Baked Tolerance in Cow's Milk Allergy: Quite Frequent, Hard to Predict!

INTRODUCTION: Cow's milk protein allergy (CMA) is the most common type of food allergy in childhood and exclusion diet is a challenge for patients. OBJECTIVE: The study aim was to investigate the frequency of tolerance to baked foods containing milk and evaluate immediate skin prick test (SPT) and specific IgEs for different cow's milk (CM) protein types as predictors of tolerance to baked foods containing milk for CMA patients. METHODS: A cross-sectional study was performed. Fifty-four CMA patients were enrolled and oral food challenge (OFC) was performed with baked product, 6 different milk SPTs and specific IgEs to CM, casein, α-lactalbumin, and ß-lactoglobulin. RESULTS: Thirty-nine (72.2%) patients tolerated OFC with baked milk cupcake. CM-specific IgE and casein SPT showed statistical difference between positive and negative OFC groups. Probability curves for baked milk tolerance were created for specific CM IgE (Z = 2.542, p < 0.0110) and casein SPT (Z = 2.290, p < 0.0220) using logistic regression. CONCLUSIONS: The high percentage of patients able to tolerate baked goods enables an improvement in intake possibilities and quality of life of CMA patients and families. Specific CM IgE and casein SPT demonstrated to be useful predictors in relation to baked milk tolerance.

Baked egg tolerance: is it possible to predict?

OBJECTIVE: To assess the frequency of baked egg tolerance in IgE-mediated egg allergy patients through the oral food challenge and to assess the tolerance predictability of different skin prick tests, as well as specific serum IgE measurement to egg proteins. METHODS: In this cross-sectional study, 42 patients with a diagnosis of egg allergy were submitted to different skin prick tests with egg (in natura, boiled, muffin, ovalbumin, and ovomucoid), and specific IgE to egg white, ovalbumin, and ovomucoid; as well as to the oral food challenge with food containing egg, extensively baked in a wheat matrix. RESULTS: Of the total, 66.6% of patients tolerated the ingestion of egg-containing foods in the oral food challenge. A comparative analysis with positive and negative oral food challenge found no significant differences regarding age, gender, other food allergies, or even specific skin prick tests and IgE values between the groups. CONCLUSIONS: The study demonstrated an elevated frequency of baked egg food-tolerant individuals among egg allergy patients. None of the tested markers, skin prick tests, or specific IgE, were shown to be good predictors for identifying baked egg-tolerant patients. The oral food challenge with egg baked in a matrix is central to demonstrate tolerance and the early introduction of baked foods, improving patients' and families' quality of life and nutrient intake.

Aditivos empregados em panificadoras de Uberlândia, MG / Additives used in bakeries Uberlândia, MG

Tem sido crescente a aplicação de novos aditivos e soluções inovadoras na área de panificação a fim de buscar qualidade, preço e lucratividade na comercialização dos pães. Este trabalho teve por objetivo divulgar os efeitos dos principais aditivos nas características físicas e reológicas da farinha de trigo e na qualidade do pão francês, buscando traçar o perfil das panificadoras de Uberlândia e o conhecimento das funções desses aditivos. Notou-se que 90 por cento do produto mais consumido nas padarias continua sendo o pão francês e, em relação aos aditivos utilizados no pão, 80 por cento dos entrevistados não tinham conhecimento de enzimas, 75 por cento de oxidantes e 30 por cento de bromato de potássio, que é um produto cancerígeno e proibido no Brasil. Esses resultados tornam evidentes as necessidades de treinamento dos proprietários e padeiros, para que possam oferecer à sociedade alimentos seguros e de qualidade, dentro dos padrões propostos pela ANVISA.

High-fat diet: a trigger of non-alcoholic steatohepatitis? Preliminary findings in obese subjects.

OBJECTIVE: We correlated dietary profile and markers of visceral and somatic obesities in non-alcoholic fatty liver disease. METHODS: Patients with histologically proven fatty infiltration of the liver (n = 25, 52 +/- 11 y of age, 64% women) underwent abdominal computed tomography, bioelectrical impedance, and anthropometric measurements. Insulin resistance was evaluated (homeostasis model assessment) and dietary intake of macronutrients was estimated by 24-h recall. Main outcome measurements were correlation of carbohydrate and fat ingestion with liver histology. RESULTS: Metabolic syndrome was present in 72% of the population, and increased waist circumference and low high-density lipoprotein cholesterol occurred in 66%. Total body fat (bioimpedance) and dietary intake of lipids were higher in patients with non-alcoholic steatohepatitis (P < 0.05), but not in diabetic subjects who exhibited more steatosis than non-alcoholic steatohepatitis. Waist circumference exhibited a good correlation with homeostasis model assessment, total energy intake, and ingestion of specific fatty acids. Body mass index correlated well with somatic and visceral adiposities. CONCLUSION: Energy intake and visceral adiposity were predisposing factors for fatty liver disease. Lipid input correlated with non-alcoholic steatohepatitis in the entire group and after stratification for diabetes. These findings suggest that lipid intake may play a greater role in non-alcoholic steatohepatitis than hitherto suspected.