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Kumar S, Ahmad MF, Nath P, Roy R, Bhattacharjee R, Shama E, Gahatraj I, Sehrawat M, Dasriya V, Dhillon HS, Puniya M, Samtiya M, Dhewa T, Aluko RE, Khedkar GD, Raposo A, Puniya AK. Controlling Intestinal Infections and Digestive Disorders Using Probiotics. J Med Food 2023; 26:705-720. [PMID: 37646629 DOI: 10.1089/jmf.2023.0062] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/01/2023] Open
Abstract
After consumption, probiotics provide health benefits to the host. Probiotics and their metabolites have therapeutic and nutritional properties that help to alleviate gastrointestinal, neurological, and cardiovascular problems. Probiotics strengthen host immunity through various mechanisms, including improved gut barrier function, receptor site blocking, competitive exclusion of pathogens, and the production of bioactive molecules. Emerging evidence suggests that intestinal bowel diseases can be fatal, but regular probiotic consumption can alleviate disease symptoms. The use and detailed description of the health benefits of probiotics to consumers in terms of reducing intestinal infection, inflammation, and digestive disorders are discussed in this review. The well-designed and controlled studies that examined the use of probiotics to reduce life-threatening activities caused by intestinal bowel diseases are also covered. This review discussed the active principles and potency of probiotics as evidenced by the known effects on host health, in addition to providing information on the mechanism of action.
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Affiliation(s)
- Sanjeev Kumar
- Department of Life Science and Bioinformatics, Assam University, Silchar, India
| | - Md Faruque Ahmad
- Department of Clinical Nutrition, College of Applied Medical Sciences, Jazan University, Jazan, Saudi Arabia
| | - Priyakshi Nath
- Department of Life Science and Bioinformatics, Assam University, Silchar, India
| | - Rubina Roy
- Department of Life Science and Bioinformatics, Assam University, Silchar, India
| | - Rudrarup Bhattacharjee
- Adelaide Medical School, Faculty of Health and Medical Sciences, University of Adelaide, Adelaide, Australia
| | - Eman Shama
- Department of Clinical Nutrition, College of Applied Medical Sciences, Jazan University, Jazan, Saudi Arabia
| | - Indira Gahatraj
- Department of Life Science and Bioinformatics, Assam University, Silchar, India
| | | | - Vaishali Dasriya
- Dairy Microbiology Division, ICAR-National Dairy Research Institute, Karnal, India
| | | | - Monica Puniya
- Science and Standards Division, Food Safety and Standards Authority of India, New Delhi, India
| | - Mrinal Samtiya
- Department of Nutrition Biology, Central University of Haryana, Mahendergarh, India
| | - Tejpal Dhewa
- Department of Nutrition Biology, Central University of Haryana, Mahendergarh, India
| | - Rotimi E Aluko
- Department of Food and Human Nutritional Sciences, University of Manitoba, Winnipeg, Canada
| | - Gulab D Khedkar
- Paul Hebert Centre for DNA Barcoding and Biodiversity Studies, Dr. Babasaheb Ambedkar Marathwada University, Aurangabad, India
| | - António Raposo
- CBIOS (Research Center for Biosciences and Health Technologies), Universidade Lusófona de Humanidades e Tecnologias, Lisboa, Portugal
| | - Anil Kumar Puniya
- Dairy Microbiology Division, ICAR-National Dairy Research Institute, Karnal, India
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MacKenzie H, Grundy J, Glasbey G, Dean T, Venter C. Information and support from dietary consultation for mothers of children with food allergies. Ann Allergy Asthma Immunol 2014; 114:23-9. [PMID: 25454014 DOI: 10.1016/j.anai.2014.10.001] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2014] [Revised: 09/23/2014] [Accepted: 10/01/2014] [Indexed: 01/22/2023]
Abstract
BACKGROUND Professional dietetic input is essential to ensure that children with diagnosed food allergies have an individualized avoidance plan and nutritionally adequate diet. However, it is not clear what dietary information and support parents require. OBJECTIVE To explore what information and support parents of children with food allergies require from a dietary consultation. METHODS Focus groups were conducted with 17 mothers who attend an allergy center for dietary advice for their food allergic child. A number of issues around food allergy dietary advice needs were explored and analyzed using thematic analysis. RESULTS Six themes were identified. The mothers described how they sought to protect their child from harm, to maintain normality for their child, and to promote child independence. They described needing to become an expert in their child's food allergy and fight their corner when needed. The dietitian supported their needs by ensuring their child's diet was safe and nutritionally adequate and giving information and support to help them provide a normal life for their child. Dietitians also taught mothers about food allergy and provided advocacy and emotional support. CONCLUSION Mothers of children with food allergies want to understand how to provide a nutritionally adequate, allergen-safe diet while maintaining a normal life. Hence, mothers value a range of support from dietitians, including monitoring their child's health and providing information, practical advice and support, and emotional support.
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Affiliation(s)
- Heather MacKenzie
- Graduate School, University of Portsmouth, Portsmouth, United Kingdom
| | - Jane Grundy
- The David Hide Asthma and Allergy Research Centre, Isle of Wight, United Kingdom
| | - Gillian Glasbey
- The David Hide Asthma and Allergy Research Centre, Isle of Wight, United Kingdom
| | - Taraneh Dean
- The David Hide Asthma and Allergy Research Centre, Isle of Wight, United Kingdom; School of Health Sciences and Social Work, University of Portsmouth, United Kingdom
| | - Carina Venter
- The David Hide Asthma and Allergy Research Centre, Isle of Wight, United Kingdom; School of Health Sciences and Social Work, University of Portsmouth, United Kingdom.
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Vähämiko S, Isolauri E, Poussa T, Laitinen K. The impact of dietary counselling during pregnancy on vitamin intake and status of women and their children. Int J Food Sci Nutr 2013; 64:551-60. [PMID: 23373762 DOI: 10.3109/09637486.2013.766153] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
We aimed here to assess the impact of dietary counselling during pregnancy on dietary intake of vitamins and the vitamin status of women and their children. At the first trimester of pregnancy, 89 women from allergic families were randomized to a control group (n = 45) or to receive individual dietary counselling (n = 44). Women's vitamin intakes and serum concentrations were analyzed during and after pregnancy. Further, vitamin concentrations were measured from breast milk and infant serum at one month of age. The study is registered as clinical study (NCT00167000; section 3, http://www.clinicaltrials.gov ). Dietary counselling resulted in a higher intake of beta-carotene and vitamin E compared to controls. Further, in women lower serum beta-carotene and higher colostrum vitamin A concentrations were found in the intervention group compared to controls. Dietary counselling during pregnancy improves women's vitamin intakes but does not provide unambiguous effects on vitamin status of women or children.
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Affiliation(s)
- Sanna Vähämiko
- Functional Foods Forum, University of Turku, FI 20014, Turku, Finland.
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Groetch ME, Christie L, Vargas PA, Jones SM, Sicherer SH. Food allergy educational needs of pediatric dietitians: a survey by the Consortium of Food Allergy Research. JOURNAL OF NUTRITION EDUCATION AND BEHAVIOR 2010; 42:259-264. [PMID: 20579608 PMCID: PMC3799872 DOI: 10.1016/j.jneb.2009.06.003] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/11/2008] [Revised: 04/15/2009] [Accepted: 06/01/2009] [Indexed: 05/29/2023]
Abstract
OBJECTIVE To determine pediatric dietitians' self-reported proficiency, educational needs, and preferences regarding food allergy (FA) management. DESIGN AND SETTING An Internet-based, anonymous survey was distributed to the Pediatric Nutrition Practice Group (PNPG) of the American Dietetic Association. PARTICIPANTS Respondents (n = 311) were registered dietitians and members of the PNPG. ANALYSIS Results are presented using descriptive statistics. Chi-square tests were applied for subgroup analyses. Percentage responses were calculated per question based on the number of respondents answering the question. RESULTS On a 4-point scale of proficiency ("high," "moderate," "low," and "none"), respondents primarily rated themselves "moderate" for educating families, creating diets, and evaluating safe food items, and "low" for creating diagnostic food challenges. Education was primarily self-taught (75%). Preferences for future resources included handbooks (77%) and Web-based instructional programs (53%). On a 4-point scale ("very" to "not at all" needed) among practices that included >10% patients with FA, ratings of "very" were defined as need resources to update FA knowledge (87%) and need for a FA "tool kit" (84%). CONCLUSIONS AND IMPLICATIONS Pediatric dietitians manage FA for a substantial patient base although their self-reported proficiency is overall only moderate. Dietitians would prefer and likely benefit from Internet-accessible management handbooks and patient handouts.
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Affiliation(s)
- Marion E Groetch
- Jaffe Food Allergy Institute, Division of Allergy and Immunology, Department of Pediatrics, Mount Sinai School of Medicine, New York, NY 10029, USA.
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Vieira MC, Morais MB, Spolidoro JVN, Toporovski MS, Cardoso AL, Araujo GTB, Nudelman V, Fonseca MCM. A survey on clinical presentation and nutritional status of infants with suspected cow' milk allergy. BMC Pediatr 2010; 10:25. [PMID: 20416046 PMCID: PMC2873518 DOI: 10.1186/1471-2431-10-25] [Citation(s) in RCA: 76] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/06/2009] [Accepted: 04/23/2010] [Indexed: 12/03/2022] Open
Abstract
BACKGROUND Cow's milk is the most common food allergen in infants and the diagnosis of cow's milk allergy is difficult, even with the use of several diagnostic tests. Therefore, elimination diets and challenge tests are essential for the diagnosis and treatment of this disorder. The aim of this study is to report the clinical presentation and nutritional status of children evaluated by pediatric gastroenterologists for the assessment of symptoms suggestive of cow's milk allergy. METHODS An observational cross-sectional study was performed among 9,478 patients evaluated by 30 pediatric gastroenterologists for 40 days in 5 different geographical regions in Brazil. Clinical data were collected from patients with symptoms suggestive of cow's milk allergy. The nutritional status of infants (age < or = 24 months) seen for the first time was evaluated according to z-scores for weight-for-age, weight-for-height, and height-for-age. Epi-Info (CDC-NCHS, 2000) software was used to calculate z-scores. RESULTS The prevalence of suspected cow's milk allergy in the study population was 5.4% (513/9,478), and the incidence was 2.2% (211/9,478). Among 159 infants seen at first evaluation, 15.1% presented with a low weight-for-age z score (< -2.0 standard deviation - SD), 8.7% with a low weight-for-height z score (< -2.0 SD), and 23.9% with a low height-for-age z score (< -2.0 SD). CONCLUSION The high prevalence of nutritional deficits among infants with symptoms suggestive of cow's milk allergy indicates that effective elimination diets should be prescribed to control allergy symptoms and to prevent or treat malnutrition.
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Affiliation(s)
- Mário C Vieira
- Centre for Paediatric Gastroenterology, Hospital Pequeno Príncipe, R. Desembargador Motta, 1070, Curitiba-PR 80250-060, Brazil
| | - Mauro B Morais
- Department of Paediatrics, Universidade Federal de São Paulo, R. Botucatu, 598, São Paulo-SP 04023-062, Brazil
| | - José VN Spolidoro
- Department of Paediatrics - School of Medicine, Pontifícia Universidade Católica, Av. Ipiranga, 6690, Porto Alegre-RS 90610-000, Brazil
| | - Mauro S Toporovski
- Department of Paediatrics - School of Medicine, Santa Casa de São Paulo, R. Cesário Motta Jr., 112 São Paulo-SP 01221-020 Brazil
| | - Ary L Cardoso
- Department of Paediatrics, Instituto da Criança, Hospital das Clínicas, Faculdade de Medicina da Universidade de São Paulo, Av. Dr. Enéas Carvalho Aguiar, 647, São Paulo - SP 05403-000, Brazil
| | - Gabriela TB Araujo
- Health Economics, Axia.bio Consulting, R. Setembrino Woitechumas, 38/4, São Paulo-SP 04563-090, Brazil
| | - Victor Nudelman
- Department of Paediatrics, Hospital Albert Einstein, Av. Albert Eisntein, 627, São Paulo - SP 05651-901, Brazil
| | - Marcelo CM Fonseca
- Health Economics, Axia.bio Consulting, R. Setembrino Woitechumas, 38/4, São Paulo-SP 04563-090, Brazil
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Abstract
Food hypersensitivity (FHS) is the umbrella term used for food allergies that involve the immune system and food intolerances that do not involve the immune system. FHS has a huge impact on quality of life and any dietary advice given should aim to minimise this effect. Despite many advances made in diagnosing and managing patients with FHS, the cornerstone of management still remains avoidance of the relevant food. However, a commonly-presenting dilemma in clinical practice is deciding to what extent the food(s) should be avoided. The level of avoidance required is currently based on the type of FHS the patient has, characteristics of the particular food protein and the natural history of the particular FHS. In addition to management of other FHS, management of cow's milk allergy requires the healthcare professional to choose the appropriate formula. Information required by the patient also includes understanding food labels and issues surrounding cross-contamination. In order to ensure that the diet is nutritionally sound, advice should be given about suitable food choices and following a healthy balanced diet, whilst taking into account the dietary restrictions. Practical issues that need to be addressed include going on holiday, travelling and eating away from home. The dietitian plays a crucial role in this process. At present, there are no standardised documents or protocols for the management of FHS and practices differ within and between countries. If adrenaline auto-injectors are prescribed, correct administration should be demonstrated and reviewed on an ongoing basis.
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Cortez APB, Medeiros LCDS, Speridião PDGL, Mattar RHGM, Fagundes Neto U, Morais MBD. Conhecimento de pediatras e nutricionistas sobre o tratamento da alergia ao leite de vaca no lactente. REVISTA PAULISTA DE PEDIATRIA 2007. [DOI: 10.1590/s0103-05822007000200002] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
OBJETIVO: Avaliar o conhecimento de pediatras e nutricionistas sobre a dieta de exclusão do leite de vaca e seus derivados, com ênfase em questões relacionadas à nutrição da criança. MÉTODOS: Estudo transversal descritivo, do qual participaram pediatras (n=53) e nutricionistas (n=29), vinculados a hospitais públicos do Município de São Paulo, no ano de 2005. Os dados foram coletados por questionário auto-administrado. RESULTADOS: A idade dos profissionais variou de 21 a 50 anos. Quanto ao tempo de graduação, 41,2% eram formados a menos de cinco anos e 91,6% possuíam especialização, mestrado e/ou doutorado. A maioria (97,5%) afirmou avaliar a dieta de crianças submetidas à exclusão do leite de vaca, entretanto, somente 48% o faziam de forma mais detalhadas, incluindo o cálculo da ingestão alimentar. Apenas 38,7% comparam a ingestão alimentar da criança com algum padrão de recomendação. A recomendação diária da ingestão de cálcio para crianças com até 36 meses foi corretamente assinalada por 22% dos pediatras e 60,7% dos nutricionistas (p=0,001). Produtos não adequados como substitutos do leite de vaca seriam recomendados por 66% dos pediatras e 48,3% dos nutricionistas. Com relação à leitura de rótulos de produtos industrializados, 81,6% dos pediatras e 96,4% dos nutricionistas orientam os pais a ler todos os termos que indicam a presença das proteínas do leite de vaca. CONCLUSÕES: Os pediatras e nutricionista demonstraram erro conceitual no que se refere às principais recomendações terapêuticas na alergia às proteínas do leite de vaca.
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Mannion CA, Gray-Donald K, Johnson-Down L, Koski KG. Lactating Women Restricting Milk Are Low on Select Nutrients. J Am Coll Nutr 2007; 26:149-55. [PMID: 17536126 DOI: 10.1080/07315724.2007.10719596] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
OBJECTIVE Currently there are no recommendations for vitamin/mineral supplementation for lactating women but supplementation may be important, particularly for those women who choose to restrict milk intake during lactation. The objective of this study was to assess nutrient adequacy for lactating women and compare their dietary intake, including supplements, between those who restrict milk and those who do not. METHODS A cohort of 175 healthy exclusively breast-feeding women (19-45 yrs) recruited from prenatal classes were divided into milk restrictors (RS) defined as milk intake < or = 250 ml/day and non-restrictors (NRS) (>250 ml/day) and followed for six months postpartum. Participants provided repeated 24-hr dietary recalls, detailed use of vitamin/mineral supplements and reasons for restricting milk. STATISTICAL ANALYSES Observed intakes were adjusted to remove day-to-day variability. Nutrient intakes were estimated for macronutrients and vitamins C, D, thiamin, riboflavin, niacin, and minerals, calcium and zinc, with and without vitamin/mineral supplements. Chi-square was used to compare the number of RS and NRS with intakes less than the Estimated Average Requirement (EAR). RESULTS Milk restriction was practiced by 23% of the sample. Sixty per cent of RS reported protein intakes <EAR compared to 38% of NRS (chi(2) = 6.22, p < 0.05). Prior to supplementation, mean levels of calcium and vitamin D intakes for RS were below the adequate intake level (AI) and lower than NRS estimated intakes (p < 0.05). Following supplementation, mean levels of these nutrients reached AI for both groups. RS remained lower than NRS. RS had lower energy intakes than NRS (p < 0.05) but no difference in weight loss at 6 months was noted. A higher proportion of RS were below the EAR for thiamin, riboflavin and zinc. CONCLUSIONS Milk restriction compromised protein and nutrient intakes in lactating women who restricted milk to <250 mL. Vitamin/mineral supplements helped exclusively breastfeeding milk restrictors improve their vitamin D and calcium intakes. Milk restriction is not recommended during lactation and where unavoidable, nutrients provided by milk should be compensated for by other foods or supplements.
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Affiliation(s)
- Cynthia A Mannion
- School of Dietetics and Human Nutrition, McGill University, Montreal, Quebec, Canada.
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Piirainen T, Isolauri E, Lagström H, Laitinen K. Impact of dietary counselling on nutrient intake during pregnancy: a prospective cohort study. Br J Nutr 2007; 96:1095-104. [PMID: 17181885 DOI: 10.1017/bjn20061952] [Citation(s) in RCA: 89] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
The aim of this study was to assess the impact of dietary counselling combined with the provision of food products on food and nutrient intake in pregnant women. We carried out a prospective cohort study of healthy and atopic pregnant women (n 209), who were randomized into dietary intervention and control groups. The intervention group received dietary counselling and food products to modify the fat composition of their diet to meet current recommendations. Three-day food records were collected during each trimester of pregnancy. Women in the intervention group consumed more vegetables, fruits, soft margarines and vegetable oils and less butter than those in the control group during the course of pregnancy (P < 0·05). The main distinction between the groups in nutrient intake over the pregnancy was attributable to a higher energy intake (% energy) of PUFA by 0·5 %energy (95 % CI 0·1, 0·8) and to a lower intake of SFA by 0·8 % energy (95 % CI − 1·4, − 0·4) in the intervention group. Dietary intake of vitamin E was 1·4 mg (95 % CI 0·6, 2·2), folate 20·9 μg (95 % CI 0·8, 41·0) and ascorbic acid 19·8 mg (95 % CI 3·5, 36·0) higher in the intervention group compared to the controls, while no differences in other nutrients were detected. Dietary counselling combined with the provision of food products during pregnancy is of importance in modifying food and nutrient intake, with potential health benefits.
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Affiliation(s)
- T Piirainen
- Department of Paediatrics, University of Turku, Turku, Finland.
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Huurre A, Laitinen K, Hoppu U, Isolauri E. How practice meets guidelines: evaluation of nutrition counselling in Finnish well-women and well-baby clinics. Acta Paediatr 2006; 95:1353-9. [PMID: 17062460 DOI: 10.1080/08035250600660925] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
AIM To assess the current practices of nutrition counselling given by nurses in well-women (WW) and well-baby (WB) clinics in Finland. DESIGN A semi-structured questionnaire was distributed to nurses and their clients in clinics nationwide. MAIN OUTCOME MEASURES The source and the quality of nutrition counselling and specific conditions including allergic diseases and vitamin D supplementation. RESULTS The clinics constituted the most important source of information for the clients. Personal counselling was highly appreciated. However, 83% of pregnant women reported having received dietary counselling, which deviates from the figure reported by nurses (99%, p=0.0003). Counselling concerning allergies was targeted to reduce the risk of infant allergy by means of elimination diets. In contrast to the report of the nurses (60% in WW and 18% in WB clinics), only 16% (p<0.0001) of the pregnant and 7% (p=0.022) of the breastfeeding women reported that they had been advised to use vitamin D supplements during the winter season. CONCLUSION This study calls for co-operation between scientists, governmental policy makers and healthcare professionals to ensure a continuous chain of information, applicable to nutrition counselling, from scientific data to everyday practice.
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Affiliation(s)
- Anu Huurre
- Department of Paediatrics, Turku University Central Hospital and University of Turku, Turku, Finland.
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Mikkelsen A, Lissner L, Borres MP. Milk allergy school: nutritional therapy in group for parents of children with cow's milk allergy/intolerance in Primary Health Care. Pediatr Allergy Immunol 2005; 16:86-90. [PMID: 15693918 DOI: 10.1111/j.1399-3038.2005.00228.x] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
The objective of this study was to create a method for group nutritional therapy for parents of children with cow's milk allergy/intolerance in a paediatric primary care setting to increase accessibility to nutritional therapy. A second objective was to evaluate a milk allergy school. Follow-up time after the group session was 3 yr. All parents to newly diagnosed children (n=98) with cow's milk allergy/intolerance in the Primary Health Care system in the city of Goteborg during an 11-month period were invited. The majority of the families chose to participate (n=84, 86%). The mean age of the children was 9 months (3 months to 5 yr). The number of participants obtaining nutritional treatment within a month after diagnosis has significantly increased. Seventy-four families (88%) could be re-contacted 3 yr after participation for a second evaluation. Seventy-eight per cent of the children no longer had cow's milk allergy/intolerance. Most participants expressed satisfaction with the information obtained in the meeting. The milk allergy school does not replace but complements individual counselling. The milk allergy school seems to meet the families' needs for information, has few administrative routines and is cost-efficient. This activity has become permanent, is being offered weekly and can be recommended.
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Matsubara T, Yoshitomi T, Kaneko M, Ichiyama T, Furukawa S. Ketotic hypoglycemia in patients with allergic diseases. Pediatr Int 2003; 45:653-5. [PMID: 14651535 DOI: 10.1111/j.1442-200x.2003.01809.x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
BACKGROUND Ketotic hypoglycemia is the most common cause of recurrent hypoglycemia in early childhood but its etiology is poorly understood. Elimination diets have been used for the prevention or treatment of some allergic diseases; however, these diets entail a risk to the normal nutrition and growth of children. The present study investigated whether elimination diets are related to the occurrence of ketotic hypoglycemia. METHODS The prevalence of allergy treated with elimination diet therapy was retrospectively investigated in 18 patients with ketotic hypoglycemia seen in Yamaguchi University Hospital between January 1995 and September 1999. Data were gathered by reviewing the patients' medical charts. RESULTS Ten (55.6%) of 18 patients with ketotic hypoglycemia had allergic diseases. Six (60%) of the patients had been treated with strict elimination diets and the others were on incomplete elimination diets for the prevention of allergy. The ketotic hypoglycemia patients with allergic diseases had experienced fewer pre-existing infectious diseases than those without allergic diseases. CONCLUSIONS Patients with allergic diseases treated with elimination diets have a relatively high tendency towards developing ketotic hypoglycemia. They might have a lower capacity to tolerate fasting due to their excessive avoidance of many foods, even during periods when they are not undergoing strict elimination diets.
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Affiliation(s)
- Tomoyo Matsubara
- Department of Pediatrics, Yamaguchi University School of Medicine, Ube, Yamaguchi, Japan.
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14
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Abstract
BACKGROUND A varied nutrient intake provides the opportunity for an adequate nutrient intake balance while reducing malnutrition risks. When a food allergy diagnosis has been made, medical nutrition therapy with scheduled follow-up visits can provide a way to monitor the overall health effects of food elimination. Identifying individuals at risk may protect and possibly improve the patient's nutritional and overall health status. Medical nutrition therapy with appropriate food allergen substitution(s) provides the tools necessary giving the food-allergic patient the specific focus needed for improved nutrition self-care and food allergen avoidance. OBJECTIVE To reduce the food allergic patient's risk of developing malnutrition by providing exceptional nutrition intervention. DATA SOURCES Review of the literature with clinical perspectives. CONCLUSIONS The food-allergic patient is less likely to develop nutrient deficiencies or malnutrition when provided with appropriate food alternatives and careful monitoring while eliminating the food allergen(s), short- or long-term, from the diet. The dietitian is the most qualified professional to address the food-allergic patient's medical nutrition therapy needs.
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Affiliation(s)
- Sherry Hubbard
- Oklahoma Allergy and Asthma Clinic, Oklahoma City, Oklahoma 73126, USA.
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Novembre E, Leo G, Cianferoni A, Bernardini R, Pucci N, Vierucci A. Severe hypoproteinemia in infant with AD. Allergy 2003; 58:88-9. [PMID: 12580819 DOI: 10.1034/j.1398-9995.2003.23710_6.x] [Citation(s) in RCA: 16] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Affiliation(s)
- E Novembre
- Az Osp A Meyer, V Luca Giordano, 13, 50132 Florence, Italy.
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Laiho K, Ouwehand A, Salminen S, Isolauri E. Inventing probiotic functional foods for patients with allergic disease. Ann Allergy Asthma Immunol 2002; 89:75-82. [PMID: 12487210 DOI: 10.1016/s1081-1206(10)62128-x] [Citation(s) in RCA: 31] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
OBJECTIVE The primary objective of this review is to discuss the rationale for and applicability of probiotics as part of the nutritional approach to the prevention and management of allergic disease. DATA SOURCES This review represents a synthesis of recent literature published in the fields of probiotics, nutrition, and allergic disease. STUDY SELECTION The expert opinions of the authors were used to select the relevant data for the review. RESULTS The hygiene hypothesis suggests that allergic disease may arise from a lack of counterbalancing microbial exposure at an early age. Thus, the initial compositional development of gut microbiota is considered a key determinant in the development of both the immune responder phenotype and the normal gut barrier functions. A wide range of data documents the specific actions of selected probiotics. The regulatory role of probiotics in allergic disease has been demonstrated as improving the clinical course or preventing the development of atopic eczema in infants given a probiotic-supplemented diet. In addition, certain types of fatty acids and antioxidants have been proposed for protective effects against the development of allergy and to diminish the inflammatory response in allergic disease. CONCLUSIONS The increase in the prevalence of allergic disease during the past decades is likely to be explained by changes in the environment, including reduced microbial exposure and altered food consumption. Scientifically composed functional foods containing probiotics and other functional components offer a nutritional strategy for both the prevention and the management of allergic disease. Further research is needed to characterize the gut microbiota and to clarify the mechanisms of action that control specific physiologic processes not only in the evolution of allergic disease in at-risk populations but also in the management of allergic diseases.
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Affiliation(s)
- Kirsi Laiho
- Department of Paediatrics, University of Turku, Turku, Finland
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Abstract
Cow's milk allergy affects approximately 2% of infants under 2 years of age. This review summarizes the recent advances in understanding its pathophysiology and immunological mechanisms. Apart from IgE-mediated atopic manifestations, T cell-mediated reactions have been demonstrated in infants with cow's milk allergy. The clinical spectrum ranges from immediate-type reactions, presenting with urticaria and angioedema to intermediate and late-onset reactions, including atopic dermatitis, infantile colic, gastro-oesophageal reflux, oesophagitis, infantile proctocolitis, food-associated enterocolitis and constipation. The exact mechanisms of these disorders are still poorly understood. Double-blind, placebo controlled food challenge, the definitive diagnostic test for cow's milk allergy, is increasingly being replaced by the measurement of food-specific antibodies, in combination with skin-prick or atopy patch testing. The treatment of cow's milk allergy relies on allergen avoidance and hypoallergenic formulae, or maternal elimination diets in breast-fed infants.
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Affiliation(s)
- Ralf G Heine
- Department of Allergy, Royal Children's Hospital, Parkville, Victoria, Australia.
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18
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Kalliomäki M, Isolauri E. Breastfeeding and atopic sensitisation. ADVANCES IN EXPERIMENTAL MEDICINE AND BIOLOGY 2001; 478:389-90. [PMID: 11065096 DOI: 10.1007/0-306-46830-1_41] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Affiliation(s)
- M Kalliomäki
- Department of Paediatrics, Turku University Hospital, Finland
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