Winter 2013

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Research Update


Factors influencing food choices of food-allergic consumers: findings from focus groups

Background & Summary: Forty six adults participated in a focus group investigating factors that influence food choice. Participants were either: diagnosed with food allergy (IgE – immediate), self-reported food allergy/intolerance or had no food allergy concerns. The restricted diet participants, particularly those with diagnosed food allergy, were more likely to feel their diet was not emotionally satisfying. Some expressed concerns that choosing safe foods really limited their diet and that food preparation was a burdensome task.

Application to Dietetic Practice: With clients on a restricted diet, dietitians should address many issues beyond, “what to avoid”. Ideas to simplify food shopping/preparation, alternative food choices and finding pleasure in eating would be helpful.

The questions used to guide the focus group discussions (Table 1) could also be used as a group counselling tool. For example, a dietitian could facilitate a group discussion with members of a local celiac support group. When difficulties are expressed, other participants and the dietitian could offer suggestions. This may be an effective way for private practice dietitians to connect with clients that need more individualized counseling.
Pub Med ID: 22913718

Probiotics in the development and treatment of allergic disease

Background & Summary: An infant’s intestinal microbiota may impact the development of food allergy and other inflammatory diseases. The mother’s microbiota is an important determinant of the type and quantity of microbiota that are established in the infant.  The mother may transfer healthy or unhealthy bacteria through prenatal placenta and amniotic fluid, birth canal delivery and breastfeeding. Pre and probiotic supplementation for the mother and/or infant is a potential therapy to prevent or treat allergic disease. However, meta-analyses have not supported this theory. The author discusses some of the limitations of the published meta–analyses.
Application to Dietetic Practice: There is insufficient evidence to recommend pre and probiotics for the prevention and treatment of allergic disease. Hopefully, future research will provide specific direction. Nevertheless, this is a fascinating article for dietitians that are interested in this topic.
Pub Med ID: 23101685

Nutritional aspects in diagnosis and management of food hypersensitivity-the dietitians role

Background & Summary: In most settings, the dietitian’s role in food hypersensitivity nutrition care is limited to nutrition education based on a physician prescribed restriction. This interesting article provides an opportunity to look beyond that role. Questions the dietitian (or other health care provider) can include in an allergy-focused clinical history and factors to consider when interpreting the information are provided. Three case studies illustrate the dietitian’s important role in identifying food allergens and providing nutrition care. The paper was written by three steering committee members of the International Network for Diet and Nutrition in Allergy (INDANA). General membership is open to any health care professional with a relevant first degree who is working in the field of food hypersensitivity.
Application to Dietetic Practice: This is a great article for all dietitians that work with food hypersensitivity clients. Student dietitians (or experienced dietitians looking for a change) can get an overview of the dietitian’s role in food hypersensitivity nutrition care.
Pub Med ID: 23150738

Clinical diagnosis and management of food protein-induced enterocolitis syndrome

Background & Summary: Food protein-induced enterocolitis syndrome (FPIES) is a delayed food allergy primarily seen in young infants. Vomiting, lethargy, and diarrhea are common symptoms.  Milk and soy proteins in formula are the primary triggers. These infants may develop additional symptoms when solid foods are introduced. Rice is the most common trigger (likely because it is usually the first food). For infants diagnosed with milk or soy FPIES, the authors empirically recommend delaying cow’s milk, soy, grain, legumes and poultry until 1 year of age and starting with yellow fruits and vegetables. The allergy is usually out-grown, but the decision to reintroduce the food trigger should be made by a physician. Exposure can lead to severe symptoms and may need to be performed under medical supervision.
Application to Dietetic Practice: This is a great review article for pediatric dietitians.
Pub Med ID: 23042254

Resources Update


Celiac disease & gluten-free webinars

Description: The National Foundation for Celiac Awareness provides free monthly webinars with critical information provided by celiac disease and gluten-free experts.  Past webinars are archived on the NFCA’s website.
Target Audience: This is a great resource for clients, and would also be a rich learning opportunity for dietitians.
Organization: National Foundation for Celiac Awareness
Website Link

Food allergies and cross-reactivity

Description: Food allergen cross-reactivity is a complicated topic.  This article was written by an expert allergist and provides an informative, but simple overview of this topic.
Target Audience: It is intended for the public, but would also be good for dietitians that are not familiar with this topic.
Organization: Kids with Food Allergy Website
Website Link