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The Gut-brain interface

Tuesday, January 25th, 2011

The human digestive tract

Today I came across an interesting article in the Wall Street Journal. I've spent much of the day trying to track down background information and, thus far, appear to have only scratched the surface.

The initial article was titled "Hungry? Your stomach really does have a mind of its own." It described an research effort by scientists working for the Nestle SA company, a huge firm headquartered in Switzerland, but operating in 86 countries and employing well over a quarter million people.

When I think of Nestle, I think of chocolate, but they started with condensed milk and baby formulas. They've done some praiseworthy things and some that have been severely criticized. Among the former are efforts to halt child labor in cocoa production; the latter includes promotion of the use of infant formula to mothers in developing countries.

The article I was reading talked about satiety factors to stop us from overeating. Nestle has a group of its scientists working on foods that potentially can trick what is termed the gut brain. That's known to physicians as the enteric nervous system, a huge collection of nerve cells involved in actions and reactions in the GI tract: the esophagus, stomach, small intestine and large intestine.

So here's how it works, or at least some of how it functions, in hunger and satiety. Eating stretches the stomach, causing "I'm full" messages to be sent to the real brain, the one in your head. Chemicals called peptides are released when food is present in the intestine; that also signals the brain. Then there's another mechanism I'd never heard of, one called the "Ileal Brake."

The ileum is part of the small intestine and apparently another "I'm full" message can be sent upstairs when there is an excess of fat reaching that part of the gut, in this case excess means more than can be handled (processed) at the moment.

So the Nestle scientists developed a mechanical model of the human GI system, one that cost a million dollars, is the size of a really big refrigerator and is computer-controlled. Using this machine, their lead scientist, Heribert Watzke, and his crew are simulating the progress of a meal through our GI tracts.

I found a video of Dr. Watzke speaking to what appeared to me to be a mostly college-age audience at Oxford, England. He's a very entertaining speaker, obviously partakes a bit too much of his own company's products (or other food) and admits this. He thinks we shouldn't be called omnivores, but rather "Coctivores," creatures that eat cooked food.

His premise is that cooking allowed mankind to develop larger brains and freed them to be able to move around the planet. He wasn't speaking of the food products his company produces, but rather presented a formula: food + cooking = energy.

I need (pun intended) to digest this concept a little more; I'll return to it at a later time.

Meanwhile I suggest you Google Dr. Watzke and observe his show.

Posted in cooking: new ideas, Corporations and healthy foods, medically-oriented background info | 2 Comments »

What's Good for General Bullmoose...

Thursday, January 20th, 2011

A Bull Moose has some clout

Several major concerns in Americans' diets have apparently taken another step to resolution. I've written how the dietary salt (sodium really) recommendation has recently been lowered so that about 70% of us (all but the young, white and quite healthy) should be ingesting only 1,300 to 1,500 mg. of sodium per day. That's tough enough to do. I saw a recipe yesterday in a "Light Cooking" magazine my wife gets that was interesting: a steak hash. But per portion it had 1,000 mg. of sodium.  That's over two thirds of what I should eat in a whole day. I didn't bookmark that recipe.

Then there's the relatively high cost of fresh fruits and vegetables compared to some other choices, so called "prepared foods" one can buy in the supermarket. Those mixtures are often filled with sodium, fats and sugars, but they're comparatively cheaper in many instances.

We're fortunate enough, as a pair of USAF retirees,  to be able to buy our fruits at the Air Force Base Commissary closest to us as we did when we drove to Cheyenne to see our Dermatologist today. And in the summer, of course, we've again purchased a veggie share and a fruit share from the local CSA, Grant Family Farms. Next summer two sets of friends will join us in that, so the variety will go up and the price per item down as we purchase larger shares. Then we got a quarter of a "hand-raised" cow this year at a wonderful per pound price. That came through friends whose neighbor has a very small herd and sells a few each year.

So what if you're on a tighter budget and don't live where friends and their neighbors have livestock?

Today in The New York Times appeared an article titled "Promote Healthy Foods."  It details how Wal-Mart (since 2008 I think it's actually Walmart), now the biggest retail concern in the country has a new plan, one that over the next five years will cut down on packaged foots content of the sodium, fat and sugars. That gradual approach doesn't ring well with some; I saw some negative quotes, but other countries have followed the same pattern with success. it's hard to go from high-salt to low-salt diets in one urgent push. I know since I tried that when my own blood pressure first went up in the early 1980s.

I tried some "no-salt" foods and hated them. Yet now, some 25+ years later, I'm quite comfortable adding pepper and other spices and using no table salt and no cooking salt.  We cook with a little salt when we have company, using less than the recipe calls for, and I frequently see our guests adding salt at the table. When we eat alone there's no salt shaker there.

Wal-Mart is also planning to offer fruits and vegetables at lower prices. And the article said they plan to build some more stores in rural and "underserved" areas. The company has been discussing healthy eating and our epidemic of childhood obesity with the First Lady and she apparently endorsed their efforts. Why is this significant? Well it's because they can pressure their suppliers to follow along with the concept. They are the Bull Moose herd leader and others tend to tag after them.

We don't do much shopping with them, but in this case I say, "Hooray for Wal-Mart."

Posted in cooking: new ideas, Corporations and healthy foods, Food Additives, Food producers and less-healthy foods, Governmental Efforts, medically-oriented background info, our kids and their weight issues | No Comments »

Focus on Vitamin B-12 again

Tuesday, January 18th, 2011

high-dose B-12

I've been reading a number of articles about Vitamin B-12 lately. One convinced me we should be taking a higher dose at our age. In young people B-12 deficiency is rare; that's not true for the elderly where some have estimated up to 15% may be lacking in this essential nutrient. What I hadn't fully realized is the omeprazole (Prilosec) I take chronically could potentially also block absorption of B-12.

B-12 deficiency, when severe, causes macrocytic anemia, low red blood cell counts with the cells themselves being larger than normal. That's the flip side of iron-deficiency anemia where the cells are smaller than usual. But there are a host of other issues attributed to B-12 deficiency: depression, dementia, confusion, appetite loss, balance problems. All those have many other causes, of course.

We had been taking a multivitamin for seniors, but added high-dose B-12, (1500 mcg/day. Like the rest of the B vitamins, B-12 is water soluble and if one takes "too much' it can be excreted in urine. That's not true for fat-soluble vitamins like Vitamin D where the potential for overdose is worth thinking about (although there is ongoing debate as to how much Vitamin D we should be getting; see my last post). Our senior vitamin mixture has 25 mcg of B-12 or about 4 times the recommended daily (RDV) value for young healthy adults, but I don't care if I take more than that since I'm about to turn 70 and take that proton pump blocker omeprazole.

beef liver

Today the Wall Street Journal in its Health and Wellness section had an article about B-12 deficiency. It is more likely to be seen in people who don't eat meat or dairy products (beef liver has 48 mcg/slice which is 800% of the RDV). Several chronic bowel diseases  (e.g., celiac disease) can lower its absorption.

The Institute of Medicine recommends that anyone in their 50s or older get most of their intake of this essential vitamin from supplements or, alternatively from so-called "fortified" cereals. When I looked at the NIH's lists of foods that contain larger amounts of B-12, I was somewhat surprised to see at least eight cereals listed.

There is a blood test for B-12 with normal levels of 200-800 picograms per milliliter  cited as the normal range. But my own doc just said my level was superb, ~1,000 pcg/ml in January of 2009. There are now B-12 nasal sprays and some people with severe deficiency have to get B-12 shots, but she talked to a hospital pharmacist who said, just tell me to take my Prilosec at a different time of the day than my B-12.

So if you are 70+ or have a chronic bowel disease or are a vegan, you may want to ask your physician about a B-12 level.

Posted in medically-oriented background info, supplements, Vitamins and Minerals | No Comments »

When even the experts disagree

Friday, January 14th, 2011

A good source of calcium

I saw two interesting articles this week that made me pause and chuckle a bit. One came from the American College of Physicians' publication, "ACPInternist:" the other from medscape.com as A "Best Evidence Review," and compared and contrasted recent US and Canadian authoritative recommendations." The topics were calcium intake/supplements and Vitamin D optimal dosage and the suggestions varied considerably.. I doubt it's because Canada is further north, but that thought crossed my mind.

So let's talk about calcium first.

In July 2010 an article appeared in the British Medical Journal which made many physicians change their recommendations on calcium supplements. There was nearly 1/3 more heart attacks in a group of patients taking calcium pills as opposed to another group who weren't. At a later revelation at an American medical society meeting, the same group of research scientists showed a data from the Woman's Health Initiative (WHI) that also found a heart risk from calcium supplements, this time both in heart attacks and calcification of coronary arteries.

We quit taking our calcium pills, but continued to drink and eat milk and milk products.

Now other medical researchers have cast doubts on the significance of the data saying the overall WHI statistics showed what is a small heart risk at most. There's still a debate as to whether calcium supplements do or do not decrease hip fractures (a major problem, especially in older women).

Then the Institute of Medicine report issued in November as a joint US-Canadian dictum said most Americans, except possibly for teenage girls and some of the elderly, get enough Vitamin D and calcium without using any supplements and that the major risk of too much calcium intake was really kidney stones. There was a specific caveat that postmenopausal women taking supplements may be getting too much calcium.

High-dose Vitamin D

Now the January 5th, 2011 Medscape review looked at Vitamin D recommendations in Canada versus those in the United States. Both came from authoritative sources: The Osteoporosis Canada study concluded that many of us are low in Vitamin D and that more is good, mostly in promoting bone health, but possibly in colon cancer prevention and also in decreasing older adult falls. They suggest taking larger doses than the US Institute of Medicine does.

SO...how do I parse these varying studies and what do we plan to do. First, we will continue to get our calcium from food sources, mostly milk, soy milk (with its added calcium), cheese and yogurt. Secondly we'll continue to take a larger dose of Vitamin D in pill form, but perhaps slightly less than we are now, and I may get a little more sun exposure.

One comment in the Medscape article was a "young white person needs approximately 4 minutes of direct exposure to sunlight on the arms and legs to generate approximately 1,000 IU of vitamin D3." There's debate as to using sunscreen or not with a small, but randomized Australian study showing a similar increase in blood levels of Vitamin D, measured as 25-hydroxyvitamin D3 (25-OH-D) whether actual sunscreen was used or a placebo sunscreen. Notice, please, that nobody is suggesting prolonged or facial sun exposure.

Sun and Clouds

I may try some arm and leg skin exposure to sunlight; my wife who has had one skin lesion removed won't. We'll continue taking Vitamin D and she needs a follow-up blood level test as her first one was low. We're now on 5,000 IU per day and that may be too much; the Canadian study suggests 800 to 2,000 IU per day; the US recommendations, while lower (800 IU per day for those 71 and older; we're just shy of that), say risks from too much Vitamin D don't increase until doses are over 4,000 IU per day.

Confusing, isn't it; I suggest you ask your own personal physician as to what you should be doing and also ask them if they've seen the most recent recommendations.

Posted in Governmental Efforts, medically-oriented background info, supplements | No Comments »

Caveat Emptor

Friday, January 7th, 2011

An article that got me thinking and Googling

Remember when phlogiston was the answer? Well maybe not; that was a long time ago, but ideas in science and medicine come and go.

Two things reminded me of that in the last few days. I usually try to keep up with developments in those areas of medicine that I have a direct or even peripheral interest in. I read the abstracts in the Annals of Internal Medicine and decide which articles make sense to read in full. I look through the bi-monthly Journal Club appended to Annals and do the same.

Then I find suggestions in the two papers and several magazines I read and hunt down the original articles on which they are based.

Some of that is personal; we each take several prescription meds plus a senior vitamin, a large-dose B12 pill, vitamin C, fish oil capsules and vitamin D each day and our supplements have varied over the years as new articles come out.

But even as a medically-trained (now retired for 12+ years) individual, there are times when I find a sudden switch  in the conventional thinking to be jarring.

Two of those happened in the past week.

I was about to write a blog post on Omega-6 to Omega-3 ratios in our diet and give my take on what our optimum ratio should be. American diets have had a ratio well over that in many countries; some advise altering that from the current/recent 15:1 or even 40+:1 to 2:1 or 1:1.

Then my wife, aware of my interest in the area, showed me an article that led me to contacting a senior Harvard professor. Dr. Frank Sacks works in the Department of Nutrition in the Harvard School of Public Health and has chaired, co-chaired or been the principal investigator on a number of well-known, multi-center studies.

He was kind enough to respond to me email and sent me two of his publications, one from the journal "Circulation 2009; 119; 902-907 and the other from The Journal of Clinical Endocrinology and Metabolism 91(2): 309-400.  Bottom line: he feels both Omega-6s and Omega-3s are good polyunsaturated fatty acids (PUFAs) and that ratios make no sense. I'm still digesting his articles and may comment on them later.

Then a friend gave me an article from The Atlantic. It had the intriguing title I pasted in above. I read the lay publication and then Googled the man written about.

Dr. John Ioannidis is a Professor of Medicine at a Greek university, Adjunct Professor at Tufts (where he did his fellowship after graduating from Harvard) and Director of the Preventive Medicine Research Center at Stanford.

Nearly ten years ago he began a project in Greek hospitals that eventually led him to state as much as 90% of the research articles published in medical journals have one or more critical flaws. This isn't limited to medicine, of course. Similar work, termed meat-resaerch, has been done in a variety of scientific fields, with the same conclusions.

Yet a late 2007 blog post by a surgeon/scientist comments 1). to paraphrase Churchill's famous bon mote on democracy, medicine's use of randomized clinical trials and peer-review is the worst way to find the best new treatments, except for all other ways. Whether "evidence-based" reviews have improved the system remains to be seen.

Statistical analysis, as done in a commentary on Ioannnidis's work, can explain why even a quarter of the very best studies can yield incorrect results.

Yet medicine moves on, discarding treatments found to be ineffective or harmful.

In the meantime, I'll not try the latest and "best"..at least not most of the time.

Posted in Food Additives, Healthy eating, medically-oriented background info, supplements | No Comments »

More on salt; is it addictive?

Friday, December 31st, 2010

Salt for your addiction

Finished with shoveling snow for the second time in twenty-four hours, I sat down to eat hot oatmeal with pumpkin, a treat Lynnette dreamed up recently. In her mail stack I noted a copy of Prevention, a magazine I seldom read, but this particular issue had a story with an intriguing title "The Food Addiction That's Making you Fat,"

After reading the article, which I regraded as strong on suggestions, but light on references, I went back to the medical literature trying to discover if the basic premise, that salt can cause a spike in the level of dopamine, a chemical that stimulates our brain's "pleasure center" made medical sense. It took a while, but I found a 2008 article on PubMed Central (part of the National Library of Medicine's website that offer access to abstracts and full-text articles), and discovered the background data for the statement.

In 2008, in the journal Physiology and Behavior, a University of Iowa group published an article titled "Salt Craving: The Psychobiology of pathogenic sodium intake." I won't bore you with the details, but the 46-page article was well=written and the data seemed sound.

The abstract mentioned that salt is essential to our physiological functions and generally is regarded as "highly palatable." Other sources say it brings out flavor in many foods and a humorous Time Magazine article on that subject that I found  (Josh Ozersky May 17, 2010) said a New York legislator had recently proposed banning all salt use in restaurant kitchens, making the author think of fleeing to Canada. He called salt "cocaine for the palate."

That made me delve into the body of the much longer article. The data and studies quoted did point to the dopaminergic mechanism being involved in salt depletion experiments. But that's salt depletion and our typical diet is a long ways from leading to that state.

I think the bottom line is salt enhances taste and we get conditioned to expect it as a learned behavior. Newborns either dislike salt or don't care; we're two or three before the baby-food industry or our parents get us hooked on salt.

But hooked most of us are; that's the bad news. The good news is that addiction can be broken, starting with removing salt shakers form your dining area and coking without salt. We now use many other spices, not spice mixes which may have salt as a major ingredient...and get by just fine.

The bottom line is that many things can be regarded as addictive: drugs of course, but also fats, chocolate, carbs, sex and voluntary exercise. And with that note, I think it's time to go to the gym. Now there's an addiction I enjoy.

Posted in Food Additives, Food-related disease, medically-oriented background info, Unhealthy eating | 2 Comments »

Maybe not all trans fats are bad for you

Monday, December 27th, 2010

We're back at the trans fat farm

I got my copy of the Annals of Internal Medicine today and, for once, read at least the summary of almost all the articles. One in particular caught my eye. It's a report of a prospective study that was multi-institutional (Harvard, the NIH, University of New Mexico and University of Washington with associated branches for two of the schools), fairly large (3,736 adults), multi-racial and lengthy (1992-2006). The study group was limited to adults over 65 who were living in the community, not in institutions. It was termed a "cohort study" and one definition of that is "A study in which a particular outcome, such as death from a heart attack, is compared in groups of people who are alike in most ways but differ by a certain characteristic, such as smoking."

In other words it's not a prospective controlled study, which I view as a higher level of medical research; in those you decide in advance what the object of the study is and select groups again in advance who will differ in some important aspect (e.g., they will or will not receive a particular medicine that's being studied or they'll be put on differing diets with one group getting whole milk and the other low-fat or non-fat milk). That may seem a subtle distinction, but it's an important one to me.

In any case the outcome was fascinating, though I'd term it preliminary.

Remember I mentioned trans fats (or more precisely trans fatty acids) as being bad guys. Well here's a case where one particular trans fat may be a good guy.

Most trans fats in the diet of Americans are/were artificially produced (I say were because a number of places (NYC and California) have almost totally banned them (less then 0.5% is allowed in the CA law). The FDA required strict labeling of these in 2006.

But small amounts are found in milk and  red meat. This study appears to demonstrate that a  particular trans fat called trans-palmitoleate, found in whole milk is associated with a lower risk for developing diabetes in adults. The effect wasn't found with red meat consumption or low-fat milk consumption.

Now that's very interesting, but it doesn't prove this particular fatty acid itself is healthful, only that, in this admittedly large and well-conducted study, that it's "associated with" several good metabolic effects, i.e., less diabetes and less obesity. The fatty acid could be a marker for consumption of something else that causes the effect.

More studies need to follow this one, of course, but the authors suggest that if those were to show the same effect, a case might be made for enriching/supplementing milk with this fatty acid. They also mention that, until this issue is resolved, the current push toward drinking only low-fat or even no-fat dairy products may be viewed differently.

No pun intended, but I need to digest this information a little before making a choice for myself.

Posted in Food Additives, Healthy eating, medically-oriented background info | 2 Comments »

Fats and fatty acids and our health: chemistry and politics

Thursday, December 23rd, 2010

Butter on a dish

I wrote about omega-3 fatty acids the last time, but, until I read Professor Robert L. Wolke's wonderful book, What Einstein Told His Cook, I didn't understand the name or remember much of the chemistry behind the fatty acids or fats themselves for that matter.

So let's start with a little chemistry, thanks to Wolke who is an emeritus  professor of that discipline and wrote a Food 101 column for the Washington Post for a number of years.

Fats, also called triglycerides, are chemical substances whose molecules are made up of three fatty acid, long chains of carbon atoms hooked onto a connector called glycerol. The carbon atoms themselves usually have two hydrogen atoms and if every carbon in the fatty acid chain has both its soul-mate hydrogens then we call it a saturated fatty acid.

When one carbon hydrogen is lacking its pair of hydrogens, the fatty acid is termed monounsaturated; if two (or three or more) carbons find themselves without their hydrogens, the fatty acid is polyunsaturated.

And then there's olive oil

The last carbon on a fatty acid's chain is termed the omega carbon from the final letter in the Greek alphabet. Omega-3 fatty acids, the good kind I've mentioned before, are missing hydrogens three carbons from the end of their chain.

So Omega-6 fatty acids, the much less healthful kind, lack hydrogens six places away from the omega end of the carbon line. And so on for Omega-9 fatty acids.

And while we're at it, if we're talking about a mostly saturated fat, it's likely to be a solid and from  an animal source (or a chemistry lab). Those that are mostly unsaturated are usually from vegetable sources and are much more commonly liquids.

Two more chemistry concepts for today, then I'll quit. If you look at the composition of a particular vegetable oil, part may be saturated, part monounsaturated and part polyunsaturated. The proportions count in deciding if the veggie oil is good for you or not, as saturated fats aren't healthy.

When food manufacturers want to stack the deck and sell you solids, not liquids (think margarine versus canola oil), they can add hydrogens in a technical process. On the other hand, partially unsaturated fats are easier to spread than totally solid ones.

That process, hydrogenation, can produce molecules rarely found in nature and one of the consequences of doing so led to trans fats, where the hydrogens added end up on opposite sides of a carbon. Those trans fats turned out to be nasty beasts (this was suggested in the medical literature as early as 1988), causing heart disease, with one estimate of 20,000 additional deaths per year in the United States. That number was published in  The American Journal of Public Health in 1995.

Thirteen years later, in January 2008, the state of California passed a law to minimize restaurants use of trans fats to less than half a gram per serving and in 2010 started to enforce that law. Apparently the state didn't think the restaurants would be able to comply with the new rules immediately and gave them two years to make changes. During all that time they could serve more than the limit of trans fats. Bakeries will have to comply with a similar law beginning on January 1, 2011.

I'll come back to the various kinds of fatty acids next time as there's more to add.

In the meantime, especially over the holidays, be aware of what you choose to eat.

Have a Merry (and healthy) Christmas.

Posted in Food producers and less-healthy foods, Governmental Efforts, medically-oriented background info, Unhealthy eating | No Comments »

Omega-3s to the rescue or not?

Monday, December 20th, 2010

A while back (actually in March 2010) I accompanied my wife on a trip to Phoenix where she was going to attend an Integrative Mental Health Conference with Dr Andrew Weil as the co-director. One of the sessions she attended was on new methods for treating depression.

Among the alternative medicine approaches to this major issue, said to be the world's fourth leading cause of morbidity and death, is the use of Omega-3 supplements. The notes from the conference intrigued me, especially since we were already taking fish oil.

fish in the raw

So we've both dug into the literature and talked to others about fish oil and omega 3s. I just watched a video on the National Library of Medicine's MedlinePlus site and printed off articles from that website, Science Daily and the University of Maryland Medical Center and read portions of a book, The Omega-3 Connection published in 2001 by a Harvard researcher.

So here's my take on Omega 3s.

They are helpful in lowering triglyceride levels, likely effective for preventing heart attacks and possibly are effective for a host of other conditions, including depression.

You can get them from oily fish, but eating large amounts of fish may expose you to mercury, dioxin and PCBs; the NIH feels it's well worth the risk to eat fish, at least moderately. If you do eat fish several times a week, bake or broil them, don't fry them or eat so-called fish sandwiches.

Fish oil supplements appear to help a number of conditions, although the evidence seems mixed. I think the real benefit likely comes from taking a moderate dose of fish oil, using a good brand and keeping the bottle in the dark and probably in the freezer.

fish-oil capsules

The use of high-dose fish oil should be restricted to people who are under the care of an experienced physician. We take two capsules a day and some of the research results I read about would require 12 or more capsules.

High doses of fish oil can reduce your ability for blood clotting and therefore increase the risk of strokes and other bleeding problems. I'd avoid it if I were on blood-thinners (e.g., Coumadin) or high-dose aspirin.

When it comes to depression (and I'm talking about so-called unipolar depression, not bipolar (severe mood swings, what used to be called manic-depressive disorder), a number of studies seem to show the EPA fatty acid in fish oil works, not the DHA.

If you're on an anti-depressive medication, taking a small amount of fish oil may help potentiate the drug's effect. Again, using large amounts of fish oil without any medication could be effective, but must be restricted to Rxs from an experienced physician.

And, fish oil may also potentiate the efects of anti-hypertensive meds. So if you're on one and start taking fish oil capsules, have your blood pressure checked several times.

But, having read as much as I have on fish oil, I'm certainly going to keep taking it. When taken in low doses, the MedlinePlus website says "it's likely safe for most people." And my bet is it can help a lot of us.

Posted in medically-oriented background info, supplements | No Comments »

Guidelines for diagnosing food allergies in flux

Wednesday, December 15th, 2010

I've been tracking down some changes in the diagnosis of food allergies, especially in kids. I started with a Wall Street Journal article, dated Tuesday, December 7, 2010 and titled "New Rules for Food Allergies." That mentioned the National Institute of Allergy and Infectious Diseases, a segment of the NIH under the US Department of Health and Human Services, had recently convened an expert panel on the subject.

The resultant guidelines were published in the "Journal of Allergy and Clinical Immunology." I found a review in WebMD (webmd.com) and then the lengthy report itself online at the NIAID website. I realized it was so voluminous there was a separate 29-page summary for clinicians and a much shorter set of guidelines for patients with a more thorough patient guideline to be published in 2011.

An Epi-Pen for severe allergic reactions

So what's the short version? Well to start with about 5% of kids and 4% of adults have food allergies. If they eat specific foods they may have reactions varying from mild to life-threatening.

The most freguent food allergies are to eggs, milk, peanuts and tree nuts, soy (that surprised me), wheat and some shellfish. Kids often outgrown an allergy to milk, eggs, soy and wheat, but not those to peanuts and tree nuts.

There are no cures to these allergies and having a mild reaction to a food once doesn't mean you won't have a severe reaction on another exposure.

Allergies often are seen in people who have some other diseases, asthma for one example and eczema (a skin disease) for another. Those plus a family history of food allergy may alert you and should alert your physician to your having a greater risk of food allergies.

Neither of the usual office tests used to diagnose food allergies, is definitive. Those include a blood test looking for antibodies to specific food and skin-prick test where a tiny amount of a suspected allergen is paced on a forearm then pricked to see if a wheal result.

The only test that proves you have a food allergy is a food challenge. That must be done, for safety reasons, under the careful direction of an experienced healthcare professional.

Yet all is not as dire as the above sounds. One study published in the Journal of Pediatrics this fall looked carefully at the medical records and testing of 125 children who had been sent to the National Jewish Hospital in Denver for evaluation of eczema and food allergies.

After careful food challenge tests were evaluated, over 90% could go back to eating foods they had been avoiding.

A few other tidbits caught my eye: peanut allergies are especially severe and, fortunately, I'm seeing more and more labels that specify this product is (or is not) produced in a peanut-free environment. Wheat protein allergies are not synonymous with celiac disease, so those having such allergies may not react to gluten in oats, rye and barley. And fish allergies, which tend to start after childhood, can be another very severe problem.

I give my wife her allergy shots at home, so I keep Benadryl and an Epi-Pen handy. Food allergies are nothing to sneeze at (no pun intended), so if there is a family history of them or you or your child have eczema or asthma, make sure you get a thorough evaluation by a qualified physician.

Posted in Governmental Efforts, medically-oriented background info, our kids and their weight issues, Unhealthy eating | 1 Comment »

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