Rona, R.J., T. Keil, C. Summers, D. Gislason, L. Zuidmeer, E. Sogergren, S.T. Sigurdardottir, T. Lindner, K. Goldhahn, J. Dahlstrom, D. McBride, C. Madsen, 2007. The prevalence of food allergy: a meta-analysis. Allergy Clin Immunol. 120:638-646.
Background: There is uncertainty about the prevalence of food allergy in communities. Objective: To assess the prevalence of food allergy by performing a meta-analysis according to the method of assessment used. Methods: The foods assessed were cow’s milk, hen’s egg, peanut, fish, shellfish, and an overall estimate of food allergy. We summarized the information in 5 categories: self-reported symptoms, specific IgE positive, specific skin prick test positive, symptoms combined with sensitization, and food challenge studies. We systematically searched MEDLINE and EMBASE for publications since 1990. The meta-analysis included only original studies. They were stratified by age groups: infant/preschool, school children, and adults. Results: A total of 934 articles were identified, but only 51 were considered appropriate for inclusion. The prevalence of self-reported food allergy was very high compared with objective measures. There was marked heterogeneity between studies regardless of type of assessment or food item considered, and in most analyses this persisted after age stratification. Self-reported prevalence of food allergy varied from 1.2% to 17% for milk, 0.2% to 7% for egg, 0% to 2% for peanuts and fish, 0% to 10% for shellfish, and 3% to 35% for any food. Conclusion: There is a marked heterogeneity in the prevalence of food allergy that could be a result of differences in study design or methodology, or differences between populations. Clinical implications: We recommend that measurements be made by using standardized methods, if possible food challenge. We need to be cautious in estimates of prevalence based only on self-reported food allergy.
Fitó, M., M. Guxens, D. Corella, G. Sáez, R. Estruch, R. de la Torre, F. Francés, C. Cabezas, M. del C. López-Sabaterl, J. Marrugat, A. García-Arellano, F. Arós, V. Ruiz-Gutierrez, E. Ros, J. Salas-Salvadó, M. Fiol, R. Solá, M.I. Covas; for the PREDIMED Study, 2007. Effect of a traditional Mediterranean diet on lipoprotein oxidation: a randomized controlled trial. Arch Intern Med. 167:1195-203.
Background: Despite the richness in antioxidants of the Mediterranean diet, to our knowledge, no randomized controlled trials have assessed its effect on in vivo lipoprotein oxidation. Methods: A total of 372 subjects at high cardiovascular risk (210 women and 162 men; age range, 55-80 years), who were recruited into a large, multicenter, randomized, controlled, parallel-group clinical trial (the Prevencio’n con Dieta Mediterra’nea [PREDIMED] Study) directed at testing the efficacy of the traditional Mediterranean diet (TMD) on the primary prevention of coronary heart disease, were assigned to a low-fat diet (n=121) or one of 2 TMDs (TMD + virgin olive oil or TMD + nuts). The TMD participants received nutritional education and either free virgin olive oil for all the family (1 L/wk) or free nuts (30 g/d). Diets were ad libitum. Changes in oxidative stress markers were evaluated at 3 months. Results: After the 3-month interventions, mean (95% confidence intervals) oxidized low-density lipoprotein (LDL) levels decreased in the TMD + virgin olive oil (−10.6 U/L [−14.2 to −6.1]) and TMD + nuts (−7.3 U/L [−11.2 to −3.3]) groups, without changes in the low-fat diet group (−2.9 U/L [−7.3 to 1.5]). Change in oxidized LDL levels in the TMD + virgin olive oil group reached significance vs that of the low-fat group (P=.02). Malondialdehyde changes in mononuclear cells paralleled those of oxidized LDL. No changes in serum glutathione peroxidase activity were observed. Conclusions: Individuals at high cardiovascular risk who improved their diet toward a TMD pattern showed significant reductions in cellular lipid levels and LDL oxidation. Results provide further evidence to recommend the TMD as a useful tool against risk factors for CHD.
Ryan, E., K. Galvin, T.P. O’Connor, A.R. Maguire, N.M. O’Brien, 2006. Fatty acid profile, tocopherol, squalene and phytosterol content of brazil, pecan, pine, pistachio and cashew nuts. International Journal of Food Sciences and Nutrition. 57(3/4):219-228.
Nuts contain bioactive constituents that elicit cardio-protective effects including phytosterols, tocopherols and squalene. The objective of the present study was to determine the total oil content, peroxide value, fatty acid composition and levels of tocopherols, squalene and phytosterols in oil extracted from freshly ground brazil, pecan, pine, pistachio and cashew nuts. The total oil content of the nuts ranged from 40.4 to 60.8% (w/w) while the peroxide values ranged from 0.14 to 0.22 mEq O2/kg oil. The most abundant monounsaturated fatty acid was oleic acid (C18:1), while linoleic acid (C18:2) was the most prevalent polyunsaturated fatty acid. The levels of total tocopherols ranged from 60.8 to 291.0 mg/g. Squalene ranged from 39.5 mg/g oil in the pine nut to 1377.8 mg/g oil in the brazil nut. β-Sitosterol was the most prevalent phytosterol, ranging in concentration from 1325.4 to 4685.9 mg/g oil. In conclusion, the present data indicate that nuts are a good dietary source of unsaturated fatty acids, tocopherols, squalene and phytosterols.
Vlieg-Boerstra, B.J., S. van der Heide, C.M.A. Bijleveld, J. Kukler, E.J. Duiverman, S.A.A. Wolt-Plompen, A.E.J. Dubois, 2006. Dietary assessment in children adhering to a food allergen avoidance diet for allergy prevention. European Journal of Clinical Nutrition. 60:1384–1390.
Objective: The purpose of this investigation was to verify if avoidance of allergenic foods in children adhering to a food allergen avoidance diet from birth was complete and feasible, and whether dietary assessment can be used as a tool in predicting the outcome of double-blind, placebo-controlled food challenges (DBPCFCs). Design: Children adhering to an allergen avoidance diet from birth underwent DBPCFCs. The investigator-dietician verified whether the elimination was complete, using food frequency questionnaires for common allergenic foods. Setting: University Medical Centre Groningen, the Netherlands. Subjects: Thirty-eight children aged 1–13 years, who were consecutively referred to the University Medical Centre Groningen for DBPCFC between January 2002 and February 2004. Results: Among the 38 children undergoing DBPCFCs, there were 15 challenges with egg, 15 with peanut, five with hazelnut and three with soy. Fifteen food challenges (39%) were positive. Small quantities of allergenic foods were inadvertently present in the diets of 13 patients (34%), were possibly present in the diets of 14 patients (37%) and could not be identified in the diets of 11 patients (29%). Seven patients (54%) who had inadvertently ingested small quantities of allergenic foods without sequelae had a positive DBPCFC. Conclusion: Dietary avoidance was incomplete and not feasible in most cases. Tolerance of small amounts of allergenic foods does not preclude positive challenge reactions. Dietary assessment does not seem a useful tool in predicting the outcome of DBPCFC in children adhering to an elimination diet. Sponsorship: The Stichting Astma Bestrijding (Foundation for the Prevention of Asthma), The Netherlands.
Sicherer, S.H., D.Y.M. Leung, 2006. Advances in allergic skin disease, anaphylaxis, and hypersensitivity reactions to foods, drugs, and insects. J Allergy Clin Immunol. 118:170-177.
This review highlights some of the research advances in anaphylaxis; hypersensitivity reactions to foods, drugs, and insects; and allergic skin disease that were reported primarily in the Journal in 2005. Although studies documented deficiencies in community management of anaphylaxis, guidelines and National Institutes of Health summary reports provide direction toward improved research and education. At least 9% of young children ‘‘outgrow’’ a tree nut allergy. Advances in food allergy diagnosis include reports of probability of reactions to peanut at various peanut-specific IgE concentrations and skin test response size and the utility of evaluating IgE binding to specific epitopes. Future food allergy treatments might include selection of ‘‘less allergenic’’ fruit cultivars, genetic silencing of major allergens, and treatment of allergic patients with Chinese herbal remedies. Osteopontin might be a useful biomarker for success of venom immunotherapy. Progress in our understanding of the immunology of atopic dermatitis and autoimmune urticaria has also been made. These observations will likely contribute toward optimizing management of these common allergic disorders.
Lee, L.A., A.Wesley Burks, 2006. Food allergies: prevalence, molecular characterization, and treatment/prevention strategies. Annu Rev Nutr. 26:3.1–3.27.
A significant proportion of the population is either affected by or concerned about food allergy. Our knowledge about food allergens and how they stimulate the immune system has increased dramatically over the past decade. However, reasons for the increased prevalence of food allergy are not clear. The diagnosis of food allergy requires that the patient and caregivers examine all foods for the presence of potential allergens in order to prevent inadvertent ingestion and further reactions. Fortunately, many children develop tolerance to allergenic foods after a period of dietary elimination. Various immunotherapy approaches are under investigation to alleviate or prevent food-induced reactions in those who have persistent food allergies.
Venkatachalam, M., S.K. Sathe. 2006. Chemical composition of selected edible nut seeds. J Agric Food Chem. 54, 4705-4714.
Commercially important edible nut seeds were analyzed for chemical composition and moisture sorption. Moisture (1.47-9.51%), protein (7.50-21.56%), lipid (42.88-66.71%), ash (1.16-3.28%), total soluble sugars (0.55-3.96%), tannins (0.01-0.88%), and phytate (0.15-0.35%) contents varied considerably. Regardless of the seed type, lipids were mainly composed of mono- and polyunsaturated fatty acids (>75% of the total lipids). Fatty acid composition analysis indicated that oleic acid (C18:1) was the main constituent of monounsaturated lipids in all seed samples. With the exception of macadamia, linoleic acid (C18:2) was the major polyunsaturated fatty acid. In the case of walnuts, in addition to linoleic acid (59.79%) linolenic acid (C18:3) also significantly contributed toward the total polyunsaturated lipids. Amino acid composition analyses indicated lysine (Brazil nut, cashew nut, hazelnut, pine nut, and walnut), sulfur amino acids methionine and cysteine (almond), tryptophan (macadamia, pecan), and threonine (peanut) to be the first limiting amino acid as compared to human (2-5 year old) amino acid requirements. The amino acid composition of the seeds was characterized by the dominance of hydrophobic (range = 37.16-44.54%) and acidic (27.95-33.17%) amino acids followed by basic (16.16-21.17%) and hydrophilic (8.48-11.74%) amino acids. Trypsin inhibitory activity, hemagglutinating activity, and proteolytic activity were not detected in the nut seed samples analyzed. Sorption isotherms (Aw range = 0.08-0.97) indicated a narrow range for monolayer water content (11-29 mg/g of dry matter). No visible mold growth was evident on any of the samples stored at Aw < 0.53 and 25 °C for 6 months.
Segura, R., C. Javierre, M.A. Lizarraga, E. Ros, 2006. Other relevant components of nuts: phytosterols, folate and minerals. British Journal of Nutrition. 96, Suppl. 2, S36-S44.
Nuts contain significant amounts of essential micronutrients that are associated with an improved health status when consumed at doses beyond those necessary to prevent deficiency states. Nuts do not contain cholesterol, but they are rich in chemically related phytosterols, a class of compounds that interfere with intestinal cholesterol absorption and thus help lower blood cholesterol. Nuts also contain folate, a B-vitamin necessary for normal cellular function that plays an important role in detoxifying homocysteine, a sulphur-containing amino acid with atherothrombotic properties that accumulates in plasma when folate status is subnormal. Compared to other common foodstuffs, nuts have an optimal nutritional density with respect to healthy minerals, such as calcium, magnesium and potassium. Like that of most vegetables, the sodium content of nuts is very low. A high intake of calcium, magnesium and potassium, together with a low sodium intake, is associated with protection against bone demineralization, arterial hypertension, insulin resistance, and overall cardiovascular risk. Phytosterols might justify part of the cholesterol-lowering effect of nut intake beyond that attributable to fatty acid exchange, while the mineral richness of nuts probably contributes to the prevention of diabetes and coronary heart disease observed in epidemiological studies in association with frequent nut consumption.
Nichenametla, N.E., T.G. Taruscio, D.L. Barney, J.H. Exon, 2006. A Review of the effects and mechanisms of polyphenolics in cancer. Critical Reviews in Food Science and Nutrition, 46:161-183.
This paper is a comprehensive review of the effects of bioactive polyphenolic compounds commonly found in many fruits and vegetables on cancer. These include the phenolic acids, anthocyanins, catechins, stilbenes and several other flavonoids. We have attempted to compile information from most of the major studies in this area into one source. The review encompasses the occurrence and bioavailability of the polyphenolics, the in vitro and in vivo evidence for their effects on cancer, both positive and negative, and the various mechanisms by which the chemicals may exert their effects. Although most of the work done to date indicates a chemopreventative activity of these compounds, there are some studies that show cancer-inducing or no effects. There are several common mechanisms by which these chemicals exert their effects that could be conducive to additive, synergistic, or antagonistic interactions. These include effects on cellular differentiation, proliferation, and apoptosis, effects on proteins and enzymes that are involved in these processes at a molecular level, and other various effects through altered immune function and chemical metabolism.
Kornsteiner, M., K.H. Wagner, I. Elmadfa, 2006. Tocopherols and total phenolics in 10 different nut types. Food Chemistry. 98:381-87.
The study was conducted to assess the content of tocopherols (α-, β-, γ- and δ-) and carotenoids (α- and β-carotene, zeaxanthin, lutein, cryptoxanthin and lycopene) in the unsaponifiable matter as well as the amount of total phenols of 10 different types of nuts. Tocopherols and carotenoids were analyzed with HPLC, total phenols photometrically. The mean value of α-tocopherol equivalents ranged from non-detectable (macadamias) to 33.1 mg/100 g extracted oil (hazelnuts). Among all nuts, almonds and hazelnuts had the highest mean α-tocopherol content (24.2 and 31.4 mg/100 g extracted oil, respectively). β- and γ-tocopherols were prevalent in Brazil nuts, cashews, peanuts, pecans, pines, pistachios and walnuts. Mean values oscillated between 5.1 (cashews) and 29.3 (pistachios). Traces of δ-tocopherol (<4 mg/100 g extracted oil) were analyzed in cashews, hazelnuts, peanuts, pecans, pines, pistachios and walnuts. There were no carotenoids detected in the tested nuts with the exception of pistachios. The mean content of total phenolics varied between 32 mg gallic acid equivalents/100 g (pines) and 1625 mg (walnuts). The results show the eterogenic amounts of antioxidants in nuts, which emphasizes the recommendation of a mixed nuts intake.