Happy & Healthy Families Expo Fremantle 2012

Myth and fact in the gluten debate

by Sarah Berry, Sydney Morning Herald, 29th February 2012.

Gluten-free is a big buzzword with big bucks behind it. In 2010, the global market for gluten-free products was worth $2.5 billion. Over the next five years, it is expected to grow to more than $5 billion.

But, how much of the buzz behind being gluten-free is bona fide?

A new study raises questions about the hype surrounding the gluten-free phenomenon. According to the study published in the Annals of Internal Medicine, titled Nonceliac Gluten Sensitivity: Sense or Sensibility?, there are 4598 Google citations of noncoeliac gluten sensitivity for every science journal article about the condition.

"Considerable debate about noncoeliac gluten sensitivity has recently surfaced on the internet, with a sharp increase in forums, patients or patient groups, manufacturers, and physicians advocating a gluten-free diet," the study's authors said. "Claims seem to increase daily, with no adequate scientific support to back them up."

The researchers acknowledge that "recent studies support the existence of a new condition, noncoeliac gluten sensitivity", but say gluten may not be the problem in a lot of the sensitivity that patients feel.

Gluten is found in products that contain wheat, rye and barley. In the study, the researchers noted that other ingredients in wheat flour or wheat-based foods may actually be causing symptoms that might be attributed to gluten sensitivity.

Yet, another study was specifically designed to establish whether gluten or fructans, which are another component in wheat, was the culprit. In the study, subjects were given bread and muffins that were low in starch. One batch of the bread and muffins contained gluten, the other did not.

The study found that gluten itself may trigger gut symptoms and fatigue in individuals who do not have coeliac disease.

"There was a clear difference in symptoms [between those who had the muffins with gluten and those who didn't]," says co-author of the study and Director of Medicine at the Angliss Hospital in Melbourne, Dr Evan Newnham. "There's a perception that [gluten-free] is a fad and that gluten is an evil food. But trials [like these] establish that it might be a clinical and medical problem."

Indeed, an essay published in the BioMed Central Journal says that gluten is "toxic" to humans and predicts that gluten-related problems are set to rise.

Since the introduction of grains containing gluten to the human diet about 10,000 years ago, selective breeding has seen the gluten content of wheat rise considerably to make it more palatable. The offshoot of this is that it is more harmful to humans. "Wheat varieties grown for thousands of years and mostly used for human nutrition up to the middle ages ... contain less quantities of the highly toxic 33-mer gluten peptide."

The authors say that our gastrointestinal and immunological responses have not adapted and so we remain "largely vulnerable to the toxic effects of this protein complex ... All individuals, even those with a low degree risk, are therefore susceptible to some form of gluten reaction during their life span."

But, because it is only in the last decade that coeliac disease and gluten sensitivities (for which doctors cannot test) have moved into the spotlight the research is still in its infancy. Which makes the distinction between how much is fact or fad a challenging call to make.

And it is not just the medical professionals debating the issue.

Mia Freedman recently expressed her exasperation in a post titled: "Does anyone eat anything anymore?". In the blog, she quotes nutritionist, Joanna McMillan.

"Some people cannot tolerate gluten yet suddenly everyone thinks gluten is bad. The truth is: it is modern refined foods that are causing most of our health problems. Not the individual components of food. We're missing the point."

"It never used to be like this," Freedman says. "Nobody had an intolerance when I was a kid, let alone wanted one."

In response, blogger and author, Sarah Wilson wrote an article titled "What's with all the gluten intolerances?? let me explain..."

"The short form: gluten is a poison," she says. "We tolerate it, and tolerate it, like cigarettes in the lungs. And then. One day. It's too much. Things tip over and BANG we have lung cancer. Or gluten intolerance. Or coeliac's disease."

Wilson also points out that we eat more wheat than ever before and cites the Pottinger cats theory as a possible explanation for the growth of gluten-related problems.

Over a period of ten years, Pottinger conducted a series of diet experiements on cats. "He found the illnesses (including infertility and the same degenerative diseases we're now seeing in humans) took several generations to kick in. And that it took four generations again of being fed good food for normal health to be restored," Wilson said.

"The point being...intolerances haven't just suddenly happened now. They've built up and accumulated over the generations. Our grandparents started eating processed, high-wheat and gluten diets. Now we're copping it."

There is something to this, says Newnham. "Environment, awareness...genes and how [previous generations] have eaten all have a role," he says. "The difficulty is to tease it all out."

Teasing out is exactly what the medical profession is now attempting to do. "While [gluten sensitivities] are anecdotally common, the medical community has been slow on the uptake," Newnham says. "On the whole we do tolerate [gluten], but it's increasingly recognised that there is a subset of the population that doesn't. What we don't know is the prevalence...[it] still needs more research"

If you do believe gluten is causing you problems, Newnham does not see a problem with going gluten-free provided it is done under the supervision of a dietitian or doctor. "But, I'd just like to emphasise that before embarking on a gluten-free diet ensure you don't have coeliac disease. Complications can ensue [if you do] and you can find out with a simple blood test or endoscopy."

What's the difference:

Coeliac disease (CD) is an autoimmune enteropathy triggered by the ingestion of gluten. Gluten-sensitive individuals (GS) cannot tolerate gluten and may develop gastrointestinal symptoms similar to those in CD, but the overall clinical picture is generally less severe.

Gluten sensitivity refers to an adverse reaction to eating gluten that usually does not lead to damage of the small intestine.

Wheat allergy is not specifically related to the gut. Reactions to wheat can vary significantly and like other classic food allergies can affect the skin, gastrointenstinal tract or respiratory tract.

Coeliac denotes a response to gluten that causes the immune system to attack its own body tissue

For more information go to: http://gluten-intolerance-symptoms.com/ or www.gesa.org.au

Three Hidden Ways Wheat Makes You Fat

by Mark Hyman, Huffington Post, February 18 2012

Gluten-free is hot these days. There are books and websites, restaurants with gluten free menus, and grocery stores with hundreds of new gluten-free food products on the shelf. Is this a fad, or a reflection of response to a real problem?

Yes, gluten is a real problem. But the problem is not just gluten. In fact, there are three major hidden reasons that wheat products, not just gluten (along with sugar in all its forms) is a major contributor to obesity, diabetes, heart disease, cancer, dementia, depression and so many other modern ills. 

This is why there are now 30 percent more obese than undernourished in the world, and why chronic lifestyle and dietary driven disease kills more than twice as many people as infectious disease globally. These non-communicable, chronic diseases will cost our global economy $47 trillion over the next 20 years.

Sadly, this tsunami of chronic illness is increasingly caused by eating our beloved diet staple, bread, the staff of life, and all the wheat products hidden in everything from soups to vodka to lipstick to envelope adhesive.

The biggest problem is wheat, the major source of gluten in our diet. But wheat weaves its misery through many mechanisms, not just the gluten! The history of wheat parallels the history of chronic disease and obesity across the world. Supermarkets today contain walls of wheat and corn disguised in literally hundreds of thousands of different food-like products, or FrankenFoods. Each American now consumes about 55 pounds of wheat flour every year. 

It is not just the amount but also the hidden components of wheat that drive weight gain and disease. This is not the wheat your great-grandmother used to bake her bread. It is FrankenWheat -- a scientifically engineered food product developed in the last 50 years.

How Wheat -- and Gluten -- Trigger Weight Gain, Prediabetes, Diabetes and More

This new modern wheat may look like wheat, but it is different in three important ways that all drive obesity, diabetes, heart disease, cancer, dementia and more.

1. It contains a Super Starch -- amylopectin A that is super fattening.
2. It contains a form of Super Gluten that is super-inflammatory.
3. It contains forms of a Super Drug that is super-addictive and makes you crave and eat more.

The Super Starch

The Bible says, "Give us this day our daily bread." Eating bread is nearly a religious commandment. But the Einkorn, heirloom, Biblical wheat of our ancestors is something modern humans never eat. 

Instead, we eat dwarf wheat, the product of genetic manipulation and hybridization that created short, stubby, hardy, high-yielding wheat plants with much higher amounts of starch and gluten and many more chromosomes coding for all sorts of new odd proteins. The man who engineered this modern wheat won the Nobel Prize -- it promised to feed millions of starving around the world. Well, it has, and it has made them fat and sick.

The first major difference of this dwarf wheat is that it contains very high levels of a super starch called amylopectin A. This is how we get big fluffy Wonder Bread and Cinnabons.

Here's the downside. Two slices of whole wheat bread now raise your blood sugar more than two tablespoons of table sugar.

There is no difference between whole wheat and white flour here. The biggest scam perpetrated on the unsuspecting public is the inclusion of "whole grains" in many processed foods full of sugar and wheat, giving the food a virtuous glow. The best way to avoid foods that are bad for you is to stay away from foods with health claims on the labels. They are usually hiding something bad.

In people with diabetes, both white and whole grain bread raises blood sugar levels 70 to 120 mg/dl over starting levels. We know that foods with a high glycemic index make people store belly fat, trigger hidden fires of inflammation in the body and give you a fatty liver, leading the whole cascade of obesity, pre-diabetes and diabetes. This problem now affects every other American and is the major driver of nearly all chronic disease and most our health care costs. Diabetes now sucks up one in three Medicare dollars.

The Super Gluten

Not only does this dwarf, FrankenWheat, contain the super starch, but it also contains super gluten which is much more likely to create inflammation in the body. And in addition to a host of inflammatory and chronic diseases caused by gluten, it causes obesity and diabetes.

Gluten is that sticky protein in wheat that holds bread together and makes it rise. The old fourteen-chromosome-containing Einkorn wheat codes for the small number of gluten proteins, and those that it does produce are the least likely to trigger celiac disease and inflammation. The new dwarf wheat contains twenty-eight or twice as many chromosomes and produces a large variety of gluten proteins, including the ones most likely to cause celiac disease.

Five Ways Gluten Makes You Sick and Fat

Gluten can trigger inflammation, obesity and chronic disease in five major ways.

1. Full-blown celiac disease is an autoimmune disease that triggers body-wide inflammation triggering insulin resistance, which causes weight gain and diabetes, as well as over 55 conditions including autoimmune diseases, irritable bowel, reflux, cancer, depression, osteoporosis and more.
2. Low-level inflammation reactions to gluten trigger the same problems even if you don't have full-blown celiac disease but just have elevated antibodies (7 percent of the population, or 21 million Americans).
3. There is also striking new research showing that adverse immune reactions to gluten may result from problems in very different parts of the immune system than those implicated in celiac disease. Most doctors dismiss gluten sensitivity if you don't have a diagnosis of celiac disease, but this new research proves them wrong. Celiac disease results when the body creates antibodies against the wheat (adaptive immunity), but another kind of gluten sensitivity results from a generalized activated immune system (innate immunity). This means that people can be gluten-sensitive without having celiac disease or gluten antibodies and still have inflammation and many other symptoms.
4. A NON-gluten glycoprotein or lectin (combination of sugar and protein) in wheat called wheat germ agglutinin (WGA)[1] found in highest concentrations in whole wheat increases whole body inflammation as well. This is not an autoimmune reaction, but can be just as dangerous and cause heart attacks.[2]
5. Eating too much gluten-free food (what I call gluten-free junk food) like gluten-free cookies, cakes and processed food. Processed food has a high glycemic load. Just because it is gluten-free, doesn't mean it is healthy. Gluten-free cakes and cookies are still cakes and cookies! Vegetables, fruits, beans, nuts and seeds and lean animal protein are all gluten free -- stick with those.

Let's look at this a little more closely. Gluten, a protein found in wheat, barley, rye, spelt and oats, can cause celiac disease, which triggers severe inflammation throughout the body and has been linked to autoimmune diseases, mood disorders, autism, schizophrenia, dementia, digestive disorders, nutritional deficiencies, diabetes, cancer and more. 

Celiac Disease: The First Problem

Celiac disease and gluten-related problems have been increasing, and now affect at least 21 million Americans and perhaps many millions more. And 99 percent of people who have problems with gluten or wheat are NOT currently diagnosed.

Ninety-eight percent of people with celiac have a genetic predisposition known as HLA DQ2 or DQ8, which occurs in 30 percent of the population. But even though our genes haven't changed, we have seen a dramatic increase in celiac disease in the last 50 years because of some environmental trigger.

In a recent study that compared blood samples taken 50 years ago from 10,000 young Air Force recruits to samples taken recently from 10,000 people, researchers found something quite remarkable. There has been a real 400 percent increase in celiac disease over the last 50 years.[3] And that's just the full-blown disease affecting about one in 100 people, or about three million Americans. We used to think that this only was diagnosed in children with bloated bellies, weight loss and nutritional deficiencies. But now we know it can be triggered (based on a genetic susceptibility) at any age and without ANY digestive symptoms. The inflammation triggered by celiac disease can drive insulin resistance, weight gain and diabetes, just like any inflammatory trigger -- and I have seen this over and over in my patients. 

Gluten and Gut Inflammation: The Second Problem

But there are two ways other than celiac disease in which wheat appears to be a problem.

The second way that gluten causes inflammation is through a low-grade autoimmune reaction to gluten. Your immune system creates low-level antibodies to gluten, but doesn't create full-blown celiac disease. In fact, 7 percent of the population, 21 million, have these anti-gliadin antibodies. These antibodies were also found in 18 percent of people with autism and 20 percent of those with schizophrenia.

A major study in the Journal of the American Medical Association reported that hidden gluten sensitivity (elevated antibodies without full-blown celiac disease) was shown to increase risk of death by 35 to 75 percent, mostly by causing heart disease and cancer.[4] Just by this mechanism alone, over 20 million Americans are at risk for heart attack, obesity, cancer and death. 

How does eating gluten cause inflammation, heart disease, obesity, diabetes and cancer?

Most of the increased risk occurs when gluten triggers inflammation that spreads like a fire throughout your whole body. It damages the gut lining. Then all the bugs and partially-digested food particles inside your intestine get across the gut barrier and are exposed your immune system, 60 percent of which lies right under the surface of the one cell thick layer of cells lining your gut or small intestine. If you spread out the lining of your gut, it would equal the surface area of a tennis court. Your immune system starts attacking these foreign proteins, leading to systemic inflammation that then causes heart disease, dementia, cancer, diabetes and more. 

Dr. Alessio Fasano, a celiac expert from the University of Maryland School of Medicine, discovered a protein made in the intestine called "zonulin" that is increased by exposure to gluten.[5] Zonulin breaks up the tight junctions or cement between the intestinal cells that normally protect your immune system from bugs and foreign proteins in food leaking across the intestinal barrier. If you have a "leaky gut," you will get inflammation throughout your whole body and a whole list of symptoms and diseases.

Why is there an increase in disease from gluten in the last 50 years?

It is because, as I described earlier, the dwarf wheat grown in this country has changed the quality and type of gluten proteins in wheat, creating much higher gluten content and many more of the gluten proteins that cause celiac disease and autoimmune antibodies.

Combine that with the damage our guts have suffered from our diet, environment, lifestyle and medication use, and you have the perfect storm for gluten intolerance. This super gluten crosses our leaky guts and gets exposed to our immune system. Our immune system reacts as if gluten was something foreign, and sets off the fires of inflammation in an attempt to eliminate it. However, this inflammation is not selective, so it begins to attack our cells -- leading to diabesity and other inflammatory diseases.

Damage to the gastrointestinal tract from overuse of antibiotics, anti-inflammatory drugs like Advil or Aleve and acid-blocking drugs like Prilosec or Nexium, combined with our low-fiber, high-sugar diet, leads to the development of celiac disease and gluten intolerance or sensitivity and the resultant inflammation. That is why elimination of gluten and food allergens or sensitivities can be a powerful way to prevent and reverse diabesity and many other chronic diseases. 

The Super Drug

Not only does wheat contain super starch and super gluten -- making it super fattening and super inflammatory -- but it also contains a super drug that makes you crazy, hungry and addicted.

When processed by your digestion, the proteins in wheat are converted into shorter proteins, "polypeptides," called "exorphins." They are like the endorphins you get from a runner's high and bind to the opioid receptors in the brain, making you high, and addicted just like a heroin addict. These wheat polypeptides are absorbed into the bloodstream and get right across the blood brain barrier. They are called "gluteomorphins," after "gluten" and "morphine." 

These super drugs can cause multiple problems, including schizophrenia and autism. But they also cause addictive eating behavior, including cravings and bingeing. No one binges on broccoli, but they binge on cookies or cake. Even more alarming is the fact that you can block these food cravings and addictive eating behaviors and reduce calorie intake by giving the same drug we use in the emergency room to block heroin or morphine in an overdose, called naloxone. Binge eaters ate nearly 30 percent less food when given this drug. 

Bottom line: wheat is an addictive appetite stimulant.

How to Beat the Wheat, and Lose the Weight

First, you should get tested to see if you have a more serious wheat or gluten problem.

If you meet any of these criteria, then you should do a six-week 100 percent gluten-free diet trial to see how you feel. If you have three out of five criteria, you should be gluten-free for life.

1. You have symptoms of celiac (any digestive, allergic, autoimmune or inflammatory disease, including diabesity).
2. You get better on a gluten-free diet.
3. You have elevated antibodies to gluten (anti-gliadin, AGA, or tissue transglutaminase antibodies, TTG).
4. You have a positive small intestinal biopsy.
5. You have the genes that predispose you to gluten (HLA DQ2/8).

Second, for the rest of you who don't have gluten antibodies or some variety of celiac -- the super starch and the super drug, both of which make you fat and sick, can still affect you. So go cold turkey for six weeks. And keep a journal of how you feel. 

The problems with wheat are real, scientifically validated and ever-present. Getting off wheat may not only make you feel better and lose weight, it could save your life.

My personal hope is that together we can create a national conversation about a real, practical solution for the prevention, treatment, and reversal of our obesity, diabetes and chronic disease epidemic. Getting off wheat may just be an important step.

To learn more and to get a free sneak preview of The Blood Sugar Solution where I explain exactly how to avoid wheat and what to eat instead go to www.drhyman.com.

Please leave your thoughts by adding a comment below.

To your good health,

Mark Hyman, MD

References:

[1] Saja K, Chatterjee U, Chatterjee BP, Sudhakaran PR. "Activation dependent expression of MMPs in peripheral blood mononuclear cells involves protein kinase." A. Mol Cell Biochem. 2007 Feb;296(1-2):185-92

[2] Dalla Pellegrina C, Perbellini O, Scupoli MT, Tomelleri C, Zanetti C, Zoccatelli G, Fusi M, Peruffo A, Rizzi C, Chignola R. "Effects of wheat germ agglutinin on human gastrointestinal epithelium: insights from an experimental model of immune/epithelial cell interaction." Toxicol Appl Pharmacol. 2009 Jun 1;237(2):146-53.

[3] Rubio-Tapia A, Kyle RA, Kaplan EL, Johnson DR, Page W, Erdtmann F, Brantner TL, Kim WR, Phelps TK, Lahr BD, Zinsmeister AR, Melton LJ 3rd, Murray JA. "Increased prevalence and mortality in undiagnosed celiac disease." Gastroenterology. 2009 Jul;137(1):88-93

[4] Ludvigsson JF, Montgomery SM, Ekbom A, Brandt L, Granath F. "Small-intestinal histopathology and mortality risk in celiac disease." JAMA. 2009 Sep 16;302(11):1171-8.

[5] Fasano A. "Physiological, pathological, and therapeutic implications of zonulin-mediated intestinal barrier modulation: living life on the edge of the wall." Am J Pathol. 2008 Nov;173(5):1243-52.

Mark Hyman, M.D. is a practicing physician, founder of The UltraWellness Center, a four-time New York Times bestselling author, and an international leader in the field of Functional Medicine. You can follow him on Twitter, connect with him on LinkedIn, watch his videos on YouTube, become a fan on Facebook, and subscribe to his newsletter.

Cracking the code: A guide to understanding food labels

This article was originally published on the More than Medication website.  You can find the original article by clicking here.  And the More than Mediaction home page by clicking here.

Study to crack egg allergy - News article

Source: The West Australian | Date: 2009-10-07

Doctors are testing a theory that the most common food allergy in children could be prevented by feeding egg to babies by the age of six months.

In a move that goes against recent advice to delay giving babies potentially allergy-causing foods, researchers from Princess Margaret Hospital's Childhood Allergy and Immunology Research centre believe exposure to egg early in life could help develop immune tolerance.

They are recruiting 125 babies with eczema who are at higher risk of developing food allergies, half of whom will be given egg powder each day while continuing their regular feeding. The rest will be given a non-egg substitute.

Susan Prescott, from the University of WA's school of paediatrics and child health, said allergy to egg was the most common susceptibility in Australian children.

There was no treatment for the condition and avoiding the food often put a burden on families.

"We think the immune system probably learns these foods are harmless by being exposed to them regularly from an early age," Professor Prescott said.

Find Dr Susan Prescott's book "The Allergy Epidemic - A Mystery of Modern Life" on  your Healthy Shelf today. 

One in 10 babies have life-threatening food allergy - News article

by Cathy O'Leary, Medical Editor, The West Australian September 24, 2011

 An epidemic of potentially life-threatening reactions is affecting a record one in 10 Australian babies, a Perth expert has warned.

Princess Margaret Hospital paediatric allergist and immunologist Susan Prescott said the recent rate, the highest ever reported in the world, included a 500 per cent increase in serious anaphylactic food allergies in pre-schoolers in the past 10 years.

She said it had led to long outpatient clinic waiting lists of babies and children with severe allergies that were rare in their parents.

Professor Prescott has written a book, The Allergy Epidemic, in which she details theories about the unprecedented rise in allergic diseases and gives advice to parents about how to manage them.

She said modern lifestyle factors were creating inflammation in the immune system and in turn more allergies and immune diseases.

People were more preoccupied with hygiene, spending more time indoors and away from sunlight, and eating less fruit, vegetable and fibre.

"We don't have all the answers, because food allergies have been the poor cousin in research, but it seems you can be allergic to almost anything these days," she said.

"The main culprits are egg, cow's milk, peanuts and seafood but it's really whatever food the immune system decides to react to and we know that the immune system is very vulnerable to modern life compared to 50 years ago."

Despite the once-held view that children outgrew food allergies, many were still affected as teenagers and adults, causing an alarming epidemic that was getting worse with each generation.

"We're seeing more and more kids not growing out of them," Professor Prescott said.

Charlotte Crainie, 2, was diagnosed with a cashew allergy a year ago, after she became violently ill after eating a dip.

Her mother Aimee said the family now had to be cautious when eating out.

 
Professor Prescott is donating proceeds from the book to allergy research.

Find Dr Susan Prescott's book "The Allergy Epidemic - A Mystery of Modern Life" on  your Healthy Shelf today.

Lifestyle trigger to allergy epidemics - News Article

by Marnie McKimmie, The West Australian October 3, 2011

The puzzling 20- to 30-year lag between the wave of hayfever that gripped the world and the recent wave of food allergies has experts questioning whether the allergy epidemic is partly driven by an "amplifying effect" across generations.

With alarming food allergies now appearing within months of birth, it suggests the factors driving this new epidemic are operating very early in development, most likely in pregnancy, says leading WA paediatric allergist and immunologist Susan Prescott.

"Every mother provides the first environment for her foetus," Professor Prescott said. "Her immune system directly influences the developing foetal immune function. It is already very clear that allergic mothers directly increase the risk of allergy in their babies, so the dramatic rise in maternal allergy is another compounding factor in the allergy epidemic.

"One question is, 'Has there been another wave of environmental changes that is driving this more recent epidemic?' Or is it that you have got a continuing modernising environment overlaying the maternal allergy itself? So it's not just mum's genetics, it's her expression of disease. If she has got a more inflammatory state, she might have a direct influence on the baby's immune system just by her being allergic."

Professor Prescott said it was almost certain that today's rising allergy to common foods such as milk and eggs, that had been consumed by humans for 1000 years, was directly because of a sudden change in our modern way of life.

It was possibly a yet-to-be- identified damaging combination of environmental factors that had emerged over the past 10 years, she said.

Environmental factors under investigation and suspected of triggering allergy-causing inflammation range from pollutants such as cigarette smoke, traffic fumes and pesticides, to a lack of sunlight, physical activity and fruit and vegetables, and a "too clean" environment.

However, researchers were also starting to wonder if it might possibly be that modern environmental changes that had affected the immune system of the hayfever-prone mother were then further altering the immune gene expression in her developing foetus.

Beginning research into this area, some researchers suspected this "amplifying effect" might be partly the reason why today's alarming food allergy wave was far more severe, seeing babies showing signs of allergic disease within a few weeks of birth and those under one-year-old having life-threatening anaphylactic reactions.

Australia has one of the highest allergy rates in the world. Ten per cent of one-year-olds now have a food allergy and in the past decade there has been a five-fold rise in anaphylactic food allergies in preschoolers.

When this younger generation reaches adulthood, the burden of allergic diseases is expected to increase even more. They are at greater risk of developing hayfever and other allergies.

"The problems we are seeing today, they just did not exist like this in the past," Professor Prescott said.

"We see allergic disease much younger in babies and more severe. We are seeing more cases of anaphylaxis in the under one-year-olds from food. And on top of that, we are seeing that they are less likely to grow out of it than they used to be.

"It is all really adding up to an enormous and growing burden. And we do not know what is in store for this generation as they grow up.

"At this stage, we cannot explain the secondary rise in food allergy and why this has been delayed so long after the asthma and hayfever epidemic. One thing is clear, the environmental pressures that are causing this rise in infant allergy must be acting very early in life, even before birth. And it may be no coincidence that this food allergy epidemic is affecting the children of the hayfever generation."

Based at the University of WA and Princess Margaret Hospital, Professor Prescott's research team had shown how pregnancy changed maternal immune response and that allergic mothers had lower Type 1 responses to foreign foetal antigens compared with non- allergic women.

"This means there are likely to be differences in the 'immune environment' experienced by the foetus, which could influence its patterns of development," Professor Prescott said.

Her team had found that even at birth, allergic children displayed differences in the internal machinery of their T cells, with reduced levels of certain proteins involved in the ability to respond to signals.

"This might hold promise as a possible predictive test, however, prediction is of limited value until we can do something to prevent disease," she said.

Professor Prescott saw the allergy epidemic as a flow-on effect from disturbing the natural balance of our environment. Looking at trying to determine exactly what were the environmental factors driving it, she said it was hard to pin the blame on any one factor.

Increasing "hygiene" had been a lead candidate, she said, but many other factors were known to have immune effects, such as modern environmental pollutants, reduced sunlight exposure and lower vitamin D levels caused by more screen-time and indoor activities and modern dietary patterns which promoted inflammation because of the lower levels of fresh fruits, vegetables, fibre and omega-3 fats.

"There are so many things that have changed and it is very hard to prove which one if any," Professor Prescott said.

"It is most likely to be a combination of factors."

Ultimately, the goal was to help prevent allergic disease through the same pathways - including focusing on the optimal condition in the womb for a developing foetus and the genes that were most vulnerable to environmental effects.

For now, the best advice to pregnant mothers was to avoid cigarette smoke - a definite adverse exposure - and breastfeed for general good health. Food avoidance in non-allergic babies had been scrapped as an allergy-prevention strategy, with current notions being that the immune system learnt a food was harmless by a baby eating it early in life and regularly.

 
More research is needed to confirm this and there are several Perth studies aiming to determine if earlier introduction of allergenic foods such as egg will actually reduce the risk of food allergy. Families interested in participating can contact Professor Prescott's researchers on 9340 8834.

Find Dr Susan Prescott's book "The Allergy Epidemic - A Mystery of Modern Life" on  your Healthy Shelf today.

Salt (sodium); is your child having too much?

by Linda Sara and Emma Copleston-Trent, Healthy Shelf partners.

Food Standards Australia estimates that 2 year-old Australian children are typically consuming 2,150mgs of sodium per day on average, from around 5.5grams of table salt.(1)   This amount is approximately five-times the average daily intake of sodium recommended by the National Health and Medical Research Council for children aged 1 – 3 years old.(2)   

Sodium chloride, commonly known as table salt, is often added to processed and prepared foods as a preservative and flavour enhancer.  However, table salt is not the only source of sodium in the typical modern diet.  Sodium bicarbonate is another form of salt added to self raising flour as a raising agent.  Some food additives, such as sodium ascorbate (a form of vitamin C), sodium saccharin (a sweetener), and sodium metabisulphite (preservative), add to the amount of sodium we consume daily.  Sodium itself is a commonly occurring element and is naturally present in most foods.

It isn’t just treats and snacks, such as potato chips and biscuits, which can be high in sodium.  Other foods that are considered staples in our diet can also be surprisingly high in sodium, for example; bread, meat products, cereals, savoury sauces and condiments (including products like baked beans) and cheese.(1)  Sodium is also present is some foods you may not expect it to occur in, such as milk.

But the main source of sodium in our diets is sodium chloride, estimated to provide around 90% of our dietary sodium intake.(1)

DO I NEED SODIUM IN MY DIET?

Yes.  Sodium is a natural mineral that is used by your body to control fluid balance; maintaining blood volume and blood pressure.  Sodium is also important for regulating your body’s acid-base level, utilised in nerve-signal conduction and facilitating the passage of various other nutrients into cells.

Your body continually regulates its’ level of sodium, your intestines absorb it and your kidneys filter it from your blood, excreting it in urine each day.  So we do require some salt in our diet to assist in replacing the sodium we lose.  However, the amount of sodium we need daily is equivalent to approximately one quarter of a teaspoon of table salt in total.

WHY IS TOO MUCH SODIUM BAD?

The effects of a high sodium diet are not always immediate.  Too much sodium in your diet increases your blood pressure.  High blood pressure increases the risk of cardiovascular disease, possibly resulting in a heart attack or stroke.

A high sodium diet also leads to fluid retention, resulting in swelling of the legs and feet, and may also cause water to collect around the lungs causing shortness of breath.  It is for this reason that high sodium in children is a particular concern as it can trigger fatigue, confusion, headaches, muscle cramps and nausea.  All of which can impact on a child’s ability to learn and develop normally.

HOW MUCH SODIUM SHOULD MY CHILDREN AND I CONSUME?

The National Health and Medical Research Council recommend the following average daily intakes of sodium(2).  These guidelines have been converted to grams of sodium chloride, for your convenience; 1 gram of sodium chloride contains 390 mg of sodium.(2)  However, there are other sources of sodium in your diet besides table salt;

Age Group          Recommended Daily         Equivalent Recommended Daily

                              Average Intake                        Average Intake

                          (milligrams of sodium)          (grams of sodium chloride)

0 – 6 months                120                                        0.31

7 – 12 months              170                                        0.44

1 – 3 years             200 – 400                               0.51 – 1.03

4 – 8 years             300 – 600                               0.77 – 1.54

9 – 13 years           400 – 800                               1.03 – 2.05

14 – 18+ years       460 – 920                               1.18 – 2.36

These recommendations are a practical guide.  Consult your health care professional if you have any health concerns, or for a dietary recommendation specific to your needs.

The current National Health and Medical research Council recommendation for the Australian adult population in general is that dietary sodium intake be under 2,300mg of sodium per day.  This is equivalent to approximately 6 grams of sodium chloride.(3)

IS MY TODDLER CONSUMING TOO MUCH SODIUM?

A toddler can easily exceed twice their recommended daily average intake of sodium by lunch time, which is 400mgs sodium for children aged 1 – 3 years.

Breakfast  

¾ cup cereal                         162mgs*

50ml full cream cows’ milk    20mgs*

       

Morning Tea  

Snack bar                             72mgs*

Fruit                                      Nil

       

Lunch  

2 slices wholemeal bread      332mgs*

20gms cheese                      150mgs*

5gms spread                        174mgs*

       

Total mgs of sodium             910mgs

*Please note the mgs of sodium per item can vary from brand to brand. 

TIPS TO REDUCE YOUR SALT INTAKE

Become aware of the salt content in the foods you consume.  For example, salt content in both wholemeal and white bread is often similar.  Buying fresh from a bakery is no guarantee of low salt content, bakeries often use more salt than you might find in other store-bought breads to improve the flavour of their product.

Invest in a bread maker; only purchase low-salt ingredients for the dough.

Avoid Take-away foods.  Some burgers can deliver 100%+ of your recommended daily average intake of sodium.

Choose products with ‘No Added Salt’ over being ‘Salt-Reduced’.  ‘Salt-Reduced’ generally means the product contains approximately 75% of the salt you would find added to the regular version of the same product.  If the added salt content of the regular version is high to begin with, reducing this by one quarter is not necessarily going to make the ‘Salt-Reduced’ version particularly low in salt.

When reading product labels remember any Recommended Daily Intake (RDI) values that may be quoted are usually based on the dietary requirements of adults, not children.

Explore the wonderful range of herbs and spices readily available to most Australians to flavour your food, instead of using salt.  Variety is the spice of life.

REFERENCES

(1) Food Standards Australia Fact Sheet; How much sodium and salt are we eating? (2009) – http://www.foodstandards.gov.au/scienceandeducation/factsheets/factsheets2009/howmuchsodiumandsalt4340.cfm

(2) Australian National Health and Medical Research Council publication; Nutrient Reference Values for Australia and New Zealand, including recommended dietary intakes. (2005) – http://www.nhmrc.gov.au/_files_nhmrc/file/publications/synopses/n35.pdf

(3) Australian National Health and Medical Research Council publication; Dietary Guidelines for Australian Adults. (2003) – http://www.nhmrc.gov.au/_files_nhmrc/file/publications/synopses/n33.pdf

FURTHER INTERESTING READING

Food Standards Australia Fact Sheet; How much sodium and salt are we eating - further information. (2009) – http://www.foodstandards.gov.au/scienceandeducation/factsheets/factsheets2009/howmuchsaltandsodium4551.cfm

Australian National Health and Medical Research Council publication; Food for health.  Dietary guidelines for Australians, a guide to healthy eating. (2005) – http://www.nhmrc.gov.au/_files_nhmrc/file/publications/synopses/n31.pdf

University of California, San Francisco Children’s Hospital; Patient Education Guidelines for a Low Sodium Diet – http://www.ucsfhealth.org/adult/edu/lowSodiumDiet.html

faqs.org; Sodium imbalance – http://www.faqs.org/health/topics/4/Sodium-imbalance.html

Australian Division of World Action on Salt & Health – www.awash.org.au/cons_saltandchildren.html

Anne Collins Weight Loss Diet Program Online; Sodium in your diet. – http://www.annecollins.com/sodium-diet.htm