2015年4月13日 星期一

Special issue of Gastroenterology highlights how food impacts health and disease – 腸道問題反映出食物如何影響健康

Patients are always interested in understanding what they should eat and how it will impact their health. Physicians are just as interested in advancing their understanding of the major health effects of foods and food-related diseases. To satisfy this need, the editors of Gastroenterology, the official journal of the American Gastroenterological Association, are pleased to announce the publication of this year's highly anticipated special 13th issue on food, the immune system and the gastrointestinal tract.
"This special issue provides a tour de force of biological and clinical data regarding how food impacts health and disease," said Douglas A. Corley, MD, PhD, MPH, and Detlef Schuppan, MD, PhD, guest editors for this special issue. "We hope this will inform future research by identifying gaps in knowledge, while providing patients and clinicians with evidence-based summaries to guide clinical recommendations."
In the last two decades, we have witnessed a marked expansion of research into how food and nutritional elements influence health and disease. Food and its interactions with the immune system are a critical topic for gastroenterology to address, changing our view of digestion and resorption of food as the principal role of the gastrointestinal tract. Articles in this special issue of Gastroenterology evaluate immunology, biological mechanisms and clinical studies of foods and food-related diseases for all the major topic areas, including food allergies, celiac disease, non-celiac wheat sensitivity, carbohydrate (FODMAP) intolerance in relation to irritable bowel syndrome, cancer, obesity and brain-gut interactions.
The specific topics covered in this special 13th issue of Gastroenterology are outlined below.
Food and the Microbiome
  • Diet in the Pathogenesis and Treatment of Inflammatory Bowel Diseases; by Dale Lee, et al.
    • The question of what to eat is among the most commonly asked by patients, and among the most difficult to answer for clinicians.
  • Food, Immunity, and the Microbiome; by Herbert Tilg and Alexander R. Moschen
    • By increasing our understanding of interactions between diet, immunity and the microbiota, we might develop food-based approaches to prevent or treat many diseases.
    Food Allergies
  • Food Allergies: The Basics; by Rudolf Valenta, et al.
    • Learning about the structure of disease-causing food allergens has allowed researchers to engineer synthetic and recombinant vaccines.
  • Diagnosis, Management, and Investigational Therapies for Food Allergies; by Mike Kulis, et al.
    • Although there are no therapies currently available for routine clinical care [of food allergies], recent reports have indicated that immunotherapies targeting the mucosal immune system may be effective.
    Eosinophilic Esophagitis
  • Molecular, Genetic, and Cellular Bases for Treating Eosinophilic Esophagitis (EoE); by Marc E. Rothenberg
    • We propose that EoE is a unique disease characterized by food hypersensitivity; strong hereditability influenced by early life exposures and esophageal-specific genetic risk variants; and allergic inflammation and that the disease is remitted by disrupting inflammatory and T-helper type 2 cytokine?mediated responses and through dietary elimination therapy.
    Food and Functional Bowel Disease
  • Food Components and Irritable Bowel Syndrome; by Peter R. Gibson, et al.
    • The concepts behind, and delivery of, specialized diets differ from those of pharmacologic agents.
    Celiac Disease: Clinical Spectrum and Management
  • Advances in Diagnosis and Management of Celiac Disease; by Ciarán P. Kelly, et al.
    • There is increasing interest in developing nondietary therapies.
  • Local Communication Among Mucosal Immune Cells in Patients with Celiac Disease; by Jeroen van Berge, et al.
    • We review the immune processes that occur in the lamina propria and their potential effects on epithelial pathology in celiac disease.
    Nonceliac Gluten and Wheat Sensitivity
  • Nonceliac Gluten Sensitivity; by Alessio Fasano, et al.
    • Although there is clearly a fad component to the popularity of the gluten free diet, there is also undisputable and increasing evidence for nonceliac gluten sensitivity.
    Food and the Brain: How the Brain Responds to Nutrients
  • Neural Responses to Macronutrients: Hedonic and Homeostatic Mechanisms; by Alastair J. Tulloch, et al.
    • A greater understanding of the neural circuits affected by the consumption of specific macronutrients, and by obesity, might lead to new treatments and strategies for preventing unhealthy weight gain.
  • Peripheral Mechanisms in Appetite Stimulation; by Michael Camilleri
    • Understanding these mechanisms is key to the physiological control of feeding and the derangements that occur in obesity and their restoration with treatment (as shown by the effects of bariatric surgery).
    Nutrients and Gastrointestinal Malignancies
  • Diet and Upper Gastrointestinal Malignancies; by Christian C. Abnet, et al.
    • Public health recommendations for normal-risk individuals regarding diet and gastrointestinal cancer should probably emphasize the importance of eating for overall health rather than eating specific foods to reduce risk for specific cancers.
  • Nutrients, Foods, and Colorectal Cancer Prevention; by Mingyang Song, et al.
    • Diet likely influences colorectal carcinogenesis through several interacting mechanisms. These include the direct effects on immune responsiveness and inflammation, and the indirect effects of overnutrition and obesity -- risk factors for colorectal cancer.

2015年4月11日 星期六

色香味飄流廚房

(綜合報道)廚師對烹飪有熱誠,無論身處甚麼地方都能做出好菜式。最近坊間出現了另類Pop-up餐飲服務,廚師每次在不同餐廳「借場一晚」主理美食,名副其實是「飄流廚房」,所供應菜式帶Fusion風格,廚師除追求色香味,還重交流,讓客人感受非一般美食之旅。
  Pop-up餐廳即期間限定食肆,營業時間為數星期至三個月不等,但這家Urban Health Pop-Up Kitchen每次只會營業一晚,原因是創辦人兼主廚Andy會定期在不同餐廳「借場」主理美食,每次與不同廚師合作設宴一晚。明天(4月16日)是Pop-Up Kitchen首次晚宴日子,選址是位於西營盤的Opendoor Cafe,他找來印度菜高手Chef Seema合作,炮製六道菜套餐,菜式健康,糅合了中菜、印度及非洲食材,包括素菜版麻婆豆腐、非洲南瓜扁豆羹等,客人可感受多國風味,每位優惠價$350。
  沒接受過正統餐飲業訓練的Andy,因自小熱愛烹飪,加上身為中國及印尼混血兒,擅長東南亞菜及廣東菜。他原本打算在美國當私家偵探,偶然機會下幫助朋友「破案」,替對方查出食物過敏源頭,令他決心當上廚師。他見不少香港外國人因食物過敏而煩惱,去年成立了網上公司Urban Health,專門設計健康餐單,獲知名旅遊網站《TripAdvisor》給予不俗評價。最近,Andy增設Pop-Up Kitchen服務,菜式以健康為大前提,用料天然及無麩質,不下味精及雞粉調味,挑選合作的廚師是名不經傳的Home Chef,因而能煮出住家風味。例如這次合作的Chef Seema是健康食材店店主,也是入廚多年家庭主婦,其自家製雲呢乳酪鼠尾草布甸是罕有美味甜品,而且營養豐富,打破健康食品的沉悶印象。
資訊來源: 

2015年4月9日 星期四

10 million Britons have food allergies – 大約1000萬個英國人都有食敏敏感

An estimated 10 million people in the UK are allergic or intolerant to at least one foodstuff yet many think sufferers make an unnecessary fuss about the problem, research has found.

While a third (35%) of people think those with them make a fuss, a quarter (24%) admit they feel no empathy.

More than half (57%) of those questioned who have an allergy or intolerance said they find it very difficult to live with their condition and it affects their quality of life, with nearly the same amount (53%) saying they find people are generally dismissive of the issue.

A 1997 study found hospital admissions in the UK due to food intolerance or allergies had risen by more than 500% since 1990.

The charity Allergy UK said it is unclear exactly why so many more people are suffering from food allergies and intolerances, but possible reasons could be due to diets made up of more processed foods and fewer fruit and vegetables.

Researchers are investigating whether reduced levels of nutrients like Vitamin D, omega-3 fatty acids (found in fish) or antioxidants might be the reason.

The most common food allergies among adults are to fish and shellfish and nuts, while children are often allergic to milk and eggs.

Food intolerances are much more common than allergies, with lactose, or dairy, the biggest cause of intolerance.

Source: http://www.freshplaza.com/article/138876/10-million-Britons-have-food-allergies

2015年4月6日 星期一

Battle to keep kids with food allergies safe away from home – 跟家中致敏原搏鬥

When your child has food allergies or intolerance it's scary. While they're at home you can generally ensure they're safe. But what about when they're away from home - at school, at a friend's house or staying with family?
Children are not adults, they do not have the same ability to advocate for their health and may not always make the best food decisions - especially if something yummy is offered to them.
Many young allergy-affected children would find it difficult to easily turn down a piece of chocolate cake if it was offered by an adult and there were no allergy-free options available. Especially if they were in a room full of their cake-eating friends.
As a parent, you've got to be able to trust that the people who are looking after your child are following the dietary instructions you've provided. However, all too often I've heard of cases where people have either deliberately or accidentally ignored parental advice.
READ MORE: 
Recently I received an email from a concerned mum. Her children are gluten and dairy intolerant and, despite informing the school repeatedly of their dietary needs, this week they were given Anzac biscuits by their teacher.
No prior notice was given, so the parents couldn't provide an alternative option, nor did the school make any effort to safeguard the child in question. I have no idea whether this was a deliberate case of willful ignorance on the part of the school, or a genuine mistake, but it's not good enough.
Children should be safe at school, and that means ensuring they aren't exposed to hazardous substances - and for allergy-affected children, food can be a hazardous substance.
I've also heard of many cases of grandparents or other well-meaning family members giving children with food allergies unsafe foods because they felt the child was "missing out on treats".
Allergies tough on families
As a child, my parents were very clear about their desire for me not to have much sugar in my diet. And it was for good reason - when I had sugar I was miserable for at least a week and had awful stomachaches (and damn it, this is still the case as an adult).
My nana, who was the kindest, most lovely grandmother you could hope for, was constantly giving me sugary treats. Chocolate, lollies and all kinds of yums. It used to drive my parents crazy because after staying with my grandparents I was sick as a dog for weeks afterwards.
So why do people insist on ignoring the dietary guidelines set by parents? I can only think of two reasons:
1. They think they know better what your child should be eating.
2. They don't want the child to miss out on treats
Let's be clear, neither of these reasons are acceptable for ignoring the dietary guidelines provided by the child's parent. Parents have to deal with the fall-out when their advice is not adhered to, and this could be anything from mild to sever, from behavioural issues to physical illness.
Just because a child doesn't go into immediate anaphylaxis does not mean that they do not have a food allergy or intolerance.
Whatever the side-effects of dietary slip-ups, it is not for other people to judge whether they are serious enough to follow a specific diet.
Let me say it once very clearly: if you've been advised by a parent not to feed their child a certain food, DO NOT feed that food to the child. It's not difficult.

2015年4月4日 星期六

寶寶過敏還是感冒?防4大過敏原!

如何分辨寶寶過敏還是普通感冒
因為感冒也通常會有咳嗽、打噴嚏、鼻塞等症狀,因此很多家長不知道寶寶到底是感冒還是過敏。上海市第一人民醫院兒科主任李臻提醒家長,可以從以下幾個方面區別寶寶是否是過敏:如果寶寶還表現為發燒,並有感冒的接觸史,則考慮可能是感冒;如果寶寶鼻塞、流涕的同時伴有長紅疹,或者超過兩星期鼻塞、流
涕治療不好,則考慮可能是過敏;如果寶寶有過敏原接觸史,則可能是過敏,如寶寶本來正常,到公園遊玩後開始打噴嚏、流鼻涕等,則可能考慮花粉過敏。
預防過敏,謹記4大常見過敏原
1.吸入性過敏:如花粉、塵蟎、灰塵、真菌、動物皮毛、羽毛、寒冷的空氣等。
2.食物過敏:如牛奶、雞蛋、海鮮等。牛奶過敏比較常見於新生兒,通常表現為濕疹、腹痛、便秘、腹瀉甚至嘔吐等症狀。
3.接觸性過敏:如化妝品、油漆、酒精、藥膏等。
4.藥物過敏:藥物過敏比較少見。一般來說,藥物引起的過敏大都會有發熱現象,一旦停用引致過敏的藥物,體溫就會下降。

寶寶年齡不同過敏症狀不同,家長應區別對待
隨著寶寶年齡的增長,過敏性疾病的表現也會發生階段性的變化,寶寶身體的各個系統都會隨著成長而陸續出現過敏症狀,這種現象被稱為過敏進程。家長應該瞭解寶寶過敏的過敏進程,看看自己的孩子屬於哪個年齡段,是不是出現了這個年齡段多發的過敏症狀。
0-3歲寶寶
過敏類型1:食物過敏 過敏症狀:腹瀉、濕疹
一般來說,孩子最早出現的過敏是食物過敏,其中牛奶、雞蛋、海鮮是較為常見的過敏原。如果孩子對某種食物過敏,一般會出現腹瀉和濕疹等症狀。
預防小叮嚀:
1.母乳餵養:母乳餵養是最安全的,可以避免孩子對牛奶的過敏,如果母乳不足,適度水解配方奶是預防過敏的首選。
2.食物過敏沒有特殊的治療手段,對牛奶過敏又無法母乳餵養的孩子,可以用完全水解配方奶或元素配方奶。
3.有過敏體質的孩子,可以適當推遲添加固體食物的時間,6個月以後再逐步添加。在給孩子添加食物時,要一次只添加一種食物,觀察幾天,如果沒有不良反應再添加另一種。這樣即使孩子對某種食物過敏也容易發現,能儘快避免孩子受到過敏的折磨。
過敏類型2:皮膚過敏 過敏症狀:濕疹
濕疹是嬰幼兒的常見病,病因比較複雜。通常得濕疹的孩子很多是先天性過敏體質,在受到一些致敏因數刺激後,就會引起發病。食物過敏是引起濕疹的主要原因之一。此外,春天是寶寶濕疹高發期,因為春天正是樹木花草生長的時期,孩子吸進了空氣中的花粉、粉塵或蟎蟲,因而引起濕疹。
預防小叮嚀:
如果你們兩人中有一人或雙方有過敏性疾病史,從孩子出生起,就要開始注意,儘量避免濕疹的發生。
1.保持房間內及孩子生活用品的清潔。
2.儘量避免讓孩子接觸揚塵、花和樹木的花粉等過敏因數。
3.不要用鹼性大的香皂給孩子洗臉、洗澡。
4.選用寬鬆透氣的純棉衣物,最好別給他穿化纖織物的衣服,尤其是內衣。
5.母乳餵養,如母乳不足,選用適度水解配方嬰兒奶粉。

2015年4月3日 星期五

Food Sensitivities, Intolerances and Allergies – 食物敏感與食物不耐受

Food Allergies vs. Food Intolerances

Did you know there are differences between a food intolerance and food allergy? Naturopath, Mubina Jiwa, shares everything that you need to know!

Since our body is so good at managing reactions it is tough to isolate food intolerances. Intolerances can pop up three days after eating a culprit food, and in some cases it may be weeks before the symptoms are bothersome enough to notice.
There are two basic immune based reactions. Food Allergies and Intolerances

The first thing to determine is whether what you are experiencing is truly an intolerance and not an allergy.

Allergies
Food allergy symptoms typically appear immediately after eating, touching, inhaling or getting injected with the allergen. Food allergy symptoms are often quite severe and may even be life-threatening. If you have an allergic reaction you may notice a red skin rash, difficulty breathing, red eyes or even a drop in blood pressure. Most people know what their allergies are at a young age, but some can develop later in life. The best way to get an allergy tested is to go to an allergist and have a skin prick test.

Intolerances
Food intolerance symptoms are not life-threatening and are delayed. They can cause a variety of symptoms and may contribute to chronic health concerns. Like allergies, an intolerance can develop at any point in life.

What is an intolerance?
It is your body fighting the food that you are eating. That food is scratching at your intestinal lining and causing inflammation which can lead to a disturbance in your gut lining that then produces adverse symptoms. When testing for intolerances the gold standard is to eliminate foods and then introduce them one at a time. Yet, this can be difficult due to the fact that there are many ingredients in foods that we eat. Many people will opt for a simple blood test that can determine your intolerances. Blood testing for food intolerances can be done at your naturopath, certain pharmacies and other health clinics.

Intolerance symptoms:
  • Joint pain
  • Gas and bloating
  • Mood swings
  • Headaches
  • Lower back pain
  • Acid reflux
  • Congestion
  • Skin issues
  • Diarrhea
  • Constipation
  • Weight gain
  • Cravings
How do you do the elimination diet?
The idea is to take away common aggravators, flush out your system and then re-introduce them one at a time.

How do you prep for this type of elimination?
It’s tough to jump right in to it. They key to any successful change is preparation. Pick a few weeks when you aren’t going to any parties or special events.

Give yourself two to three days to prep with these five steps:

1. Get armed with a list of common allergens
This includes; dairy, beef, pork, shellfish, soybeans, peanuts, corn, wheat, spelt, kamut, rye, barley, oats, banana, citrus fruit, eggplant,  potato, tomato, bell peppers, sugar

2. Mental gymnastics
Any task is manageable as long as you put your mind to it. Instead of thinking about what you can’t eat focus on the things you can eat! Base your diet on free-range lamb, chicken, turkey and fresh fish. You can have any whole grain that is gluten-free and brown rice. Don’t forget that you can eat vegetables that are seasoned with fresh spices.

3. Read labels
The most important thing you can do is start reading labels. Doing this will show you just what you buy contains (usually multiple ingredients) and chances are you had no idea what was in your food. For example soy sauce contains wheat and many flavourful sauces are made with sugar.

4. Eat more home cooked meals and reduce your intake of processed/refined foods.

5. Make healthy swaps
Switch your sweet snacks to fruit and your crunchy snacks to vegetables. Switch from coffee to green tea and then move to herbal teas, like dandelion.

Now that you’ve prepared well and found a good time to start off you go. Ideally you want to try to eat clean for two to three weeks. This gives your body a chance to reduce any inflammation and heal up your digestive system.

Once the two to three weeks have passed you can re-introduce culprit foods one at a time. But don’t eat foods with multiple culprits, like pizza which includes tomatoes, cheese, wheat and gluten. If you have a reaction you won’t know which of the three things is bothering you. Start by eating a banana and monitor how you feel for the following three days. If you feel fine, great, you can add the banana to your dietary rotation. If you feel any differently than how you were feeling during its elimination, keep the banana out. If you do experience symptoms give your body two days to flush it and then move onto the next item.

Final tips;
  • Remember that just because you are okay eating a food doesn’t mean you should gulp it down every chance you get. You should rotate it with other foods in your diet and avoid eating the same thing more than twice a week.
  • You just did a fantastic diet! Remember that healthy feeling and try to stay away from the refined and processed foods (or at the very least keep them to a minimum) - your body will thank you!


2015年4月1日 星期三

藥物引過敏 女子鬼門關走一回

25歲王姓小姐吃抗癲癇藥「樂命達」後出現過敏等症狀,醫師初期誤診,就醫時未立刻停藥,讓王小姐吃盡苦頭。
王女常在自己的部落格分享遊歷點滴,是「愛玩、愛旅行」的樂觀、活潑少女,她最近寫下與過往不同的心境,文字搭配圖片,敘述服藥後引起藥物過敏的不凡體驗。
王女服用抗癲癇藥物「樂命達」後,開始出現過敏、咳嗽、發燒、喉嚨痛症狀,診所就醫一間換了一間,都沒有診斷出來,到台北的醫院竟然進行氣切,病情持續惡化,醫師也同意持續用「樂命達」下,醫院才協助轉院到醫學中心,診斷為「史蒂芬強森症候群」,住進加護病房。
在加護病房,皮膚及身體症狀持續惡化,家人也收到病危通知,鬼門關前走一回,親身經歷藥物過敏可怕。她將奇蹟活下來的過程記錄在部落格,永不放棄的信念持續支撐自己,並相信一定會雨過天晴。
長庚醫院北院區藥物過敏中心主任鐘文宏說,藥物引起嚴重過敏史蒂文生氏強生症候群(SJS)案件中,樂命達排第3名,樂命達是抗癲癇藥及躁鬱症用藥。
他說,澳洲一名19歲少女,這個月也因服用樂命達出狀況,初期被誤診為(泡)疹、口蹄疫、麻疹、水痘,最後才被診斷出SJS。
他指出,樂命達藥物1年新使用者約1、2萬人,引起SJS約有10例,有的輕微、有些嚴重;例如王小姐的個案很嚴重,特別是已出現症狀,仍持續服用樂命達。
鐘文宏說,目前會引起SJS的藥物除了樂命達外,還有降尿酸藥品「Allopurinol」、抗癲癇藥物「Carbamazepine」及「Phenytoin」;提醒醫師開立前述藥物時,應注意患者是否有引起過敏反應。