Peanuts and shrimp cause the most problems, survey finds
Black male children are particularly at risk for food allergy, according to researchers who examined the results from the first representative U.S. survey where quantitative sensitization to various foods was investigated.
Presented at the 2009 Annual Meeting of the American Academy of Allergy, Asthma & Immunology (AAAAI), the study involved 8,203 participants, ranging in age from 1 to 85, from the National Health and Nutrition Examination Survey (NHANES) 2005-2006. Each of these individuals was found to have serum-specific immunoglobulin E or IgE to egg, milk, peanut and shrimp. The presence of specific IgE antibodies indicates allergic reaction to individual foods.
Researcher Andrew H. Liu, MD, and colleagues investigated the prevalence and demographic risk factors for food allergic sensitization and levels of sensitization more likely associated with clinical food allergy. Sensitization levels were each defined using specific quantitative increments.
Analysis showed that the estimated prevalence for clinical food allergy was 2.55%, with peanut and shrimp being the most common allergens. Blacks, males and children, especially black male children, were found to have higher levels of sensitization associated with clinical food allergy.
The prevalence of food sensitization was 16.8%, again with peanut and shrimp being the most common, and was significantly higher in children, males, non-Hispanic blacks and persons of lower income.
Asthmatics living close to heavy traffic lowers lung function
The results of a new study appear to expand the link between traffic exposure and poor lung function among people with asthma.
In a study of 176 adults with asthma or rhinitis, Dr. John R. Balmes of the University of California, San Francisco, and colleagues found “the closer adults with asthma live to roadways with heavy traffic…the lower their lung function.
“Living close to any road was associated with lower lung function,” Balmes told Reuters Health.
Other studies have shown lung health effects from major roadways, Balmes and colleagues note in the Journal of Allergy and Clinical Immunology. “Ours is the first to show evidence that living near any road can do so,” said Balmes.
He and colleagues therefore advise asthma patients minimize their traffic exposures.
The researchers assessed lung function and quality of life measures among the 176 adults (71 percent female) who were about 43 years old, on average, and undergoing treatment for chronic asthma with rhinitis (145 individuals) or rhinitis alone (31 individuals). The groups had similar proportions of current and former smokers.
Researchers found out how close each participant lived to the nearest roadway using road-location data provided by geographic information systems. They then compared lung function with the distance from a roadway of any type.
Those living the closest to a roadway had the lowest lung function (forced expiratory volume of 81.5 percent) while those living the farthest from a roadway had the highest lung function (forced expiratory volume of 89.7 percent).
Excluding individuals with rhinitis alone, factoring in the effects of lower socioeconomic status, smoking, and obesity, did not significantly alter the findings. However, the researchers found no association between traffic exposure and quality of life measures.
The investigators highlight the need for further confirmation of these findings, as well as continued research into the mechanisms by which traffic emissions impact lung function.
Low Vitamin A, C intake tied to asthma risk
But British team says findings don’t prove cause and effect
People who don’t get enough of the antioxidant vitamins A and C in their diet may be at increased risk for asthma, British researchers say.
The pooled results of 40 studies conducted between 1980 and 2007 showed that people with asthma had a significantly lower dietary intake of vitamin A than those without the disease. The average intake among those with asthma was 182 micrograms a day, which is between a quarter and a third of recommended daily intake.
The review authors also found that people with severe asthma had a significantly lower intake of vitamin C (about half the recommended daily intake) than those with mild asthma. In addition, low circulating levels of vitamin C in the blood and lower dietary intake of foods containing vitamin C were associated with a 12 percent increased risk of asthma.
There was no association between vitamin E intake and asthma risk, but blood levels of vitamin E were much lower among people with severe asthma than in those with mild asthma. Those with severe asthma had an average vitamin E intake of 2 milligrams/day, which is 20 percent lower than the daily recommended amount, the review authors said.
These findings don’t prove cause and effect, but they do challenge a study published last year that found no association between antioxidants and asthma risk, said Dr. Jo Leonardi-Bee, of the division of epidemiology and public health at the University of Nottingham in the United Kingdom, and colleagues.
“Overall, our findings from [the current] systematic review and meta-analysis indicate that low levels of vitamin C intake, and to a lesser extent vitamin A, are consistently associated with asthma risk to a degree that, if causal, would be sufficient to be clinically relevant,” they concluded.
Their findings for an association between dietary antioxidants and wheezing were less consistent. The report was published in a recent issue of Thorax.
Visible mold puts infants at risk for asthma development
Visible mold exposure early in life may be a strong risk factor for early asthma development, but exposure to mold components with no visible mold present may have an opposite effect according to a study published this month in Annals of Allergy, Asthma & Immunology, the scientific journal of the American College of Allergy, Asthma and Immunology (ACAAI).
Investigators from the University of Cincinnati and the Cincinnati Childhood Allergy and Air Pollution Study (CCAAPS) found children at age 3 years with high visible mold in the home during infancy, evaluated through home inspection, were seven times more likely to have a positive Asthma Predictive Index (API) criteria.
In contrast, those with exposure to fungal components – known as (1-3)-ß-D-Glucan, a measure of biologically active exposure – were at a decreased risk. The study included a birth group of children born to atopic parents- those with a tendency to develop allergies/asthma.
Previous studies have shown that home dampness and visible mold are associated with the severity of respiratory symptoms in children, but few studies have investigated whether exposure to dampness or visible mold enhance risk for development of asthma in young children, Yulia Y. Iossifova, M.D., Ph.D., and colleagues report.
“The unique aspect of this study is that we did not rely on parental reports of mold,” said Tiina Reponen, Ph.D., professor of Environmental Health at the University of Cincinnati, Cincinnati, Ohio. “Instead, the homes were evaluated by trained teams before the child’s first birthday. After this, the children were prospectively followed by annual clinic visits to evaluate their respiratory health.”
According to the authors, using standardized evaluation of visible mold, the study “prospectively demonstrates that exposure to high visible mold during the first year of life is associated with higher risk of asthma. This study also shows that an increase in exposure to high (1-3)-ß-D-Glucan concentrations may decrease the risk of future asthma based on the API.”
Of the 483 children in this study, almost half (7 of 16) with high visible mold at home had a positive API, and one-third (4 of 11) had atopic wheezing. Of the total cohort, 203 children (42 percent) had aeroallergen sensitization and 19 (3.9 percent) had mold sensitization. Mother’s smoking was the second strongest predictor of future asthma based on the API.
Researchers conclude that “home remediation measures to remove visible mold and parental smoking cessation may prevent asthma development in high-risk children.”
Patient information on allergic diseases, including asthma, is available by calling the ACAAI toll free number at (800) 842-7777 or visiting its Web site at www.acaai.org.
Acid reducers may not help all with asthma
Acid-suppressing medications won’t ease asthma symptoms if you don’t have heartburn symptoms as well, a new study has found.
Many people with asthma also have gastroesophageal reflux disease, or GERD. But some people have what’s known as silent GERD, meaning they have no symptoms.
Doctors have suspected that if people with asthma breathe in during reflux, they might breathe irritating stomach fluids into the lungs. To reduce that possibility, doctors have been prescribing acid-suppressing medications known as proton pump inhibitors, or PPI. Proton pump inhibitors work by suppressing acid production. A study in the April 9 issue of the New England Journal of Medicine repots that a PPI probably isn’t going to help lessen wheezing in people with silent GERD.
“Patients with asthma that is not adequately controlled with the usual asthma medications, and who have no symptoms of heartburn, but who may or may not have silent GERD, don’t seem to have any improvement of asthma when treated with esomeprazole (Nexium),” said one of the study’s authors, Dr. Robert Wise, a professor of medicine in the division of pulmonary and critical care medicine at Johns Hopkins University School of Medicine in Baltimore.
Although the two conditions may seem quite different, doctors have long suspected that they’re linked, with each disorder possibly triggering the other. Acid reflux might cause asthma symptoms through aspiration of fluid into the airways, or acid might irritate the esophagus and upper airway, according to the study. And asthma might trigger GERD when it causes difficulty breathing. The diaphragm may overinflate, and the extra pressure may cause the esophageal sphincter to herniate, allowing fluids to wash out of the stomach.
The study was funded by the American Lung Association and the U.S. National Institutes of Health and included 412 people whose asthma was badly controlled even though they were being treated with inhaled corticosteroids. All had either no symptoms or just minimal symptoms of GERD. They took 40 milligrams of Nexium or a placebo twice a day.
According to Wise, people given the drug took a larger-than-standard dose. In most people, he said, a 40-mg dose would suppress nearly all acid production in the stomach.
There was no statistically significant difference between those who took Nexium and the placebo group with respect to asthma control, lung function, GERD symptoms, night awakenings and quality of life, the study found. The rate of asthma events was 2.3 per person-year for the placebo group and 2.5 events per person-year for the treatment group.
“Our study showed this is not an effective practice,” Wise said. “These drugs are effective for treating heartburn, and if you have asthma and heartburn, then these drugs may well be used for those symptoms.”
Whole Foods joining nationwide recall of Bulk Pistachio Products due to possible health risk
Whole Foods Market South Region is voluntarily recalling all code dates of the following bulk and pre-packaged items because they may contain pistachios that have the potential to be contaminated with salmonella:
Bulk Products:
UPC# 222446 Bulk Roasted Salted Pistachios
• UPC# 222447 Bulk Roasted Unsalted Pistachios
• UPC# 222450 Bulk Roasted Unsalted Shelled Pistachios
• UPC# 222451 Bulk Dry Roasted Salted Shelled Pistachios
• UPC# 222476 Bulk Chili Lemon Pistachios
• UPC# 222463 Jalapeno Pistachios
• UPC# 222462 Garlic Onion Pistachios
Pre-packaged Products:
• UPC# 72305520446 Pre-packaged Roasted Salted Pistachios Packed on 3/27/09 Sell by 9/23/09
• UPC# 72305520447 Pre-packaged Roasted Unsalted Pistachios Packed on 3/18/09 Sell by 9/14/09
• UPC# 72305520450 Pre-packaged Roasted Unsalted Shelled Pistachios Packed on 10/23/08 Sell by 4/21/09
• UPC# 72305520451 Pre-packaged Dry Roasted Salted Shelled Pistachios Packed on 11/06/08 Sell by 5/6/09
• UPC# 72305520476 Pre-packaged Chili lemon Pistachios Packed on 3/11/09 Sell by: 9/6/09
• UPC# 72305520463 Pre-packaged Jalapeno Pistachios Packed on 3/11/09 Sell by 9/6/09
• UPC# 72305520462 Pre-packaged Garlic onion Pistachios Packed on 12/29/08 Sell by 6/27/09
• UPC# 72305520330 Pre-packaged Roasted Salted Pistachios Packed on 3/17/09 Sell by 9/18/09
• UPC# 72305520331 Pre-packaged Chili Lemon Pistachios Packed on 3/11/09 Sell by 9/12/09
• UPC# 72305520333 Pre-packaged Jalapeno Pistachios Packed on 3/11/09 Sell by 9/12/09
• UPC# 72305520842 Pre-packaged Oriental Wasabi Mix Sell by 3/26/09 9/27/09
• UPC# 72305520991 Pre-packaged Gourmet Holiday Nut Platter Sell by 3/31/09
Salmonella is an organism which can cause serious and sometimes fatal infections in young children, frail or elderly people, and others with weakened immune systems. Healthy persons infected with Salmonella often experience fever, diarrhea (which may be bloody), nausea, vomiting and abdominal pain. In rare circumstances, infection with Salmonella can result in the organism getting into the bloodstream and producing more severe illnesses such as arterial infections (i.e., infected aneurysms), endocarditis and arthritis.
This action was taken as a result of the recently expanded recall by Setton Pistachio of Terra Bella, Inc. to include all pistachio ingredients produced in their California facility, in turn affecting Whole Foods Market suppliers for bulk pistachios. None of the recalled Whole Foods Market products have been directly linked to the salmonella outbreak, and there have been no illnesses reported.
The recalled products were sold in Whole Foods Market stores located in Missouri, Illinois, Alabama, Georgia, Kentucky, Maryland, Michigan, Minnesota, Nebraska, New Jersey, North Carolina, Ohio, Pennsylvania, South Carolina, Tennessee, Virginia, Washington D.C., Wisconsin and Toronto, Ontario, Canada.
Customers are encouraged to return any of these products to Whole Foods Market or Harry’s Farmers Market for a full refund.
FDA issues stronger warnings for bowel cleansing agents
FDA announced new safety measures for oral sodium phosphate (OSP) products used for bowel cleansing before colonoscopies and other procedures. These products are associated with acute phosphate nephropathy, a rare but serious type of kidney injury. The events have been reported with the prescription products Visicol and OsmoPrep, and also over-the-counter sodium phosphate products when they are used as bowel cleansers.
FDA first warned about this problem in 2006, but cases of kidney injury continue to be reported. So FDA is requiring the manufacturer of Visicol and OsmoPrep to take several steps. First, a boxed warning about the risk of acute phosphate nephropathy will be added to the product label. The manufacturer will also conduct a new clinical trial to further study the risk of acute kidney injury with these products, provide a Medication Guide for patients, and implement a risk evaluation and mitigation strategy to ensure that the benefits of using these products outweigh their risks.
FDA believes that oral sodium phosphate products should be available only by prescription when they are used for bowel cleansing. Because of this, C.B. Fleet Company has voluntarily recalled the company’s oral sodium phosphate products sold over the counter, (Fleet Phospho-soda and Fleet EZ-PREP) and has advised healthcare professionals not to instruct patients to use these products for bowel cleansing. Unico Holdings, Inc. is also recalling its over-the-counter oral sodium phosphate products sold for bowel cleansing.
Users of colon preparation productions can avoid dehydration by drinking enough clear liquids before, during and after bowel preparation. They should also tell patients to be alert for symptoms of acute kidney injury, including malaise, lethargy, drowsiness, decreased urine volume and swelling of the ankles, feet and legs.