Effects of food allergy on the dietary habits and intake of primary schools' Cypriot children.

SUMMARY: Aim. To determine whether food allergy affects overall dietary intake and food choices in Cypriot primary school children. Methods. As part of the first epidemiological study in Cyprus on food allergy in primary school children, two 24-hour recalls (one from a week and one from a weekend day) of twenty-eight food allergic children (21 girls) and thirty healthy children (20 girls) aged 6-11 years old, were analysed and compared regarding their macro- and micronutrient content, food choices and meal distribution. Results. Significant differences between the two subgroups of children were estimated regarding the total energy intake and macronutrients, where food allergic children were found to consume in lower quantities, as well as for calcium, niacin, fiber and vitamin E. Food allergic children were also found to avoid combining foods from the various food groups in their meals, and to prefer specific food products from each category, whereas they consumed higher amounts of sugar and fructose. Conclusion. Food allergy in Cypriot food allergic children impacts on both the quality and quantity of food choices, probably due to lack of nutritional education regarding proper elimination diet and alternative nutrient sources.

Milk hypersensitivities: where is the grey line regarding their dietary management?

The proportion of people suffering or reporting to have a hypersensitivity caused by cow's milk consumption is increasing, and even health professionals often face difficulties into elaborating properly with a milk reaction due to misdiagnosis. The scope of this review is to present literature data that lead into putting the border line between cow's milk allergy and cow's milk intolerance, mainly focusing on how the different pathophysiology leads to their different dietary diagnosis and management.

Further studies on the biological activity of hazelnut allergens.

BACKGROUND: Sensitization to hazelnut allergens vary depending on the geographic origin and age of the patients. The objective of this study was to further investigate the allergenic activity of hazelnut allergens using sera from patients recruited in various European regions and presenting different sensitization patterns to hazelnut proteins. METHODS: Natural Cor a 11 and Cor a 9 were purified from hazelnut whereas Cor a 1 and Cor a 8 were produced as recombinant proteins (rCor a 1.04 and rCor a 8). Sera from hazelnut allergic patients were collected in France (n = 5), Switzerland (n = 2), Greece (n = 11) and Spain (n = 3), within the Europrevall project. Total and allergen-specific IgE were quantified by enzyme allergosorbent test and IgE immunoblot were performed using pooled sera from birch-pollen endemic region or from Greece. Histamine Release (HR) assays were performed with stripped basophils passively sensitized with individual sera and challenged by a hazelnut extract or the different hazelnut allergens. RESULTS: As previously described, hazelnut allergic patients from Mediterranean countries are mainly sensitized to the nsLTP Cor a 8 whereas patients from France and Switzerland are sensitized to pollen-related allergens. Interestingly, an intermediate profile was evidenced in patients from Madrid. Hazelnut 7S globulin (Cor a 11) and 11S globulin (Cor a 9) were found to be minor allergens, recognized only by patients from Mediterranean countries. The biologic activity of the 4 tested allergens, analysed by HR assay, further confirmed the sensitization patterns, but also demonstrated the very high elicitation potency of Cor a 8. CONCLUSIONS: This work, extending previously published researches, represents a step towards the better understanding of the complexity of hazelnut allergy and provides new data on the biological activity of hazelnut allergens and extracts.

Use of a common food frequency questionnaire (FFQ) to assess dietary patterns and their relation to allergy and asthma in Europe: pilot study of the GA2LEN FFQ.

BACKGROUND/OBJECTIVES: Comparable international data on food and nutrient intake is often hindered by the lack of a common instrument to assess food intake. The objective of this study was within the Global Allergy and Asthma European Network of Excellence (GA(2)LEN), we developed and piloted a food frequency questionnaire (FFQ) to assess its validity in Europe. SUBJECTS/METHODS: Five countries participating in GA(2)LEN took part in the pilot study. A total of 200 adults aged 31-75 years were invited to complete a FFQ in two occasions and to give a blood sample. The intra-class correlation coefficient (ICC) was used to assess repeatability of the FFQ. Plasma phospholipid fatty acids (FAs) were analysed by gas chromatography. Pearson correlation was used to analyse the correlation between estimated dietary FA intake and plasma phospholipid FA levels. RESULTS: A total of 177 participants (89%) had complete data on FFQ(1) and plasma phospholipid FAs. In all, 152 participants (76%) completed both FFQs. ICCs between macronutrients ranged from 0.70 (saturated FAs) to 0.78 (proteins) and between 0.70 (retinol) and 0.81 (vitamin D) for micronutrients. Dietary n-3 FAs showed a good correlation with total plasma phospholipid n-3 FAs and with docosahexaenoic acid in the whole sample (0.40) and in individual countries. Poor correlations were observed for other FAs. CONCLUSIONS: The GA(2)LEN FFQ is an appropriate tool to estimate dietary intake for a range of nutrients across Europe regardless of cultural and linguistic differences. The FFQ seems to be useful to estimate the intake of n-3 FAs but not other FAs.

Evaluation and standardisation of different matrices used for double-blind placebo-controlled food challenges to fish.

BACKGROUND: Fish allergens represent one of the most common causes of adverse reactions to food worldwide. Double-blind placebo-controlled food challenges (DBPCFC) are the gold standard for food allergy diagnosis. However, no standardised recipes are available for common food allergens such as fish, and a well trained dietitian is essential for creating and standardising them. The present study aimed to create and standardise recipes for use in DBPCFCs to fish. METHODS: Three recipes were prepared. Employing a standardised procedure, a total of 35 panelists evaluated the different matrices using an evaluation form. A paired comparison test was used to estimate total evaluation's outcome. Fish allergic patients were challenged with different fish species blinded with the selected matrix and evaluated the recipe using the same form. RESULTS: From a base recipe and step-by-step modifications, a low fat recipe was selected among other recipes tested, which proved to be appropriate for fish blinding, in terms of taste, odour, appearance and blinding. Patients challenged with the final matrix found it acceptable, no matter which fish type was used. CONCLUSIONS: In this pilot study, a recipe with satisfactory organoleptic characteristics was developed and validated for DBPCFC to fish.

Infant feeding and allergy prevention: a review of current knowledge and recommendations. A EuroPrevall state of the art paper.

The relationship between infant feeding patterns and the later development of food allergies has been the focus of much debate and research over the last decade. National recommendations have been made by many countries on how to feed infants to reduce the risk of food allergy but due to the lack of firm evidence the recommendations differ widely. This review has been developed as part of EuroPrevall, a European multicentre research project funded by the European Union, to document the differing feeding recommendations made across Europe, to investigate the current evidence base for any allergy prevention feeding recommendations and to identify areas where further research is needed. This review will also provide information which, when combined with the infant feeding data collected as part of EuroPrevall, will give an indication of compliance to national feeding guidelines which can be utilised to assess the effectiveness of current dissemination and implementation strategies.

In vitro digestibility of beta-casein and beta-lactoglobulin under simulated human gastric and duodenal conditions: a multi-laboratory evaluation.

Initially the resistance to digestion of two cow's milk allergens, beta-casein, and beta-lactoglobulin (beta-Lg), was compared using a "high-protease assay" and a "low-protease assay" in a single laboratory. The low-protease assay represents an alternative standardised protocol mimicking conditions found in the gastrointestinal tract. For the high-protease assay, both proteins were incubated with either pepsin or pancreatin and digestion monitored by sodium dodecyl sulphate-polyacrylamide gel electrophoresis and reverse phase-high performance liquid chromatography. The low-protease assay involved gastroduodenal digestion in the presence or absence of phosphatidylcholine (PC). Both beta-casein and beta-Lg were susceptible to hydrolysis by pepsin and pancreatin in the high-protease assay. In contrast, the kinetics of beta-casein digestion in the low-protease assay were slower, beta-Lg being pepsin resistant. During duodenal digestion, beta-Lg was gradually degraded and addition of PC slowed digestion. Subsequently, the reproducibility of the low-protease assay was assessed in 12 independent laboratories by visual assessment of the gels and densitometric analysis: the inter- and intra-laboratory variability was affected by sampling and electrophoresis method employed. The low-protease assay was shown to be reproducible. Future studies will extend these findings using a broader panel of proteins.

Dietary and lifestyle factors in relation to plasma insulin-like growth factor I in a general population sample.

There is evidence that the insulin-like growth factor system (IGF), particularly IGF-I, is important in human carcinogenesis. We studied in a general, though not strictly random population sample of 620 adults, the relationship of IGF-I to demographic, lifestyle and dietary factors, the latter ascertained through an extensive validated questionnaire. Plasma IGF-I levels declined significantly with age and the decline was more evident among women than among men. Tobacco smoking, body mass index and regular physical activity were unrelated to this hormone and a positive association with height was not statistically significant. Neither protein nor carbohydrate intake was related to plasma IGF-I levels but there was inconsistent evidence that ethanol intake may be inversely associated with plasma IGF-I and saturated and polyunsaturated lipids may be positively associated with it. The findings are evaluated in conjunction with evidence indicating that the incidence of cancer is lower among women than among men, height is a risk factor for several forms of cancer, and saturated and polyunsaturated lipids have been more closely linked to human and animal carcinogenesis than monounsaturated lipids.