Utah Food Allergy Conference: June 23, 2012

by Kelley Lindberg


If you or a family member has food allergies, you won’t want to miss the upcoming Utah Food Allergy Conference, on Saturday, June 23, 2012.

Hosted by the Utah Food Allergy Network (UFAN), this annual conference is THE place in Utah to hear from experts on the latest news and research, learn about available resources, pick up helpful ideas and tips, and connect with other people in our food allergy community. It will be held at the Doty Family Education Center in the Intermountain Medical Center in Murray, UT.

And best of all – it’s free!

The conference is only a half-day long, so it won’t take up your entire Saturday, but you’ll get a ton of useful information in that short time-span. The planned conference schedule is below.

Even though it’s free, you need to register to attend so that UFAN will know how many people to accommodate. To register, go to the UFAN website at www.utahfoodallergy.org, click on the link to the Conference, and then click on the registration link. The registration form just takes a minute to fill out (don’t forget to choose which breakout session you want to attend), and then you can print your own tickets!

The conference promises to be educational, helpful, and fun! If you have any questions, contact support@utahfoodallergy.org. See you there!

Conference Schedule:

2^nd Annual Utah Food Allergy Conference

Saturday June 23, 2012
8:30am – 1:00pm
Intermountain Medical Center - Doty Family Education Center
5121 Cottonwood St, Murray, Utah

8:30 – 9:00 am            Registration

9:00 – 9:10 am            Welcome
                                    Michelle Fogg, President – Utah Food Allergy Network

9:10 – 10:10 am          Food Allergy, Anaphylaxis Management, & Research

                                    Rafael Firszt, MD, MBA – Allergy & Immunology

10:10 – 10:20 am        Break

10:20 – 11:20 am        Concurrent Sessions (choose one to attend):

                                    * Allergy and Asthma Safety at School and at Home

Andrea Johnson, CHES - Environmental Health Educator, Utah County Health Department, and mother of a son with food allergies and asthma, will address strategies for creating a safe environment both at home and at school. Topics to be covered include basics of setting up an allergy and asthma friendly home environment, working with school personnel to establish an allergy and asthma friendly school environment, and Utah laws and resources that can be used to aid in accomplishing both of those goals.

                                    * Developmental Stages of Kids with Food Allergy

Kristen Kauke, MSW, LCSW. Understand how children accomplish tasks and growth at each developmental stage and how food allergies can impact this. Gain strategies to cope with bullying and how to be a supportive adult along the way.

                                    *Eosinophilic Gastrointestinal Disorders (EGIDs)

Jan Bernhisel-Broadbent, MD – Allergy & Immunology, and Kathryn Peterson, MD – Gastroenterology. Learn the fundamentals of EGIDs and how they relate to food allergy, current treatments, studies & research findings, and support/resources available.

11:20 – 11:30 am        Break

11:30 – 12:15 pm        Avoiding Food Fights

                                    Kristen Kauke, MSW, LCSW

12:15 – 12:50 pm        Question & Answer Discussion w/ Panel of Presenters

12:50 – 12:55 pm        Awards Presentation

                                    Tiffany Scherbel, Vice President – Utah Food Allergy Network

12:55 – 1:00 pm          Closing Remarks

Your Family Doctor vs. an Allergist

by Kelley Lindberg


One of the first questions I ask someone who has been newly diagnosed with a food allergy (or who suspects they may have a food allergy) is “Have you seen a board-certified allergist?” There’s a good reason for this question.

A January 2010 article published in Pediatrics magazine, the official journal of the American Academy of Pediatrics, included an article called “Food Allergy Knowledge, Attitudes, and Beliefs of Primary Care Physicians,” by Ruchi S. Gupta, MD, MPH; Elizabeth E. Springston, BA; Jennifer S. Kim, MD; Bridget Smith, PhD; Jacqueline A. Pongracic, MD; Xiaobin Wang, MD, MPH, ScD; and Jane Holl, MD, MPH.

In this article, the authors describe their research into food allergy knowledge and perceptions among pediatricians and family physicians in the United States. They surveyed 407 primary care physicians around the U.S., 99% of which reported that they provide care for food-allergic patients.

The results of the study show that while general-practice physicians and pediatricians are of course invaluable in many ways for many common illnesses or preventative care, their knowledge of a complex, specialized, and rapidly changing field like food allergies is not necessarily what most patients or parents of food-allergic might expect.

According to the article, participants in the study answered only 61% of knowledge-based items correctly. Only 80% of the physicians knew that the flu vaccine is unsafe for egg-allergic patients. While 90% knew the number of food-allergic children is increasing in the United States, only 23% knew that milk-based yogurt and cheese are unsafe for children with IgE-mediated milk allergies.

Even more concerning: “Fewer than 30% of the participants felt comfortable interpreting laboratory tests to diagnose food allergy or felt adequately prepared by the medical training to care for food-allergic children.”

Some other particularly concerning statements from the article:

• “There was some confusion among participants regarding signs and symptoms suggestive of an underlying food allergy.”
• “The majority of participants believed that anaphylaxis posed the greatest threat to young children rather than teenagers.”
• “…only half chose the correct concentration and route of administration for epinephrine in the event of food-induced anaphylaxis.”

The article’s authors suggested that part of the problem may be that “Most pediatric and family medicine training programs do not offer formal training in food allergy, although experience likely varies by program.” As broad and far-ranging as the entire field of medicine is today, that’s not surprising. A general-practice physician tries to be a generalist to do the most good for the most patients – they usually strive to be well-grounded in the basics of healthcare, with a more surface-level knowledge of various specialties. But there are simply not enough hours in the day for anyone to be a specialist in everything.

From this study, it’s important to realize two things:

1. Patients with food allergy probably should not rely on their family doctor or pediatrician for expert diagnosis, treatment, and ongoing care of their food allergies. Instead, they should seek out the knowledge and experience of an AAAAI board-certified food allergist. (To find one in your area, click here for the American Academy of Allergy Asthma & Immunology Physician Referral Directory.)
2. Physicians are often aware of their limitations, but even so, they may not be willing to refer their patients to allergy specialists. In some cases, because of their limited knowledge or experience, they may even downplay the seriousness of food allergy symptoms, such as treating severe eczema with creams instead of identifying a possible root cause of food allergy.

The authors conclude by rating the overall knowledge of their sampled physicians as “fair.” The authors go on to recommend: “With the recent increase in childhood food allergy and the threat posed by food-induced anaphylaxis, it is important for generalists to be educated about the diagnosis and treatment of this condition.” They also suggest that general physicians can take advantage of the many resources already available to increase their knowledge, such as “a food allergy practice parameter, outlining risk factors, diagnostic techniques, and treatment plans,” which was developed and published in 2006 by the American Academy of Allergy Asthma & Immunology and the American College of Allergy, Asthma, and Immunology.

Please understand – pediatricians and family doctors are essential and invaluable, and I am NOT trying to undermine them. Instead, I am just pointing out that once they identify a possible food allergy, you will probably be better served by a dedicated allergist, in the same way that if your family doctor suspects (or confirms) cancer, you would probably then go see a cancer specialist.

I absolutely love and depend upon my son’s pediatrician for most of his ailments and normal childhood problems. But I also love and depend upon my son’s allergist for all of his food-allergy issues. We can’t live without either of them.

Reading Past the NY Times Headline

by Kelley Lindberg


This week, several friends have forwarded me the New York Times story, “Doubt Is Cast on Many Reports of Food Allergies.”

Stories like this make me sigh. On the one hand, the information in the story is accurate. On the other hand, the headline appears intended to fuel controversy, not spread helpful information. A better, more constructive headline would have been something like:

     “Think You Have Food Allergies? See a Specialist before Panicking”

or perhaps:

     “Diagnosing Food Allergies is Tricky – It May Take More Than a Skin Test.”

Many people think they have food allergies, while they probably have an intolerance or sensitivity instead – completely different diseases. For example, often people confuse lactose intolerance with a true milk allergy, yet they are completely different illnesses. With lactose intolerance, the body can’t digest milk proteins adequately. People with lactose intolerance can often tolerate small amounts of dairy, especially if it’s baked in something like bread. And they can often take a medication to help digest the milk proteins, which allows them to indulge in the occasional dairy treat. With a true milk allergy, the body’s immune system is involved, and medication can’t help. Lactose intolerance may give you an upset stomach, but it won’t send you into anaphylactic shock. A true milk allergy will.

And how many times have you heard someone complain that they’re allergic to cigarette smoke? It’s probably not a true allergy, but a different disease, such as reactive airway disease or asthma. It’s no less serious, but using the wrong name makes data difficult to track (leading to misleading reporting, like this article).

It’s also true that many general practice doctors are jumping on the bandwagon of skin-prick testing for everything, and calling any sign of a bump a positive test – end of discussion. General practitioners are great resources for many things – but you have to understand that they simply cannot have specialized, up-to-date knowledge about all possible human ailments. It’s not humanly possible to specialize in everything. They usually know a little bit about a lot of things. This can be vitally helpful when narrowing down possible causes of sickness and determining which type of specialist can help you further, but for anything as complicated and individual as food allergies, a board-certified allergist who keeps up with the latest allergy research, conferences, and journals is who you want to work with, not a busy general practitioner.

That’s because allergy testing is very much an art, not just a science. Interpreting results isn’t always cut-and-dried. Test results should be combined with careful analysis of the individual’s history, the family history, direct experiences, food challenges, and other aspects of your life that can help pinpoint exactly what is causing your problems.

I’ve met many people who are in the panicky “I’ve-just-been-diagnosed-and-I’m-allergic-to-everything!” stage. My first question is always “Who diagnosed you?” If it wasn’t a board-certified allergist, I strongly recommend they take the results to a board-certified specialist and continue digging. It’s not unheard of to have a positive skin-prick test to a food you’ve been eating without any problems. So eliminating the food without further research or testing may cause unnecessary stress at the grocery store or restaurant. Several of those people I’ve talked to have ended up working with an allergist and narrowing the list of what they’re really allergic to down to one, two, or three foods, making it easier to manage and less overwhelming. This might not hold true for everyone, but it’s common enough that it’s worth digging deeper.

So I think it’s important to find an allergist you trust and really work with him or her to get to the bottom of your true allergies.

The other interesting point in this article is its statistics, which may very well get lost in the “See? Those food allergy nutcases are making it all up” controversy:

• “While there is no doubt that people can be allergic to certain foods, with reproducible responses ranging from a rash to a severe life-threatening reaction, the true incidence of food allergies is only about 8 percent for children and less than 5 percent for adults, said Dr. Marc Riedl, an author of the new paper and an allergist and immunologist at the University of California, Los Angeles.”

ONLY 8% in children? The more usual statistics that get quoted are 3 – 5%. So while I often tell people that about 1 out of every 20 kids is estimated to have a food allergy, this article says it’s closer to 3 out of every 25. That’s three in every classroom, instead of one in every classroom.

The article’s wording sounds like it’s pooh-poohing the incidence of food allergies, but then it tosses out a pretty high percentage rate as if it’s nothing.

So… Here’s what we should take away from this article. Diagnosing food allergies is difficult and varies from individual to individual, so find yourself an allergist certified by the American Academy of Allergy, Asthma, & Immunology (AAAAI) to help you find out if you’re really suffering from food allergies and how to deal with them if you are. (Click here to search for a board-certified allergist on the AAAAI website). And don’t let people tell you food allergies are a hoax. Even this article’s statistics are alarming, despite its misdirecting headline.

Food Allergy Desensitization – Rushing Now Could Jeopardize Long-Term Success

by Kelley Lindberg


Two weeks ago, I wrote about a new British study being funded to research desensitization for food allergies on a larger scale than some previous studies (“New Desensitization Research Project in England”). Whenever I write about a new study like this, I worry that allergic individuals will try desensitizing themselves – or, more worrisome, their children – without benefit of the careful dosing and treatment regimen that the studies’ doctors provide.

I talked to Dr. Douglas Jones, a board-certified allergist in Layton (Rocky Mountain Allergy, Asthma, Immunology), last week about this very issue. He had just attended the February meeting of the Utah Society of Allergy and Asthma and the Annual meeting for the American Academy of Allergy, Asthma, and Immunology. He asked me to share with everyone some highlights of those meetings regarding this topic of food desensitization.

There are some limited studies that show some promising results as far as patients being desensitized and even becoming tolerant to foods they are allergic to (peanut in particular). There is not a standardized protocol yet. This is something that is currently under investigation and of high interest to allergists across the country and here in Utah. When there is appropriate medical evidence and support, food desensitization is something that will likely be offered by Dr. Jones and some other board-certified allergists in their clinics and under their supervision sometime in the near future.

Given the risks associated with this and the limited data, it is important to proceed appropriately and safely. Please do NOT try things at home on your own. Dr. Jones understands the frustrations of patients, your anxiety, and your desire to have safer and more effective treatment. He is just as anxious to try to provide a safe and effective treatment for patients with food allergies. He just wants to emphasize that it is important to go about things the right way, however. That way, when we do start using them in a clinical environment, we’ll have the best information and protocols possible for success. A little caution now is the key to long-term success. And that long-term success – in the form of a food allergy cure – is what we all want for our children and for their children in the years to come. Stay tuned, this is a rapidly developing area!

Many thanks to Dr. Douglas Jones for allowing me to share this information with my readers.

Highlights from Dr. Jones' Talk, Part 1

At our July UFAN chapter meeting, we were fortunate enough to have Dr. Douglas Jones come speak to our group about the latest food allergy news in testing, treatments, and research. As the only full-time board-certified allergist in Davis County, he discovered when he opened his practice almost a year ago that people in this area have a dire need for accurate, up-to-date information about food allergies. Our group was no exception – we may be more well-informed than many of the people he sees, but we were still anxious to learn more, and he obliged beautifully!

Dr. Jones covered a wide variety of topics for us, and delved into both the science and the regulations that affect research and testing. He covered so much that I’m going to mention a few highlights from his presentation this week, and more next week.

How early can children be tested for food allergies? Dr. Jones said there’s no specific limit on when a child can be tested. It’s more important to look at the child’s and family’s history of reactions, what they want to learn, the family’s needs, and so on. Theoretically, you can test anytime if the child’s history really warrants it, but it’s a case-by-case decision. Dr. Jones recommends retesting every 6 to 12 months for younger kids, less frequently for older kids.

Should you avoid common food allergens when pregnant or nursing to avoid causing your baby to have allergies? Dr. Jones doesn’t feel there’s enough good data to base a decision on. He says it’s probably more important to continue to eat a healthy diet and not worry so much about the allergens in it, because the fetus needs the nutrition. He stresses to mothers: “It’s not your fault!” As for nursing, there is some evidence to suggest nursing for 4-6 months may be beneficial. As far as mothers avoiding foods while nursing in an effort to try and prevent food allergies, there is no data to support this. If you can identify a pattern with nursing and reactions, then that’s one thing, but avoiding things to try to prevent allergies is not recommended. He says it could be more likely that children develop food allergies through accidental skin contact (Uncle Fred forgot to wash his hands after eating those peanuts) rather than through breast milk. Until there’s more data, it’s another case-by-case decision.

Eczema: Apart from Dr. Jones’ discussion, the group had a general discussion about eczema, and why so many pediatricians don’t seem to realize that most cases have an underlying root cause, and most often that root cause is food allergies. Dr. Jones didn’t have an answer for why this is unrecognized or ignored by primary care doctors. But, we all know people whose children have suffered for years with eczema, and their doctors have simply prescribed steroid creams and sent them away, before the parents finally went to an allergist and had their children tested. Often those children’s skin is clear in a matter of a couple of weeks after eliminating the offending food – often milk or eggs – from their diet. It's such a simple thing to test for and cure, yet these children suffer for years sometimes because their doctors don’t know or won’t accept that food allergies could be the cause.

For More Information: Dr. Jones recommended a book called Food Allergy Survival Guide, by Vesanto Melina, Dina Aronson, and Jo Stepaniak.

Those are some of the topics we discussed, and we all learned a tremendous amount. Next week I’ll write about more highlights from his talk, including blood serum testing, the latest news on the Chinese herbal study, and more. Many, many thanks to Dr. Jones for coming to share his knowledge with all of us. If you want to contact his office for an appointment, here’s his information:

Dr. Douglas H. Jones, MD
Rocky Mountain Allergy, Asthma, Immunology
1660 W. Antelope Dr ., Suite 310
Layton , UT 84041
801-775-9800
www.RockyMountainAllergy.com