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Fending off food allergy

Date
What to put in the lunch box? ... conflicting allergy advice has parents bewildered.

What to put in the lunch box? ... conflicting allergy advice has parents bewildered. Photo: Marina Oliphant

Hands up: what's the most common food allergy in children? If (like me) you guessed peanuts, you'd be wrong. Egg allergy is the number one food allergy, says Associate Professor Debbie Palmer of the School of Paediatrics and Child Health at the University of Western Australia, but it has an advantage that peanuts don't – it's generally short lived. While egg allergies often disappear by school age, peanut allergy can be forever – only around 20 per cent of children grow out of it.

With food allergy on the rise – it's three times more common than it was a generation ago - researchers are looking for ways to stem the tide.  Until recently the advice on preventing food allergy has been to avoid giving babies potentially allergenic foods early.  Now the pendulum is swinging the other way and a strong contender for allergy protection is introducing babies earlier rather than later to foods that cause most childhood food allergy - eggs, cow's milk, peanuts, tree nuts, soy, wheat, fish and shellfish, says Palmer.

"The thinking is that introducing these foods early helps babies develop a tolerance and the allergy prevention advice from the Australasian Society for Clinical Immunology and Allergy is to introduce solids from four to six months of age." 

With eggs, for instance, the advice from the 2003 guidelines from Australia's National Health and Medical Research Council and still used by some health professionals, is to introduce yolk at eight months and egg white at 12 months. But some studies have found that introducing egg and other foods that cause allergy before nine months may help prevent allergies, says Palmer.

"The thinking is that introducing these foods early helps babies develop a tolerance and the allergy prevention advice from the Australasian Society for Clinical Immunology and Allergy is to introduce solids from four to six months of age."

But this recommendation from medical allergy specialists clashes with the new NH&MRC guidelines for feeding babies – still in draft form – that recommends giving babies breast milk alone for the first six months. As Palmer points out, this advice originates from the World Health Organisation and is aimed at preventing infection in babies – a problem that's less common in developed countries like Australia where allergy is more of an issue.

So what's a bewildered parent to do?

"The best advice is to keep breastfeeding for at least six months and use your intuition about introducing solids after four months if the baby seems ready to try them," she says.

As for eating in pregnancy, it's a similar story - don't shun common allergy foods like peanuts.

"Even when women have a food allergy themselves, they should only avoid the food they're allergic to. There's now more emphasis on mothers getting enough vitamin D, vitamin E and zinc. These nutrients are important for the immune system of both mothers and babies - it may be that getting enough of them can help prevent allergy," explains Palmer who's part of a research team looking at whether giving vitamin D to babies lowers their risk of allergies.

Although it's still not certain, vitamin D may be important for helping to prevent asthma too, she adds. In contrast to many European countries, Australian babies aren't routinely given vitamin D supplements - it's been assumed they get plenty of sunlight to make enough of the vitamin themselves.

"But even in Perth we find some pregnant women are low in vitamin D. In Australia our practices around sunlight exposure have changed – you now see babies with wraps over their prams to protect them from the sun, for instance. "

What about supplements of omega 3 fats, probiotics or prebiotics – can they help prevent allergies?

"Research in Perth found that giving omega-3 fats directly to young babies didn't make a difference, but Adelaide researchers found that the babies of women who took omega-3 supplements in pregnancy were less likely to have egg sensitisation (meaning they had a lower risk of egg allergy), and, to a lesser extent, less likely to have eczema," she says. "With probiotics and prebiotics, there's no strong evidence for mothers or babies – but they won't do any harm."

Has food allergy been a problem for your kids?

41 comments so far

  • "Now the pendulum is swinging the other way and a strong contender for allergy protection is introducing babies earlier rather than later to foods that cause most childhood food allergy - eggs, cow's milk, peanuts, tree nuts, soy, wheat, fish and shellfish, says Palmer"

    Cripes.

    Did it occur to any of these researchers that an allergy to a specific substance might be indicative of it's suitability as a food for humans?

    Half of the things on that list are relatively new 'foods' which are out of sync with our evolution.

    Commenter
    Jeff
    Date and time
    July 03, 2012, 10:05PM
    • yeah but there's a real shortage of wooly mammoths and sabre-toothed eggplants these days... tell me what was the life expectancy of people when they were eating foods that were "in sync" with our evolution? even given the advances in medical science and sanitation, diet has played a major role in improving health and longevity.

      The recent, sudden spike in allergies is not due to a "new diet" (people have been eating eggs and peanuts for a long time), but is most likely a result of the massive introduction of chemicals and plastics into virtually every aspect of daily life. This truly *is* a recent event and has nothing to do with crackpot notions of paleo diets.

      Commenter
      joe
      Date and time
      July 04, 2012, 9:42AM
    • Err, Jeff. I'm pretty sure nuts, fish and grains have been part of our diet since time immemorial. In fact, it is red meat which is one of the latest additions to our common foods, and allergy to actual meat is extremely rare.

      Is this just a round about way of pushing vegan diets? If so, can I suggest that vegans needing to so carefully eat a range of foods to avoid malnutrition - some foods which were totally unavailable to people on certain continents, might suggest that humans were never meant to be vegan?

      Commenter
      Ken
      Location
      Sydney
      Date and time
      July 04, 2012, 9:58AM
    • @ joe / July 04, 2012, 9:42AM
      I'm Trying to find the LIKE button.

      Commenter
      Lippy Queen
      Date and time
      July 04, 2012, 10:04AM
    • @Joe. Yep spot on. Only problem with being right though is there's not a lot a thoughtful modern western citizen can do about it. Its everywhere (and I wouldn't suggest it shouldn't be).

      Commenter
      Peter
      Location
      Oz
      Date and time
      July 04, 2012, 10:23AM
    • @joe

      What is a sabretooth eggplant? Something you dreamt up along with your unsubstantiated theory about plastics being the death knell of of human health?

      Paleolithic man ate poultry, seafood, ruminants and many of the plants we eat now. Or perhaps you think those things just magically appeared on earth very recently? your ill-informed and cartoonish depiction of the diet of our ancestors would suggest so

      As for your questions about the health of paleo folk- the main causes of death amongst hunter-gatherers was bacteria, viruses and physical trauma. They were in good health. Once humans began to practice agriculture it all went south, including life expectency. And unlike you I'll provide evidence for my claims:
      http://www.ncbi.nlm.nih.gov/pubmed/19003886
      http://www.ditext.com/diamond/mistake.html
      http://books.google.com.au/books/about/The_Paleopathological_Evidence_Indicator.html?id=Gv0aLgEACAAJ&redir_esc=yvw
      http://thepaleodiet.com/published-research

      Our current life expectancy has nothing to do with a supposedly healthier diet (you may have noticed that obesity, heart disease and diabetes are on the rise) and everything to do with sanitation. Long life does not imply good health when people can be stuck together with prescription drugs. Quality of life matters more.

      When you claim people have been eating peanuts for a long time so that is proof they are fine, you show that you have no knowledge of human evolution, and little logic. Peanuts are modern cultivars, humans have been eating for less than 10,000 years which is the evolutionary equivelent of about 5 minutes ago. Tolerating a food does not mean it is healthy. If something is not acutely toxic, it does not mean it is harmless.

      But Joe says we don't need to worry about any of the science which suggest some foods are more suited to our biology than others- apparently it's all down to plastics and chemicals so we can just eat anything we want! Great!

      Commenter
      Jeff
      Date and time
      July 04, 2012, 7:33PM
    • \@joe

      What is a sabretooth eggplant? Something you dreamt up along with your unsubstantiated theory about plastics being the death knell of of human health?

      Paleolithic man ate poultry, seafood, ruminants and many of the plants we eat now. Or perhaps you think those things just magically appeared on earth very recently? your ill-informed and cartoonish depiction of the diet of our ancestors would suggest so

      As for your questions about the health of paleo folk- the main causes of death amongst hunter-gatherers was bacteria, viruses and physical trauma. They were in good health. Once humans began to practice agriculture it all went south, including life expectency. And unlike you I'll provide evidence for my claims:
      http://www.ncbi.nlm.nih.gov/pubmed/19003886
      http://www.ditext.com/diamond/mistake.html
      http://books.google.com.au/books/about/The_Paleopathological_Evidence_Indicator.html?id=Gv0aLgEACAAJ&redir_esc=yvw
      http://thepaleodiet.com/published-research

      Our current life expectancy has nothing to do with a supposedly healthier diet (you may have noticed that obesity, heart disease and diabetes are on the rise) and everything to do with sanitation. Long life does not imply good health when people can be stuck together with prescription drugs. Quality of life matters more.

      When you claim people have been eating peanuts for a long time so that is proof they are fine you show that you have no knowledge of human evolution, and little logic. Peanuts are modern cultivars, humans have been eating for less than 10,000 years which is the evolutionary equivelent of about 5 minutes ago. Tolerating a food does not mean it is healthy. If something is not acutely toxic, it does not mean it is harmless.

      But Joe says we don't need to worry about any of the science which suggest some foods are more suited to our biology than others- apparently it's all down to plastics and chemicals so we can just eat anything we want! Great!

      Commenter
      Jeff
      Date and time
      July 04, 2012, 7:40PM
    • @Ken

      "Err, Jeff. I'm pretty sure nuts, fish and grains have been part of our diet since time immemorial. In fact, it is red meat which is one of the latest additions to our common foods"

      What makes you 'pretty sure' of either of those things Ken?

      Certainly not knowledge of the historical record.

      Grain consumption goes back only 10,000 years-

      http://www.beyondveg.com/cordain-l/grains-leg/grains-legumes-1a.shtml

      Where is your evidence that red meat is one of our 'latest additions'?

      Commenter
      Jeff
      Date and time
      July 04, 2012, 7:47PM
    • The idea that grain consumption is only 10,000 years old has been challenged, e.g. http://www.sciencemag.org/content/326/5960/1680.abstract

      Commenter
      Paula
      Date and time
      July 04, 2012, 10:35PM
    • I can't access the full text but there are a few papers similar to this doing the rounds and are being held up as proof of paleolithic grain consumption.

      The abstract doesn't doesn't say that they were actually being consumed, only that it was found on tools. It was common for such grasses to be used as bedding.

      It's also important to note that the grains people are eating today are modern creations. Modern wheat for example is nothing like it's ancesteral counterpart, Einkorn, which doesn't provoke the same reaction in celiac's sufferers.

      http://www.ncbi.nlm.nih.gov/pubmed/17060124

      Collecting wild grains would also inevitably mean they would up make a smaller percentage of the diet. Only farming techniques could provide constant, high supply.

      Commenter
      Jeff
      Date and time
      July 05, 2012, 9:17PM

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