Friday, August 16th, 2013
For parents, having a child with one or more food allergies can, at the very least, be worrisome. And if those allergies are life threatening, the fear of your child eating at school, at a restaurant, or even anywhere outside of your home can be downright frightening.
Although there’s no one cause of food allergies, they’re certainly on the rise among children in the United States. According to the Centers for Disease Control and Prevention (CDC), the prevalence of food allergies among 0 to 17-year-old children in 2009 to 2001 was 5.1%, up from 3.4% in 1997 and 1999. Despite this uptick in food allergy incidence, emerging evidence suggests that some dietary steps may help prevent food allergies and the toll they take on children and their families.
In a new study published in Journal of Allergy and Clinical Immunology, researchers from the University of Southampton in the United Kingdom looked at prospective food diary data kept by mothers of infants to determine whether the infant diet during the first year of life was linked with the development of food allergy. Lead researcher Kate Grimshaw, PhD, RD and her colleagues found that a dietary pattern in later infancy that was rich in fruits, vegetables, and home-prepared foods was associated with less food allergy by the age of two years. One reason cited by the researchers for their results is the presence of vitamin C, beta-carotenes, folate, and oligosaccharides in fruits and vegetables. Such nutrients, they note, may have immune-boosting and anti-inflammatory benefits. The apparently protective dietary pattern was also associated with eating more home-prepared foods and fewer processed convenience foods, something the researchers suggest may also protect against the development of food allergies.
“Even though studies like this one are compelling, we still don’t know a surefire way to prevent food allergies,” says Kristi Winkels, a registered dietitian nutritionist who specializes in food allergies and intolerances. She adds, “My first thought when I read about this study was that it isn’t consistent with my own experience as a mom. When my first son was a baby, I breastfed him exclusively until he was four months old. I then introduced solids starting with rice cereal and followed that with variety of fruits and vegetables that I prepared myself. Despite that, he was diagnosed with multiple severe food allergies (egg, dairy, wheat and peanut) when he was nine months old. With that said, I think everyone can benefit from eating fewer processed foods whether they are trying to prevent food allergies or not.”
Although Winkels acknowledges that there’s a lot we still need to learn about the development and possible prevention of food allergies in children, she advises all parents to offer their infants a variety of fruits, vegetables and minimally processed grains and proteins starting at four to six months of age. She recommends introducing each new food two to three days apart and to watch for any symptoms of an allergic reaction (hives, lips swelling, irritability, etc.). She adds, “It’s crucial for parents who have allergies themselves to be even more aware of the signs and symptoms of an allergic reaction since their children are at higher risk of developing food allergies.”
The American Academy of Allergy, Asthma & Immunology (AAAAI) recommends exclusive breast-feeding for at least four to six months of age to reduce the incidence of cow’s milk allergy in the first two years of life. For those who cannot breast-feed, the AAAAI recommends hydrolyzed formula which appears to offer advantages to prevent cow’s milk allergy. Also, when complementary foods are introduced and tolerated between four and six months of age, parents are urged to introduce highly allergenic foods including cow’s milk protein (except for whole cow’s milk), egg, soy, wheat, peanut, tree nuts, fish and shellfish at home (rather than at a day care or at a restaurant). According to the AAAAI, there’s evidence that introducing such foods early may actually reduce food allergy risk among children.
To learn more about food allergies, go to the Food Allergy Research and Education website and that of the Allergy Kids Foundation.
Image of baby eating red strawberry via Shutterstock.
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Thursday, July 25th, 2013
A recent report by the CDC shows that food allergies in children are on the rise. Based on national survey data, the report reveals that among children between the ages of 0 and 17, the prevalence of food allergies rose from 3.4% in 1997 to 1999 to 5.1% in 2009 to 2011. According to the nonprofit Food Allergy Research and Education (FARE), food allergies currently affect up to 15 million people in the United States, including one in 13 children.
If you have a child with a food allergy, it’s likely an enormous challenge to keep him or her safe, especially in the current landscape of full-time access to processed and packaged foods. Helping your child eat out safely when at school or at a restaurant is also something that requires considerable thought and planning. But it can also be a challenge to raise a food-allergic child when other children or family members don’t have food allergies.
To get some perspective on this, I turned to Susan Weissman, author of Feeding Eden: The Trials and Triumphs of a Food Allergy Family. In her book, Weissman poignantly chronicles how she discovered her son’s multiple anaphylactic food allergies. Eden is ten years old and has life threatening allergies to dairy, soy, peanuts, tree nuts, sesame seeds, egg whites, and a variety of fish, shellfish, and legumes. He also has oral allergies to some fruits and spices. Eden’s older sister, Dayna, does not have any food allergies. While Feeding Eden narrates many universal challenges of parenting, a specific takeaway for readers is how food restrictions of any kind can transform families. Weissman points out that sometimes, it can even make families stronger.
Here are some highlights of my conversation with Weissman:
EZ: How does your family accommodate the needs of your food-allergic child?
SW: When feeding my family, I balance three concerns—safety, nutrition, and the emotional dynamic in the family. Obviously, when you deal with anaphylaxis—a severe reaction to an allergen that can be life-threatening—making sure your child stays safe is paramount. But keeping a peanut-free household can be rather simple. Realistically, I know I cannot “ban” all of Eden’s allergenic foods while providing adequate nutritional support for my daughter. For example, she is a growing teenager and needs accessible forms of calcium. So I do give her dairy products. But we also follow certain rules and take a few precautions as a family. For example, I use separate spoon rests while cooking to avoid cross-contamination. We run all our plates through a high-powered dishwasher. We also make sure to thoroughly wash our hands before and after eating.
EZ: Can you elaborate about your concern about the “emotional dynamic” in your family.
SW: If you come over to my home for dinner, you might often see different foods on our plates. Our intimacy is not about sharing specific foods. Instead, our family solidarity comes from focusing on our shared experiences, routines, and conversations.
EZ: Of course it’s a necessity to change family habits to accommodate one child or family member’s needs, but does it ever feel like a burden?
SW: In short, yes. I cook from scratch more often than many parents. I can’t take shortcuts like popping frozen chicken nuggets in the oven when I feed Eden. It’s especially a challenge when we’re away from home and need to eat in restaurants while traveling, or when we eat at other people’s homes. Besides finding or preparing safe foods, another challenge is helping Eden meet his nutrient needs within his restrictions. I really need to think about what he is not getting enough of, and how I can help him compensate through supplementation or balanced portioning. For example, in addition to the calcium deficiencies in dairy- and soy-free diets, nut- and fish-free diets can lack in essential fatty acids and vitamin E. I’m always on the lookout for ripe avocados to make up for that. On the flip side, my daughter has been under-exposed to fish because the smell of those cooking fumes are uncomfortable for Eden to breathe in and can trigger an asthma attack. Possibly, as a result, my daughter doesn’t care for fish at all.
EZ: I’m sure it can feel unfair at times to you and your daughter who don’t have food allergies.
SW: It is. I might be able to bake a “safe” cake that looks and tastes close to a dessert my daughter might eat, but Eden also sees that his sister has far more choices at every given meal and snack. His sister’s diet is less repetitive and we can find her favorites foods easily both inside and outside our home.
EZ: How does the your daughter cope with Eden’s allergies?
SW: Besides adhering to our safety measures, my daughter is careful of our emotional dynamic too. She is sensitive about Eden’s feelings and tries not to make a big show of enjoying special foods that she knows he would love to taste. And now that she is a teenager living in New York City, I encourage her to try new and tantalizing foods with her friends outside of our home.
EZ: Can you offer any perspective or solutions for others in a similar boat?
SW: Parents who have kids with food allergies should consider thinking outside the box when it comes to nutrition and family traditions. When my husband and I were children growing up in Manhattan, we often ate Chinese food on Sunday nights with our families. Eden can’t eat Chinese food (sesame, peanuts, soy ingredients.) But he has developed a genuine interest in cooking for himself and using safe substitutes. So we bought Eden a wok and he has been re-creating stir fry dishes based on recipes he reads, Food Network demos, and his own imagination! Lately, as a busy family, since there is more time to shop and chop on weekends, come Sunday nights, Eden might make us all Asian inspired food that even his sister has preferred to the real deal.
Full disclosure: I received a complimentary copy of Feeding Eden from the publisher.
For more information about Weissman and her book, Feeding Eden, click here.
For more information about food allergies, check out the American Academy of Allergy Asthma and Immunology.
Image of no peanuts allowed via Shutterstock.
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