Managing Dairy Allergy in Infants

Archives of Disease in Childhood has to be one of the saddest names for a medical journal, but at least it publishes invaluable information for doctors.

Their October issue contains a study of major interest to us, "Guidelines for the diagnosis and management of cow’s milk protein allergy in infants," by Yvan Vandenplas, Martin Brueton, Christophe Dupont, David Hill, Erika Isolauri, Sibylle Koletzko, Arnold P Oranje, and Annamaria Staiano. Arch Dis Child 2007; 92: 902-908. doi:10.1136/adc.2006.110999. (Full text available here.

This is the full review mentioned in my earlier post, UK Sets Standards for Allergy Formulas.

That had a fair amount of jargon in it and didn't have a direct link to the review itself. I found a plain English summary by Crystal Phend at MedPageToday.com that's easier reading.

Allergic infants should be given only extensively hydrolyzed formula or an amino-acid based formula rather than a soy-based product as a first line substitute for cow's milk...

...

The new guidelines are reasonable but more conservative than American Academy of Pediatrics recommendations, commented Paul V. Williams, M.D., of the Northwest Allergy and Asthma Center in Seattle, who has been involved in developing the new AAP guidelines on the infant feeding, due out soon.


"Economics are always an issue," he said, "and extensively hydrolyzed formulas and amino-acid formulas are extremely expensive."


Both sets of guidelines recommend breastfeeding as the ideal option for these infants, but the Taskforce recommended only documented hypoallergenic formulas for infants who need formula.

...

Other recommendations in the guidelines include:

● Infants with failure to thrive because of allergic symptoms should be given amino acid based-formula for rapid weight gain.

● Pediatricians should take a comprehensive history with careful physical examination to exclude other causes of the infant's distress, identify concurrent conditions, and determine allergy severity.

● Diagnostic tests may include skin prick, specific IgE blood tests (CAP-RAST), and the atopy patch test, which is not approved for use in the U.S., but the gold standard is elimination diets and challenges.

● Cows' milk challenge under medical observation should be done to establish if the allergy persists through childhood.

Ok Foods Unveils Christmas Line

Ok Foods is one of the major independent producers of gluten-, wheat- and dairy-free foods in the UK. Yes, it seems really to be spelled with a capital O and small k. At least they spell it that way on their products, if not always consistently on their web site, www.ok-foods.co.uk/.

Ok Foods was established in 2003 with the aim of becoming one of the leading independent manufacturers of gluten free, wheat free and dairy free bakery products in the UK. To this end, we built a dedicated gluten, wheat and dairy free bakery, sourced the best ingredients available and set the most stringent quality standards for our manufacturing process.

...

All Ok Products are suitable for Coeliacs and Vegetarians and can be purchased from all major supermarkets and good health-food stores across the UK.

Selected Ok Foods products are available from Sainsbury’s, Waitrose, Asda, Morrisons, Booths, Boots, leading food halls and health-food stores across the UK.

Ok Foods put out a press release announcing its line of traditional English foods for Christmastime. Hey, it's already September, what can you expect?

The Christmas range is crafted in small batches, in a dedicated gluten, wheat and dairy free bakery. Using premium ingredients which have undergone strict testing to ensure they are free from gluten, casein and lactose, the most stringent quality standards for manufacturing processes are set in place.

The Ok Christmas Range

Mincemeat Slices – pack of 5

Fruit mincemeat made with juicy vine fruits and topped with toasted almond flaked almonds layered on a sweet almond base. Available in Morrisons, Waitrose and good health food stores or at www.ok-foods.co.uk. RRP £2.29.

Christmas Cake

A rich cake filled with vine fruits, apricots, dates, cranberries and seasoned with festive spice. Available in Asda, and Morrisons or online. RRP £3.99.

Christmas Pudding

Traditional Christmas pudding, with fruit and nuts. Available from Waitrose, selected health food stores and online. RRP £2.49.

Cultured Buttermilk Is Low Lactose

Yesterday I warned you about fermented products that weren't cultured and therefore probiotic. Today I'll tell you about one that is.

Buttermilk.

An unsigned article on the Tuscaloosa News website gives the best summary of today's buttermilk I've seen in a long time.

[W]hat the heck is buttermilk?

It’s not what it used to be, that’s for sure. In bygone days, when dairy products were made on small farms, buttermilk was the byproduct of butter making. Great grandma would leave pans of fresh, raw milk in the cool of the cellar for a day or so, waiting for the cream to rise to the top. Then she’d skim off the cream and churn it until the butter formed. The thin, slightly soured liquid left was the original buttermilk. It was prized for baking because, being acidic, it reacted with baking soda to make biscuits, muffins, pancakes and other quick breads rise. Many people also enjoyed it as a beverage.

With the advent of huge commercial dairies, mechanical cream separators and pasteurization, traditional “churn” buttermilk went the way of — well, of fresh, raw milk....

So what’s in those cartons labeled “buttermilk” in your grocery store? Pasteurized milk that’s been cultured with bacteria, just like yogurt. This process yields a product which, unlike traditional buttermilk, is consistent in flavor, texture, nutritional value and cooking properties. Cultured buttermilk is thicker in texture than the watery traditional buttermilk.

What buttermilk doesn’t have in it is butter. Many people assume from the name “buttermilk” that the stuff is quite rich. Not so. Cultured buttermilk is usually made from fat-free milk. I’m no fan of a fat-restricted diet, but if you’re watching your fat, buttermilk is friend, not foe.

Buttermilk also doesn’t have much lactose. Just as in yogurt, the bacteria have digested the lactose, yielding the lactic acid that gives both products their tangy flavor. This means that buttermilk is far easier than sweet milk on the guts of those who are lactose intolerant. It also means that buttermilk is suitable for those of us who watch our carb intake.

...

Cultured buttermilk is great for baking, adding moisture, tenderness and lightness to everything from pancakes to cornbread. Still, once buttermilk is cooked, the cultures are no longer active. How can you use buttermilk without cooking it?

When I was a kid, it wasn’t uncommon for people to simply drink the stuff. I have a book from the 1960s that recommends drinking buttermilk as a delicious and filling pick-me-up. If you’re fond of plain yogurt, try a glass of buttermilk. Or you can run chilled buttermilk through the blender with a handful of fruit and a little sweetener for a healthy fruit smoothie.

David B. Fankhauser, of the University of Cincinnati Clermont College, has a great Making Buttermilk page.

There's even a specialty buttermilk cookbook, Better With Buttermilk: The Secret Ingredient in Old-Fashioned Cooking, by Lee Edwards Benning.

Fermented Food Isn't Cultured Food

It's nice of people to want to help those of us with lactose intolerance. It would be even nicer if they knew what the heck they were talking about first. Never take any advice from an article on the internet without checking it first.

An Indian website, IBNLive.com, published an article by Harmanpreet Kaur extolling the virtues of probiotics.

Nothing wrong there. It's just the point gets lost in the fine details.

Any fermented product contains probiotic bacteria, which are good bacteria.

Well, no. Not at all true. Fermentation, historically, is far more associated with yeast than with bacteria. That kind of fermentation happens when yeast convert sugar to alcohol. Beer, wine, cider, and other regional alcoholic beverages are fermented and none of them contain probiotic bacteria.

In fact, there are dozens of fermented foods that are part of just about every culture. The Wikipedia article on fermentation contains a long list. Some of them might have probiotic bacteria in them, but that's a coincidence.

What you want to look for are cultured products. Cultured products do have bacteria in them, and these bacteria may have probiotic properties. The distinction is a fine one: bacteria do fermentation. But instead of converting sugar to alcohol, this different fermentation process produces acids.

Some of the most familiar acids are produced this way. Vinegar is acetic acid, and it is made by bacterial fermentation. Cheese is made by acid curdling the casein protein.

And then there's pyruvate. Glucose is the most important sugar in the world, at least to humans. All carbohydrates, including all complex sugars, eventually break down in the process of digestion and metabolism into the simple sugar glucose. Glucose is the energy source that the body runs on.

In glucose metabolism, a molecule of glucose breaks down into two molecules of pyruvic acid. Lactic acid fermentation breaks down the pyruvate into lactic acid.

Bacteria can also do the same sort of fermentation of lactose (which is a chemical combination of the simple sugars glucose and galactose) into lactic acid. Lactic acid sours milk, and gives yogurt and other forms of sour milk such as koumiss, kefir, and leban their distinct flavor. Breaking down the lactose also makes these naturally low-lactose milk products, which is one reason they are so well tolerated by those with lactose intolerance.

It's these lactic acid bacteria, like Lactobacillus bulgaricus, the bacteria that is in all yogurt, that has the useful probiotic properties. The fact that they also ferment lactose is secondary.

In short, not all fermented products are alike. Take warning: fermented foods - like the Indian foods dosa, idli and uttapam that Kaur mentions - may be good for you or not, but the fact that they are fermented does not mean that they have beneficial probiotic bacteria. They don't.

And it helps to know some of these basic facts about food if you are lactose intolerant or have any reason to avoid certain foods or ingredients. Knowledge is power. Lack of knowledge, in the famous quote, and you'll be a eunuch all your life.

Silk Plus for Bone Health

"Functional" is the new buzzword in the food industry. Functional products have had some "extra" added to them to make them healthier. At least according to whatever the latest fad in health might be.

I scoff, but it's hard to dismiss these foods. It's far better to add ingredients designed to promote health than more sugar and fat.

I've written extensively about these products in the past. In Functional Nondairy Makes Europe Healthier I mentioned several European soymilks that had plant sterols added in the hopes of lowering cholesterol counts in those who drank them.

And in this country, I looked at two new products from Silk that they claimed offered "nutritionally dense and very smart solutions by incorporating all the vitamins, minerals and heart-healthy soy protein of regular Silk, plus added fiber or Omega-3 DHA."



Silk is at it again, launching yet another functional soymilk, Silk Plus for Bone Health.

Silk's press release has more detail:

This new addition to the Silk Plus product line provides added calcium in every glass, and incorporates all the vitamins, minerals and heart-healthy soy protein of regular Silk. As an added benefit, NutraFlora® natural prebiotic fiber has been included to help the body absorb calcium more effectively.

Silk Plus For Bone Health is a great way to take in more of the nutrients that support strong, healthy bones. Every serving of Silk Plus For Bone Health delivers 400mg of calcium – 40 percent of the recommended daily value and 30 percent more than you’ll find in a glass of dairy milk.

"Silk has always delivered great-tasting, high-quality soy products to health-minded consumers," said Scott Stevens, general manager for Silk Soymilk. "By introducing Silk Plus For Bone Health with NutraFlora® prebiotic fiber and added calcium, we continue to meet their needs and make it easier for consumers to get more of the nutrients they need in the products they use every day."

Prebiotic? That's not a typo for probiotic. Yes, I've written about that before as well, in Prebiotics and Probiotics. I quoted Wesley Canfield of the Grand Forks Human Nutrition Research Center:

Prebiotics ("before life") are nondigestible or fiber components of foods, usually complex carbohydrates that beneficially affect the host by stimulating the growth of intestinal bacteria. Certain bacteria prefer a particular prebiotic to use as a source of energy.

More about Silk soymilks at their website.

LI Celebrity Alert: Orlando Bloom and Victoria Beckham

Last week I posted about the latest bad news from Britain, that somehow 20% of the British population has managed to convince itself that it has food allergies.

I've done so many posts about the seemingly limitless ignorance about all issues having to do with lactose intolerance or dairy allergy in the UK that I could fill up a book. Just check for the UK tags to get a long list.

With doctors, nutritionists, and newspaper columnists giving out advice that ranges from the inaccurate to the sheer loony, you'd think there'd be plenty of blame to go around when deciding who is at fault for the omnipresent ignorance.

You'd be wrong. It's the fault of celebrities.

Nic Fleming, the Medical Correspondent for the Daily Telegraph wrote that over 60% of general practitioners (GPs) have seen an increase in the number of patients complaining to be intolerant to wheat or dairy.

You might think that there's a clue staring you in the face. When a Medical Correspondent can't use the term allergy properly and sows confusion between allergies and intolerances, how in the world would ordinary readers understand the crucial difference?

But let's continue. Fleming quotes from a recent survey of 1000 adults and 250 GPs.

More than a fifth - 22 per cent - of people said they had first heard of food intolerances and allergies through interviews with celebrities, magazines and television, and 19 per cent had done so via friends and family.

This is a doubled-edged statistic. I admit readily - indeed I shout it out loud here at my blog - that getting medical information from headlines or the media equivalent is an extremely bad idea. But if getting medical information from television is so bad, why are health features a daily segment on every major news program? That survey makes no distinction between believing everything heard and using the media as a critical disseminator of valuable knowledge. Same for hearing from friends and family. Personal experiences with allergies and intolerances can be an invaluable sharing of hard-won knowledge, while other gossip is glurge as bad as any internet rumor.

Clearly people are getting bad advice about food from somewhere, however. Maybe we can identify one source. It's an article by Nic Fleming, the Medical Correspondent for the Daily Telegraph.

That's right. The following quote appears in the very same article blaming television and celebrities:

Patrick Holford, the founder of the Institute for Optimum Nutrition, said: "Probably as many as one in five people show an allergic reaction to wheat or milk, generating symptoms such as headaches, fatigue, facial puffiness, itching, eczema, bloating, abdominal pain, constipation and joint aches.

Hogwash. Crackpot hogwash.

You can read more about the Institute for Optimum Nutrition on Wikipedia, which also carries this warning:

Prof David Colquhoun has criticised the ION's Diploma in Nutritional Therapy, arguing that:

The give-away is the term Nutritional Therapy. They are the folks who claim, with next to no evidence, that changing your diet, and buying from them a lot of expensive ’supplements’, will cure almost any disease (even AIDS and cancer)... The IoN is run by Patrick Holford, whose only qualification in nutrition is a diploma awarded to himself by his own Institute. His advocacy of vitamin C as better than conventional drugs to treat AIDS is truly scary.

Thank you Nic Fleming, Medical Correspondent.

Oh, the celebrities. Right. Fleming mentions that:

the actor Orlando Bloom and Victoria Beckham are said to be intolerant to dairy products.

You know where else you might have seen that?

Right here. My post of April 15, 2006. "Free From" Foods Grow in Sales.

Orlando Bloom and ex-Spice Girl Victoria Beckham have to stay away from dairy products, say sources close to them (or tabloids or somebody equally respectable).

Somebody equally respectable. Like Nic Fleming.

FDA Approves New Sugar Substitute

Isomaltulose doesn't exactly trip off the tongue. What about something more palatable? Palatinose, perhaps. Would you put that in your products?

Perhaps you should. Isomaltulose, which is being produced under the trade name of Palatinose by German manufacturer Palatinit, is a combination of glucose and fructose. Normally you know a combination of glucose and fructose as sucrose, or common table sugar. Give it a slight enzymatic twist and it develops properties that are particularly desirable.

An article by Clarisse Douaud on FoodProductionDaily-USA.com gave details on what some of those properties are.

[T]he sweetener is said to maintain sweetness while also having a low glycemic effect. It can be used to enhance the nutritional value of foods since it is digested much more slowly than sucrose, providing energy over a longer time period.

And the US Food & Drug Administration (FDA) has authorized a non-cariogenic health claim for isomaltulose. Non-cariogenic means that it does not promote caries, or tooth decay, because the oral bacteria that digest other sugars like sucrose, lactose, and fructose can't break down isomaltulose's unique molecular form.

This has potentially huge applications in the commercial world.

According to Palatinit, the approval of isomaltulose as a non-cariogenic sweetener could lead to new opportunities for product development and specific dental health claims, such as "does not promote tooth decay" or "may reduce the risk of dental caries".

Palatinose is produced from real sugar, but its strong molecular binding ensures it cannot be broken down by plaque bacteria and prevents the generation of acids that harm tooth enamel. As such, dental caries do not form with Palatinose.

The sweetener was originally developed as a means to help manage diabetes as part of a low-glycemic diet. Palatinit claims its sweetener is the only low-glycaemic carbohydrate that supplies energy in the form of glucose over a prolonged period of time. However, it also has advantages for beverage applications.

Palatinit says that Palatinose is non-hygroscopic, making it ideal in instant drinks as it does not lump and remains dispersible. In dairy products, too, it can be used as a carbohydrate because it is resistant to fermentation by the surrounding microbes and lactobacilli.

Palatinose is also applicable in weight control and 'slimming' products. Liquid meal replacements with milk, fruit or cereal as well as instant tea and specialty coffee could also be repositioned in the wellness sector with Palatinose.

If the sweetener can replace lactose in commercial products, then it would be a boon to the many groups who have to avoid lactose.

This will undoubtedly take a while, as lactose is a cheap sugar easily refined from what would other be the waste product from cheese manufacturing and isomaltulose will be expensive at first, but any good alternative sweetener is bound to cut into the market for lactose in the long run.

Sarah's Cure

I've written about Galactosemia before.

People with galactosemia digest lactose properly, splitting it into the simple sugars glucose and galactose, but they lack the enzyme that converts the galactose into more glucose. The galactose accumulates in the bloodstream and effectively poisons the body. This otherwise completely harmless sugar can lead to brain damage, blindness and death through liver failure. Only one in 80,000 babies are born with this condition.

Sarah Southard of Texas is another little girl with this lifelong problem. Because it is so rare, there has been little research and no possibility of a cure in sight. Her family wants to change that.

An article by Jessica Langdon in the Wichita Falls TimesRecordNews reports that for the second year they're staging a fundraiser called "Sarah's Cure."

For the second year in a row, the Southards are inviting the North Texas community to help Sarah — and all children who have Galactosemia — during an October Saturday filled with fun and Texas music in Decatur.

The event is called “Sarah’s Cure,” and this year, it’s a project of a group the Southards spearheaded — a nonprofit organization called Galactosemic Families of the Southern States. Funds will go to the national group, Parents of Galactosemic Children Inc., to help fuel research.

For more information:

Parents of Galactosemic Children Inc.

Parents of Galactosemic Children, Inc. (PGC) is a national, non-profit, volunteer organization whose mission is to provide information, support, and networking opportunities to families affected by galactosemia.

Galactosemic Families of the Southern States.

Galactosemic Families of the Southern States is a non-profit, volunteer organization that was created by parents just like you. We are a support system for families in Texas, Oklahoma, Arkansas and Louisiana who live with galactosemia everyday.

Vitasoy Launches Breast Health Education Initiative

Vitasoy is one of the pioneers in the soy milk industry. I wrote about them extensively in my book, Milk Is Not for Every Body.

Worries about what they call the "misperception that soy may be too risky for people with breast cancer" have led them to encourage women to educate themselves more about breast health and soy.

They're doing so, according to their press release, with Pinkies, named for the pink ribbon symbol of the breast health movement. (If you look carefully, you'll see that "lactose free" is emblazoned around the cap.)

Vitasoy's specially-designed pink 8-ounce chocolate organic soymilks, dubbed "Pinkies" by the Vitasoy innovations team, feature the breast health movement's pink ribbon symbol and an invitation to sign up for a free subscription to the Vitasoy breast health e-newsletter at http://www.vitasoy-usa.com/breasthealth.

...

According to Suzanne Dixon, MPH, MS, RD, an internationally recognized expert in cancer nutrition and epidemiology, it's time to set the record straight about the soy-cancer link.

"Soymilk is safe for people with a history of cancer when it is taken as part of a healthy diet. It also supports overall health because it is cholesterol-free, high in protein, and a good source of calcium and other vitamins and minerals. Soymilk has many cancer fighting properties. So do other soy foods, including tofu, tempeh and edamame..."

Dixon believes soy supplements may be at the heart of the misperceptions about the soy-breast health link. "Studies show that soy supplements, since they don't use the whole soy bean, may not be safe for individuals with hormone-sensitive cancer, but there is no definitive research yet," said Dixon. "There is plenty of research that soymilk and some other soy foods can be a part of a healthy diet, however. Just don't rely on soy foods alone to improve the diet. You need to focus on total diet improvement for the best cancer prevention benefit."

In true press release fashion, the marketing gurus haven't coordinated with the web site masters, and so the breasthealth link given in the press release doesn't yet work. It'll probably be fixed after the weekend. (I work every day at this blog, but I've stopped expecting that anybody else does.) Try go to the main Vitasoy page for info. Click on "In the News" if you don't see the Pinkie bottle on that page.

Nude PETA Ad Banned in Texas

Remember the Barenaked Ladies line from "One Week"?

"I have a history of taking off my shirt."

That might be PETA's motto, with all the ads they've done featuring celebrities - female, for some reason - who need to take off their clothes to prove that they don't eat meat.

No, I don't get it either.

The latest vegan celeb is Alicia Silverstone, 2004's sexiest female vegetarian, whose nude swim ad was banned in Houston by cable provider Comcast.

Comcast Cable bosses banned the spot because Silverstone is naked, and they don't want to upset viewers in Texas.

PETA chose to debut Silverstone's new ad -- which is also available on Peta's website, PETA.org -- in Texas because the states' leading cities "repeatedly rank among the least healthy in America."

Wait a second. They banned the ad on cable because you can, gasp, see the sides of her body, and not a single naughty bit is shown even for a Janet Jackson second? The print ad above shows more of her body and it's still safe for little children. (Though I have a question. She's 5'5". How does somebody that short have legs that long? It's not from veganism.)

Who's nuttier, PETA or Comcast?

Here's the 30-second video spot itself.



Hysteria, over nudity or milk or any other imaginary issue, is bad for your health. And that's the only health guarantee you'll get out of this whole scandal.

Emilee's Italian Ice

The winner of Taste of Boston's Best Dessert, Emiliee's Italian Ice has reformulated its ingredients to make it dairy-free and lactose-free.



From their press release:

Emilee’s set out to create a dessert in which almost all could enjoy. This included a dessert for those who were lactose intolerant. Chirs Tabora, co-owner, comments, “If I included dairy ingredients in my product, it would mean nothing to millions of people who are searching for desserts and treats that fit into their dietary restrictions. If I can produce a unique concession for these folks as well as the general public, and leave behind all that would hinder them from eating it, I’ve won for the both of us.”

Emilee’s Italian Ice (www.EmileesItalianIce.com) has hit this market with success and are in their fourth summer of hosting concessions. Primarily in states such as New York, Connecticut, Massachusetts, and Rhode Island Emilee’s can be found through outdoor event locations. In addition, Emilee’s can be found at numerous retail establishments and more recently, their first stand-alone pilot location in Columbus, Ohio.

Emilee's Ice is also cholesterol free, fat free and sugar free.

All good, though I can't help but get a good laugh from an easlier line in the press release.

Emilee’s Italian Ice successfully changed their product ingredients without compromising taste or quality in order to cater to the 11.03% of the United States’ population who are lactose-intolerant.

11.03%? Who measures anything to this precision? We don't even know how many people in the U.S. are LI in the first place.

Apparently, they took the number from another line:

Approximately 1 in 9 or 30-50 million people in this country have been diagnosed as lactose-intolerant.

Of course, 1 in 9 is 11.11%, not 11.03%. Somebody's calculator needs new batteries.

Remember, always doublecheck numbers, especially percentages, to see if they mean what they claim to mean. Even if they're from the good guys.

UK Sets Standards for Allergy Formulas

A press release announced that Act Against Allergy, an independent international taskforce of allergy experts, set forth standards and guidelines for the diagnosis and management of cow's milk allergy (CMA) in infants in the UK. The guidelines were published in the journal Archives of Disease in Childhood.

In their paper, the Taskforce recommends against the use of soy, especially in infants under six months old, due to the risk of secondary intolerance which can be present in up to 60% of CMA infants. Alternative mammalian milks, such as sheep, buffalo, horse, camel or goat, present an even higher risk of cross-reactivity and are not recommended at all in CMA. Furthermore, milk substitutes based on grains, legumes or nuts, such as rice, oat, pea or almond milk, are to be avoided in infants and young children due to their poor nutritional profile. According to the Act Against Allergy Guidelines, the only milk alternatives recommended for the effective management of CMA are specialised hypoallergenic CMA formulas, namely eHF's and AAF's.

AAF is the only formula type recommended for all degrees of CMA severity (i.e. mild, moderate and severe). These formulas are based on amino acids, the building blocks of protein, which are considered virtually incapable of provoking an allergic reaction, while providing optimal nutrition for of the infant. Immediate usage of AAF is also recommended in infants with suspected CMA showing failure to thrive - insufficient weight and/or length gain - in order to rapidly stabilise the infant's physical development.

In cases of mild to moderate, but not severe, CMA, the Taskforce advises that an eHF may be sufficient. When milk proteins are broken down (hydrolysed) into smaller fragments - as happens in the production of eHF's - their ability to provoke an allergic reaction is reduced. However, if symptoms do not improve sufficiently on an eHF, an AAF should be considered.

The SHS / Nutricia portfolio of hypoallergenic infant formulas is the only range of products that fully covers all degrees of CMA severity (i.e. mild to moderate and severe). The portfolio also includes the only AAF that is globally available and the most extensively clinically validated.

The guidelines are similar to those promoted by the American Academy of pediatrics.

The full guideline manuscript is available at: http://adc.bmj.com/.

More information on the Act Against Allergy Taskforce is available at: http://www.media.actagainstallergy.com/.

Sorrento Lactose Free String Cheese

I received an email from Nicole S. telling me that Sorrento string cheese was lactose free. Their website doesn't confirm this, but before I could go any further the enterprising Nicole contacted the company and received this excellent response.

String cheese is made when a special culture changes the milk sugar into lactic acid, however there is some residual lactose left.

Our lactose free string cheese has a special added enzyme that further breaks down the residual lactose into two other easily digested sugars- galactose and glucose. Thus lactose is eliminated!

Sincerely,
Joyce LaRoche
Quality Assurance Specialist

Terrific.

You can see more about Sorrento Stringsters Mozzarella String Cheese and Sorrento Stringsters Reduced Fat Mozzarella String Cheese at the Sorrento snack cheese products page.

Many thanks, Nicole!

Are Lactaid Scoopfuls MIA?

Lactaid is one of the few companies, if not the only one, to make completely lactose free ice cream in a variety of flavors, as I reported last year in Lactaid Scoopfuls.

I said at the time that Lactaid didn't even mention Scoopfuls on its own webs site. Today it does, kinda. There is a product request form page that mentions Scoopfuls as part of a form that readers can send to store managers as a "wish list of LACTAID® Brand Products that we hope you will carry in your store." But no ice cream is listed under the regular products page.

So is Lactaid Scoopfuls currently in any store?

Amazon no longer lists Scoopfuls on its web site. All links to the Scoopfuls pages return an error message. Even the one from the Amazon ad for Lactaid Scoopfuls that appears when you enter those words into Google!

I tried dozens of other links that popped up at the Google search page, but each of them apparently had originally led eventually to Amazon, and each of them turned up broken or empty.

If anybody out there knows of a site that still sells Lactaid Spoonfuls, please let me know. I'll try to get in touch with someone at Lactaid who might know what's going on.

Otherwise, the first paragraph of my previous post on Scoopfuls holds up better than ever.

Where's the lactose-free ice cream, everybody asks. It doesn't sell, I reply.

So true. So sadly true.

LI Celebrity Alert: Denise Lewis and Rachel Hunter

The Brits are at it again. Three million Britons are suffering from "imaginary" food intolerances, according to researchers.

An article at ThisIsLondon.co.uk reports that up to 12 million Brits - that's 20% of the population - claims to have a food intolerance of some sort. It's not even clear whether they mean they have allergies or true intolerances; apparently they're using the terms interchangeably. But what can you expect when:

One in 50 of the 1,500 men and women polled in a survey on food intolerances decided they suffered from an intolerance on hearing a friend's diagnosis.

No such article is complete without quoting celebrities for their views. Fortunately, we get a fairly intelligent set of quotes.

Olympic gold medalist Denise Lewis mistakenly tried self-diagnosis as she attempted to find the cause of the stomach problems that had plagued her for years.

"I've suffered from irritable bowel syndrome-related symptoms for 13 years and these have affected my performance on and off the track," she said.

"I was often guessing what could be wrong with me and eliminating a range of foods I thought could be the problem."

However, she discovered what the problem was after taking a food intolerance test.

"I found out I was intolerant to cow's milk, egg yolk and garlic.

"Since reducing these from my diet, I've not suffered my usual bloating and stomach cramps, have more energy and feel brighter and lighter.

She's not alone.

Research by Norwich Union Healthcare found that 19 per cent believe they have a gluten intolerance, such as that suffered by TV presenter Carol Vorderman, while 18 per cent claim a lactose intolerance like that of Rod Stewart's ex-wife Rachel Hunter.

That's right. "Stacey's Mom" is LI.

Answers on Probiotics

Julie Deardorff, the Chicago Tribune's health and fitness reporter, has an interesting column that, wonder of wonders, actually names names when it comes to product recomendations based on studies. Just a few excepts.

QUESTION: Which probiotic strain do I want?

ANSWER: "If you have a specific health concern, see if any products on the market have been specifically tested for that condition," said industry expert Mary Ellen Sanders, co-founder and executive director of the International Scientific Association for Probiotics and Prebiotics. "For mild irritable bowel syndrome, I'd encourage Procter & Gamble's Align [probiotic supplement] since they have data with this population. Women with vaginal concerns I might direct toward FemDophilus, again since there is research on this," she said.

Q: What's the deal with yogurt?

A. All non-heat-treated yogurts do contain live active cultures, which include the bacteria used as starter cultures to make the yogurt [Lactobacillus bulgaricus and Streptococcus thermophilis], Sanders said. "Yogurts may also contain added cultures, including probiotics. A wider range of health benefits have been documented for some of these added probiotic strains," Sanders said. But "many of the organisms in yogurt cannot survive in the acidic environment of the stomach," said Sri Komanduri, an assistant professor of medicine in gastroenterology and nutrition at Rush University Medical Center. Sanders also suspects many yogurts marketed as "probiotics" with added strains don't contain enough bacteria to be effective or haven't been studied.

Q: Are there non-dairy sources of probiotics?

A. Try naturally fermented pickles that don't contain vinegar; sauerkraut; the Korean condiment kimchi; soy yogurt; and miso. New products include probiotic-enriched fruit juices, teas and water, which are popular in Europe. Kashi's Vive is a probiotic-enriched cereal. Many supplements also claim "dairy free."

Q: What's the difference between live active cultures and probiotics?

A. Live cultures are often food-fermentation agents and haven't necessarily been tested for health benefits. Probiotics are live microbes that show a health benefit when consumed in high enough doses.

Q: What should the dose be?

A. It depends on the probiotic strain, what health effect you want to see and whether it has been studied. Most research shows doses greater than 1 billion have effects.

Q: What are the best brands to take?

A. The most researched brands include Culturelle, Florastor, Jarrow-dopilus, Fem dophilus, Theralac, VSL # 3, Activa, DanActive and Yakult, according to "The Probiotics Revolution."

A "Breastfeeding-Friendly" Environment, with Dairy-Free Options

The U.S. is apparently not the only country in which otherwise sane adults grow hysterical at the site of a women breastfeeding her baby. New Zealand has the same problem.

Cure? A "breastfeeding-friendly" environment.

Adam Long started Koffee Kulture after women had been told not to breastfeed in other upscale cafés.

According to an article by Andy Hay on the New Zealand Herald website:

As well as allowing mothers to feed anywhere in the café, it provides a breastfeeding booth, so a mother can feed baby in private and keep an eye on siblings in the play area, Long says.

The café also offers gluten and dairy-free options, hosts a pram walking group and holds "bouncy castle days".

Other parent and child-friendly cafés have been popping up all over New Zealand as well.

Good for them. It's a trend we need to import.

Top Allergy-Friendly Food Finds

Allison Van Dusen wrote a very useful article, Top Allergy-Friendly Food Finds on Forbes.com.

Anne Munoz-Furlong, CEO and founder of The Food Allergy & Anaphylaxis Network, says there's been a steady increase in the number of available foods in this market over the last 10 years. She expects the trend to continue as the health issue grows.

"It used to be you could only get these specialty foods online, but now we're seeing it in mainstream grocery stores," she says. "You can get a box mix or a ready-made product. It's getting easier to feed [people] with food allergies."

...

Jay Berger, owner of AllergyGrocer.com, says food-allergic customers have been so desperate in the past for foods they can eat that they've been willing to settle for products that don't taste good, even though they typically cost three times more than similar non-allergy friendly versions.

"They'd go into the store and pick up two items that, thank God, meet their needs and they're so grateful," says Berger, who manufacturers the popular Miss Roben's baking mixes, which are free of wheat, gluten, dairy, nuts and eggs, and whose site sells many other companies' allergen-free foods. "It's important for people to know there are good things out there."

You can also click on a link there to take you to a slideshow of 10 Allergy-Friendly Foods.

Gluten-Free, Sugar-Free Cookbook

About two weeks ago I mentioned Alice Sherwood's new Allergy Free Cookbook.

CeCe Sullivan, of the Seattle Times food staff, just caught up with Sherwood's cookbook and added another book of interest, Susan O'Brien's Gluten-Free, Sugar-Free Cooking: Over 200 Delicious Recipes to Help You Live a Healthier, Allergy-Free Life.

The book description for O'Brien reads:

With millions of people suffering from food allergies, obesity, and generally less-than-perfect health, the connection between how we feel and the food we eat has never been more apparent.

Now, in Gluten-free, Sugar-free Cooking, gourmet chef and food-allergy sufferer Susan O’Brien offers more than 200 great-tasting recipes — covering everything from breakfast to dessert — that are perfect for people with food allergies as well as for those who simply want to adopt a more healthy way of eating. Free of gluten, sugar, and usually dairy, these tasty dishes are also invaluable for people living with medical conditions such as candida, fibromyalgia, Crohn’s disease, diabetes, autism, and ADHD, who must avoid certain foods to better control their symptoms.

Complete with product sourcing information, substitute ingredients, dining out advice, and online resources, Gluten-free, Sugar-free Cooking makes eating healthfully and avoiding problematic foods easy and delicious.

It's available in both hardback and paperback editions. I hope to be adding it to my Milk-Free Bookstore on the Wheat and Gluten-Free Books page. There's been a glitch in posting new pages to my website, but I hope to have that straightened out very shortly.

Sullivan's article also lists several good resources for allergy information on the net. I've listed many of them before, but it's always good to have them in one place.

•Aaaai.org (American Academy of Allergy Asthma and Immunology) has an archive of articles offering news and information regarding food allergies.

•Aafa.org (Asthma and Allergy Foundation of America) supplies a number of links relating to food allergies.

•Foodallergytalk.com is an invaluable resource for sorting out the ingredients listed on labels that may pose a risk to allergy sufferers.

•Glutenfreegirl.com, written by local blogger Shauna James Ahern, is an entertaining and insightful look at living the good life without gluten. (Ahern's book, "Gluten-Free Girl: How I Found the Food That Loves Me Back ... & How You Can Too" will be published by Wiley in October.)

•Kidswithfoodallergies.org provides parents with support, resources and recipes to help their children live healthy, active lives.

•Mayoclinic.com supplies information and tools to help manage the symptoms of allergies.

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.