There is no scientific evidence that complementary therapies or kits sold through websites can identify allergies, the UK NHS watchdog NICE says. It says sites for services such as hair analysis use plausible stories but are not backed up by scientific evidence. It is publishing new guidance to help doctors in England and Wales identify when a child may have allergy problems. NICE says some parents end up turning to alternative therapies after a perceived lack of help from their GPs.
It is estimated that one in 20 young children has a food allergy. Dr Adam Fox, an allergy specialist based at the Evelina Children's Hospital in London, says not all children suffer immediate and obvious symptoms. “Food allergies can actually be extremely subtle. Lots of children have eczema, colic or spit up more food than usual. For some of those children the underlying problem is an allergy to something within their diet.”
The guidelines include detailed advice about how to recognise symptoms and when to refer to specialists. Dr Fox, who helped write the guidelines for National Institute for Health and Clinical Excellence (NICE), says he often sees parents in his specialist clinic who have wasted money on complementary or alternative tests.
The review by NICE looked for any scientific research of the usefulness of approaches including hair analysis and Vega testing, which uses mild electric currents, or kinesiology, in diagnosing allergies in children. “The websites are very well put together, the stories behind them are plausible, but we were unable to find any evidence to support them,” says Dr Fox. He says there are two types of testing used in NHS clinics – skin prick and blood sample – which are backed by scientific research. NICE is warning that parents sometimes turn to alternative tests when they have failed to convince their family doctor to listen to their concerns.
It took Alison Berthelson more than two years to get an allergy diagnosis for her first son Harris. She had been to the local surgery several times when he suffered rashes and stomach upsets without any particular cause being identified. After Harris ate a small piece of chocolate containing nuts he suffered a more extreme reaction, becoming agitated, with an extreme rash covering his entire body. The out-of-hours GP gave her son a medicine to reduce swelling, but did not send him on to hospital as an emergency. “It was really very terrifying, terrifying at the time because we didn't know what was happening, and terrifying later when we did know what had happened and how lucky we were.” A new GP correctly diagnosed possible food allergies, and sent Harris for testing at a specialist NHS clinic. He now has to avoid nuts, sesame and some other ingredients used in prepared foods.
Allergies on rise The number of children suffering from food allergies appears to be increasing, although experts are at a loss to understand exactly why. Family doctors are now more likely to see very young children suffering allergic reactions. Dr Joanne Walsh, a GP involved in drafting the advice, says she now sees several children a week with suspected allergic reactions. Some are babies just a couple of weeks old. By gradually eliminating, and reintroducing different foods, she can help parents manage the allergy without the need for hospital visits. “There's nothing more rewarding than a parent coming back and saying it's like having a different child.”
One of Australia’s leading juvenile justice services providing secure and safe care of up to 500 young offenders.
Review adequacy of summer and winter menus to address concerns raised to the State by the public.
Ensure compliance with Nutrient Reference Values for Australia and New Zealand
Ensure compliance with Dietary Guidelines for Children and Adolescents in Australia
Ensure compliance with Standards for Juvenile Custodial Facilities
Review of custodial health findings in various State jurisdictions around Australia and overseas.
Computer based macro and micro nutrient analysis of menus and individual recipes including protein, fat, carbohydrate and protein percentages
Computer based energy analysis of menus and individual recipes
Analysis of menus against nutrient reference values and appropriate recommendations.
Analysis of menus against dietary guidelines and appropriate recommendations
Analysis of food variety and appropriate recommendations
Analysis of special dietary needs and appropriate recommendations
Analysis of food choice and satisfaction and appropriate recommendations
A coordinating committee representing 34 professional organizations, advocacy groups and federal agencies oversaw the development of the guidelines. The coordinating committee selected a 25-member expert panel, chaired by Joshua Boyce, M.D., co-director of the Inflammation and Allergic Disease Research Section at Boston's Brigham and Women's Hospital. The panel used an independent, systematic literature review of food allergy and their own expert clinical opinions to prepare draft guidelines. Public comments were invited and considered as well during the development of the guidelines.
“These guidelines are an important starting point toward a goal of a more cogent, evidence-based approach to the diagnosis and management of food allergy,” says Dr. Boyce. “We believe that they provide healthcare professionals with a clear-cut definition of what constitutes a food allergy and a logical framework for the appropriate use of diagnostic testing and accurate interpretation of the results.”
Additional topics covered by the guidelines include the prevalence of food allergy, natural history of food allergy and closely associated diseases, and management of acute allergic reactions to food, including anaphylaxis, a severe whole-body reaction. They also identify gaps about what is known about food allergy.
“The food allergy guidelines provide a rigorous assessment of the state of the science, and clearly identify the areas where evidence is lacking and where research needs to be pursued,” says Daniel Rotrosen, M.D., director of the Division of Allergy, Immunology and Transplantation at NIAID. “This information will help shape our research agenda for the near future.”
Food allergy has become a serious health concern in the United States. Recent studies estimate that food allergy affects nearly 5 percent of children younger than 5 years old and 4 percent of teens and adults. Its prevalence appears to be on the rise. Not only can food allergy be associated with immediate and sometimes life-threatening consequences, it also can affect an individual's health, nutrition, development and quality of life. While several potential treatments appear promising, currently no treatments for food allergy exist and avoidance of the food is the only way to prevent complications of the disease.
More information on the guidelines may be found at http://www.niaid.nih.gov/topics/foodAllergy/clinical/Pages/default.aspx
This month the federal Department of Agriculture and Health and Human Services will release the 2010 dietary guidelines. These guidelines directly impact the eating habits of one in every four Americans whose meals are subsidized by federal programs. The precise timing of the release this month is unknown, according to John Webster, a spokesman for the USDA.
The major question here is whether or not the new guidelines will impact the obesity epidemic that is increasing ever so quickly in our country. Decisions about what to eat are generally made at the supermarket, not while reading federal guidelines. “What we need to do is put more effort into figuring out how to engage people who don’t use nutrition as a major deciding point when buying food,” says Alice H. Lichtenstein, a professor at the Friedman School of Nutrition Science and Policy at Tufts University. “We really need to learn more about consumer behavior.’’ Some experts wonder if more nutrition information helps or confuses shoppers.
It is arguable that the guidance needs to be much clearer, more like the wildly popular “Eat This, Not That!,’’ a magazine column, which was then reworked into a book and an iPhone app, that made its mark by telling readers which fast food was nutritionally better than others. Dr. David L. Katz, director of Yale University’s Prevention Research Center and an associate professor at the university’s School of Medicine, is an advocate for more specific guidance. For example, 45 to 65 percent of daily calories should come from foods that contain carbohydrates. But “lollipops and lentils are both carbs,’’ Katz says. And while the current federal recommendations do stress eating carbohydrates from whole grains, fruits, and vegetables, he adds, “We need to do a better job of specifically defining highly recommended foods.’’
While no one is talking about the final 2010 recommendations before their release, a June advisory report, open for public comment, gives some clues. Cohen of UMass Amherst expects the final guidelines to place even greater emphasis on physical activity and continue to recommend that people include more fruits, vegetables, nuts, seeds, foods with Omega-3 fatty acids, and a suggestion to eat three servings of low-calorie dairy products a day (some argue that calcium supplements should be used in place of the third serving).
Individuals with either type 1 or type 2 diabetes know that maintaining a nutritious diet is one of the most important things they can do to control their disease. The findings of a new study suggest that the services of a registered dietitian may help individuals accomplish this goal.
A team of investigators from the American Dietetic Association reviewed evidence from previous research and summarized their findings in a report published in the Journal of the American Dietetic Association.
In their write-up, researchers laid out a set of exhaustive dietary guidelines for individuals affected by diabetes. Researchers said that the services of registered dietitians may be key in helping individuals follow the guidelines, which could help them significantly improve their condition.
“The evidence is strong that medical nutrition therapy provided by registered dietitians is an effective and essential therapy in the management of diabetes. Registered Dietitians are uniquely skilled in this process,” said Marion Franz, who led the investigation.
The guidelines developed by the research team lay out 29 nutritional points that can help diabetics improve their blood sugar control.