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Immunology, In the News, Nutrition, Pediatrics, Research

Peanut products and babies: Now okay?

Peanut products and babies: Now okay?

peanut butter2 - big

Updated 2-25-15: Allergy expert Sharon Chinthrajah, MD, discussed the study and its implications on KQED’s Forum today:

***

2-24-15: Any parent of young children is likely familiar with the warnings: It’s not okay to give your baby peanut butter, or any other peanut product, before he or she turns one. Don’t do it! These instructions are so imprinted on my brain that I practically did a double-take when I came across headlines about new research suggesting that infants should, indeed, be fed peanut products – in order to prevent the development of peanut allergies.

This isn’t the first time that the benefits of giving allergenic foods to babies have been outlined, but the language surrounding this study has been particularly strong. As the writer of a New York Times blog entry explained, the authors of the study and accompanying editorial “called the results ‘so compelling’ and the rise of peanut allergies ‘so alarming’ that guidelines for how to feed infants at risk of peanut allergies should be revised soon.” He went on to outline the study findings:

In the study, conducted in London, infants 4 to 11 months old who were deemed at high risk of developing a peanut allergy were randomly assigned either to be regularly fed food that contained peanuts or to be denied such food. These feeding patterns continued until the children were 5 years old. Those who consumed the foods that had peanuts in them were far less likely to be allergic to peanuts when they turned 5.

After hearing the news, I reached out to the folks at the Sean N. Parker Center for Allergy Research at Stanford to get their take on the findings. Sharon Chinthrajah, MD, a clinical assistant professor of medicine, explained that this work is the first randomized controlled study to look at how to prevent peanut allergies. She told me:

We’ve all been waiting for the results of this landmark study to confirm the shift in the paradigm of when to introduce foods into the diet. Early introduction of peanut in the right infants can prevent peanut allergy. Dr. [Gideon Lack, the leader of the study] and colleagues were able to show an 80 percent reduction in peanut allergy in children who started eating peanut early and incorporated it into their regular diet.

Chinthrajah believes the guidelines on babies and peanut products should be revised, “because peanut allergies affect 2 percent of our population in the U.S. and most people do not outgrow this allergy.” But, as other experts have done, she cautions that not everyone should introduce peanuts and other foods into their diet early. “Those who are ‘high-risk’ – who have other allergic conditions such as eczema or other food allergies – should consult with their allergist to see if it would be safe to introduce peanut into their child’s diet,” she advised.

Previously: Taking a bite out of food allergies: Stanford doctors exploring new way to help sufferers, Simultaneous treatment for several food allergies passes safety hurdle, Stanford team shows, Researchers show how DNA-based test could keep peanut allergy at bay, A mom’s perspective on a food allergy trial and Searching for a cure for pediatric food allergies
Photo by Anna

Autoimmune Disease, Chronic Disease, Health and Fitness, Nutrition, Obesity, Research

Study clarifies link between dieting, exercise and reduced inflammation

Study clarifies link between dieting, exercise and reduced inflammation

4503404991_13da58b6e6_bIf you’ve ever wondered how dieting and exercise reduce inflammation, read on. According to new research, a compound that our bodies crank out when energy supplies are low could be the link between diet and exercise, and reduced swelling in the body.

When diet, fasting and exercise starve the body for calories, the body increases production of a compound called beta hydroxybutyrate (BHB). This compound has long been known as an alternate source of energy; the new research suggests that BHB can also block the inflammatory response.

In their study, published this week in Nature Medicine online (subscription required), a team of scientists co-led by Yun-Hee Youm and Kim Yen Nguyen at the Yale School of Medicine, discovered that the compound BHB reduces swelling in the body by inactivating a group of proteins, called the inflammasome, that drive the inflammatory response.

The research team used human immune cells and mice to explore the effects of BHB in the body. They found that mice given BHB directly, and mice fed a low-carbohydrate diet (that prompted their bodies to synthesize their own BHB), both benefited from reduced inflammation.

These results are noteworthy because a better understanding of the mechanism that links diet, exercise and inflammation could help scientists develop more effective treatments for inflammatory disorders such as Type 2 diabetes, atherosclerosis and Alzheimer’s disease.

Previously: Newly identified type-2 diabetes gene’s odds of being a false finding equal one in 1 followed by 19 zeroesImproving your health using herbs and spices, Exercise may alleviate symptoms of arthritis regardless of weight loss, Study points to inflammation as cause of plaque buildup in heart vessels and Examining the role of exercise in managing and preventing diabetes
Via ScienceDaily
Photo by Dave Nakayama

Ask Stanford Med, Events, Nutrition, Obesity, Stanford News

Sticky situation: How sugar affects our health

Sticky situation: How sugar affects our health

132244825_dbf0e21d9f_zHere’s a shocking statistic: On average, Americans consume three pounds of sugar each week, or 3,550 pounds in an entire lifetime. This leads some to blame the sweet stuff for the increase of chronic disease in modern society. But simply reducing our sugar intake is easier said than done, in part because identifying foods with added sugars can be tricky.

This Thursday, Alison Ryan, a clinical dietician with Stanford Health Care, will deliver an in-depth talk on sugar and our health as part of a Stanford Health Library lecture series. Those unable to attend can watch the presentation online here.

In the following Q&A, Ryan discusses the controversies surrounding sugar and the role of sugar in our diet, and she offers tips for making sure your consumption doesn’t exceed daily guidelines.

Why does our body need sugar?

Sugar, in the form of dextrose or glucose, is the main fuel or energy source for the cells of the human body. Without glucose, our body has to get creative and rely on other metabolic pathways, like ketosis, to keep our brain and other organs running. There is an optimal range for our blood sugar levels, and our bodies are making constant efforts to keep blood sugar within this range.

Our body can make glucose from any carbohydrate that is consumed, so consuming monosaccharide (glucose and the like) is not biologically required. This is one of the reasons it’s difficult to determine the right amount of sugar that is required for the human body. Do we think of the optimal amount as the amount needed to function at peak level? Or an amount not to go over in order to avoid detrimental effects on our health?

Sugar intake has been on the rise in human diets. Why do you think that is?

At one time, sugar used to be a seldom available food item. It is now ubiquitous and more of a hallmark for highly processed, low nutritional value foods. Now, consider the food industry and the politics of sugar. Soda companies, makers of desserts, cakes, sugary snack foods, the sugar and corn syrup refiners all lobby to keep their products “part of a balanced diet.” The food industry is deeply involved (or at least vocal about) the food and nutrition guidelines in the U.S. Then there’s the reality that sugar tastes good! Most people enjoy the taste of sweet foods and are drawn to consuming them.

What are some of the health risks of consuming too much sugar?

Sugar has been implicated as playing a role in some obvious ways, like obesity, diabetes, and tooth decay; but also in less direct appearing ways such as heart disease, chronic inflammatory conditions, cancer, etc. Often, when we’re consuming foods high in sugar, we’re not consuming foods that are rich in nutrients. These calorie-dense foods displace the nutrient-dense foods. The net effect is higher intake of calories, with concurrent lower intake of vitamins, minerals, phytonutrients, protein, etc.

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Clinical Trials, Nutrition, Pediatrics, Research, Stanford News

Batman has his utility belt – and I have my EpiPen

Batman has his utility belt - and I have my EpiPen

Batman“Matt, do you have your EpiPen?” Those six words have echoed throughout my house each morning ever since I could understand them.

“Matt, do you have your EpiPen?” “Matt, do you have your EpiPen?” “Matt, do you have your EpiPen?” How many times have I heard that? Thousands. Growing up with a food allergy was a huge burden requiring constant vigilance. Vigilance about carrying my EpiPen and about knowing where to sit at the school lunch table, who would chaperone the field trip, whose birthday party my mom or dad would have to hang out at, whose house was safe for me to hang out at – and vigilance about which foods I eat.

Since enrolling and subsequently graduating from a Stanford food allergy study led by Kari Nadeau, MD, PhD, my anxiety surrounding my allergy has greatly decreased, but my vigilance remains steadfast. The Stanford study has given me safety from cross contamination and a life without fear.

Yet, just as Batman has his utility belt, I have my EpiPen. The EpiPen may as well be tattooed on to my skin, as it still travels with me everywhere I go. In my opinion, this should be the same for every severely allergic person. My good friend (who has multiple food allergies) doesn’t carry one when he’s with me. His rationale behind it is, “I’m with you, so I don’t need one.” I recently met someone who doesn’t carry an EpiPen although she has a diagnosed anaphylactic allergy to tree nuts and peanuts. Her rationale? “I’ve never had a reaction, and I am really careful about what I eat.”

I can’t understand when I meet people with food allergies and they don’t carry an EpiPen. Sometimes they say, ” I just get hives around my mouth.” Or “I just get a little itchy on my tongue.” Or “I have one – it’s in my car.” CAN YOU BE SERIOUS?

Unfortunately for me, before entering the allergy study, I had to use my trusted EpiPen several times. It was very tense, scary and thankfully quick. After a person gets over the paralyzing fear of the needle (which is actually hidden inside the pen), the EpiPen is actually easy to use (once you get the hang of it). It works so fast. It actually stops the allergic reaction in its tracks. It’s the only life-saving medication food that allergic people can use to help prevent life threatening reactions.

So yes, under the advice of my doctor, I still carry an EpiPen. Even though I successfully eat a lot (4,000 milligrams each) of all of my allergens daily, (which are wheat, rye, barley and oats), it’s always by my side – at camp, tennis, school or a party. I know the facts of how quickly a reaction can escalate, and I may still have a reaction. I am after all, a living science experiment.

The words, “Matt, do you have your EpiPen?” are still essential to my life.

Matthew Friend is a high-school junior from Chicago. A version of this piece originally appeared in the Huffington Post.

Previously: Participant in Stanford food-allergy study delves into lifestyle-changing research, Taking a bite out of food allergies: Stanford doctors exploring new way to help sufferersSimultaneous treatment for several food allergies passes safety hurdle, Stanford team shows, Researchers show how DNA-based test could keep peanut allergy at bay and A mom’s perspective on a food allergy trial and Searching for a cure for pediatric food allergies
Photo by JD Hancock

Nutrition, Obesity, Research, Stanford News

New insulin-decreasing hormone discovered, named for goddess of starvation

New insulin-decreasing hormone discovered, named for goddess of starvation

530468355_133d4da701_zLimos, the Greek goddess of starvation, must have relied on limostatin, the eponymous hormone recently discovered by Stanford researchers, to survive hunger.

She was clearly not well fed. As Ovid writes: “Her hair was coarse, her face sallow, her eyes sunken, her lips crusted and white; her throat scaly with scurf. Her parchment skin revealed the bowels within…”

Limostatin slashed her insulin levels, keeping nutrients in her blood so they could be used. Without limostatin, humans develop diabetes-like symptoms such as low blood sugar and a tendency toward obesity.

From our press release describing the Stanford work:

The researchers first discovered limostatin in fruit flies but then quickly identified a protein with a similar function in humans.

“Starvation or famine is an ancient, ever-present specter faced by all living organisms,” said Seung Kim, MD, PhD, professor of developmental biology. “The ways to deal with it metabolically are likely to be ancient and conserved. This research clearly connects the dots between flies and humans, and identifies a new potential way to regulate insulin output in humans.”

The researchers discovered limostatin by following a series of “biological breadcrumbs:”

Kim and his colleagues withheld food from their laboratory fruit flies for 24-28 hours and looked to see which genes were highly expressed during this time. They narrowed the list to those genes that encoded proteins resembling hormones, which are special signaling molecules that circulate throughout the body to affect the function of distant cells. They observed that one of these, limostatin, caused characteristics of insulin deficiency when overexpressed in flies…

Once the researchers had identified the receptor for limostatin in fruit flies, they looked to see if it resembled any human protein. A trail of biological breadcrumbs led them to the receptor for a protein called Neuromedin U. The protein is produced in the brain, and controls a variety of physiological responses including smooth muscle contraction, blood pressure control, appetite and hormone function in humans.

Based on their experiments in fruit flies, Kim and his colleagues expected that Neuromedin U might also be important in insulin regulation. They found that the protein is also expressed in the stomach and intestines, and the Neuromedin U receptor is found on insulin-producing beta cells in the pancreas. Neuromedin U and its receptor appeared to neatly connect nutrient sensing in the gut with insulin-producing cells elsewhere in the body.

Previously: Tiny fruit flies as powerful diabetes model, Beta cell development explored by Stanford researchers and Correspondence on the discovery of insulin
Photo by William Murphy

Health and Fitness, Nutrition, Public Health

Why establishing a health baseline is a “critical starting point for achieving future health goals”

Why establishing a health baseline is a "critical starting point for achieving future health goals"

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Raise your hand if you want to be more successful at achieving health goals, such as losing weight or lowering your cholesterol levels, and maintaining a healthy lifestyle. Perhaps it’s time to consider creating a health baseline. “A health-care baseline is essentially where you are “at” on the broad, complex spectrum of physical, mental and emotional health,” explains Mary James, MD, an internal medicine physician at Stanford. “This can be a critical starting point for achieving future health goals.”

On Thursday, James will deliver an in-depth talk on the benefits of partnering with your primary care provider to establish a health baseline as part of the Stanford Health Library lecture series. Those unable to attend can watch the presentation online here.

In anticipation of the event, I contacted James to learn more about why its important to have a basis for comparison, beyond the ever-fluctuating number on your bathroom scale or if you’re able to fit into your skinny jeans, to use in measuring progress in meeting your health goals. Below she discusses how assessing the state of your health now can pay off in a longer, more active life in the future.

What is a health baseline?

Your baseline has two basic components: existing illness and potential future illness. Your current baseline has been shaped by your medical, social and family history and is constantly being influenced by common factors in everyday life. Although some components of your healthcare baseline are more modifiable than others, it is important to have an accurate understanding of your current health status.

Why is it important to determine your personal health baseline?

You may be thinking, “I’m healthy – I take no medications and never go to the doctor. Why should I start now?” There are two fundamental components to good health. They are: appropriate treatment for current illness and appropriate preventative care to reduce health decline in the future. While most people actively seek care for the former, we often forget about the latter. Although the data is mixed on whether “routine check ups” are beneficial, there is strong evidence behind many of the preventative maneuvers that are typically discussed and ordered at these visits. Taking appropriate preventative health-care steps can help you avoid the need for prescription medications, hospitalizations and procedures and can help ensure a longer, healthier life.

How can establishing a health baseline help you be more successful in reaching personal wellness goals?

Many wellness goals start with changes in diet and exercise. Your primary care provider can help determine how to start making these changes in a safe, effective manner. Are there exercises you should avoid due to chronic back pain? Is it okay to start running if you have high blood pressure? Is it safe for you to start a vegan diet? What is a safe amount of weight to lose?

Wellness also includes mental and emotional health. Your primary provider can help determine what treatment is most appropriate for common conditions such as depression and anxiety. Maybe you’ve been feeling “down” lately – is this true depression that warrants medical treatment, or is it safe try a new yoga or meditation class first? These are just a few of the many things that can be assessed and addressed as part of your health baseline. Together, you and your primary care provider can prioritize health problems and determine effective interventions.

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Nutrition, Public Health

Eating for good blood: Tips for boosting iron levels and hemoglobin

Eating for good blood: Tips for boosting iron levels and hemoglobin

eggs and chard

Have you ever gone to donate blood only to be deferred for low iron count? Also referred to as low blood count, low iron, or low hemoglobin, approximately 10 percent of donors are deferred for this reason. When a donor is deferred, that means they’re unable to donate blood that day. You’ve probably wondered why this happens and if there’s anything you can do about it. Hopefully, the following information will shed some light on the subject.

What is iron and what does it have to do with blood donation?

Iron is a nutrient that is found in the foods we eat, which then combines with certain proteins to become hemoglobin in your red blood cells. The red blood cells are important because they carry oxygen from the lungs to other parts of the body. When the body experiences low iron and hemoglobin, this essentially means you do not have enough red blood cells in your body to donate blood. Low iron levels may cause you to feel tired, and extremely low iron levels may cause damage to organs. There are several reasons one may have a low blood count – including not eating enough iron-rich foods, donating blood too frequently, chronic illness, or other invisible causes.

Testing your blood

In order to keep our donors safe and healthy, our collections staff must ensure that each donor we see has sufficient levels of iron and hemoglobin before they donate. Therefore, when you visit a center to donate, the collections staff will do a finger prick to test a small amount of blood to assess hemoglobin levels. If your levels are low, we will not be able to collect your blood that day but do encourage you to try some simple measures to raise your levels in order that you can come back to donate again in the future.

What can I do to improve my hemoglobin levels prior to donation?

One way to try to boost your iron levels is through your diet. By eating iron-rich foods, you can promote blood regeneration and increase the amount of iron in your body. Typically, iron-rich foods are colorful and deeply pigmented. Some examples of good sources of iron include:

  • Chard
  • Dates
  • Eggs
  • Lean beef and pork
  • Raisins
  • Shrimp
  • Spinach
  • Whole grain breads

For a more detailed list of foods and their iron content, the USDA provides a nutrient database for reference.

Kristin Stankus is the digital community & social media specialist at Stanford Blood Center. This blog entry originally appeared on the blood center’s blog.

Photo by Patent and the Pantry

Ask Stanford Med, Health and Fitness, Nutrition, Obesity

How to keep New Year’s resolutions to eat healthy

How to keep New Year's resolutions to eat healthy

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New Year’s Day always offers the opportunity to hit pause, reflect on our lives and set goals to improve our health and well-being. For many of us, this year also involved making promises to eat healthier and lose weight. To help you achieve your nutrition goals, I reached out to Stanford health educator Jae Berman. Below she shares how to select New Year’s resolutions that you’ll actually keep (perhaps you’ll have to tweak the ones you made last week!), offers strategies for eating healthy even when you’re pressed for time, and explains why cooking for yourself is a key factor in changing nutritional habits.

What are some examples of smaller, more manageable, goals that could help someone make better food choices?

People often jump in too hard, too fast when creating New Year’s resolutions. This perfectionist and “all or nothing” attitude tends to result in grand, lofty goals that we quit if we have a setback or don’t see immediate results. When considering health and weight loss-related goals make sure they are realistic and sustainable.

Instead, closely examine your routine and note one thing you can improve. This behavior may be something obvious, such as you drinking soda every day and wanting to stop. Or, it could be an aspiration to make healthy habits more sustainable, for example, bringing your lunch to work so you can lose weight and save money. Those who already eat well and exercise regularly may want to adopt a goal on a larger scope and learn to cook or try a new form of exercise.

Pick one thing (just one!) and make sure it is SMART – specific, measurable, achievable, results-focused and time-bound. Pick a resolution that is within reach, yet a bit of a stretch so that it’s a challenge. Additionally, goals should lead towards creating a sustainable habit. Some ideas include: Bring your lunch to work Monday-Thursday for the entire month of January; eat five fist-sized servings of vegetables every day; drink coffee only at breakfast; go to sleep at at the same time every night and wake up at the same time every morning for the month of January; or do 30 minutes of weight training three times a week.

In an effort to slim down in the New Year, some individuals may go on the Atkins diet and other popular weight-loss plans, or decide to do a juice fast, like the Master Cleanse. What’s your advice for those considering these approaches?

It’s very difficult to change someone’s mind when they decide to try these types of weight loss plans. So I usually say, “Go for it!” After a few days, the person often feels miserable and wants to create a long-term plan for managing their weight. I will say the one benefit of these quick fixes and fad diets, which I do not endorse, is that they teach a person what it feels like to be hungry. This may sound strange, but this awareness is an important lesson.

Many people overeat and are used to eating to avoid being hungry. We also tend to mindlessly eat out of boredom, or simply because food is in front of us. Going on a restrictive diet results in some feeling hungry for the first time in long time and, as a result they learn their hunger cues. When you experience a hunger cue, which is right when you think “I could eat,” then you should eat just enough food to get through the next three to four hours. You don’t need a huge meal to feel stuffed and small; unsatisfying snacks aren’t helpful either. Understanding what it feels like to be satiated is very important for long-term success.

Ongoing research at the Stanford Prevention Research Center shows that “one diet really does not fit all.”  So I can’t tell you exactly what to eat, but I can tell you that creating a long-term sustainable plan is key.

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Chronic Disease, Nutrition, Obesity, Videos

The role of nutrition in diabetes prevention and management

The role of nutrition in diabetes prevention and management

Can certain diets help patients prevent or manage their diabetes? Which foods are best for diabetics and which ones should they avoid? If you increase your coffee consumption, will it reduce your risk of diabetes? Kathleen Kenny, MD, a clinical associate professor at Stanford, and Jessica Shipley, a clinical dietitian at Stanford Hospital & Clinics, answered these questions and others about diabetes and nutrition in a recent Stanford Health Library talk.

In the above video, Kenny and Shipley also discuss the glycemic index and how it should be used to tailor dietary choices; examine how Mediterranean, low-carb and low-calorie diets affect diabetes; and explain how eating healthy can prevent or reverse the disease. The lecture is a must-watch for anyone wanting to make healthier food choices to benefit their health.

This video is the final lecture in a three-part series addressing important questions related to diabetes and lifestyle choices.

Previously: Diabetes and nutrition: Healthy holiday eating tips, red meat and disease risk, and going vegetarian, Diabetes and nutrition: Why healthy eating is a key component of prevention and management, Diabetes self-management program helps at-risk teens and their families make healthier choices and New evidence for a direct sugar-to-diabetes link, Examining how diet soft drinks impact your health

Mental Health, Nutrition

Eating healthy, managing stress, and staying well during the holidays: A round-up of experts’ tips

dog in Santa hat - smallOver the last five years, since Scope launched in 2009, we’ve published many holiday-themed posts. This year, we’re collecting the best of them in one place, and they include tips about eating well, exercising and managing stress during the holidays, as well as healthy ways to kick off your new year.

Eating healthy during the holidays

Managing holiday stress

Starting the new year off right

Other holiday themes

Photo by starsandspirals

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