❓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.
Also known as Retinol or Retinoic Acid.
Those names derive from an area in the back of the eye.
It was the first 𝘧𝘢𝘵-𝘴𝘰𝘭𝘶𝘣𝘭𝘦 but not the first Vitamin to be discovered.
🇪🇬It all started with the 𝘌𝘨𝘺𝘱𝘵𝘪𝘢𝘯𝘴, as they found that some types of 𝘣𝘭𝘪𝘯𝘥𝘯𝘦𝘴𝘴 could be cured by 𝘦𝘢𝘵𝘪𝘯𝘨 𝘭𝘪𝘷𝘦𝘳.
🔶️This Vitamin plays a vital role in 👁𝘷𝘪𝘴𝘪𝘰𝘯, 𝘨𝘳𝘰𝘸𝘵𝘩, 𝘤𝘦𝘭𝘭 𝘥𝘪𝘷𝘪𝘴𝘪𝘰𝘯 and 𝘪𝘯𝘵𝘦𝘨𝘳𝘪𝘵𝘺 (mainly 𝘢𝘪𝘳𝘸𝘢𝘺𝘴, 𝘶𝘳𝘪𝘯𝘢𝘳𝘺 𝘵𝘳𝘢𝘤𝘵 and 𝘨𝘶𝘵), 𝘳𝘦𝘱𝘳𝘰𝘥𝘶𝘤𝘵𝘪𝘰𝘯 and 𝘪𝘮𝘮𝘶𝘯𝘪𝘵𝘺. We cannot forget how important it is for foetal development.
🤰But beware, pregnant women DO NOT need a Vitamin A dose higher than the daily recommended dose.
✅Due to this, many believe it is 𝐭𝐡𝐞 𝐦𝐨𝐬𝐭 𝐞𝐬𝐬𝐞𝐧𝐭𝐢𝐚𝐥 𝐕𝐢𝐭𝐚𝐦𝐢𝐧 in animal life (not just humans).
🔻When there is a deficiency, it can lead to:
➡️Low immune response
➡️Dry skin and hair
✴𝐍𝐨𝐭𝐞 𝐨𝐟 𝐜𝐚𝐮𝐭𝐢𝐨𝐧: If you use creams containing Vit A, do not go on long sun exposures, leading to skin cancer development! On the other hand, sun exposure decreases skin Vit A.
✳𝗪𝐡𝐚𝐭 𝐭𝐨 𝐝𝐨?
Use it after sun and/or at nighttime.
❓Is there a connection between Vitamin A and allergies?
🔸️The only relationship found so far is between lack of it and increased risk of allergic asthma and allergic rhinitis (hayfever).
‼️There is a hypothesis saying that Vit A might help prevent an adverse reaction when eating different kinds of food.
❌Too much Vitamin A can also lead to problems. Such as:
➡️Pain in the joints and bone
⚠️Sometimes, when having an 𝐚𝐥𝐥𝐞𝐫𝐠𝐢𝐜 𝐫𝐞𝐚𝐜𝐭𝐢𝐨𝐧, it can become a more severe reaction.
✳The most severe allergic reactions are called 𝐀𝐧𝐚𝐩𝐡𝐲𝐥𝐚𝐱𝐢𝐬.
📝The definition of 𝐀𝐧𝐚𝐩𝐡𝐲𝐥𝐚𝐱𝐢𝐬 is not uniform worldwide.
For you to have an idea, the WAO (𝘞𝘰𝘳𝘭𝘥 𝘈𝘭𝘭𝘦𝘳𝘨𝘺 𝘖𝘳𝘨𝘢𝘯𝘪𝘻𝘢𝘵𝘪𝘰𝘯), the WHO (𝘞𝘰𝘳𝘭𝘥 𝘏𝘦𝘢𝘭𝘵𝘩 𝘖𝘳𝘨𝘢𝘯𝘪𝘻𝘢𝘵𝘪𝘰𝘯), the AAAAI (𝘈𝘮𝘦𝘳𝘪𝘤𝘢𝘯 𝘈𝘤𝘢𝘥𝘦𝘮𝘺 𝘰𝘧 𝘈𝘭𝘭𝘦𝘳𝘨𝘺, 𝘈𝘴𝘵𝘩𝘮𝘢 𝘢𝘯𝘥 𝘐𝘮𝘮𝘶𝘯𝘰𝘭𝘰𝘨𝘺), the EAACI (𝘌𝘶𝘳𝘰𝘱𝘦𝘢𝘯 𝘈𝘤𝘢𝘥𝘦𝘮𝘺 𝘰𝘧 𝘈𝘭𝘭𝘦𝘳𝘨𝘺 𝘢𝘯𝘥 𝘊𝘭𝘪𝘯𝘪𝘤𝘢𝘭 𝘐𝘮𝘮𝘶𝘯𝘰𝘭𝘰𝘨𝘺) and the ASCIA (𝘈𝘶𝘴𝘵𝘳𝘢𝘭𝘢𝘴𝘪𝘢𝘯 𝘚𝘰𝘤𝘪𝘦𝘵𝘺 𝘰𝘧 𝘊𝘭𝘪𝘯𝘪𝘤𝘢𝘭 𝘐𝘮𝘮𝘶𝘯𝘰𝘭𝘰𝘨𝘺 𝘢𝘯𝘥 𝘈𝘭𝘭𝘦𝘳𝘨𝘺), all have slightly different definitions.
✴The one I like the most is actually the ASCIA one:
"𝘈 𝘳𝘢𝘱𝘪𝘥𝘭𝘺 𝘦𝘷𝘰𝘭𝘷𝘪𝘯𝘨, 𝘨𝘦𝘯𝘦𝘳𝘢𝘭𝘪𝘴𝘦𝘥 𝘮𝘶𝘭𝘵𝘪-𝘴𝘺𝘴𝘵𝘦𝘮 𝘳𝘦𝘢𝘤𝘵𝘪𝘰𝘯 𝘤𝘩𝘢𝘳𝘢𝘤𝘵𝘦𝘳𝘪𝘴𝘦𝘥 𝘣𝘺 𝘰𝘯𝘦 𝘰𝘳 𝘮𝘰𝘳𝘦 𝘴𝘺𝘮𝘱𝘵𝘰𝘮𝘴 𝘰𝘳 𝘴𝘪𝘨𝘯𝘴 𝘰𝘧 𝘳𝘦𝘴𝘱𝘪𝘳𝘢𝘵𝘰𝘳𝘺, 𝘤𝘢𝘳𝘥𝘪𝘰𝘷𝘢𝘴𝘤𝘶𝘭𝘢𝘳 𝘢𝘯𝘥 𝘰𝘵𝘩𝘦𝘳 𝘴𝘺𝘴𝘵𝘦𝘮𝘴 𝘴𝘶𝘤𝘩 𝘢𝘴 𝘵𝘩𝘦 𝘴𝘬𝘪𝘯 𝘢𝘯𝘥/𝘰𝘳 𝘎𝘐 𝘵𝘳𝘢𝘤𝘵."
Given this, how do we know it is 𝐀𝐧𝐚𝐩𝐡𝐲𝐥𝐚𝐱𝐢𝐬 or not
⬆️Have a look at the image above.
❓What to do if you think you, or your child, are having an anaphylactic reaction?
▶️If you are sure it is, give 𝐀𝐝𝐫𝐞𝐧𝐚𝐥𝐢𝐧𝐞.
▶️If you are unsure it is, STILL GIVE 𝐀𝐝𝐫𝐞𝐧𝐚𝐥𝐢𝐧𝐞.
▶️If you are sure it is not, ONLY in this case, give 𝐀𝐧𝐭𝐢𝐡𝐢𝐬𝐭𝐚𝐦𝐢𝐧𝐞𝐬.
‼️In ALL circumstances (or if you don't have an Adrenaline AutoInjector), 𝐜𝐚𝐥𝐥 𝟗𝟗𝟗 and ALWAYS ask for 𝐡𝐞𝐥𝐩.
✅(𝘵𝘩𝘦 𝘢𝘭𝘨𝘰𝘳𝘪𝘵𝘩𝘮 𝘐 𝘩𝘢𝘷𝘦 𝘶𝘴𝘦𝘥 𝘰𝘯 𝘮𝘺 𝘪𝘮𝘢𝘨𝘦𝘴 𝘪𝘴 𝘵𝘩𝘦 𝘯𝘦𝘸 𝘥𝘳𝘢𝘧𝘵 𝘰𝘯𝘦, 𝘸𝘢𝘪𝘵𝘪𝘯𝘨 𝘵𝘰 𝘣𝘦 𝘱𝘶𝘣𝘭𝘪𝘴𝘩𝘦𝘥)
🔶️It is important to know that 𝐀𝐧𝐚𝐩𝐡𝐲𝐥𝐚𝐱𝐢𝐬 is a 𝐫𝐚𝐫𝐞 𝐞𝐯𝐞𝐧𝐭, and most times, it 𝐃𝐎𝐄𝐒 𝐍𝐎𝐓 𝐥𝐞𝐚𝐝 𝐭𝐨 𝐝𝐞𝐚𝐭𝐡.
🆕️In fact, recently published research said there had been a significant increase in hospital admissions with Anaphylaxis, but a decrease in deaths.
This seems like a contradiction, but it is not.
⁉️Why is that?
✅On the one hand, we know there is a significant increase in the incidence of allergies, so naturally, the number of Anaphylactic cases will increase.
✅But on the other hand, the health care professionals awareness has increased, leading to better recognition and prescription of appropriate medication.
I will put my hands down, and agree with whoever tells me what is done, is still not enough.
The bottom line is:
➡ ️𝐑𝐞𝐜𝐨𝐠𝐧𝐢𝐬𝐞 it Fast.
➡️Have your 𝐦𝐞𝐝𝐢𝐜𝐚𝐭𝐢𝐨𝐧 with you AT ALL TIMES!
🆘️Ask for 𝐇𝐄𝐋𝐏!
⚠️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)
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)
🤧 It is a reaction from our immune system to something we got in contact with that the immune system did not recognize as "safe".
This can happen to a multitude of substances, with the best known being 🥘foods, 🐈pet dander, pollen, house dust mites, 🐝bee or wasp venom. But chemicals can also lead to those reactions.
The substance that causes such a reaction is called an "allergen".
Allergens can be found all around us.
In 🥘food, 🍵drinks, environment, being them airborne (which can be either 💦droplets or minuscule solids) or solids we get in contact with.
The primary reaction that will happen is the immune system trying to destroy that "invader" (allergen), and for that, it uses a significant amount of the immune mediators.
The outcome is an allergic reaction that can come in all sorts of presentations and severity.
Saying that not all allergens we get in contact with will make our immune system react.
Some are relatively harmless, depending on each individual's immune system and, often, prior exposure to that substance.
What are the most common allergens in children?
🔸️ Tree nuts
How does it affect 👶children:
🔸️Increased risk of developing allergies if one/both 👫parents are atopic
🔸️33% with moderate/severe eczema may present with a food allergy
🔸️There is a close relationship between asthma, 👃allergic rhinitis and food allergy in school-age
🔸️Food allergy is associated with severe asthma
The outcome of the allergies depends on the food the child is allergic to.
🔸️ Milk and egg - usually resolved by teenage years
🔸️ Wheat and soy - those are transient allergies of childhood
🔸️ Peanut and tree nut - typically starts in childhood and only 20% resolve
🔸️ Fish - it is often lifelong
Milk, soy, egg and wheat - are the most common foods involved in non-IgE mediated food allergy.
Dr Costa is a Consultant Paediatrician and fellow of the Royal College of Paediatrics and Child Health.