If you are a Celiac disease sufferer, you know that experts recognize 20 parts per million (ppm) as the standard in gluten tolerance.  Eating a variety of foods below this limit is considered safe, even when eaten cumulatively.  While there may be a tiny percentage of individuals with extreme sensitivity for who this standard may still be a problem, The World Health Organization (WHO) recognizes this limit as not only safe for Celiacs but also manageable by the food industry.  As a result, the European Union moved their gluten free labeling from 200 ppm to 20 ppm recently and food processors are stepping up to that challenge.  While there are still many challenges there including testing and compliance which I won’t get into, at least there is a common understanding that most can adhere to.

Wouldn’t it be nice to have the same limit for food allergens too?  So if you were allergic to peanuts and peanut free label regulations required the food processor to be below say, 1 ppm, we would all know exactly what peanut free means on the label.  This could even open up more foods to the peanut allergic population because companies could test their products and in theory, we would see fewer “may contains”.   That would certainly be a plus for my family.

But here’s the problem with that scenario:  Documented cases of peanut allergy show a wide range of sensitivities and the ramifications of reaction in a very sensitive individual are more severe with anaphylaxis being the ultimate price to pay.  And unlike true Celiac disease (as opposed to gluten sensitivity/intolerance), children have been known to grow out of their food allergies so it’s possible that their level of sensitivity may decrease over time, making it very difficult for researchers to create a scientifically controlled experiment to determine specific levels.

They’re trying though, and that’s the good news.  Over time, if scientists are able to determine a threshold amount that can be tolerated for a variety of food allergies, we can have better food labeling.  This might allow us Allergy Moms to spend less time in the grocery store, phoning food manufacturers, searching for information  on food allergy forums and abandoning our food chemistry degree courses that we’ve all been plunged into.   Trust in proper labeling and regulation compliance notwithstanding, I’d be thrilled to have that time back.

If you’d like to read more about the technical aspects of this scientific challenge, you can download this free report at:  http://www.informaworld.com/smpp/content~content=a914017328 .  The report is authored by a group of scientists called the ILSI Threshold Working Group which includes renowned food allergy scientist  Steven L. Taylor from the Food Allergy Research and Resource Program, Dept. of Food Science & Technology, University of Nebraska.

When I was younger, I had a friend with a shrimp allergy who seemed determined to overcome his food allergies by sheer willpower.  I’m sure you’ve heard of allergic people like this, perhaps you’re one of them.  These are the people who know they have a food allergy but  disregard food labels and maybe even actively try to prove they’re no longer allergic to the food they reacted to as a child.  In any case, my friend stopped his antics after purposefully ingesting shrimp on New Year’s Eve and ended up in the hospital.  This was around the time when everyone in our social group refused to eat with him any longer.  None of us wanted responsibility for his playing Food Allergy Roulette.

I’m sure many of you are thinking this young man was foolish and I don’t disagree with you.  But if you are thinking that he is rare, think again.  Governments everywhere around the world are reviewing food allergy statements on ingredient labels after alarming studies showing that many of the food allergic ignore those warning statements.  These are the manufacturer’s voluntary “may contains…” that we see on pretty much every food label, ours included.

A recent UK survey indicates that only around 50% of British parents that shop for their nut allergic child heed the precautionary ”may contain traces of nuts”  warnings on food labels. 20% of those same parents ignore the “may contain nuts” warning on food.  Yet studies conducted a few years ago indicated that roughly one third of chocolates labeled with the “may contain traces of nuts” statement actually contained measurable amounts of nut proteins.

It may be that the majority of foods labeled with precautionary warnings don’t have the protein in them but many do.  Or what seemed fine last time may not be fine this time.  Is it worth the chance?

Just when it seems that you’ve got one thing under control with an allergic child, something else pops up.  My journey started with 2 children allergic to dairy, followed by a peanut reaction, followed by outgrowing the dairy (both girls thankfully) and then discovering kiwi and almond allergies.  Like many parents, I had to educate myself, learn to read labels, educate family and friends,  learn how to use an epi-pen and ask a lot of questions.

Then, when I was just beginning to feel comfortable with the change in our lives, we needed to begin thinking about birthday parties and then the big one:  school.  I had thought that once we conquered school, we’d have a little comfort zone and generally we did with smaller issues coming up such as Valentine’s Day, continued education of teachers and school trips.

Last year, our daughter moved to junior high and that created a new round of anxiety, both on the part of our child and us as parents.  We needed to begin the education process again, explore new options for cleanliness in the school, pin down specific eating areas for our child (since the kids can generally be where they choose) and tackle the issue of cooking in home economics class.  We’re now at the end of that school year this week and everything worked really well so all is good, right?

Yes and no.  While some issues are old hat and our allergic child has a very careful personality, there are so many other issues that are going to need to be dealt with.  In the last month alone,  we’ve had to discuss what to do with the epi-pen belt when you’re wearing a dress at the school dance (and no, leaving it on a table with your friend’s jacket is not okay) to an end of the year birthday party tomorrow night which is a co-ed extravaganza of kick the can, water fights and capture the flag.  Unlike little kid birthday parties, where the parent controls the activities and food, these 12 and 13 year olds are getting to the age where they are doing more policing of themselves. 

Therefore, the bedtime discussion last night was about if you’re not feeling well, telling a friend and bringing them with you to find an adult is necessary.  This includes not going to the bathroom alone if she’s not well.  Otherwise, what happens if she passes out before reaching an adult or can’t speak?  Not exactly the conversation I want to have but  an absolute must.  So she’s picked 3 friends she’s comfortable with who she will have accompany her in the event of a concern. 

Thankfully, she’s not at the age yet (at least I hope I’m not thinking this naively) where any party would have drugs or alcohol but we’ve already had those conversations too.  Whether drinking something that has a potential allergen in it, sharing a glass or cigarette/drug that someone else has inadvertently left an allergen on or even being inebriated and having less care and inhibitions about personal safety have all been part of discussions since she was about 10.  In the next few years, we can hope that the earlier education will have a positive effect but we now must trust her to take care of herself in so many more situations that are not as controlled as we would like.

Anaphylaxis Canada has put out a website specifically for teens called Why Risk It?  There are various sections to the site but they do cover the issues of partying, carrying your epinephrine, drugs, alcohol, peer pressure, dating, kissing and more.  The site also features different situations that allergic teens have found themselves in and how they dealt with them.  At the very least, this website may allow your allergic child to explore aspects of an allergic teen’s life that they may not want to share with you.  I hope for most families, it gives a tool to begin those very important conversations.

A recent study in Spain showed that the gut health of individuals on gluten free diets was worse than those not on gluten free diets.  The theory behind this study’s results is that when we remove gluten containing grains from our diet, we reduce the amount of food that probiotics (healthy bacteria in the gut) have to feed upon and stay healthy. 

This information doesn’t help those who have no choice in eating a gluten free diet such as those with Celiac disease and food allergies but should give those pause who go on a gluten free by choice without a direct medical need.  What can help the gut health of those who must be on the gluten free diet medically is to eat gluten free foods that are prebiotic (the “food” for those healthy probiotic bacteria).  Prebiotics are a type of fiber rich carbohydrate that are not as easy to digest as some kinds of foods.  Examples of prebiotics are:  oats (pure, gluten free oats, most – 95% of Celiacs - can tolerate these), inulin, resistant starches, gums, asparagus, bananas, artichokes, spinach, cranberries, garlic, onions and legumes such as chickpeas, lentils and navy beans.

If you are attending the Canadian Celiac Association Conference this weekend in Waterloo, please come by and visit me in Booth 37.  I’m then home for 3 days and then off to the Gluten Intolerance Group Conference in Seattle for June 4 and 5th.  Come see me there too!

Like the economy and the swine flu, allergy and Celiac news seems to have a certain pattern.  Doom, gloom, and then a light at the end of the tunnel.  Recent news from the specialty diet world is no exception.  But, like life, sometimes it takes the doom and gloom to truly appreciate that light so here are a few highlights from various places around the globe:

Allergy Mom’s Newsletter:  Gina Clowes is the mom of a multiple food allergic child and a tireless advocate for special diet families.  Her most recent newsletter was disturbing because it features an interview with a parent who lost a child last year to a peanut allergy.  What was very enlightening was that this parent mentions that his family had come to expect a certain kind of reaction from their teen and were completely caught off guard when this life-ending reaction occurred.  It’s also a wake-up call to remind all food allergic parents that a “mild” allergy is not always predictable.  Our family had quite a discussion around this terrible tragedy.  You can read Gina’s interview with the father on the Allergy Mom’s April 25 Newsletter.

Recently Anaphylaxis Canada has asked for those living in British Columbia to respond to proposed changes to the BC medical act that would allow naturopaths to treat allergic patients as part of their scope of practice.  Anaphylaxis Canada’s concerns are that  food allergic individuals (as opposed to intolerances) should be treated in a medical setting where intervention would be possible in the case of an anaphylactic reaction to treatment.  That position bears thought when hearing about a recent Dublin inquest where a man died from peanut allergy while being treated with alternative methods.

Did you know that this week is National Food Allergy Awareness Week in the United States and last week was National Food Allergy Awareness Week in Canada?  To learn more about increasing awareness any week of the year, please visit the FAAN website (Food Allergy and Anaphylaxis Network) in the US and Anaphylaxis Canada’s website in Canada.

Nonuttin’ Foods began providing GMO (Genetically Modified Organism) free products 2 years ago because there have been questions raised as to whether genetically engineered food could be having an effect on the rising rates of food allergies.  Since there have been no specific studies to date really delving into that question, we prefer to avoid genetically manipulated foods and advocate labeling (not currently required in North America) to allow the customer a choice.  Recently, the Environmental Protection Agency announced that they have provided a research grant to the Mount Sinai School of Medicine to investigate that question.  It may take many years to have the question answered but at least it is a start.

Did you know that there is a correlation between rising food allergy rates and the rising rates of childhood obesity?  A new study looks at the possibility that one is affecting the other.

Peanut allergy gets a lot of media attention often because of its severity and in recent years, the amount of well known food processors that have begun labeling their products as peanut free (Mars, Nestle, Christie to name a few in Canada).   However, as reported in the UK recently, fruit and vegetable allergies, particularly Oral Allergy Syndrome, is gaining ground on the peanut and may be considered the epidemic of the food allergy world for the new century.

And finally, (are you getting tired of all of this news yet?) it looks like pure oats will finally be allowed gluten free certification in Canada.   For any of you who have tried to decipher exactly why you don’t see “gluten free” on our Canadian labels and website while we can on our US information, the confusion may finally be coming to an end.  Essentially, Health Canada’s position is that pure oats are a suitable addition to most gluten free diets and may help add some needed fiber and nutrition to the Celiac diet within reason (i.e. 10 bowls of pure oats a day is too much of a good thing – for anybody!).  But that doesn’t mean we’re allowed to put “gluten free” on our granola labels in Canada because oats aren’t allowed to be called gluten free, also according to Health Canada.  However, the Canadian Celiac Association is expected to roll out a new pure oats certification program at their annual conference in Kitchener/Waterloo, Ontario on May 31 which may change all of that.  I’ll be there with bells on!

Happy Friday! And we’ve got sunshine too!

There’s been much written recently about the “hysteria” of food allergies.  Granted, emptying an entire school bus because a peanut is found on the floor is a little over the top but there have been several editorials of late suggesting that food allergies are all in the heads of uptight suburban yuppies.  Scientific tests, studies and food allergy related deaths each year tell the real story but that hasn’t stopped many uneducated people from espousing otherwise.

When I first began Nonuttin’ Foods, a fair amount of education was necessary with our ingredient suppliers because 5 years ago, not all ingredient manufacturers had allergen control as part of their quality assurance.  I had to create forms for each supplier to fill out, ask a lot of questions and have good communication with the quality assurance and/or production managers of each supplier.  Over time though, it has became evident that I’m not the only one asking these questions and requiring specific answers; most suppliers now have their own forms and documented processes ready to go and can answer questions very quickly and concisely.

So imagine my surprise when one of our suppliers questioned our specifications when we refused an order today.  To clarify, our requirements for testing levels are specified with the Quality Assurance department, not the sales team, but when we say that the allergen in question must be negative to the limits of a particular test, we mean it.   So it was causing the sales person who was shipping the order some consternation (and extra work).  While I understand that extra work isn’t appreciated, being told that we should accept an ingredient because the testing was “pretty close” is just mind-boggling.   Note to Self:  Pick jaw up off the floor.

In the end, there are just some people who just don’t get it.  I only hope that all of the so-called hysteria publicity doesn’t stop the average person from being open to learning about what it’s like to walk in these shoes.

I’m glad to know that I’m not going crazy; well, not in one sense at least.  It had seemed to me that we’ve fielded many more sesame questions over the last couple of years and it seemed that sesame was an allergen that was present with 1 or more other food allergens, such as peanut or dairy.  My hunch has now been proven right.

At John Hopkins University School of Medicine in Baltimore, Robert Wood has indicated that their evidence shows that sesame allergies have grown the most of any food allergy in the last 2 decades and is now in the top 6-7 food allergens.  This statistic, gleaned from patient files over 3 years, was presented at the recent American Academy of Asthma and Immunology annual meeting.  You can read more about this article at:  http://www.medicinenet.com/script/main/art.asp?articlekey=98576 

Sesame is already listed in Canada as one of the top 10 food allergens and in the UK and Europe as one of the top 12 but the FDA is reviewing whether sesame should be declared in the US (it’s currently not in their top 8).   In my limited experience, I’ve found that many US parents of sesame allergic children aren’t aware of where sesame might be lurking beyond the obvious crackers and hamburger buns simply because manufacturers aren’t declaring it.  As the use of sesame becomes more common due, in part, to the growing ethnic food availability, it will be very difficult to avoid, particularly when used as a whole as opposed to paste.  Sesame testing for such tiny particulate matter can literally be hit and miss.

If these numbers are accurate, it would appear that sesame should be added to US declarations sooner rather than later. 

The CBC ( Canadian Broadcasting Corporation) had a really informative documentary recently on their Passionate Eye program called Allergy Planet.  Unfortunately, I wasn’t aware that the documentary was on and I only caught the last half hour.

What I did see was fascinating.  What I thought was really interesting was that scientistis believe the antibody Immunoglobulin E (IgE) was created in the body to fight parasites.  Since our bodies generally no longer fight parasites, the IgE has turned on what should be innocuous substances such as food, creating a surge in food allergies but also in other immune diseases such as asthma.  This gives further credence to the Hygiene Theory.

I saw a small part of the program that followed a woman who believed she had allergies and sensitivities to essentially everything from the car steering wheel to her fridge and wore gloves and used oxygen constantly.  While scientific studies hadn’t been able to bear out all of those allergies, she felt she couldn’t cope in the outside world and had isolated herself to get some relief. 

One portion of the program dealt with scientific studies of Barbados due to the significant increase in asthma and allergies there over the last several decades.  So far, the studies have shown that the air pollution is non-existent on the island due to its isolation.  Conclusions drawn from the studies so far seem to indicate that modernization (including better hygiene) and genetics seem to be creating the perfect storm for asthma and allergies to explode.  See http://news.bbc.co.uk/2/hi/health/7766656.stm for further information on this particular issue.

Overall, the portion of the documentary I saw was very well done and I’ll try to keep an eye on when it might be on again.  You can also watch the schedule for your own interest at:  http://www.cbc.ca/documentaries/passionateeyemonday/2009/allergyplanet/.

I’m on a lot of different news lists and have been absolutely inundated over the last 10 days or so with research, interviews and more coming from the allergy world.   Here are some links that may be of interest to you:

Black male children have a 4 times greater possibility of developing food allergies:  http://www.nydailynews.com/lifestyle/health/2009/03/18/2009-03-18_black_male_children_are_four_times_more_.html

Parents of Australian food allergic children found to lack food allergy awareness in a recent study:   http://www.eurekalert.org/pub_releases/2009-03/ra-cpl031609.php

Kids found to be misdiagnosed with food allergies on a regular basis and that skin and blood tests aren’t reliable on their own:  http://www.npr.org/templates/story/story.php?storyId=101944263