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PubMed1988

Dietary aspects of adverse reactions to foods in adults.

Dietary considerations play an important role in the diagnosis, treatment and management of immunologic and nonimmunologic reactions to foods. Food diaries and trial elimination diets may prove helpful in identifying the responsible foods. Elimination diets must be monitored carefully for nutritional adequacy and should be used no longer than absolutely necessary; in some instances appropriate vitamin and mineral supplementation may be necessary. Ideally the identification of foods that provoke symptoms should be confirmed by means of double-blind challenge testing. Avoidance of some problem foods is unlikely to cause nutritional problems, but the practical and nutritional implications of allergies to staple foods such as cow's milk, eggs and wheat are far greater. Nonimmunologic adverse reactions that may mimic food allergic reactions include gastrointestinal disorders, sensitivity to food additives and psychologically based adverse reactions. There may be some degree of tolerance in metabolic disorders, which makes dietary management easier. Sensitivity to food additives necessitates careful scrutiny of food labels. In psychologic adverse reactions to foods, several foods are often involved, which increases the risk of nutritional problems.

Adult↗
PubMedDate not supplied

Tracking nutrition trends, 1989-1994: an update on Canadians' attitudes, knowledge and reported actions.

The National Institute of Nutrition tracks changes in Canadians' attitudes, understanding and reported actions related to nutrition issues--particularly fat cholesterol and fibre. Personal interviews were conducted in 1994 with a national sample of 1,953 adults, and the results were compared with data obtained in 1989. The number of people claiming that nutrition is of considerable importance in choosing their food has increased from 59% to 66%. More Canadians are now concerned about fat (82% vs 71%) and "chemicals" in foods (76% vs 68%) and more are planning to further reduce fat or increase fibre intake. Forty-three percent report having excellent or very good eating habits. The apparent use of food labels, lower fat/low--cholesterol products, and bran/high-fibre foods has grown in five years. Although awareness of nutrition terms has increased, understanding has changed little. The challenge is to build on consumer interest to reduce barriers to healthy eating through education and a supportive marketplace.

Adolescent↗
PubMed1978

Nutrition policy--from neglect and uncertainty to debate and action.

Until recent years, nutrition has received little attention in U.S. agriculture, food, and health policies. This circumstance is changing. In the late sixties and early seventies, reports of hunger and malnutrition sparked public reaction and a shift in policy. The White House Conference on Food, Nutrition and Health in 1971 prompted the Senate select Committee on Nutrition and Human Needs to address itself to this problem, with the result that the Food Stamp, child nutrition, WIC, and Nutrition for the Elderly programs were initiated or expanded. Then, in the mid-seventies, the Select Committee turned its attention to broader issues of nutrition and health and declared that the goal of any food system is the maintenance and improvement of nutritional health of the population. This objective emerged as public policy in the Food and Agriculture Act of 1977. As the Select Committee continued its work, problems of overnutrition became more apparent. The culmination of its studies was the issuance early in 1977 of the "Dietary Goals for the United States," designed to improve the nutrition and reduce health problems of the population. To that same end, the Select Committee has also made recommendations regarding food labeling and nutrition education.

Aged↗
PubMed2001

School readiness for children with food allergies.

BACKGROUND: Food allergy reactions and anaphylaxis may occur in children while at school. However, information regarding school readiness for children with food allergies is unknown. OBJECTIVE: To identify school education and prevention and treatment policies for food-allergic children in Michigan. METHODS: A questionnaire assessing food allergy awareness and avoidance and treatment strategies was mailed to a randomized sample (n = 273) of 2,082 public elementary school principals. RESULTS: One hundred four responses representing 109 schools were collected. From school estimates of 66,598 children, there was a 1.7% self-reported prevalence of food allergy. The most common allergens were milk and peanut, followed by tree nuts, shellfish, egg, and wheat. Affected children were identified primarily through office records, with few reporting individual emergency plans or designated classrooms, teachers, or lunch tables. Methods of food allergy education included parents of students and in-services. Avoidance strategies, food substitution, and "no-sharing" policies were common, whereas other measures such as food-label-teaching were uncommon. A minority of schools had epinephrine immediately accessible, either in the student's classroom, carried by the student, or passed by teachers. Principals, nurses, and teachers were most often trained to administer epinephrine. CONCLUSIONS: There appears to be a need for schools to formally educate staff on food allergy, provide information on prevention measures such as reading of food labels, establish immediate accessibility to emergency epinephrine, and train staff for appropriate epinephrine use.

Child↗
PubMedDate not supplied

Promoting the selection of healthy food through menu item description in a family-style restaurant.

We describe an attempt to influence the selection of menu items in a family-style restaurant. Three different messages, varying in content and emphasis, were used to promote one food special each intervention day. One message emphasized that the specials were particularly healthful, being relatively low in fat, sodium, and cholesterol. A second message stressed flavor and added that the choice was healthful. A third, nonspecific message made no mention of taste or health factors, but simply noted that there was a daily special. Results indicated that restaurant patrons selected healthful specials when the message noted that the choice was healthful but emphasized flavor. Patrons were apparently more open to information about the palatability of the food than its healthfulness per se. These results have implications for point-of-purchase health promotion efforts in general, especially those involving food-labeling programs in restaurants and grocery stores.

Cardiovascular Diseases↗
PubMed2004

Food allergy and the food industry.

Although most food-allergic reactions occur after ingestion of nonpackaged food products, the food industry has been subjected to increasing scrutiny of their allergen controls; the resulting impact on the industry has been remarkable. Undeclared food allergens have been responsible for many food product recalls during the past 13 years, and the food industry has made significant investment, effort, and improvements in allergen control during this time. Recently, tests for some allergenic foods have been commercialized, and proven useful to the industry in controlling allergens and helpful for regulatory agencies investigating food-allergic consumer complaints. However, testing methods still do not exist for some of the common allergenic foods. Labeling initiatives have been pursued to make ingredient listings more easily understood by food-allergic consumers, but further improvements could still be made. Additional research to determine eliciting doses for allergenic foods is needed to enable science-based risk assessment and risk management.

Allergens↗
PubMed2000

Genetic technologies. Bioengineered food--safety and labeling.

The safety and labeling of genetically engineered foods are two areas that have elicited considerable public concern and debate. This Policy Forum provides a legal analysis of these issues in the context of two bills that have been recently proposed in The U.S. Congress, the Genetically Engineered Food Safety Act and the Genetically Engineered Food Right to Know Act. Most transgenic components of foods currently on the market are plant-incorporated protectants or their inert ingredients. Therefore, they have been evaluated for safety by the Environmental Protection Agency (as well as the Food and Drug Administration), and their disclosure in labeling should not be required. If plant-incorporated protectants are considered safer than chemical pesticides, and chemical pesticides do not have to be disclosed in labels, then bioengineered foods should not be subject to stricter regulation, nor should they be required to be labeled. The two bills are inconsistent, in many respects, with well-established principles of food regulation.

Animals↗
PubMed2001

The effects of equal-energy portions of different breads on blood glucose levels, feelings of fullness and subsequent food intake.

OBJECTIVE: This study compared the effects of equal-energy portions of 7 different breads on feelings on fullness and subsequent ad libitum food intake. A satiety index score (SI) was calculated for each of the breads. DESIGN: Within-subject, repeated-measures design. SUBJECTS AND INTERVENTION: Ten healthy subjects participated in the study. Subjects fasted for > or =10 hours overnight and then reported to the research center the next morning, where they first completed baseline satiety ratings, gave a fasting blood sample, and then consumed a test bread. Additional finger prick blood samples and satiety ratings were collected at 15-minute intervals over 120 minutes, after which the subjects' ad libitum intake of food was recorded. A satiety index (SI) score was calculated for each test food by dividing the area under the 120-m satiety response curve (AUC) for the test bread by the satiety AUC for the reference bread (regular white bread) and multiplying by 100%. RESULTS: The mean SI scores for the breads ranged from 100% to 561%, with regular white bread having the lowest SI score. Mean SI scores were negatively correlated with energy intake at a test meal after 120 m (r=-0.88, P<.01, n=7) and total day energy intakes (r=-0.72, P<.05, n=7). The strongest predictor of the breads' SI scores was their portion size and thus energy density. The breads' glycemic responses were not significantly associated with fullness responses. APPLICATIONS: Ingredients and food processing methods are available for the production of palatable, high-satiety versions of processed foods, which may be useful for weight control diets. SI scores would be a useful addition to food labels to indicate which foods are less likely to be overeaten and could be used by dietitians to develop weight control plans to help reduce energy intakes without increased hunger.

Adult↗
PubMed1995

The evolution of national nutrition policy.

Domestic regulatory efforts in the area of nutrition historically have focused on achieving and sustaining the highest possible level of food safety and availability. More recently, the linkages between certain dietary practices and the risk of chronic, degenerative diseases have also become a significant focus of public policy. In order to promote good nutrition practices, the Food and Drug Administration (FDA) now requires a detailed and informative Nutrition Facts food label on virtually all food packages. Other public policies promoted by the FDA and others include increasing public knowledge of the relationship between diet and health; promoting unified food and nutrition policies among all government agencies; educating the American consumer about sound dietary practices; and encouraging the development of technologies that may result in more healthful, more abundant, and more affordable foods.

Agriculture↗
PubMed1991

Dietary sodium reduction for hypertension prevention and treatment.

Nutritional-nonpharmacological approaches for the treatment and prevention of hypertension are of great interest. Sodium reduction is one of the primary methods recommended for these purposes. The general public is interested in the reduction of dietary sodium intake and has responded with a decrease in table salt use, the purchase of lowered sodium food products, and the use of food labels to help guide food purchases. Countervailing trends in the use of convenience foods and dining out increase the difficulty for individuals to lower sodium intake. Clinical trials that have used sodium reduction alone or in combination with other lifestyle therapies have demonstrated the feasibility of reducing dietary sodium intake from 30% to 50% for up to 4 years, in a variety of populations. Trials that used lifestyle and weight loss interventions have also achieved significant reductions in body weight and alcohol consumption and increases in physical activity. A variety of studies indicate that long-term sodium reduction is feasible and that it is acceptable to patients. No negative consequences of these interventions have been observed, and in some cases improvement in the intake of other nutrients has occurred. Nonpharmacological interventions have resulted in hypertension control in significant proportions of the trial populations. These studies demonstrate that the foregoing types of interventions can significantly contribute to hypertension treatment and prevention.

Attitude to Health↗
PubMed1997

Adverse reactions to food constituents: allergy, intolerance, and autoimmunity.

Food allergies and intolerance represent important health concerns to consumers who are predisposed to these illnesses. Unlike many current food safety issues, food sensitivities are complicated by both complex and multiple individual adverse reactions, which can vary from emotional to pathophysiological ailments. In some instances, the underlying mechanisms that result in the development of food allergies or intolerance have marked differences but produce common symptoms. The present-day diagnosis of these disorders can be impeded by intrinsic limitations in generating accurate information from patient history and biochemical, physicochemical, and immunochemical tests. Oral challenge tests represent effective methods for confirming and testing food allergens and food intolerance; however, these procedures are often restricted to clinical trials. It is important to be able to distinguish among food allergy, intolerance, and autoimmune disease in the management of these disorders. The role of food in the development of autoimmune disease may be exemplified by celiac disease, a food-induced enteropathy, requiring exposure to prolamins in wheat, rye, and barley. Various wheat and soy protein sources, including the soy protein isolates used to make infant formulas, have been related to juvenile or insulin-dependent diabetes mellitus (IDDM), a common chronic disease of childhood. Employing food process technologies to eliminate food constituents with potential for intolerance in some individuals is a potentially viable approach for reducing risk to food-related disorders. Finally, the development of food labelling regulations that require the identification of potential food allergens or agents for intolerance in the ingredient declaration on prepackaged food is a positive step toward the prevention of severe adverse reactions in hypersensitive individuals.

Animals↗