allergy and Immunology. PEDIATRICS Vol. 121 No. 1 January 2008, pp. 183-191 (doi:10.1542/peds.2007-3022)

Here's the Summary:

It is evident that inadequate study design and/or a paucity of data currently limit the ability to draw firm conclusions about certain aspects of atopy prevention through dietary interventions. In some circumstances in which there are insufficient studies (pregnancy and lactation avoidance diets, timing of introduction of specific complementary foods), the lack of proven efficacy does not indicate that the approach is disproved. Rather, more studies would be needed to clarify whether there is a positive or negative effect on atopy outcomes. The following statements summarize the current evidence within the context of these limitations.

1. At the present time, there is lack of evidence that maternal dietary restrictions during pregnancy play a significant role in the prevention of atopic disease in infants. Similarly, antigen avoidance during lactation does not prevent atopic disease, with the possible exception of atopic eczema, although more data are needed to substantiate this conclusion.

2. For infants at high risk of developing atopic disease, there is evidence that exclusive breastfeeding for at least 4 months compared with feeding intact cow milk protein formula decreases the cumulative incidence of atopic dermatitis and cow milk allergy in the first 2 years of life.

3. There is evidence that exclusive breastfeeding for at least 3 months protects against wheezing in early life. However, in infants at risk of developing atopic disease, the current evidence that exclusive breastfeeding protects against allergic asthma occurring beyond 6 years of age is not convincing.

4. In studies of infants at high risk of developing atopic disease who are not breastfed exclusively for 4 to 6 months or are formula fed, there is modest evidence that atopic dermatitis may be delayed or prevented by the use of extensively or partially hydrolyzed formulas, compared with cow milk formula, in early childhood. Comparative studies of the various hydrolyzed formulas have also indicated that not all formulas have the same protective benefit. Extensively hydrolyzed formulas may be more effective than partially hydrolyzed in the prevention of atopic disease. In addition, more research is needed to determine whether these benefits extend into late childhood and adolescence. The higher cost of the hydrolyzed formulas must be considered in any decision-making process for their use. To date, the use of amino acid–based formulas for atopy prevention has not been studied.

5. There is no convincing evidence for the use of soy-based infant formula for the purpose of allergy prevention.

6. Although solid foods should not be introduced before 4 to 6 months of age, there is no current convincing evidence that delaying their introduction beyond this period has a significant protective effect on the development of atopic disease regardless of whether infants are fed cow milk protein formula or human milk. This includes delaying the introduction of foods that are considered to be highly allergic, such as fish, eggs, and foods containing peanut protein.

7. For infants after 4 to 6 months of age, there are insufficient data to support a protective effect of any dietary intervention for the development of atopic disease.

8. Additional studies are needed to document the long-term effect of dietary interventions in infancy to prevent atopic disease, especially in children older than 4 years and in adults.

9. This document describes means to prevent or delay atopic diseases through dietary changes. For a child who has developed an atopic disease that may be precipitated or exacerbated by ingested proteins (via human milk, infant formula, or specific complementary foods), treatment may require specific identification and restriction of causal food proteins. This topic was not reviewed in this document.

Are Food Labels Giving the Right Info?

The Food Allergen Labeling and Consumer Protection Act that went into effect on Jan. 1, 2006, requires foodmakers to identify, in plain language, the presence of any of the eight major food allergens. For example, a product that contains casein must specify that it contains a milk derivative.

Most firms go much farther than that. You'll commonly see statements about possible cross-contamination at the bottom at a food label. Take Newman's Own Organics' Fig Newmans, one of Paul Newman's product line. There's wheat and milk in the ingredients and those are noted. But underneath the label is a statement that the cookies are made on "equipment that may process products containing peanuts, other nuts and milk powder."

Great, right? Even the possibility of the presence of an allergen is covered. What more could anybody want?

Well, nothing satisfies everyone. And complaints are being raised even about this vast improvement over the old labeling, says an article by Julie Schmit in USA Today.

One complainer is someone I frequently quote, Anne Munoz-Furlong, founder of the Food Allergy & Anaphylaxis Network (FAAN). She's worried that manufacturers try to game the system by putting overly-broad disclaimers on the packages so that they don't have to closely monitor their manufacturing processes.

Munoz-Furlong gives one example:

Some Harry & David products include an advisory that is so broad FANN's Munoz-Furlong calls it "ridiculous." The statement: "May contain peanuts and/or trace amounts of allergens not listed in the ingredients."

Harry & David do gourmet food packages, making 571 different products in one facility. They counter by saying:

The company has "robust quality systems" checked by two sets of outside inspectors, [senior vice president Thomas] Forsythe says. Equipment and production lines are sanitized to minimize contamination risks.

Schmit continues:

Still, Harry & David had four allergen recalls in the past year. Three resulted from the wrong labels being applied. One cause was never identified. Three recalls covered products other companies made for Harry & David. Two of those companies are no longer used, Forsythe says. The other stepped up its label-control procedures, as did Harry & David. No illnesses were reported in any of the recalls.

I agree that saying merely "other allergens" is not living up to the spirit of the regulations. The impression I get is that Munoz-Furlong wants Harry & David to identify each possible cross-contamination for each food. From the limited information given in the article, it's not clear to me how the firm could effectively do that. Some compromise might be needed here.

As a general rule, however, I'm not seeing massive wrongdoing. Given that somebody always has to be the worst case in any line of work, I don't doubt that somewhere out there some firm is not keeping the highest quality standards.

The reality is, though, that the worst firm would be the worst firm regardless. And a broad label does keep the most sensitive away. It may keep too many away, to be sure, but I don't see that that's a bad thing. Before labels were required the worst firms were doing all the worst things and not warning people at all. The current system has to be an improvement over that.

The other worry in the article is that the new warnings are confusing for consumers or that they collectively drive up fears about the safety of the food supply.

Again, I'm dubious. People who have experience in checking labels should find the information given to be clear and direct and vastly better than the way things used to be. Those first encountering the world of specialty diets may be overwhelmed at the beginning but I guarantee you that this was equally true when I learned I was LI back in 1978 and I would have shouted for joy to be given labels with the current information on it.

Fearmongers might be using allergy warnings to scare consumers. I read far more articles from people who appear to think that the need to have these warnings at all is ludicrous. They're wrong. More info about our food is a good thing, and the extra line at the bottom of some ingredients lists is about as scary as the Munsters.

Munoz-Furlong has done fine work in the past. She many be seeing examples that I haven't and that USA Today didn't bother to mention. Reality is a constant compromise. We're currently at a pretty good balance, superior to where we were pre-2006. Tweak the system if necessary but keep it going. It's good for all of us.

Studentz Ar Dumm

Good grief. Patricia Kirk of WebMD.com reported on a new study by the University of Michigan Health System (UMHS). It found that 42% of students with a known food allergy still ate foods that contained that ingredient.

Why?

[R]esearchers were given answers such as: "I thought I could eat around it," "The food item did not contain enough to cause a reaction," "I knew it could be treated," or "I've outgrown my allergy," says Matthew Greenhawt, MD, a pediatrician and fellow in the division of allergy & clinical immunology at UMHS.

Greenhawt added that:

"Many of these students are accustomed to their parents being in charge of their health care. Now that they're in college, they have to take this responsibility for themselves."

How big doofuses are these students?

Only 22% of students who reported a history of allergic reaction said they possessed a self-injectable device, such as an EpiPen or Twinject, to treat a severe reaction. About 28% of those who have one say they always carry it with them. Of the 55 students reporting a severe reaction to a food allergen in the past, 27 of them did not have the device.

Blame all around on this one. Parents, schools, doctors. And the doofuses themselves, who if they are old enough for college are old enough to know better.

Pet Allergies: Not What You Think

Gizmo is a very special bunny. He's allergic to carrots and lettuce.

Yes, pets have exactly the same problems with food allergies, hypersensitivities, and intolerances as humans do. We're all mammals after all.

Take a look at this article by Siobhan Reardon in the Scotsman.

"And while there are blood and skin tests, we usually first look at doing a food trial with the animal. The owner needs to feed the animal a completely novel diet for about six to nine weeks. It's quite a challenge, particularly if the animal lives outside."

Chris [Ross, of the Braid Veterinary Hospital in Edinburgh] remembers one case of a cat which was brought in with terrible ulcers around its ears and head and it took 18 months to discover what the problem was.

"We ruled out all the usual allergies to fleas, parasites and mites and then somehow we got the condition under control.

"The cat was doing well for about a year until the owner's boyfriend moved in and the cat quickly deteriorated. After much questioning, the boyfriend admitted to feeding the cat pizza. Culprit found."

Reardon does make a common error herself later on.

ALTHOUGH its not an allergy, it is worth remembering that most animals (bar cows and humans) are intolerant to cow's milk.

Please. All adult animals are naturally intolerant to all milks. And that means that adult cows are just as intolerant to cow's milk as they would be to any other animal's milk. This holds for humans as well, since the vast majority of adult humans are intolerant to cow's milk. Just because most Scotsmen can drink it doesn't means it holds true for the whole human race.

However, the next paragraph is accurate and good advice.

People frequently call the Scottish SPCA about injured animals and, while they are waiting for an inspector to call, will resort to feeding the animal milk. But this can sometimes make the situation worse as it may cause diarrhoea and therefore cause further distress to the animal.

Avoiding Allergens at Halloween

The American Academy of Allergy, Asthma, and Immunology (AAAAI) issued a statement yesterday, Trick-or-Treat Your Way to an Allergy-Free Halloween. They're concerned about food-related anaphylaxis, which leads to 150-200 deaths every year. (I presume those are total deaths for the year, not just Halloween related fatalities.)

Symptoms of anaphylaxis include severe headache, nausea and vomiting, sneezing and coughing, hives, swelling of the lips, tongue and throat, and itching all over the body. The most dangerous symptoms include difficulty breathing, a drop in blood pressure, and shock -- all of which can be fatal.

If any of these symptoms occur, give the child self-injectable epinephrine, call 911 immediately, and schedule a follow-up appointment with your allergist/immunologist.

They also offer some helpful advice so that parents can avoid that call to 911.

► When classroom parties are planned, parents can help by packing treats from home that their food-allergic child can eat.

► Create a "candy swap" with siblings or friends so that allergen-containing candies can be traded for other treats such as stickers or toys.

► Take the focus off of trick-or-treating by hosting a costume party that emphasizes fun instead of candy. Halloween stickers, pencils, spider rings and stamps are great alternatives for goody bags.

► Provide neighbors with allergy-safe candies for your child or ask neighbors to hand out only candy with individualized labels -- so kids with allergies can determine whether the treat is safe to eat or not.

► Teach children to politely refuse offers of cookies and other homemade treats.

► Remember that candy ingredients can vary for different sizes of the same product such as full-size candy bars and their miniature versions, which are not always individually labeled.

For more information, visit the AAAAI's Web site, www.aaaai.org.

Why Some Foods Are More Allergenic Than Others

An absolutely fascinating piece of research was just published in The Journal of Allergy and Clinical Immunology

(DOI: 10.1016/j.jaci.2007.08.019.) "Evolutionary distance from human homologues reflects allergenicity of animal food proteins," by John Jenkins, Heimo Breiteneder, and Clare Mills.

Articles explaining the research can be found in more - ScienceDaily.com - or less - FoodNavigator.com - straightforward English on those sites.

The investigating team compared several types of proteins across a wide variety of types of animals, from insects to mammals to humans. If the protein was at least 55% identical to the human protein, few if any allergic reactions were produced. But proteins less similar triggered the immune system of the human body in some people.

"This explains why people who are allergic to cow's milk can often tolerate mare's milk but not goat's milk", said Dr Clare Mills of the Institute of Food Research. "Proteins in horse milk are up to 66% identical to human milk proteins, while known allergens from cows and goats are all less than 53% identical to corresponding human proteins.

Overall, the researchers believe that the reason why just a few percent of humans have milk allergies is that the protein similarities are so close to the border of tolerance.

"Animal food proteins lie at the limits of the capability of the human immune system to discriminate between foreign and self proteins", said Mills.

The researchers looked at all the main types of proteins and made a major discovery.

For the first time the researchers found that the majority of animal food allergens could be classified into one of three protein families. Tropomyosins, proteins found in muscle tissue, are the most important family.

"Tropomyosins in mammals, fish and birds are at least 90% identical to at least one human tropomyosin and none have been reported to be allergenic. In contrast, the allergenic tropomyosins are all from invertebrates such as insects, crustaceans and nematodes and at most are only 55% identical to the closest human homologue", said Dr Heimo Breiteneder of the Medical University of Vienna.

EF-hand proteins form the second largest animal food allergen family. Those in birds and mammals are not allergenic, while those in frogs and fish can cause allergy. The third animal food allergen family, caseins, are all mammalian proteins from milk. The researchers analysed milk from rabbits, rats and camels as well as sheep, goats, cows and horses.

In previous analyses of plant food allergens published in 2005, the scientists found that most belong to a highly restricted number of protein superfamilies. The research will make it easier to identify new allergens and help explain how they trigger an immune response.

I reported a year ago that work was underway to develop a vaccine for allergies, but that 7 to 10 years was likely to be needed. See Cure for Allergies? Don't Hold Your Breath. I'm not sure if this work makes that wait any shorter. However, it's extremely promising research and a critical needed step.

Exclusive Breastfeeding Doesn't Reduce Asthma or Skin Allergy Risk

The word from doctors has always been that breastfeeding - exclusive breastfeeding, with no use of formula - is the best way to reduce the risk of babies developing later allergies.

That may still be true for dairy allergies, but the risk of asthma, hay fever, or eczema was not reduced at all by exclusive breastfeeding for the first three months of live, according to a new study in the journal BMJ.

An article by Peggy Peck on MedpageToday.com has more details.

Children who were exclusively breastfed for at least the first three months of life were no less likely to develop allergies or asthma than children whose nutrition included infant formulas.

Moreover, by age six, children who were nourished solely by breast milk had a two- to threefold higher risk for positive skin prick tests for four of five antigens, Michael S. Kramer, M.D., and colleagues from Montreal Children's Hospital reported in the Sept. 12 issue of BMJ.

...

For allergic symptoms and diagnosis there was "borderline significant reductions in history of eczema both with more prolonged any breastfeeding and with more prolonged exclusive breastfeeding (P=0.08 for both associations)."


However, the strongest associations were for skin prick tests and those went "in the opposite direction," said the researchers, with significant increased risk for positive tests among children who had exclusive breastfeeding for six months or longer.

However, there were some indicators that went the other way.

For allergic symptoms and diagnosis there was "borderline significant reductions in history of eczema both with more prolonged any breastfeeding and with more prolonged exclusive breastfeeding (P=0.08 for both associations)."

Since this study did not look at dairy protein based allergies, presumably exclusive breastfeeding is still the best route to lower future risk. However, this is an interesting finding that will certainly generate more studies.

Special Diet Meals Available from Disney

The biggest kid-magnet in the universe must be Disney. With 10 million or more kids going through the gates at each Disney resort each year, even a tiny percentage can add up quickly.

Bob Mervine of the Orlando Business Journal reports that Walt Disney World offers a special diets program that can accommodate 15 types of food allergies, kosher meals, and low-sodium meals. The program started in 1993 and now serves 7-8,000 meals a month. You merely request the special meals when making meal reservations.

[Joel Schaefer, manager of the special diets department] works with chefs at each of the hundreds of Disney food locations to provide alternative ingredients that can be used to create allergy-free meals, ranging from soy ice cream to a specially blended batter for the Mickey Mouse-shaped waffles that are a signature breakfast dish.

Disney adds no service fee, even working with families who want to enjoy a buffet by individually preparing the food items the guest selects.

"It's simply a guest service," says Ed Wronski, executive chef for product development in Disney's food and beverage department.

More information about the program is available from All Ears Net.

1. When making an Advance Reservation (1-407-WDW-DINE), alert the Cast Member to your special needs, and they will make a note on the file.

2. Special dietary needs can be accommodated if requested at least 72 hours in advance at 407-WDW-DINE (407-939-3463). [Note: some sites say 24 hours. This site says that the advance time increased in 2005.]

The number at Disneyland is 714-781-DINE (714-781-3463).

At Disneyland Paris call Guest services Tel No: +33- (0)1 60 30 40 50. A food allergies guide is available at:
http://disneyworld.disney.go.com/wdw/common/helpFAQ?id=HelpFAQDiningPage