Since I'm a New Yorker addict and am fascinated by reading about food
allergies, lactation, and babies, I had a go at it... here's my summary of
the article, focused on the researchers mentioned, their research results,
and their hypotheses.

-----------

   Dr. Hugh Sampson, director of the Jaffe Food Allergy Institute at Mount
Sinai Medical Center in NY along with Dr. Scott Sicherer, a pediatric
allergist also at Mt. Sinai have been study food allergy.


Sampson believes increase in food allergies is real and that 3-5% of the
population has food allergies.  He believes the current approach to
preventing food allergies by delaying introduction of allergenic foods.


Early on, Sampson and other researchers investigated the hypothesis that
allergies could be prevented by breastfeeding as long as possible in order
to keep infants off allergenic foods until their immune systems were more
mature.  Research by Sampson's group and others in mice found that mice
could not react to a food protein they'd never been exposed to before.


In 1989 a controlled research study on allergy prevention was published in
The Journal of Allergy and Clinical Immunology by Dr. Robert Zeiger, a
pediatric allergist and immunologist at Kaiser Permanente Medical Center in
San Diego.  Mothers  "prone to allergy" were randomly assigned to groups,
one of which required an allergen- restricted diet (no dairy, eggs, peanuts)
during the last trimester of pregnancy and breastfeeding.  Infants were
supplemented only with Nutramigen, given no solids for the first 6 months,
and had restrictions on certain allergens for 12 or 24 months.  Infants on
the restricted diet showed significantly fewer allergies at one year of
age.  Public health recommendations in the UK and US were issued in 1998 and
2000 based on this research.


Dr. Scott Sicherer felt that food allergies must have arisen as a result of
the modern environment.  One theory on the causal factor is the hygeine
hypothesis.  Other theories are based on geography and diet, with vitamin D
possibly playing a role, or diets with animal fat causing more of an
inflammatory response and lack of fruit and vegetable intake leaving people
unable to mute the inflammatory response.


At first few questioned the guidelines from 1998/2000 - but one who did was
Dr. Gideon Lack at St. Mary's Hospital in London. He wrote skeptical letters
in the Lancet and the BMJ pointing to the lack of strong evidence for the
guidelines.


After discovering the rate of peanut allergy was much lower in Israel, Lack
researched family food consumption patterns and allergic diseases and found
the risk of peanut allergy in Jewish children in London was 11 times higher
than in those in Tel Aviv.  Other allergies were 2-14 times higher.  Lack
speculated that the early introduction of peanut & other allergenic foods
helped ward off food allergies.


Lack also found a correlation between children with eczema and peanut
allergy, and exposure to a peanut-oil-containing ointment.  He also found
*no* correlation between women eating peanuts while pregnant and peanut
allergy in their children.  This work was published in 2003 in the NEJM.


Lack is currently conducting a study funded by US's NIH and the FAI and FAAN
called LEAP - Learning Early About Peanut allergy.  640 babies are being
randomly assigned to eat peanut or not and allergy rates will be compared.
He is also conducting a study on 1300 babies funded by the Food Standards
Agency and the Medical Research Council of the UK about timing of weaning
from breastfeeding and consumption of allergenic foods.


Lack believes that tolerance to food proteins develops over the first six
months with exposure, e.g. through pre-masticated food.  A study in Maternal
and Child Nutrition in January 2010 reports 2/3 of current Chinese
university students were fed pre-masticated foods as infants, as compared to
14% of American infants.  Saliva delivered through pre-mastication may be an
important part of reducing the provocation of food allergies.


In January 2008, the AAP came out with a new clinical report by Sicherer
that claimed there is not evidence for maternal diet restrictions in
pregnancy or lactation, and little evidence for delaying introduction of any
complementary foods beyond 4-6 months.


The chair of the committee that released the AAP statement in 2000 defended
that recommendation for that time, saying that there were safety concerns in
particular about exposure to cows milk through formulas and that they cast a
broad net to include advice about avoiding other allergens.


The remainder of the article covers restaurant exposure, cooking methods to
alter allergenic proteins, and experimental desensitization procedures to
encourage tolerance to former food allergens.

Hope that helps!
-Rosemary McNaughton
LLL Leader, NMC Counselor
Northampton, Massachusetts, USA


On Mon, Feb 7, 2011 at 9:25 AM, nandan fogelman <[log in to unmask]> wrote:

> I am curious what the conclusions were.  Could someone with a subscription
> who read the whole article, please summarize.
> Thanks,
> Chayn in Israel IBCLC
>
>

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