Food Intolerance Research Articles

Smoke exposure and childhood atopic eczema and food allergy: A systematic review and meta-analysis.

There is no consensus on the effect of timing and type of smoke exposure on early allergy development. This study aimed to determine the relationship between early eczema or food allergy/hypersensitivity development in children by firstly investigating the effect of smoke exposure across critical development periods and secondly by analyzing effects of parental atcive or passive smoking. Four databases (PubMed, Web of Science, Scopus and Embase) were searched in May 2022 and assessed by two independent reviewers. Case-control, cross-sectional or cohort studies reporting on smoke exposure from preconception to postnatal periods and atopic eczema, food allergy and/or hypersensitivity outcomes by age 3 years were included. The Newcastle-Ottawa Scale was used to assess study quality. Random effects model was used to estimate the pooled risk ratios. From 1689 identified records, 32 studies with nearly 190,000 subjects were included. Parental smoking during preconception, pregnancy and postnatal periods was generally not associated with the risk of eczema, food allergy and food sensitisation development by age 3 years. Maternal active smoking during pregnancy was negatively associated with self-reported doctor diagnosis of eczema (RR = 0.87, 95% CI 0.77-0.98; I2 = 50.56) and maternal passive smoking during pregnancy was positively associated with clinician assessment of eczema in one study (RR = 1.38; 95% CI 1.06-1.79). Our findings highlighted the importance of in utero programming in early-life allergy development. Despite the weak evidence, our results suggest pregnant women should minimise their contact with second-hand smoke to prevent offspring eczema development. There is a need for greater utilisation of objective allergy assessments in future studies.

Eosinophilic gastrointestinal diseases with esophageal involvement: Analysis of 212 patients

BackgroundPrimary eosinophilic gastrointestinal diseases (EGID) are chronic inflammatory disorders of the gastrointestinal tract with unknown etiology.Features, utility, and evolution are still unknown in screening for EGID in adult patients with eosinophilic esophagitis (EoE). ObjectivesTo evaluate the prevalence, characteristics, comorbidities, and evolution of EGID in adults diagnosed with EoE and investigate differences between both groups. MethodsProspective unicenter observational and analytical study. Gastric and duodenal biopsies were obtained during upper baseline endoscopy in all consecutive EoE adult patients evaluated. A colonoscopy with colon biopsies was performed upon persistent diarrhea and normal duodenal biopsies. Results212 EoE patients were included. Nine patients (4.3%) also showed significant eosinophilic infiltration in at least one organ within the digestive tract. The most common site affected was the small bowel (78%). Gastrointestinal symptoms (43% vs. 100%, p<0.002) and, more specifically, either abdominal pain or diarrhea (17% vs. 78%, p<0.001), some food sensitizations, and digestive comorbidities (p<0.05) were significantly more common in patients with EGID. Gastrointestinal symptoms were present in 94/212 (44%) patients, of whom 9 (10%) had EGID. Considering only abdominal pain or diarrhea, 20% suffered from it. ConclusionsEGID rarely coexist with EoE, even when gastrointestinal symptoms are present. These findings advise against routine gastric, duodenal, or colon biopsies in adult EoE patients with gastrointestinal symptoms. Most of the characteristics of EoE do not change due to having EGID except gastrointestinal symptoms, digestive comorbidities, and sensitizations to some foods. The evolution was generally favorable despite intermittent adherence to treatment, especially maintenance.

Protocol Development of a Personalized Balanced Nutrition Concept for Preschool Children, Primarily Those with Food Allergies, Using an IT Platform.

Children with food allergies are at higher risk for severe anaphylactic reactions and for key nutrient deficiency. In order to address these concerns, enable early detection, and improve the monitoring of children with food allergies, an innovative IT platform will be developed by IT experts (IN2 Ltd. Zagreb, Croatia, part of Constellation Software Inc. (Toronto, ON, Canada)) and Srebrnjak Children's Hospital, Zagreb, Croatia (SCH) for the effective implementation of personalized balanced nutrition in preschool institutions in Croatia. Additionally, the data obtained through this research, including epidemiological data on allergic diseases, clinical data (diagnostic allergy tests and others), anthropometry, and physical activity status, will be used to create a national Allergy registry. Other than being a tool for personalized and balanced nutrition for children, especially those with special dietary requirements (including food allergy and intolerance), the IT platform developed in this study will enable the continuous monitoring of these children as a part of their clinical management plan and earlier detection of food allergies, intolerance, and other conditions, even outside of the healthcare system. This research also aims at optimizing current and developing novel personalized therapeutic regimes, detecting novel early biomarkers in children with food allergies and intolerances, and involving all key stakeholders (caregivers, preschool institutions, etc.) in the shared-care approach in the management of food allergies in children.

The gut protist Tritrichomonas arnold restrains virus-mediated loss of oral tolerance by modulating dietary antigen-presenting dendritic cells

Loss of oral tolerance (LOT) to gluten, driven by dendritic cell (DC) priming of gluten-specific T helper 1 (Th1) cell immune responses, is a hallmark of celiac disease (CeD) and can be triggered by enteric viral infections. Whether certain commensals can moderate virus-mediated LOT remains elusive. Here, using a mouse model of virus-mediated LOT, we discovered that the gut-colonizing protist Tritrichomonas (T.) arnold promotes oral tolerance and protects against reovirus- and murine norovirus-mediated LOT, independent of the microbiota. Protection was not attributable to antiviral host responses or T.arnold-mediated innate type 2 immunity. Mechanistically, T.arnold directly restrained the proinflammatory program in dietary antigen-presenting DCs, subsequently limiting Th1 and promoting regulatory Tcell responses. Finally, analysis of fecal microbiomes showed that T.arnold-related Parabasalid strains are underrepresented in human CeD patients. Altogether, these findings will motivate further exploration of oral-tolerance-promoting protists in CeD and other immune-mediated food sensitivities.

Infant colic and abdominal pain; associations with infant multimorbidity and maternal perceived stress up to 3 months postpartum-A cross-sectional/cohort study in the PreventADALL study.

The primary aim was to explore whether infants with pain symptoms (colic, abdominal pain and visit to healthcare provider with pain or other discomforts) had increased multimorbidity (common infections, eczema and food sensitivity) compared with infants without these conditions. Secondarily, we aimed to determine whether infant pain symptoms were associated with maternal perceived stress in pregnancy and 3 months postpartum. Infant colic and abdominal pain are common concerns in early infancy. Nevertheless, to our knowledge, little research exists on the relationship between infant pain and common infant infections, eczema and food sensitization as comorbidities, and the impact of infant pain on the development of maternal perceived stress from pregnancy to infancy is inconsistent. This study was cross-sectional and partly prospective. The sample consisted of mother-infant pairs (N = 1852); information regarding infant pain and multimorbidity was collected from the 3-month questionnaire and postpartum visits in the PreventADALL prospective cohort study. Chi-square tests and regression analyses were conducted. The STROBE checklist was followed. Our results showed a statistically significant higher proportion of respiratory and other infections in infants with pain symptoms. The odds of infant pain were higher for infants with multimorbidity compared to those with no comorbidity. Mothers of infants with colic and of infants visiting healthcare with pain and other discomforts reported statistically significant higher perceived stress by 3 months compared with mothers of infants with no reported pain. Our results indicate an association between infant pain symptoms and the presence of infections. Mothers of infants with colic and visiting healthcare had higher perceived stress compared to the no pain group. Our study indicates that infant pain is associated with infant multimorbidity and maternal perceived stress, which may be useful when planning diagnostic, treatment and coping strategies in infant and family care. The PreventADALL is a collaborative study with governmental and patient organisation representation. Selected infants with parents were also contributing during calibrating courses on eczema assessment for the data collectors. The study was approved by the Regional Committee in Norway (2014/518) and Sweden (2014/2242-31/4) and registered at clinicaltrial.gov (NCT02449850). Link for clinical trials: https://clinicaltrials.gov/ct2/show/NCT02449850.

Reciprocity and beyond: Explaining meat transfers in savanna-dwelling chimpanzees at Fongoli, Senegal.

To understand the function of food sharing among our early hominin ancestors, we can turn to our nonhuman primate relatives for insight. Here, we examined the function of meat sharing by Fongoli chimpanzees, a community of western chimpanzees (Pan troglodytes verus) in southeastern Sénégal. We tested three non-mutually exclusive hypotheses that have been used to explain patterns of food sharing: kin selection, generalized reciprocity, and meat-for-mating opportunities. We analyzed meat sharing events (n = 484) resulting from hunts, along with data on copulations, age-sex class, and kinship to determine which variables predict the likelihood of meat sharing during this study period (2006-2019). We found full or partial support for kin selection, direct reciprocity, and meat-for-mating-opportunities. However, the analyses reveal that reciprocity and a mother/offspring relationship were the strongest predictors of whether or not an individual shared meat. The results of this study emphasize the complexity of chimpanzee meat sharing behaviors, especially at a site where social tolerance offers increased opportunities for meat sharing by individuals other than dominant males. These findings can be placed in a referential model to inform hypotheses about the sensitivity of food sharing to environmental pressures, such as resource scarcity in savanna landscapes.

The existence of gluten-free and functional pasta in Hungary

Nowadays, instead of traditional wheat grains, alternative cereals, also known as pseudocereals, are increasingly coming to the fore. The reason for this is, among other things, that more and more people struggle with food allergies and intolerances. Gluten-related disease - such as gluten sensitivity - is a chronic disease of the small intestine with malabsorption, which is triggered by gluten, a vegetable protein found in certain cereals, in people who are sensitive to it. Because of this, the demand for foods in which alternative gluten-free pseudocereals play a prominent role has understandably increased. Our research and development goal was aimed at getting to know and examining the different raw materials and their functional enrichment possibilities, which has led to the development of a new range of pasta products.

Dietary vitamin D intake and sun exposure are not associated with type 1 diabetic schoolchildren and adolescents: A first report in Algeria1

BACKGROUND: A large number of children and adolescents worldwide suffer from physiological vitamin D (VD) deficiency, which has been associated with sun exposure and, consequently, the risk of developing various autoimmune diseases, including type 1 diabetes (T1D). However, the association of the disease with VD intake and sun exposure has yet to be explored. MATERIALS AND METHODS: We conducted a food frequency questionnaire and a 24-hour food recall survey, using “Ciqual table 2016” in 335 type 1 diabetic and age- and gender-matched healthy Algerian school children and adolescents from sunny Saharan and relatively less sunny Northern regions, aged between 5 and 19 years. RESULTS: Both dietary VD intake and VD levels were similar in T1D patients when comparing northern and southern regions (for both comparisons, p &gt; 0.05). Neither sun exposure nor VD intake was associated with the disease (respectively, relative risk [RR] = 1.050, p = 0.680; RR = 1.082, p = 1.000. For Cochran and Mantel-Haenszel analysis; RR = 0.841, p = 0.862). VD intake showed a significant difference between diabetics and non-diabetics in the sunny region (p = 0.022). Additionally, significant differences were found between normal and T1D schoolboys (p = 0.038), and when comparing the two groups according to the dry areas (p = 0.016). Moreover, in contrast to circulating VD levels, which were lower in T1D patients than in healthy controls, those of VD intake were significantly higher (p &lt; 0.05), especially in male patients and in those with balanced diet, low protein or carbohydrate consumption, specific food intolerances, and regular meals (p &lt; 0.05), as well as in patients with a moderate or low consumption of cooked meals or steamed foods (p &lt; 0.01). Conversely, VD intake was markedly lower in type 1 diabetics than in controls for dry and sunny areas, including the region of Adrar, as well as for consumption of low-fat foods and eggs (p &lt; 0.05 for all comparisons). Nevertheless, the relative risk of sun exposure and dietary vitamin D intake according to the World Health Organization (WHO) standard did not show a significant association with T1D (common Mantel-Haenszel estimation, RR = 0.841, 95% CI 0.118–5.973, p &gt; 0.05). CONCLUSIONS: T1D does not appear to be associated with VD intake and sun exposure in the Algerian Sahara region. Therefore, the consumption of VD in T1D patients in the Algerian Sahara would suspect that its association with the disease would be related to its synthesis alteration.

Role of substance P in the pathogenesis of chronic urticaria

Chronic urticaria (CU) is a serious issue in clinical allergology. Exact pathogenesis of diseases is unknown despite a fairly large number of studies. From clinical view, CU manifests as wheals and/or angioedema, lasting for more than 6 weeks. It is classified into spontaneous (without obvious triggers) and induced CU (in cases of evident physical and chemical stimuli). It is quite difficult to reveal its cause. Most often, the patients refer to specific foods as a trigger factor. Stress is the second leading cause of CU after breaking the diet. Mental or emotional stress has been shown to cause degranulation of mast cells (MC) and histamine release. Substance P (SP) is a neurotransmitter, which underlies neuroimmune inflammation, being considered the most informative marker of CU. The purpose of our study was to assess a role of SP in the CU pathogenesis and to determine the relationship of SP with known urticaria triggers and comorbidities.&#x0D; We examined 97 patients with CU and 68 apparently healthy individuals matched by sex and age. The levels of histamine and substance P (SP) were determined in blood serum by enzyme immunoassay. The patients were classified into groups, depending on the history of food and drug intolerance, presence of concomitant autoimmune thyroiditis (AIT), influence of stress as a trigger for CU.&#x0D; When analyzing the average levels of histamine and SP in the group of patients suffering from CU, compared with the control group, no significant correlations were found. We detected an almost 3-fold increase of histamine levels in the patients suffering from AIT (28.25 ng/mL versus 83.61 ng/mL). However, when assessing the level of histamine in patients with CU and with a history of food and drug intolerance, trigger stress and AIT, the average values of the indicator did not show significant differences. Meanwhile, when assessing the SP index in patients with a history of drug, food intolerance, AIT and stress as a trigger for CU, we have found a significant increase in SP in the patients when compared with control group (p 0.05).&#x0D; Our results confirm the neuroimmune inflammation system to be involved in genesis of mast cell activation in CU patients. Further studies are required in order to discern a specific phenotype of stress-induced CU and determine the opportunities for its psychopharmacological correction.

Organization of the stomy patient nutrition. Choice of food substrate

Feeding through an artificial fistula is used to organize the nutrition of patients with prolonged severe dysphagia. Gastrostomy is the most common operation to provide nutrition when oral intake is not possible. According to the information system of the St. Petersburg Territorial Compulsory Medical Insurance Fund, from 01.01.2015 to 10.20.2020, 2391 operations of imposing a nutritional fistula were paid. The choice of a food substrate for feeding an ostomy patient is difficult. Previously, pureed diets of mixed products were used; since 2000, in large hospitals, these diets have been replaced by branded enteral nutrition. The development of malnutrition, up to kwashiorkor and sarcopenia, has been noted in patients receiving an unbalanced pureed diet for a long time. The real properties of the blended diet do not allow it to be introduced into the gastrostomy without dilution with water. Blockage of gastrostomy tubes, due to the density of nutrition, is one of the frequent problems of such nutrition. On the contrary, branded enteral nutrition is fluid, well balanced in terms of the main food nutrients, vitamins and minerals, with a given energy value in small volumes of liquid. With long-term nutrition with commercial mixtures, intestinal dysbiosis develops with a loss of microbiota biodiversity. In the case of feeding a patient with a blended table, microbial biodiversity is preserved, a number of gastroenterological complaints and allergies or food intolerances to artificial nutrition ingredients are stopped. The choice of food substrate for the patient, its combination of wiped table and branded food is under study.

APPLICATION OF TWO-DIMENSIONAL ELECTROPHORESIS AND MASS SPECTROMETRY FOR THE DETECTION OF ALLERGENS IN SELECTED VARIETIES OF WHEAT, OATS AND BUCKWHEAT

The number of people suffering from food allergies and intolerances has been increasing in recent years and cereal proteins are the most common food allergens. Pseudocereals represent perspective alternative in nutrition with a positive effect on the human body. The aim of the work was to analyze the proteome of selected varieties of wheat (Triticum aestivum L.), oats (Avena sativa) and buckwheat (Fagopyrum esculentum Moench.) using two-dimensional electrophoresis (2DE) and mass spectrometry in order to detect the presence of potentially allergenic proteins. Using the PDQuest program, 221 protein spots ranging from 4.13 to 9.89 µl with experimental molecular weights from 12.42 kDa to 140 kDa were quantified in 2DE gels of wheat. In the oat sample, 168 protein spots were quantified in the range pI of 4.02 to 9.93 and an experimental molecular weight of 14.81 kDa to 67.96 kDa. Buckwheat proteins were separated on a 2DE gel into 208 protein spots in the 3 to 9.83 pI region with an experimental molecular weight of 10.10 kDa to 115 kDa. By comparing the data with the Allergome database, allergens Tri and 26, Tri and 33, Tri and 36, Tri and alpha Gliadin, Tri and 20 were detected in wheat, Ave s 11S allergens in oats and Fag e 1 allergen in buckwheat. 2DE together with mass spectrometry have been shown to be suitable and sensitive methods for the detection of allergens in food crops.

Longitudinal analysis of the impact of smoking exposure on atopic indices and allergies in early childhood

BackgroundExposure to smoking is recognized as a health hazard; however, a longitudinal analysis of the impact of smoking exposure in families on the allergic reactions related to childhood atopic diseases has not been well addressed. MethodsChildren who completed a three-year follow-up period from the birth cohort were included in this study. The history of smoking exposure was recorded, and the urine cotinine levels were measured at 1 and 6 months, and 1, 2, and 3 years of age. Specific IgE levels against food and mite allergens were measured at age 6 months, and 1, 2, and 3 years. Their relevance to family smoking exposure and the subsequent development of atopic diseases was also analyzed. This study was approved by the Ethics Committee of Chang Gung Memorial Hospital (No. 102-1842C) ResultsA total of 198 infants were enrolled in this study. The prevalence of passive smoking exposure among these children was as high as 45%. The urine cotinine levels were significantly higher in children with history of smoking exposure (P < 0.001). At 6 months of age, the food-specific IgE levels and the prevalence of eczema were significantly higher in children with smoking exposure than in those without smoking exposure (P < 0.05). By contrast, the urine cotinine levels were significantly higher in children with IgE sensitization (>100 kU/L, P < 0.05) at 3 years of age, which was also significantly associated with a higher prevalence of allergic rhinitis and development of asthma (P < 0.01). ConclusionFamily smoking exposure appears to be strongly associated with food sensitization in infancy and with IgE production in later childhood. This could potentially increase the susceptibility of developing infantile eczema and subsequent childhood airway allergies.

Identifying Associations Between Sensory Processing &amp; Food Sensitivities

Abstract Date Presented 04/22/2023 This session reviews a study that examines the correlations between sensory processing, sensory systems, mealtime behaviors, and feeding in children with identified feeding difficulties. Primary Author and Speaker: Aimee Piller Additional Authors and Speakers: Taylor Tonks

Clinical features and later prognosis of replicable early-life wheeze clusters from two birth cohorts 12 years apart.

Clustering techniques can define the heterogeneity of asthma and wheezing. Defining early-life wheezing clusters and associated asthma risk could potentially inform patient management strategies. Clustering models that yield replicable cluster groups will have greater validity and clinical utility. This study sought to identify early-life wheezing clusters that are translatable into clinical practice and assess their stability over time in two whole-population birth cohorts established a decade apart from the same geographical location. Nonparametric K-means cluster analysis was performed separately on two birth cohorts from the Isle of Wight, UK; the Isle of Wight Birth Cohort (IOWBC) and Food Allergy and Intolerance Research Cohort (FAIR), using clinically defining variables in wheezing subjects in the first 3-4 years. Associations of resulting clusters with potential early-life risk factors and 10-year asthma outcomes were further assessed. Five clusters were identified in both cohorts: (1) infantile-onset-transient-non-atopic-wheeze, (2) infantile-onset-persistent-non-atopic-wheeze, (3) infantile-onset-atopic-wheeze, (4) early-childhood-onset-non-atopic-wheeze, and (5) early-childhood-onset-atopic-wheeze. Two atopic wheezing clusters (3 and 5) were associated with greatest early-life wheeze frequency, highest wheeze persistence, and asthma prevalence at 10 years. Cluster 1 was commonest but had lowest early-life wheeze frequency and asthma prevalence at 10 years. Cluster 2, characterized by limited atopy but recurrent infantile respiratory infections and ongoing early-life wheezing, had high 10-year asthma prevalence only in IOWBC. Early-life wheeze comprises several disease clusters (two more severe and three mild-moderate) with differing relationships to later childhood asthma, which can be replicated over time supporting their potential validity and clinical utility.

Characterization of Feeding Challenges in Autistic Children &amp; Relationships Between Feeding Severity &amp; Early Feeding Challenges

Abstract Date Presented 04/22/2023 Feeding challenges in a national sample of autistic children (N = 427) are characterized, including early feeding challenges, independent feeding, mealtime routines, caregiver strategies, and reported food and environmental sensitivities. Primary Author and Speaker: Brittany St John Additional Authors and Speakers: Alana Wooley, Hsiang-Ting Chen, Karla Ausderau

Impact of Zinc Supplementation in prevention of Chemotherapy Induced Oral Mucositis

Objective: To determine the impact of Zinc supplements in prevention of oral mucositis and its consequences in patients receiving chemotherapy. Study Design: Quasi experimental study Place and Duration: Department of Paediatric Oncology, Pakistan Institute of Medical Sciences (PIMS), Islamabad from 1st March, 2023 to 31 July, 2023. Methodology: A total of 60 patients (N) diagnosed of acute lymphoblastic leukemia planned for induction of treatment were included in the study. Patients were randomly divided into two groups of thirty patients each. Group-A received Zinc supplements while group-B received the usual standard of care without any additional supplement. At the end of four weeks of induction therapy, all patients were assessed for presence and severity of oral mucositis. They were also inquired about food intolerance and need for analgesics. Results: Mean age of patients included in the study was 4.723 ± 2.84 yrs. Males were34 (56.6%) and 26 (43.3%) were females. Severity of mucositis (p-Value is 0.017) and food intolerance (p-Value is 0.020) were markedly decreased in the group receiving zinc supplements. Analgesics were required by 21 (70%) patients in the group receiving zinc supplements and by 27 (90%) in the group not receiving zinc supplements. However, p-Value remained non-significant (0.104). Conclusion: Both, severity of oral mucositis and food intolerance are significantly reduced in patients prescribed zinc supplements during the induction phase of chemotherapy. Though, requirement of analgesics was also considerably reduced amongst patients taking zinc supplements, the difference was not statistically significant for this particular variable in our study. Keywords: Acute Lymphoblastic Leukemia, Zinc, Oral Mucositis, Chemotherapy, Childhood Malignancy How to Cite This: Tariq R, Manzoor R, Batool Z, Yasmeen N, Fatima SI, Ayub S. Impact of Zinc Supplementation in prevention of Chemotherapy Induced Oral Mucositis. Isra Med J. 2023; 15(1): 3-6. DOI: https://doi.org/10.55282/imj.oa1372 This is an Open Access article distributed under the terms of the Creative Commons Attribution-Noncommercial 4.0 International License (http://creativecommons.org/licenses/by-nc/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Nutraceuticals Prepared with Specific Strains of Probiotics for Supplementing Gut Microbiota in Hosts Allergic to Certain Foods or Their Additives

Certain nutrients cause discomfort, sensitivity reaction, and an intolerance for certain foods or their ingredients when ingested by some consumers. Food reactions and gut inflammation-related problems are increasing worldwide. The primary form of management would be the avoidance of such foods, followed by treatment of their symptoms. Adopting a nutritional–therapeutic approach and establishing practices for the inclusion of functional foods and nutraceuticals in the diet could improve the ecology of gut microbiota and alleviate inflammation in the GIT. For this purpose, specific species of microorganisms characterized as probiotic strains have been studied to produce functional food and fermented beverage products. Commercially sold, such items are labelled as probiotic products, displaying the name/s of strain/s and the viable numbers of them contained in the portion size of the products. The importance of the growth of probiotic functional foods is that they can be consumed as a source of nutrition and their intake helps in the subsistence and recuperation of friendly gut bacteria. Probiotics have been reported for their role in ameliorating the risk of food reactions. Probiotic administration has been implemented for its role as an auxiliary improvement and for the prevention of food sensitivities common among pediatric patients. Probiotic products based on non-dairy substrates have potential as nutraceuticals for lactose intolerant consumers who are allergic to dairy milk products. Therefore, the aim of this article is to review GRAS microbial species characterized as probiotics up to the level of their specific strain’s name and/or number. These have been used to produce nutraceuticals that are sources of beneficial bacteria for easing discomfort and allergic reactions by maintaining an inflammation-free gut.

P96 Nutrition in dermatology practice: an unmet need for both patients and healthcare professionals

Abstract The role of diet and nutrition in the management of chronic inflammatory skin conditions such as eczema, psoriasis and acne is one of the commonest questions asked by patients. Despite this, there is little guidance or training to help healthcare professionals provide disease-specific evidence-based recommendations to patients. Furthermore, growing evidence supports the role of diet and nutrition in the management of skin conditions such as psoriasis and atopic eczema. We sought to explore dermatology professionals’ experiences of patients’ dietary habits in an outpatient setting. We circulated a questionnaire to members of the British Dermatological Nursing Group and the British Association of Dermatologists. We collected demographic data, along with information on how frequently professionals were asked about diet by patients, how confident they felt responding to questions and concerns expressed regarding dietary restrictions, and whether dietitian input or nutrition training would be of benefit to their practice. Three of the authors received funding from the Psoriasis Association. We received 95 responses from dermatology nurses and 64 from doctors. Over 60% of respondents held senior positions with over 10 years of experience. Almost 100% of respondents reported being asked about diet by patients and 73.1% did not feel confident when answering these questions. Patients were most commonly asked about nutrition in relation to inflammatory conditions such as eczema (95.3%), acne (95.3%) and psoriasis (76.6%). All doctors and 97.8% of nurses reported having experienced patients restricting their diet without supervision, and the majority expressed concerns about such dietary modifications. Dairy, gluten and refined sugar were the most commonly excluded foods. Professionals also reported that patients admitted to following restrictive diets and undertaking ‘food intolerance testing’ that they had encountered online. Over 90% of respondents felt that additional nutrition training and access to specialist dietician support would be of benefit to dermatology practice. Dermatology professionals are frequently asked about nutrition and the role of diet yet often lack confidence in responding to these enquiries. Dermatology patients appear vulnerable to dietary misinformation presented online regarding ‘intolerance tests’, and this has the potential to worsen with ongoing delayed access to secondary care. There are also concerns regarding unsupervised restrictive diets, which can negatively impact patients’ mental health and predispose to eating disorders and nutritional deficiencies. Specialist nutrition training for dermatology professionals and the support of dietitians in the clinical setting would help address this unmet need and provide holistic patient care.

Особенности пищевых интолерантностей у больных с синдромом раздраженного кишечника

The aim was to evaluate the activity of intestinal carbohydrases in patients with irritable bowel syndrome (IBS) with symptoms of food intolerance. Material and methods. 126 patients with IBS (83 women and 43 men, median age – 32.0 years (Q1–Q3: 27–38 years)) were examined. The diagnosis of IBS was established on the basis of Roman Criteria IV. A questionnaire was conducted for all patients to identify food intolerances, according to the results of which the patients were divided into three groups: the first – patients with isolated intolerance to foods with a high content of FODMAP; the second – patients with isolated intolerance to milk and dairy products; the third – patients with combined intolerance. To determine the activity of intestinal carbohydrates: lactase, sucrose, maltase and glucoamylase, all patients underwent esophagogastroduodenoscopy with biopsy samples from the duodenum. The activity of carbohydrases was determined by the Dahlquist method in the modification of N.I. Belostotsky. The control group consisted of 30 conditionally healthy people (10 men and 20 women, median age – 33.9 years (Q1–Q3: 24–35)), comparable in age and gender with patients with IBS. The activity of intestinal enzymes in this group was within the reference values. Statistical data processing was carried out using the computer program Statistica 8.0. Results. According to the results of the survey, it was found that out of 126 patients with IBS, 52 (41.3%) patients believed that they had food intolerance to certain foods. Isolated intolerance to foods with a high content of FODMAP was noted by 13 (10.3%) patients, 16 (12.7%) patients believed that they had isolated intolerance to milk and dairy products, and 23 (18.3%) patients indicated combined intolerance. In patients with IBS and isolated intolerance to foods high in FODMAP, the median activity of glucoamylase was 120.0 (68.5–209.2) ng/mg of glucose per 1 mg of tissue per minute (ng/mg × min), maltase – 630.5 (480.7–951.0) ng/mg × min, sucrose – 50.0 (32.8–68.8) ng/mg × min, lactase – 10.5 (5.5–40.5) ng/mg × min. Comparing the activity of carbohydrases with the control group revealed the statistically significant difference (p &lt; 0.05) for each enzyme studied.In the group of patients with IBS and isolated intolerance to milk and dairy products, the median activity of all the intestinal enzymes studied was also lower than that in the control group: the activity of glucoamylase was 107.0 (64.0–174.0) ng/mg × min, maltase – 622.0 (481.5–887.0) ng/mg × min, sucrose – 48.0 (35.5-60.0) ng/mg × min, lactase – 8.0 (3.0–22.5) ng/mg × min. Among patients with IBS and the presence of combined intolerance to foods (with a high content of FODMAP and dairy products), the median activity of all enzymes significantly differed from the control group (p &lt; 0.05). The activity of glucoamylase was 107.5 (57.5–194.2) ng/mg × min, maltase – 627.0 (480.7–911.7) ng/mg × min, sucrose - 47.5(34.8–61.5) ng/mg × min, lactase - 9.0 (4.0–28.8) ng/mg × min. Conclusion. Food intolerance was noted in 52 (41.3%) patients with IBS. Among the patients who noted the presence of all the studied food intolerances (isolated or combined intolerance to milk and dairy products, as well as products with a high content of FODMAP), a significant decrease in the activity of intestinal enzymes (glucoamylase, lactase, sucrose and maltase) was found compared with the control (p &lt; 0.05), which may indicate the presence of they have disaccharidase deficiency

Nutriative Support Strategy in the Catering of Preschool Children with the Food Intolerance

Catering in child welfare institutions, considering the individual characteristics of food tolerance, is an urgent problem. The research aims at substantiating and optimizing the preschool children diet with food intolerance scientifically. The authors assessed diets of children with food intolerance – pupils of a specialized preschool institution located in the ecologically unfavorable territory of the Sverdlovsk region. A man developed scientifical ly based diets in accordance with the physiological needs and clinical and immunological children profile. 97.8 % of the children included in the study demonstrated food intoler ance, and each child had the recommendation to exclude from 1 to 29 products. The diets developed by the immunologist in preschool had an unreasonably limited range of food products, did not meet the physiological need for energy, macronutrients, vitamins B1, B2, calcium. A man relates eggs, milk and fish intolerance to a permeability violation of the natural intestinal mucosa barriers. The diet modeling in the preschool institutions relied on the clinical and immunological studies data, adaptive-compensatory and detoxification mechanisms of food substances action. The developed hypoallergenic menu enables to optimize the diet in terms of nutrient and amino acid composition, in particular by imple menting foods with increased nutritional and biological value. A man adjusted the diet to the physiological needs of children, strengthened the protective-compensatory and detoxification orientation to reduce the morbidity risk. The initially formed elimination nutrition model in preschool leads to a protein-energy deficit, dietary fiber, B vitamins and minerals (calcium) deficiency, which affected the physical children development, and the metals elimination, decrease in the protective and adaptive body functions, worsening atopic dermatitis symptoms.