Read itFeb/Mar 2017 Issue

The Latest News in Food Sensitivities

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Restaurant Workers’ Knowledge of Allergies Tested

People with food allergies know that dining out can be nerve-wracking—and risky. A recently published survey of restaurant staff reveals that while many are more knowledgeable about food allergies than customers might think, there are still some key areas that could use brushing up.

For the survey, researchers from a food allergy study group interviewed managers, food preparers and servers in 278 American restaurants. They found that over 90 percent of participants were able to identify common allergens in their dishes and that nearly all knew how to handle a severe allergic reaction. However, there were some troubling findings, too. Among the food preparers, knowledge of food allergies was associated with length of work experience, meaning that newer workers may be less knowledgeable than their longer-term colleagues. Conversely, younger managers had a more positive attitude towards allergy concerns than did older managers. In addition, over 10 percent of all restaurant workers surveyed believed that people with food allergies can safely eat a small amount of the allergen, a belief that could have disastrous consequences.

Although it’s encouraging to see that so many restaurant workers are knowledgeable about food allergens, researchers still caution that a significant proportion could benefit from allergy training. Researchers also recommend that restaurants develop clear allergy management plans and designate a specific person to be in charge of allergy-related questions and concerns.

Survey results were published in September 2016 in the Journal of Food Protection.

Skin Patch for Peanut Allergy

Researchers working on a skin patch that can deliver immunotherapy for peanut allergy have recently released a new study showing significant progress.

For the study, conducted at five centers across the United States, researchers tested the skin patch on 74 children and young adults with peanut allergy. Two-thirds of the participants wore a patch containing either 100- or 250-mcg of peanut protein. The remaining third were given a placebo patch.

After one year, about half of the participants in the 100 and 250 mcg treatment groups experienced a 10-fold increase in the amount of peanut protein they were able to tolerate, which was the amount researchers had designated as a successful treatment outcome. The patch appeared to work best in the youngest participants: about 60 percent of those age 11 and under in each treatment group met the goal, compared with 15 percent and 30 percent of participants age 12 and older in the 100-mcg and 250-mcg groups, respectively.

The patch works by creating prolonged contact between peanut protein and the skin. This allows the body’s immune system to gradually develop a tolerance to the substance just as it would in traditional immunotherapy, while avoiding more invasive delivery methods, such as oral challenges or injections.

Although the patch looks promising, researchers acknowledge that more work is needed. New, longer trials of the skin patch with more ambitious treatment goals are in the works.

The study was published online in October 2016 in the Journal of Allergy and Clinical Immunology. For more about the peanut patch, visit

Risk Factors for Other Autoimmune Diseases

A new study has pinpointed the risk factors that predispose some people with celiac disease to develop at least one other autoimmune disease, a condition known as polyautoimmunity (PAI).

For the study, researchers examined the clinical records of 145 people who’d been diagnosed with celiac disease for at least one year. They compared the health data of people with PAI (33 percent of the total participants) to that of people who didn’t have PAI to determine differences between the two groups.

According to their findings, two of the biggest risk factors for PAI are female gender and a family history of autoimmune diseases. Women in the study were 88 percent more likely than men to have PAI, while family history raised the odds of developing PAI by a whopping 129 percent. Other important risk factors included vitamin D deficiency, having at least one musculoskeletal disorder, and positive results for antigliadin IgG antibodies (an antibody against gliadin, a specific protein found in gluten) or antinuclear antibodies (a general marker of inflammation in the body caused by autoimmune activity).

Researchers emphasized that doctors should be aware of the links between celiac disease and the factors listed above, as they are important clues to overall health.

The study was published in September 2016 in the journal Digestion.

New Celiac Guidelines for Children

Representatives of the American Academy of Pediatrics have issued a new set of guidelines to help pediatricians manage cases of celiac disease in their patients over the long term. To create the guidelines, a panel of six experts in childhood celiac disease examined 600 research studies and then weighed the balance of the evidence alongside their own expertise.

The panel agreed unanimously on several recommendations, including the importance of regularly testing levels of immunoglobulin A (IgA) and anti-tissue transglutaminase (tTG), the two markers considered the “gold standard” of initial screening for celiac disease, as a way to monitor whether a child’s diet contains any gluten.

Other recommendations call for testing bone density and thyroid function, for regularly checking for vitamin deficiencies and for prescribing supplements, as needed. Because children with celiac disease face potential nutritional deficiencies while they’re still growing, it’s especially important to make sure they’re healing well on the gluten-free diet—and to catch and treat any complications early on—to avoid health problems later in life.

Until now, there have been no official procedures for long-term management of celiac disease in children, resulting in differences in the length and thoroughness of follow-up. Once put into practice, these guidelines will help pediatricians give their patients with celiac disease optimal long-term care.

The guidelines were published in the September 2016 issue of Pediatrics.

Antibiotic Prescription & Food Allergy

Recent research has determined that children prescribed an antibiotic before their first birthday are more likely to develop food allergies by age 3.

To investigate the link between antibiotics and food allergy, researchers combed through the Medicaid billing data of 7,500 children between birth and 3 years old living in South Carolina. About 1,500 of them had been diagnosed with food allergy; the others did not have an allergy and served as the control group. According to the findings, children who had been prescribed a single round of antibiotics between birth and age 1 were 21 percent more likely to develop a food allergy by age 3 than those who hadn’t been prescribed an antibiotic. The likelihood increased in step with the number of antibiotics prescribed, so that children who had taken five or more rounds of antibiotics were 64 percent more likely to develop a food allergy.

Researchers were inspired to look for the link because of the effect of antibiotics on gut flora, the population of bacteria and micro organisms that lives in the intestines. Antibiotic use kills both bad and good bacteria, thereby disrupting gut flora. A recent body of research has revealed that a healthy, diverse gut flora population is essential to digesting and tolerating many foods that are common allergy culprits and that a disruption in this population is associated with a host of health conditions, including allergies.

The study was published in August 2016 in Allergy, Asthma & Clinical Immunology.

Contributor Jill Mazzetta is a health writer.

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