Cybermedlife - Therapeutic Actions Dietary Modification - Cow's Milk-Casein Free


Elimination Diet Effectively Treats Eosinophilic Esophagitis in Adults; Food Reintroduction Identifies Causative Factors.

Abstract Title: Elimination Diet Effectively Treats Eosinophilic Esophagitis in Adults; Food Reintroduction Identifies Causative Factors. Abstract Source: Gastroenterology. 2012 Mar 3. Epub 2012 Mar 3. PMID: 22391333 Abstract Author(s): Nirmala Gonsalves, Guang-Yu Yang, Bethany Doerfler, Sally Ritz, Anne M Ditto, Ikuo Hirano Article Affiliation: Division of Gastroenterology and Hepatology, Northwestern University Feinberg School of Medicine, Chicago, Illinois. Abstract: BACKGROUND & AIMS: Adults with eosinophilic esophagitis (EoE) typically present with dysphagia and food impaction. A 6-food elimination diet (SFED) is effective in children with EoE. We assessed the effects of the SFED followed by food reintroduction on the histologic response, symptoms, and quality of life in adults with EoE. METHODS: At the start of the study, 50 adults with EoE underwent esophagogastroduodenoscopies (EGDs), biopsies, and skin-prick tests for food and aeroallergens. After 6 weeks of SFED, patients underwent repeat EGD and biopsies. Histologic responders, defined by≤5 eosinophils/high-power field (eos/hpf) (n = 32), underwent systematic reintroduction of foods followed by EGD and biopsies (n = 20). Symptom and quality of life scores were determined before and after SFED. RESULTS: Common symptoms of EoE included dysphagia (96%), food impaction (74%), and heartburn (94%). The mean peak eosinophil counts in the proximal esophagus were 34 eos/hpf and 8 eos/hpf, before and after the SFED, and 44 eos/hpf and 13 eos/hpf in the distal esophagus, respectively (P<.0001). After the SFED, 64% of patients had peak counts≤5 eos/hpf and 70% had peak counts of ≤10 eos/hpf. Symptom scores decreased in 94% (P<.0001). After food reintroduction, esophageal eosinophil counts returned to pretreatment values (P<.0001). Based on reintroduction, the foods most frequently associated with EoE were wheat (60% of cases) and milk (50% of cases). Skin-prick testing predicted only 13% of foods associated with EoE. CONCLUSIONS: An elimination diet significantly improves symptoms and reduces endoscopic and histopathologic features of EoE in adults. Food reintroduction re-initiated features of EoE in patients, indicating a role for food allergens in its pathogenesis. Foods that activated EoE were identified by systematic reintroduction analysis but not by skin-prick tests. Article Published Date : Mar 02, 2012

Effectiveness of the gluten-free, casein-free diet for children diagnosed with autism spectrum disorder: Based on parental report.

Abstract Title: Effectiveness of the gluten-free, casein-free diet for children diagnosed with autism spectrum disorder: Based on parental report. Abstract Source: Nutr Neurosci. 2012 Mar ;15(2):85-91. PMID: 22564339 Abstract Author(s): Christine M Pennesi, Laura Cousino Klein Article Affiliation: The Pennsylvania State University, PA, USA. Abstract: OBJECTIVES: Studies on the gluten-free and/or casein-free (GFCF) dietary intervention for children with autism spectrum disorders (ASDs) suggest that some children may positively respond to implementation of the dietary intervention. Other research suggests that children diagnosed with ASD can be classified into subpopulations based on various factors, including gastrointestinal (GI) abnormalities and immune function. METHODS: This study analyzes parental report data collected using a 90-item online questionnaire from 387 parents or primary caregivers of children diagnosed with ASD on the efficacy of the GFCF diet. Parents reported on their child's GI symptoms, food allergy diagnoses, and suspected food sensitivities, as well as the degree and length of their diet implementation. RESULTS: Overall, diet efficacy among children whose parents reported the presence of GI symptoms, food allergy diagnoses, and suspected food sensitivities included greater improvement in ASD behaviors, physiological symptoms, and social behaviors compared with children whose parents reported none of these symptoms, diagnoses, or sensitivities (P<0.05). Parental report of strict diet implementation, indicated by complete gluten/casein elimination and infrequent diet errors during and outside of parental care, also corresponded to improvement in ASD behaviors, physiological symptoms, and social behaviors (P<0.05). DISCUSSION: These findings suggest that various intricacies related to diet implementation and GI and immune factors may play a role in differentiating diet responders from diet non-responders and substantiate the importance of further investigations into the various, nuanced factors that influence efficacy of the intervention among children with ASDs. Article Published Date : Mar 01, 2012

Allergy to cow's milk proteins: what contribution does hypersensitivity in skin tests have to this diagnosis?

Abstract Title: Allergy to cow's milk proteins: what contribution does hypersensitivity in skin tests have to this diagnosis? Abstract Source: Pediatr Allergy Immunol. 2011 Feb ;22(1 Pt 2):e133-8. PMID: 21342278 Abstract Author(s): Aldo José Fernandes Costa, Emanuel Sávio Cavalcanti Sarinho, Maria Eugênia Farias Almeida Motta, Priscila Nogueira Gomes, Sabrina Maria de Oliveira de Melo, Giselia Alves Pontes da Silva Article Affiliation: Health Sciences Center, Federal University of Pernambuco, Recife, Pernambuco, Brazil. This email address is being protected from spambots. You need JavaScript enabled to view it. Abstract: Food allergy is an immunologically mediated adverse reaction to food protein. Cow's milk protein allergy (CMPA) is the most frequent type and is the one that is most difficult to diagnose. This study had the objective of analyzing the accuracy of hypersensitivity and specific IgE skin tests among children with CMPA and predominantly gastrointestinal clinical manifestations. The participants in this study were 192 children aged one and five (median of 2 yr). Among these, 122 underwent open oral challenge to the suspected food. After evaluating the sensitivity, specificity and positive and negative predictive values (respectively, PPV and NPV) of skin and specific IgE tests in relation to the gold standard (open oral challenge); all the children underwent the skin prick test (SPT), specific IgE test and atopy patch test (APT) for cow's milk, eggs, wheat and peanuts and the open oral challenge for the food to which the child was sensitive or had suspected sensitivity. Presence of food allergy was confirmed for 50 children (40.9%). Among these cases, 44/50 (88%) were of allergy to cow's milk protein. Children who presented a positive response to an oral challenge to cow's milk protein were considered to be cases, while the controls were children with negative response. Twenty-two of the 44 cases (50.0%) presented symptoms within the first 4 h after the challenge. The SPT presented 31.8% sensitivity, 90.3% specificity, 66.7% PPV and 68.4% NPV. The APT presented 25.0% sensitivity, 81.9% specificity, 45.8% PPV and 64.1% NPV. The specific IgE test presented, respectively, 20.5%, 88.9%, 52.9% and 64.6%. Despite the operational difficulty and the possible exposure risk, oral challenge is the best method for diagnosing CMPA, because of the low sensitivity and PPV of skin and specific IgE tests. Article Published Date : Jan 31, 2011

Reversal of premature ovarian failure in a patient with Sjögren syndrome using an elimination diet protocol.

Abstract Title: Reversal of premature ovarian failure in a patient with Sjögren syndrome using an elimination diet protocol. Abstract Source: J Altern Complement Med. 2010 Jul;16(7):807-9. PMID: 20618099 Abstract Author(s): Joe Feuerstein Article Affiliation: Department of Integrative Medicine, Stamford Hospital, Stamford, CT 06902, USA. This email address is being protected from spambots. You need JavaScript enabled to view it. Abstract: BACKGROUND: Premature ovarian failure is diagnosed with a picture of amenorrhea, elevated follicle-stimulating hormone (FSH), and age under 40 years. Twenty percent (20%) of patients with premature ovarian failure have a concomitant autoimmune disease. Cases of premature ovarian failure associated with Sjögren syndrome have been reported in the literature. PATIENT AND METHOD: We report a case of a 42-year-old white woman with Sjögren syndrome and premature ovarian failure who underwent a reversal of her premature ovarian failure and restoration of normal menses using an elimination diet protocol. The patient was diagnosed with her rheumatological condition in 2005 and started on disease-modifying antirheumatoid drugs, which were taken intermittently due to a concern over medication side-effects. Her menses became irregular at the time of initial diagnosis and finally ceased in 2006, with a dramatic elevation in her FSH, indicative of autoimmune-induced premature ovarian failure. In March 2009, she commenced an elimination diet protocol, eliminating gluten, beef, eggs, dairy products, nightshade vegetables, refined sugars, and citrus fruit for 4 months. RESULTS: Her repeat laboratory tests after 4 months showed a drop in FSH from 88 to 6.5 and a drop in erythrocyte sedimentation rate from 40 to 16. Her menses also resumed and her rheumatological symptoms significantly improved. CONCLUSIONS: It is hypothesized that the restoration of normal menses was caused by reduced inflammation in the ovarian tissue and supports the hypothesis that the gut immune system can influence autoimmune disease and inflammation. Article Published Date : Jul 01, 2010

Does diet really affect acne?

Abstract Title: Does diet really affect acne? Abstract Source: Skin Therapy Lett. 2010 Mar ;15(3):1-2, 5. PMID: 20361171 Abstract Author(s): H R Ferdowsian, S Levin Article Affiliation: Physicians Committee for Responsible Medicine, Washington, DC, USA. Abstract: Acne vulgaris has anecdotally been attributed to diet by individuals affected by this skin condition. In a 2009 systematic literature review of 21 observational studies and 6 clinical trials, the association between acne and diet was evaluated. Observational studies, including 2 large controlled prospective trials, reported that cow's milk intake increased acne prevalence and severity. Furthermore, prospective studies, including randomized controlled trials, demonstrated a positive association between a high-glycemic-load diet, hormonal mediators, and acne risk. Based on these findings, there exists convincing data supporting the role of dairy products and high-glycemic-index foods in influencing hormonal and inflammatory factors, which can increase acne prevalence and severity. Studies have been inconclusive regarding the association between acne and other foods. Article Published Date : Feb 28, 2010
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Therapeutic Actions DIETARY MODIFICATION Cow's Milk-Casein Free

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Whey and casein specific IgE and the cow's milk challenge test for atopic children.

Related Articles Whey and casein specific IgE and the cow's milk challenge test for atopic children. Zhonghua Min Guo Xiao Er Ke Yi Xue Hui Za Zhi. 1998 Mar-Apr;39(2):99-102 Authors: Lin HY, Shyur SD, Fu JL, Lai YC Abstract We studied 30 atopic children who suspected of milk allergy by past history (age ranging from 1 yr 4 mo to 9 yr 6 mo, mean age: 5.03 yr.) diagnosed as having asthma, atopic dermatitis and/or allergic rhinitis. These 30 atopic children had been screened from the patients at our outpatient clinic by the Pharmacia CAP system RAST FEIA. All of them showed the presence of at least Class II (greater than 0.7 ku/l) IgE specific to proteins in cow's milk. Further analysis found IgE specific to alpha-lactoalbumin (alpha-LA) elevated in 1 patient (3.3%), 1 patient (3.3%) to beta-lactoglobulin (beta-LG), 4 patients (13.3%) to alpha-LA and beta-LG, 5 patients (16.7%) to casein, 8 patients (26.7%) to casein and alpha-LA, 11 patients (36.7%) to casein, alpha-LA and beta-LG. After 3 weeks' cow-milk-free diet, the patient's milk challenge test was performed at our outpatient clinic. According to the test result, none of these 30 atopic children showed clinical evidence of significant allergic reaction to cow's milk in the skin, the gastrointestinal tract or the respiratory tract either within two hours after the challenge test or within 3 days after they went home. We therefore conclude that: (1) No single major allergen is apparent in cow's milk: casein, alpha-LA and beta-LG all show a high proportion of positive reaction. (2) Many atopic children fully tolerate cow's milk, although they have high titer of IgE antibodies specific to cow's milk. The RAST test is only the first step to screen patients with suspected IgE-mediated allergies. To make sure, any positive reaction must be confirmed by the "golden standard" for diagnosis, i.e., the double-blind placebo-controlled food challenge. PMID: 9599898 [PubMed - indexed for MEDLINE]

Substitution of milk for serum in the production fo human leukocyte interferon.

Related Articles Substitution of milk for serum in the production fo human leukocyte interferon. Appl Microbiol. 1971 Oct;22(4):625-8 Authors: Cantell K, Tovell DR Abstract The presence of serum in suspensions of Sendai-induced human leukocytes is necessary for the synthesis of significant amounts of interferon. Very little interferon is obtained from serum-free suspensions. Cow's milk or milk casein can substitute for serum in the production of high yields of human leukocyte interferon. PMID: 4331772 [PubMed - indexed for MEDLINE]