Dr. Summit Shah

Dr. Summit Shah

The U.S. Food and Drug Administration (FDA) currently requires that companies include on their food labels the inclusion of eight common food allergens, including: peanuts, wheat, eggs, milk, shellfish, tree nuts and soybeans. Sesame may soon be added to this list

In 2014, a group that included the Center for Science in the Public Interest (CPI) petitioned the FDA to begin including sesame on the list of major allergens as evidence began to mount suggesting that more than 300,000 Americans suffer from sesame allergies and that only 100 milligrams of sesame can cause allergic reactions that can range from mild to the most severe forms that involve life-threatening anaphylaxis.

This move by CPI and others was consistent with others’ views on sesame allergies, as the European Union, Canada, Australia and New Zealand all already require companies to disclose when sesame is contained within its products.

A recent study published in Pediatrics suggests that 150,000 children in the United States are affected by sesame allergies, making it the ninth most common food allergen. More than half of those allergic to sesame carry EpiPens to protect themselves from severe allergic reactions.

Now, as the FDA considers adding sesame to the list of allergens that must be disclosed on food labels, it is also requesting information on the allergy through the end of the year, particularly from epidemiologists, allergy researchers, physicians, and nutritionists. The hope is that insights from these experts will help the FDA to deepen its understanding of sesame allergies and the threats they pose

A major goal for including sesame on the FDA’s list of major allergens would be to make it easier for consumers to identify sesame and avoid it when necessary. In addition to including major allergens on labels, companies are also required to use common names that are easily recognizable to consumers.

Currently, sesame may go unidentified because consumers are not familiar with the names that manufacturers use to describe the substance. Some other terms for sesame are: sim sim, sesamol, til, gingelly, and benne. Those with sesame allergies – and the rest of the allergy community – are anxiously awaiting the FDA’s decision on how to best handle the risks associated with sesame allergies.

Thursday, 18 October 2018 08:43

Are Asthma and Obesity Linked?

The medical community has long recognized that obesity increases the risk of developing asthma. However, new research is complicating the story, suggesting that the opposite may also be true – i.e., that asthma may also increase the risk of becoming obese. According to the new data presented at the European Respiratory Society International Congress, people who have non-allergic asthma and those who have developed asthma as adults are at the highest risk of becoming obese.

The study, led by Dr. Subhabrata Moitra, included 8,618 people from 12 countries. Recruitment for the study started in the 1990s, and followed participants over 20 years. At the start of the study, these individuals were not obese, meaning that their body mass index, or BMI, was less than 30 kg/m2. Their asthma and BMI was then assessed at 10-year intervals over two decades. Participants were deemed to have asthma if they were taking asthma medication or if they reported having asthma and had had an asthma attack or had been awoken with shortness of breath at some point during the previous year.

Researchers evaluated the correlation between having asthma when the study began and the likelihood of obesity both 10 and 20 years later. They also considered other risk factors for obesity, including age, sex and physical activity. The scientists’ most significant finding was that 10.2 percent of people who had asthma at the start of the study had become obese ten years later, compared to only 7.7 percent of those who did not have asthma. Thus, though all people tended to gain weight and be more likely to become obese as they aged, the risks for obesity were higher among those with asthma than among those without asthma.

The specific link between asthma and obesity is unclear, but there does seem to be a relationship that makes having one of these conditions increase people’s likelihood of developing the other. Future research will aim to clarify the impact of each disease on the other so that we can develop strategies for reducing the risk of obesity in those with asthma and vice versa.

Monday, 01 October 2018 08:40

How Chiggers are Spreading Meat Allergies

Over the last decade, a major mystery in the rise of red meat allergies has been partially solved, as scientists have discovered that being bitten by the Lone Star tick – which tends to be found in the southeastern United States – increases the risk of developing allergies to red meat. By increasing sensitivity to alpha-gal, which is a type of sugar molecule, ticks can make their victims become allergic to red meat that contains this type of sugar.

New evidence has now emerged that chigger bites may also lead to red meat allergies by lowering people’s tolerance to alpha-gal. The findings have been published in The Journal of Allergy and Clinical Immunology: In Practice.

The clue that chiggers may be helping to spread red meat allergies emerged from case reports from the University of Virginia and Wake Forest Baptist that described patients who had recently developed an allergy to red meat had not been exposed to ticks, but had recently experienced chigger bites. Researchers at UVA found that of 301 red meat allergy patients surveyed, 5.5 percent had experienced chigger bites over the previous decade but had not had any exposure to ticks.

To confirm whether chiggers are truly spreading red meat allergies, scientists will begin investigating whether chiggers have traces of alpha-gal in their saliva.

Chiggers are tiny red larvae that come from arachnid mites in the Trombiculidae family. These larvae eventually evolve into arachnids with eight legs. Being only about 1/150th of an inch in size, they are not easy to identify with the eye. However, once someone has been bitten by chiggers, they tend to experience intense itching. The subsequent scratching undertaken to relieve itching can lead to secondary infections.

While the itching they cause may lead people to assume that chiggers are similar to mosquitoes, they are actually more closely related to ticks. Like the Lone Star tick, chiggers can be found in the southeastern part of the United States, but they are more widespread than the Lone Star tick – also prevalent in the Midwest and found in northern states, through New York.

Red meat allergies can range from mild symptoms including hives to life-threatening reactions that involve anaphylaxis. Unlike many allergies that occur immediately after exposure to the allergen, the alpha-gal allergy often involves a delayed reaction that occurs between three and 12 hours after exposure.

There is no cure for this allergy, and the only way to prevent it is to avoid mammalian meat products. Future research into the specific causes of red meat allergy may help in the development of an effective treatment for this allergy.

Monday, 17 September 2018 08:37

Can You be Allergic to Gel Manicures?

The short answer is yes. The British Association of Dermatologists have recently reported on what they call an “allergy epidemic” resulting from exposure to a methacrylate – a chemical that is commonly used in gel polish, gel nails and acrylic nails. A major challenge with this rising allergen is that those experiencing allergic reactions do not always realize that their reaction results from a chemical on their nails because the symptoms can occur all over the body.

What happens when the allergy occurs is that the methacrylate comes into contact with the skin before it is dried or hardened by a UV light. Once this exposure occurs, nails may loosen, but severe red and itchy rashes can also occur, and these can pop up anywhere on the body. The rashes are commonly found on the eyelids, face, neck and genitals. Respiratory difficulties can even occur in the most severe cases.

It is important that people who are allergic to methacrylate identify the cause of their allergies so that they can avoid the allergen in the future. Unfortunately, gel polish and gel and acrylic nails are not the only places where methacrylate is found. They are used in acrylic plastic production and are found in devices, orthopedic cement and dressings used in surgeries and dental treatments.

According go the British Association of Dermatologists, approximately 2.4 percent of people tested are allergic to at least one type of methacrylate, and those who apply gel or acrylic nails or gel polish at home or who work in the beauty industry are at enhanced risk for methacrylate allergies. Recognizing that you are at risk for methacrylate allergies can help you identify the trigger if you do experience an allergic reaction.

A study recently published in the Annals of the American Thoracic Society has shown that four out of every 10 women with asthma may eventually develop chronic obstructive pulmonary disease (COPD). The research team, led by Teresa To, studied 4,051 women who were diagnosed with asthma. They followed the women on average for 14 years and found that 1,701 of them – or 42 percent – developed COPD.

The researchers also studied asthma and COPD overlap syndrome, which is often referred to as ACOS. They found that there has been a sharp rise in women with ACOS in recent years, and that more women than men die from ACOS. They also found that fine particulate matter, which is a common air pollutant that has been shown to travel to the lungs and cause lung disturbances, is not as much of a factor in the development of ACOS as other individual risk factors, such as smoking.

According to their analyses, women who had smoked a pack each day for at least five years developed ACOS at significantly higher rates than those who smoked fewer or no cigarettes. Nonetheless, refraining from smoking does not guarantee that women with asthma will avoid ACOS. In fact, 28 percent of those who developed ACOS had never been smokers. Other factors that are associated with higher rates of ACOS development are: obesity, lower levels of education, unemployment and rural residence.

Based on the factors that appeared to increase the risk for developing ACOS, the scientists suggested that low socioeconomic status and lower access to care or lower adherence to medication recommendations could account for the increased incidence of ACOS. Indeed, improperly treated asthma can result in more frequent asthma attacks and more opportunity for remodeling conducive to COPD to occur within the lungs.

The good news is that the factors that were identified as associated with ACOS development are modifiable, which suggests that the rising incidence of ACOS among women could be curbed with proper interventions. Given that women who developed end up in the hospital more frequently and have a poorer quality of life than those who are diagnosed with only asthma or only COPD, it is important that we figure out ways to minimize ACOS. More research aimed at how to prevent the development of ACOS will help clinicians to provide care and recommendations for their patients to reduce the likelihood that asthma will develop into COPD.

Thursday, 16 August 2018 08:31

Can Diet Reduce Asthma Symptoms?

A new study published in the European Respiratory Journal concluded that diets that include high levels of fruits, vegetables, and whole grains are correlated with better asthma outcomes. These foods are known to be healthy, with an abundance of scientific evidence pointing to the ways that these foods, and the nutrients contained within them, stave off of health problems – from cardiovascular challenges to cancer to diabetes. This new research provides support for the idea that good nutrition can also improve respiratory health.

The role that diet plays in asthma symptoms and the frequency of asthma symptoms has been a topic of debate in the immunology field. As a result, people living with asthma have not had clear guidance on how they may be able to use their diet to improve their symptoms and quality of life. One of the goals of the study that was published in the European Respiratory Journal was to provide actionable information to patients with asthma on what may be beneficial for them to eat.

The researchers looked at data from 34,776 adults from France who had participated in the NutriNet Sante study, which looked at the relationship between nutrition and health. These data included information on respiratory health, including the frequency of respiratory symptoms, use of emergency medications and the extent to which asthma symptoms interfered with daily routines and activities. Within this data set, 25 percent of the male participants and 28 percent of the female participants displayed at least one asthma-related symptom.

The NutriNet Sante study also provided data related to nutrition. Healthy diets were deemed to be those that included high levels of fruits, vegetables, and whole grains, whereas unhealthy diets were deemed to be those high in meat, salt, and sugar. What the research team revealed was that a healthy diet was associated with fewer asthma symptoms and better controlled asthma, and this effect was higher for men than for women.

Men who ate healthy diets were percent 30 less likely to display a symptom of asthma and 60 percent less likely to have uncontrolled asthma than men who ate unhealthy diets. The trend was similar but less significant for women. Compared to women who ate unhealthy diets, women on healthy diets were 20 percent less likely to have asthma symptoms and 27 percent less likely to have uncontrolled asthma.

The researchers suggested that the association between more healthy eating and better asthma outcomes may be at least partially due to the antioxidant and anti-inflammatory characteristics of certain nutritious foods and the proinflammatory properties associated with certain unhealthy foods. While the details on how diet can be used to prevent or control asthma need to be clarified through more research, this new analysis builds on evidence that diets rich in fruits, vegetables and whole grains contribute to better health.

Wednesday, 01 August 2018 08:23

Can Allergies Protect You From Skin Cancer?

When people experience allergic reactions, a blood protein or antibody, called Immunoglobin E (IgE) has recognized an allergen, interpreted it as harmful, and initiated the reaction that leads to allergy symptoms. According to some scientists, this same reaction can occur when we are exposed to environmental chemicals like those found in polluted air or tobacco smoke. This idea is known as the Toxin Hypothesis.

Researchers at Imperial College London studying the relationship between IgE and skin cancer have published new findings in Nature Immunology on how IgE may be able to protect the skin from developing cancer. This team of researchers had hypothesized that a function of IgE may be to protect against environmental chemicals, which is why IgE levels rise in response to these potentially harmful substances.

To test their idea, the scientists exposed the skin of mice to toxic chemicals. They found that this exposure did indeed cause IgE to travel to the skin and also to lower the chances of skin cancer developing in these mice. The researchers also observed skin tumors from 12 patients with a common form of skin cancer called squamous cell carcinoma. Every tumor they observed had IgE in it. Interestingly, though, the tumors that were less dangerous contained higher levels of IgE, while the tumors that were more threatening had lower levels of IgE.

Given that lower risk skin tumors were associated with higher levels of IgE, the scientists concluded that IgE may have a protective function for the skin and through this function, may prevent skin damage from developing into cancer. The details of how IgE could impart this protective effect on the skin are not yet clear, but the Imperial College London researchers hope that they will be able to uncover ways to use IgE to prevent or treat skin cancer.

While this study focused on IgE levels as they relate to environmental chemical exposure, new lines of research will likely investigate whether IgE levels associated with allergies and allergic reactions can confer the same kinds of benefits for the skin. It is possible that people who experience allergies and elevated IgE levels may have higher IgE levels on their skin in response, for example, to sun damage. If that were the case, the body’s natural reaction to allergens could help protect against skin cancer. More research is needed to understand the connection between IgE and skin cancer and the contexts in which IgE may be able to provide health benefits.

Thursday, 15 November 2018 08:10

Can You Really Outgrow Seafood Allergies?

Food allergies are often considered allergies that may be outgrown. However, the likelihood of outgrowing a food allergy depends in large part to both the severity of the allergy and the specific food that causes the allergy. Allergies to milk, egg, wheat and soy, for instance, are the common food allergies that are often outgrown by the time children reach their late teens. Indeed, between 60 and 80 percent of children who are allergic to milk or eggs are able to ingest these foods without any adverse reactions by the age of 16.

Seafood allergies, though, are not on this list of food allergies that are commonly outgrown. A recent study supports the notion that seafood allergies are not often overcome. The research, published in the Journal of Allergy and Clinical Immunology: In Practice, tracked children and adults with seafood allergies for up to six years. The patients included 63 people – 37 of whom were allergic to non-shellfish fish, 25 of whom were allergic to shellfish, and one of whom was allergic to both.

Among those allergic to non-shellfish fish, the most common allergen was salmon. Approximately 18 percent of those with non-shellfish fish allergies were allergic to salmon – or almost one in five people. The most common shellfish allergy was shrimp, to which about half of those with shellfish allergies were allergic.

The results showed that less than one percent of those with seafood allergies experienced resolution of their allergies during each year of follow up. According to the researchers, non-shellfish fish and shellfish allergies account for most life-threatening allergic reactions to food, which involve anaphylaxis. It is, therefore, important for patients to understand their allergies and what to expect in terms of how their allergic reactions may evolve.

Given that this study was conducted on a relatively small sample and over just a six-year period, it is possible that future research will find more promising results for outgrowing seafood allergies over a more extended period of time. In the meantime, other research will continue to focus on ways that seafood and other food allergies can be prevented, treated and overcome.

Obesity has long been viewed as a risk factor for developing asthma. However, new evidence now suggests that the reverse may be true – that is, that asthma may be a risk factor for obesity. An international study has shown that toddlers who are diagnosed with asthma are more likely than those without asthma to become obese during childhood. The study involved 40 researchers and was led by scientists from the University of Southern California. The results were recently published in the European Respiratory Journal.

To investigate the potential for asthma to lead to obesity in children, the researchers studied 21,130 European children who were born between the years 1990 and 2008 in the United Kingdom, France, Spain, Germany, Italy, Greece, Denmark, Sweden and the Netherlands. The results showed that the children who had been diagnosed with asthma between the ages of 3 and 4 were at a 66 percent higher risk for developing obesity than those who were not diagnosed with asthma. Children who had active asthma were almost twice as likely to develop obesity than those without active asthma.

The researchers speculate that there are a few different ways that asthma could contribute to obesity. For instance, those with asthma may be less likely to engage in physical activity. The corticosteroid medications that these children use to manage their asthma could also increase the risk for obesity.

Though this new research has not completely clarified the relationship between childhood asthma and obesity, any potential link is important because both diseases tend to lower quality of life for children. Understanding how asthma and obesity are linked may help in the development of interventions that can reduce the chances that children with one of these diseases develops the other.

We have long known that red meat can contribute to poor health in several ways. It has been implicated in cardiovascular disease before, as well as in cancer, diabetes, and stroke. When it comes to heart disease, however, the link to red meat has been focused on the high levels of saturated fat that red meat carries and how saturated fat can worsen cardiovascular health.

Recently, however, allergies to red meat have cropped up – largely in response to tick bites from the Lone Star tick, which is most commonly found in the Southeastern United States. With the rise in meat allergies, scientists have begun delving deeper into what makes our bodies react to red meat. The culprit allergen has turned out to be a complex sugar referred to as alpha-gal.

There has been some evidence to suggest that people with allergies may be more likely to have buildup of fatty plaque in their arteries, and it is thought that this may be due to the immune response to allergens, which sets off a cascade of events that could lead to this atherosclerosis. In a new study, University of Virginia scientists investigated whether those with red meat allergies are more likely to have atherosclerosis.

 

The researchers evaluated the blood of 118 people from Virginia and looked for an antibody to alpha-gal, which would indicate allergy to red meat. They identified the antibody in 26 percent of their subjects, and those with this marker did indeed have higher levels of fatty plaques in their arteries than those without the antibody. The plaques found in these allergic patients were also more unstable than any fond in those without red meat allergy, and that instability is associated with a higher likelihood of heart attack and stroke.

This new study, published in the journal Arteriosclerosis, Thrombosis, and Vascular Biology, provides some interesting insights into the potential link between allergies and cardiovascular disease. However, it does not clarify whether red meat allergies – or any allergies – actually increase the risk of heart disease. Future research will help elucidate this potential connection and improve our understanding of the relationship between allergies and heart health.

 

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