❓Often people ask me what they should do when they see a "𝘮𝘢𝘺 𝘤𝘰𝘯𝘵𝘢𝘪𝘯" label.⁣
⁣
⁉️My first question to them is, how many variations of that wording have they seen?⁣
⁣
⁣
✅In a study done many years ago, the researchers found over 20 different ways of writing an allergy warning in food.⁣
▶️They asked people how they would act, depending on what was written, and the variability was incredible.⁣
⁣
𝐒𝐨 𝐭𝐡𝐚𝐭 𝐲𝐨𝐮 𝐤𝐧𝐨𝐰, 𝐚𝐥𝐥 𝐯𝐚𝐫𝐢𝐚𝐭𝐢𝐨𝐧𝐬 𝐦𝐞𝐚𝐧 𝐞𝐱𝐚𝐜𝐭𝐥𝐲 𝐭𝐡𝐞 𝐬𝐚𝐦𝐞.⁣
⁣
✅Several other studies went to see what was the actual variation of allergen concentration.⁣
⁣
✳What did they find?⁣
➡️In products with a warning, 6.5 to 93% contained an allergen.⁣
➡️In products without a warning, 11 to 53% contained an allergen.⁣
⁣
⚠️In reality, there is still a significant risk of a not labelled food, to contain a substantial amount of allergens.⁣
⁣
❓But why is it that the food industry has this massive variability in warnings they use and still have so much potential cross-contamination of allergens?⁣
⁣
❌The problem tracks back to political parties, the way they are funded or the individual politician's financial interest.⁣
❗What I am saying might be controversial, but let's look at what is known.⁣
⁣
⚠️Most of you have never heard of the "𝘌𝘶𝘳𝘰𝘱𝘦𝘢𝘯 𝘍𝘰𝘰𝘥 𝘍𝘰𝘳𝘶𝘮".⁣
🔻This is the most powerful lobby within the 𝘌𝘜 – the 𝐟𝐨𝐨𝐝 𝐢𝐧𝐝𝐮𝐬𝐭𝐫𝐲 𝐥𝐨𝐛𝐛𝐲.⁣
🔻They have offices inside the 𝘌𝘶𝘳𝘰𝘱𝘦𝘢𝘯 𝘗𝘢𝘳𝘭𝘪𝘢𝘮𝘦𝘯𝘵 and manage to block all resolutions that can lead to improvement of food quality when this affects the profit the food industry has.⁣
🔻It is easy to see what they have done so far, as most are widely published. (the list is far too long for me to place it here).⁣
⁣
⚠️In the 𝘜𝘚𝘈 alone, in the 2014 elections, the food industry donated $𝟏𝟕𝐌, in total, to both parties.⁣
⁣
❇This comes to the 𝐏'𝐬 I have spoken about before.⁣
Those, also called 𝐄𝐃'𝐬 (𝘌𝘭𝘪𝘤𝘪𝘵𝘪𝘯𝘨 𝘋𝘰𝘴𝘦), look into the dose needed to cause an allergic reaction and the percentage of allergic people who will react.⁣
⁣
✅So a 𝐏𝟏 or 𝐄𝐃𝟏 means that the potential cross-contamination in a particular food will lead to 1% or fewer allergic people reacting to that food.⁣⁣⁣
⁣⁣⁣
✴The best collaboration done so far is the one between the food industry in Australia, the Government and Allergy Organizations.⁣⁣⁣
(see the attached table to see the ED for the 14 main allergens)⁣⁣⁣
⁣⁣⁣




















⛔Such an agreement does not exist in the 𝘌𝘜 at present.⁣⁣⁣
⁣⁣⁣
✴The hope for the 𝘜𝘒, at the moment, is that the so called "𝐍𝐚𝐭𝐚𝐬𝐡𝐚'𝐬 𝐋𝐚𝐰" will lead to a change in this practice.⁣⁣⁣
⁣⁣⁣
▶️But we need to go deeper than simple labelling, look into manufacturing practices, and avoid allergens altogether.⁣⁣
⁣⁣
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​

They are bacteria that can lead to benefits to the large bowels when taken in an appropriate amount.⁣

❓But are all Probiotics good?⁣

📝For me to have a better idea about that, I went to find the evidence behind it.⁣

✴There are over 2.5k articles focusing on 22 different probiotics.⁣
✴From those articles, I found 249 RCTs (𝘳𝘢𝘯𝘥𝘰𝘮𝘪𝘻𝘦𝘥 𝘤𝘰𝘯𝘵𝘳𝘰𝘭𝘭𝘦𝘥 𝘵𝘳𝘪𝘢𝘭𝘴), with most of them being sponsored by the company selling them.⁣
✔So take their conclusions with a pinch of salt…⁣

✅The most effective use for them is diarrhoea, IBD (𝘐𝘯𝘧𝘭𝘢𝘮𝘮𝘢𝘵𝘰𝘳𝘺 𝘉𝘰𝘸𝘦𝘭 𝘋𝘪𝘴𝘦𝘢𝘴𝘦) and IBS (𝘐𝘳𝘳𝘪𝘵𝘢𝘣𝘭𝘦 𝘉𝘰𝘸𝘦𝘭 𝘚𝘺𝘯𝘥𝘳𝘰𝘮𝘦).⁣

⚠️This image shows the conditions for which probiotics are helpful and the evidence's strength.⁣
(𝘊𝘩𝘰𝘰𝘴𝘪𝘯𝘨 𝘢𝘯 𝘢𝘱𝘱𝘳𝘰𝘱𝘳𝘪𝘢𝘵𝘦 𝘱𝘳𝘰𝘣𝘪𝘰𝘵𝘪𝘤 𝘱𝘳𝘰𝘥𝘶𝘤𝘵 𝘧𝘰𝘳 𝘺𝘰𝘶𝘳 𝘱𝘢𝘵𝘪𝘦𝘯𝘵: 𝘈𝘯 𝘦𝘷𝘪𝘥𝘦𝘯𝘤𝘦-𝘣𝘢𝘴𝘦𝘥 𝘱𝘳𝘢𝘤𝘵𝘪𝘤𝘢𝘭 𝘨𝘶𝘪𝘥𝘦. 𝘩𝘵𝘵𝘱𝘴://𝘥𝘰𝘪.𝘰𝘳𝘨/𝟷𝟶.𝟷𝟹𝟽𝟷/𝘫𝘰𝘶𝘳𝘯𝘢𝘭.𝘱𝘰𝘯𝘦.𝟶𝟸𝟶𝟿𝟸𝟶𝟻 𝘋𝘦𝘤𝘦𝘮𝘣𝘦𝘳 𝟸𝟼, 𝟸𝟶𝟷𝟾)⁣






















❇This means, not all probiotics have any evidence based effect on your health.

➡️And the helpful ones are disease specific.⁣

❗At least, from all of them, we know there are no absolute contraindications to their use.⁣

✅Other benefits found are that they:⁣
▶️Stimulate the immune system
▶️Can decrease the inflammatory response⁣
▶️Can improve vaccine response⁣

✅Where are they found:⁣
▶️Fermented milk drinks⁣
▶️Some yoghurts⁣
▶️Supplements⁣
▶️Examples: kefir, kombucha, sauerkraut, pickles, miso, tempeh, kimchi, sourdough bread, some cheeses (Cheddar, Parmesan, and Swiss cheeses are soft cheeses that contain a decent amount of probiotics. Gouda is the soft cheese that delivers the most probiotics of all)


✅How to take them⁣⁣:
▶️There is scant evidence comparing which type of formulation may be more effective.⁣⁣
▶️The choice of formulation may be based on shelf-life, in that lyophilized capsules maintain high concentrations longer than probiotics in dairy products and enteric-coated capsules show higher survival rates than non-enteric coated capsules.⁣⁣
▶️Probiotic capsules requiring refrigeration are heat-dried (not lyophilized) and thus not stable at room temperature, limiting their portability.
▶️Besides, if the patient is lactose-intolerant, yoghurts or other types of fermented dairy products may not be advisable.

‼️Careful with quality control, some will have less than stated.

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⚠️Recently publication showed there are significant 🥜peanut proteins in 🏡household dust.

But what is the relevance of this study, and how does it apply to the development of 🤧allergies?
🔸️It is known that during the 👶first year of life, exposure to allergens will lead to the development of either tolerance or allergy.
🔸️With the loss of the natural skin barrier, the presence of eczema increases the risk of developing sensitization to the allergen that gets in contact with the skin.

The best course of action to deal with eczema, and potentially prevent the development of 🤧allergies, should be:
➡️Apply moisturizers as often as you feel the skin is dry to touch.
➡️If that is not solving the problem, speak to your doctor as the child might need topical steroids as well.
➡️Consider the possibility of an allergy leading to eczema and consider an exclusion diet. That should be guided by a paediatric allergist and a paediatric allergy dietitian.

🔜(In due course, I will publish more information regarding eczema and the best way to take care of it.)


















(Main article – “Mass spectrometry confirmation that clinically important peanut protein allergens are in household dust”; Helen A. Brough, Elizabeth Naomi Clare Mills, Kerry Richards, Gideon Lack, Philip E. Johnson; 04 October 2019)

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A US study suggests that, though camps will accept 🧒 children with allergies, most are not prepared to act if something happens as often they don’t have or request individualized action plans.

🏕It seemed camps that had faced anaphylactic events in previous years were better trained and able to recognize it than others who didn’t.
Despite that, one-third of camp leaders did not think most staff would be able to act appropriately.

Though this study was not done in the UK, I would suggest👫 parents need to be aware of the possibility of the same happening in summer camps here or any other country where they might send their children to.

⚠️The main lessons to take from this study are:
🔹️Enquire if the staff at the summer camp is trained to deal with allergic conditions, mainly anaphylaxis.
🔹️See what policies and emergency measures they have in place, e.g. contacts for local ambulance service, GP or Hospital.
🔹️Provide action plans specifically for your child. If you don’t have one, ask your Paediatric Allergist to provide a BSACI action plan.
🔹️See if your child’s medication did not expire and take them to the camp, in a clearly marked container, potentially with a photo of your child outside it.
🔹️You don’t stand to lose anything by asking if the food your child is allergic to is excluded from the camp, and other children cannot bring it with them there.

🏫As more and more nurseries/schools are becoming nuts free, it would not be a bad idea for summer camps to follow suit.

(Many Summer Camps Unprepared for Allergic Campers - Medscape - Dec 10, 2019)

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