7/21/2011. Breakthroughs in Food Allergy: Keeping Nutritious Foods at the Table Dietary Guidelines for Americans on Allergies

Transcription

1 Outline Breakthroughs in Food : Keeping Nutritious Foods at the Table July 13, 2011 School Association 65th Annual National Conference Nashville, TN Patricia Kearney, MEd, RD President & CEO PMK Associates, Inc - US Dietary Guidelines - The Top Allergenic Foods - A Case Study in a School Based Setting -Best Practices for Management 2010 US DIETARY GUIDELINES Major Themes #1 Decrease obesity by decreasing/balancing calories #2 Shift to a plant-based diet that emphasizes vegetables, cooked dry beans and peas, whole grains, fruits, nuts, and seeds A HEALTHY EATING PATTERN limits intake of sodium, solid fats, added sugars, and refined grains and emphasizes nutrient-dense foods and beverages - vegetables, fruits, whole grains, fat-free or low-fat milk and milk products, seafood, lean meats and poultry, eggs, beans and peas, and nuts and seeds. #3 Reduce foods containing solid fats, added sugars (SoFAS), refined grains and sodium 2010 Dietary Guidelines for Americans on Allergies Some individuals may have an allergy or intolerance to one or more foods that are part of a healthy eating pattern. Proteins in these foods trigger an abnormal immune response in persons allergic to the food. Those who think they may have a food allergy or a food intolerance should be medically evaluated to avoid unnecessarily eliminating foods from their diet. Most persons who have a food allergy need to totally eliminate the offending food and ingredients that contain the food s protein from their diet. US DIETARY GUIDELINES Where do we go from here? RESULTS: 2010 CDC Report - Since 2000 vegetable consumption flat; fruit consumption down NCI Study on Dietary Intake: In conclusion, nearly the entire US population consumes a diet that is not on par with recommendations 1

2 According to FAAN, eight foods account for 90% of all food-allergic reactions. milk egg fish shellfish soy wheat tree nut peanut Milk Approximately 2.5% of children younger than 3 years of age are allergic to milk. Most children who have milk allergy will outgrow it in the first few years. Milk and milk products contribute: calcium, vitamin D (for products fortified with vitamin D), and potassium. Linked to improved bone health, especially in children and adolescents. Builds and maintain bone mass throughout the lifecycle. This may reduce the risk of osteoporosis. Egg Fish and Shellfish Egg allergy is estimated to affect approximately 1.5% of young children. Likely to be outgrown over time. One egg contains 6 grams of high-quality protein and all 9 essential amino acids. One egg yolk has about 300 micrograms of choline. Choline is an important nutrient that helps regulate the brain, nervous system, and cardiovascular system. An estimated 2.3% of Americans that s nearly 7 million people report allergy to seafood, including fish and shellfish. ~ 40% of those with fish allergy first experienced a reaction as an adult. ~ 60% of those with shellfish allergy first experienced a reaction as an adult. Fish provide lean protein. Omega-3 fatty acids help prevent age-related macular degeneration, a disease that impairs vision. The fats in fish are also important for heart health and child development. Soybeans are present in many products. In a national survey of pediatric allergists, the prevalence rate of soy protein allergy was reported to be 1.1%. Symptoms of soy allergy are typically mild, although anaphylaxis is possible. Soybean allergy is one of the more common food allergies, especially among babies and children. Soy Soy provides protein and soyfoods are rich in vitamins and minerals including folate, potassium and, in some cases, fiber. Soy may also lower risk of prostate, colon and breast cancers as well as osteoporosis and other bone health problems. Wheat Wheat allergy is primarily common in children, and is usually outgrown before adulthood. There has not been research on prevalence, however, Celiac Disease, affects 1 in 133 Americans. Sometimes confused with celiac disease, a digestive disorder that creates an adverse reaction to gluten. Individuals with celiac disease must avoid gluten, found in wheat, rye, barley, and sometimes oats. Evidence shows that adults who eat more whole grains, particularly those higher in dietary fiber, have a lower body weight compared to adults who eat fewer whole grains. 2

3 Tree Nut Peanut An estimated 1.8 million Americans have an allergy to tree nuts. Allergic reactions to tree nuts are among the leading causes of fatal and near-fatal reactions to foods. Tree nuts include, but are not limited to: walnut, almond, hazelnut, coconut, cashew, pistachio, and Brazil nuts. Moderate evidence indicates that eating peanuts and certain tree nuts reduces risk factors for cardiovascular disease when consumed as part of a diet that is nutritionally adequate and within calorie needs % of people have a mild to more severe peanut allergy. Nearly 20% of peanut allergies can be outgrown. A handful a day can cut risk of heart disease in half. Peanuts and Peanut Butter are very effective in stabilizing blood sugar to help manage diabetes. Daily intake can cut risk of diabetes by over 20%. Studies show peanut-eaters have lower BMI and higher nutrient diets. Population - Summary of Peanut/Nut Studies 5 Major Studies; Over 260,000 People; 6-14 years Health Outcome Risk Heart 25-50% reduction Diabetes 27% reduction with 1 ounce peanuts 5x/wk 21% reduction with 1 Tbsp. PB (1/2 srv) 5x/wk Gallbladder 25-30% reduction with more than 5x/wk Colorectal Cancer Up to 60% reduction in women (2 or + times per wk) BMI Lower in those who consume Consumption Patterns Frequency Increased frequency reduces risk (daily twice as good as weekly) Amount Age Population Small amounts ( oz.) have an impact on risk reduction Any age benefits (infants to over 85 y.o.) Benefits high risk populations (Mex-Am adolescents, Diabetics) New Study - When Peanuts Replace Carbs, Blood Sugar Control Improves Two ounces of nuts daily as replacement for carbohydrate foods improved both glycemic control and serum lipids in type 2 diabetes. Use of nuts to increase fat intake has not resulted in weight gain, and habitual nut consumption lowers LDL cholesterol. The macronutrient profile of nuts fits well with lowcarbohydrate, high-vegetable fat, and high-protein diets. (Diabetes Care. Jenkins, et al. 2011) New Study Peanuts & Peanut Butter Key Plant Foods Prevent Child Overweight In an NIH funded study, researchers found that specific plant foods may prevent overweight in children and adolescents. The frequency of consumption of grains, nuts, vegetables and LNDF (low nutrient dense foods) were inversely related to the risk of being overweight and dairy increased the risk. Nut intake significantly decreased the likelihood of overweight. Several plausible reasons exist to explain why nut consumption is not associated with increased BMI, including increased resting metabolic rate, enhanced satiety and corresponding decreased intake of other foods, and incomplete absorption of energy from nuts. Grains, nuts and peanut butter are less costly than many animal-based foods and are enjoyed by most children and adolescents. Pistachios 2% Pecans 4% Walnuts 2% Other Tree Nuts 12% Popular - The World of Nuts Almonds 13% Peanuts 67% Nut Consumption in the US USDA-ERS, % European Consumers Reporting Intake 19% European Consumers Reporting Intake 15% 23% 10% Denmark, France, Germany, Greece, Italy, Netherlands, Norway, Spain, Sweden, UK almond hazelnut walnut other tree nuts peanuts ( Journal. Matthews, et al. 2011) Jenab, et al, BJNutr,

4 Dietary Guidelines 2010 Report of the Dietary Guidelines Advisory Committee on the Dietary Guidelines for Americans, 2010 HEART HEALTHY Peanut Butter and CVD: Consumption of at least 5 servings per week of nuts or peanut butter was significantly associated with lower total, LDL, non-hdl cholesterol and apob-100 concentrations, as well as a lower risk of CVD. CVD: There is moderate evidence that consumption of unsalted peanuts, tree nuts, specifically walnuts, almonds, and pistachios, in the context of a nutritionally adequate diet and when total calorie intake is held constant, has a favorable impact on cardiovascular disease risk factors, particularly serum lipid levels. Consumption of unsalted peanuts within an energy-balanced diet has a favorable impact on cardiovascular disease risk factors, particularly serum lipid levels. PLANT PROTEIN Protein: Peanuts, because they are the major nut eaten in the United States provides an important source of plant protein and other nutrients. Plant-based Diets: Shift food intake patterns to a more plant-based diet that emphasizes vegetables, cooked dry beans and peas, fruits, whole grains, nuts, and seeds. Calories From Snacks Are Up According to the USDG, 37% of calories come from SoFAS. Prevalence of snackers increases From 48% to 78% More calories are coming from snacks* Up to 27% of caloric intake * Source: Piernas & Popkin, 2010; Health Aff TOP 10 FOODS REPORTED AS SNACKS BY 9-12 YEAR-OLD CHILDREN 1. Beverages 2. Savory snacks from grains 3. Candy 4. Fruits 5. Cookies & bars 6. Ice cream 7. Potato chips & French fries 8. Cakes, doughnuts, pastries, pies, 9. Pizza, burritos, tacos 10. Sandwiches soft drinks fruit drinks milk fruit juices popcorn tortilla chips pretzels crackers apples bananas grapes oranges chocolate chip cookies crème-filled cookies sugar cookies brownies BMI of Peanut Users is Lower Male 18.4 Mean Values Children 20.1 Female 19 Nonusers Users Source: WWEIA, NHANES , 1 day, 9-12 year olds USDA, 2009 Penn State - CSFII *P<0.05 Weight Management and Satiety Peanuts and PB stick with you for about 2 1/2 hours versus 1/2 hour for a high carbohydrate food (rice cakes) Peanut eaters feel satisfied and naturally reduce eating other calories throughout the day 5:00pm Kirkmeyer, et al,

5 Snack Intervention Substitution of nutritious snack foods Backpack Raid 1 oz portion of peanuts or ¾ oz PB given daily at school At one year, 80% of the treatment group(ili)decreased or maintained weight, while almost 65% of the (SH) control gained At two years, 62% of treatment decreased or maintained, while 65% of control gained Important Biomarkers Improved Lipids Total cholesterol Bad LDL cholesterol Triglycerides - trending down Improved Anthropometrics ie. smaller waists Improved Quality of Life Decreased Inflammatory Markers Affordable - Nutrients for Less Cost Per Ounce $ $ $0.46 $ $0.16 $ peanut butter peanuts cashews almonds pistachios pecans walnuts other tree nuts (no peanuts) peanut butter peanuts cashews almonds pistachios pecans walnuts other tree nuts (no peanuts) Source: Retail grocery store chain major brand for each nut averaged (Skippy, Planters, Diamond, Everybody s Nuts), What Can We Do To Protect Allergic Children? Educate students, staff, and parents Institute and maintain good hygiene and cleaning practices in food service areas and classrooms Know your school s food allergy plan and enforce it FAAN, the leading authority on food allergies does not advocate a ban. The recommend that parents, doctors, and school officials work together and develop a plan that best fits their situation. Resources: FAAN TPI Thank You! Patricia Kearney, MEd, RD PMK Associates, Inc pat.kearney@pmkassociates.com 5