Allergic Living Summer 2012_US by Allergic Living

HOW TO STOP TOXIC MOLD • GLUTEN’S LINK TO MIGRAINES ALLERGIES, ASTHMA & GLUTEN-FREE

Allergic Nanny Jo: My Allergies Require Discipline!

Living SUPER SUMMER RECIPES

TV’s parenting guru on allergy attitudes, food bullying and her new show

TURBULENCE OVER NUTS IN THE SKIES ‘I CAN REALLY BREATHE’ – THE JOY OF ASTHMA CONTROL

CELIAC & YOUR LOVE LIFE If your libido is lacking, gluten may be to blame

SUMMER 2012 $5.95

Be more. You can live life with severe asthma.

Itâ&#x20AC;&#x2122;s about years of control.

Donâ&#x20AC;&#x2122;t count the hours, count the years. Bronchial Thermoplasty is an innovative non-drug procedure for adults that reduces the risk of severe asthma attacks, ER visits, hospitalizations and missed daily activities due to asthma. Be more. You can start taking your life back today. Learn more at: www.BTforAsthma.com/ADP4 Brief Statement of Relevant Indications for Use, Contraindications, Warnings, and Adverse Events: The Alair Bronchial Thermoplasty System is indicated for the treatment of severe persistent asthma in patients 18 years and older whose asthma is not well controlled with inhaled corticosteroids and long acting beta agonists. The Alair System is not for use in patients with an active implantable electronic device or known sensitivity to medications used in bronchoscopy. Previously treated airways of the lung should not be retreated with the Alair system. Patients should be stable and suitable to undergo bronchoscopy. The most common side effect of bronchial thermoplasty is an expected transient increase in the frequency and worsening of respiratory-related symptoms. Results from case studies are not predictive of results in other cases. Results in other cases may vary. ÂŠ 2012 by Boston Scientific Corporation or its affiliates. Alair and are unregistered or registered trademarks of Boston Scientific Corporation or its affiliates. Alair Bronchial Thermoplasty is complementary to, and not a replacement for, conventional drug therapy. Bronchial thermoplasty is an add-on therapy to current asthma medications. CAUTION: Law restricts this device to sale by or on the order of a physician. Indications, contraindications, precautions and warnings can be found with product labeling. ENDO-66504-AA March 2012

Allergic

Living

contents ALLERGIC LIVING SUMMER 2012 • VOLUME 2, ISSUE 2

COVER STORY 18 This Allergic Life

TV parenting expert Jo Frost, aka Nanny Jo, speaks out about serious allergies, with firm expectations that others respect them. BY GWEN SMITH

Features 14 I ‘Thought’ I Had Control

Real-life stories of how four adults finally got to breathe freely. BY CLAIRE GAGNÉ

26 Celiac & Your Love Life Allergic Living talks about what many will not: how celiac disease can affect your libido. LISA FITTERMAN

52 Flying Into Stormy Skies Inconsistent policies and bad treatment are driving food-allergic travelers nuts.

BY GWEN SMITH

56 What My Kids Taught Me As An Allergist She had all the medical training, but when her own son was diagnosed with food allergies, her world crumbled. BY SARAH BOUDREAU-ROMANO

52 Return undeliverable addresses to Allergic Living magazine, P.O. Box 1042, Niagara Falls, NY 14304 3

"Before our carpet made the room look messy even when it wasn't, but now the room looks open, clean, and inviting." Actual Customer, CA

in This is whattâ&#x20AC;&#x2122;s your carpe !

Angel Fire Cherry 20 Year Warranty

For a FREE catalog or store near you, call 1-800-HARDWOOD or visit lumberliquidators.com

CONTENTS

Environmental Allergies

Notables 6

33 Healthy Home

Editor’s Letter

11 Beach Party Picnic gear for the allergy-safe outing; our editors’ top sunscreen picks.

12 Road Trip! Allergen-free, gluten-free snacks that are perfect for your summer car cruise.

Got mold? We’ve got the scoop on how to rid it from your home. BY JENNIFER VAN EVRA

Columns 22 The Food Allergy Experts Questions on: teens and kissing, the safety of goat’s milk, and the myth of worsening of food allergies.

13 Cool Finds Dairy-free cheese wedges and shreds; products for eczemaprone skin. Plus: the purifier for your car.

38-41 Allergy News Food allergy groups unite, migraines linked to celiac, Texas students get allergy policies, and the dustup over an “almost” gluten-free pizza crust.

37 FAAN Views FAAN’s Maria Acebal has a frank view on camps that won’t administer auto-injectors.

42 Ask the Allergy & Asthma Expert Answers on: asthma coming back as an adult; the benefits of breathing through the nose.

55 Parenting Coach Gina Clowes’ practical guide for airplane travel with allergic kids.

66 Our Story By jumping out of a plane, my daughter showed me the importance of enjoying life, even with allergies.

Allergy-Safe Food 60 Best of the Med Chef Simon brings an allergy-safe, gluten-free twist to the deliciously healthy Mediterranean diet. BY SIMON CLARKE

Living Gluten-Free 31 Celiac Central NFCA’s Alice Bast has a fun way to explain the gluten-free diet to kids.

44 Celiac Expert

Shelley Case shares her favorite gluten-free reads for summer.

47 Strawberries ’n Cream Watermelon Pops Strawberries and watermelon are paired for a tempting dairy- and gluten-free frozen treat. The secret? Coconut cream.

ON THE COVER Photo by Jeff Newton Hair styling: Tab Salsman Makeup: Lindsay Lowe Shot on location near Los Angeles, California

BY ALISA FLEMING

50 Gluten-Free Girl Shauna James Ahern marvels at the advent of the gluten-free menu.

ALLERGIC LIVING | SUMMER 2012

EDITOR’S NOTE | GWEN SMITH

Flying: Let’s Talk ome people are a pleasure to interview since they’re full of positive energy, good humor and can-do spirit. Jo Frost, who became famous as television’s Supernanny, is what we in the journalism biz call “a good talker” – lively, talkative, engaged in life. There she was, telling me all about her asthma and allergies and how she manages them while living in other people’s homes for her TV work. (See “This Allergic Life,” page 18.) Then quite inadvertently, I hit a nerve. I simply asked: How does she find accommodations for allergies these days? Her answer turned into a blistering tale of poor treatment on a flight when Frost asked a flight attendant if it was OK to ask people sitting near her in the first-class section not to eat nuts. Frost, who is severely allergic, was told absolutely not or she’d be asked to leave the plane. “It was like it was this self-indulgent fad, as if I’d invented it to maintain some kind of attention-seeking. It was absolutely awful,” said Frost. As it happened, I was already writing an article for this issue (“Flying Into Stormy Skies” page 52) about the growing chorus of unhappy tales when it comes to airlines and nut- and peanut-allergic passengers. Frost had another story in a recurring theme: customers feeling that the airlines are not on their side when it comes to accommodating nut allergies in particular (there has been some progress on peanuts). I can tell you from the personal experience of having a flight canceled and being hurriedly put on another carrier’s plane (with no time to check allergy policies) that it is unsettling to see an allergen that can kill you being passed out to every other passenger at 35,000 feet. (In my case, it was peanut snacks.) I’m usually calm about not expecting a problem unless I eat an allergenic food, but I felt hyper-aware of the chomping all around me. How much residue was everywhere? What if I needed to use the restroom? The airlines are very attached to serving tree nuts as a premium snack. But come on folks – it’s a snack, alternatives could be considered. What about the health and safety of nut- and peanut-allergic travelers – most fatalities are caused by the ingestion of either of those allergens – and what about their comfort? Most of us in the allergy community aren’t even calling for outright bans, we’re just asking: could we forego these allergenic snacks on flights we’ll be on if we give you advance warning? It concerns me that we already have three studies about the issue of whether allergic reactions are happening in-flight and the answer is that yes, they are. In a 2009 study, one in three of the reactions reported by passengers showed the symptoms of ana-

6 ALLERGIC LIVING | SUMMER 2012

phylaxis, the severe form of reaction. Plus, there are numerous anecdotal passenger reports of reactions. It’s time the airlines took a serious look at this issue, let’s not wait for a tragedy. Airlines still pride themselves on customer service, and with 15 million Americans with food allergies and their family members affected, that’s a lot of passengers with the same issue. It’s time to open a dialogue about how we make this vulnerable population feel safe when they’re just trying to travel like everyone else. Allergic Living would like to get that conversation rolling. Tell us your stories of traveling with food allergies. Have you had a reaction? Felt at risk? Been asked to get medical clearance? We’re collecting these stories editor@allergicliving.com to share with the airlines. And meantime, my advice is to try to choose an allergy-aware airline when possible. To assist you, our editors have built a thorough resource – the “Comparing Airlines” chart at www.Allergicliving.com/airlines, which details the allergy policies of 12 airlines. I wish you safe journeys this summer. Just be sure to confirm accommodation practices ahead of time – and bring food, auto-injectors and lots of wipes.

Tell Us Your Views Online! Visit Allergicliving.com Facebook.com/Allergicliving and see us on Twitter.

Photo: GEOFF GEORGE

Gwen Smith Editor

If your child is at risk for anaphylaxis...

and ask yourself: Are they prepared for a life-threatening allergic reaction?

For children at risk for anaphylaxis, being ready for back-to-school means being ready with EpiPenÂŽ Auto-Injector s ! RECENT STUDY FOUND THAT IN 5 3 CHILDREN SUFFER FROM A FOOD ALLERGYÂ&#x2C6;A CONSIDERABLE INCREASE FROM PREVIOUSLY REPORTED l GURES s 5P TO OF CHILDREN WITH FOOD ALLERGY HAVE EXPERIENCED A REACTION IN SCHOOL s 4HE MOST COMMON FOOD ALLERGIES IN CHILDREN ARE PEANUTS MILK AND SHELLl SH FOLLOWED BY TREE NUTS AND EGG EpiPenÂŽ and EpiPenÂŽ Jr are intended for immediate self-administration as emergency supportive therapy only. Seek immediate emergency medical treatment after use.

Important Safety Information EpiPen Auto-Injectors contain a single dose of epinephrine, which you inject into your outer thigh. DO NOT INJECT INTRAVENOUSLY. DO NOT INJECT INTO YOUR BUTTOCK, as this may not be effective. In case of accidental injection, please seek immediate medical treatment. Epinephrine should be used with caution if you have heart disease or are taking certain medicines that can cause heartrelated (cardiac) symptoms. If you take certain medicines, you may develop serious life-threatening side effects from the epinephrine in EpiPen Auto-Injectors. Be sure to tell your doctor all the medicines you take, especially medicines for asthma. Side effects may be increased in patients with certain medical conditions, or who take certain medicines. These include asthma, allergies, depression, thyroid disease, Parkinsonâ&#x20AC;&#x2122;s disease, diabetes, high blood pressure and heart disease. The most common side effects may include increase in heart rate, stronger or irregular heartbeat, sweating, nausea and vomiting, difficulty breathing, paleness, dizziness, weakness or shakiness, headache, apprehension, nervousness or anxiety. These side effects usually go away quickly, especially if you rest. Talk to your healthcare professional to see if EpiPen or EpiPen Jr Auto-Injector is right for you. You are encouraged to report negative side effects of prescription drugs to the FDA. Visit www.fda.gov/medwatch or call 1-800-FDA-1088.

Indications EpiPen and EpiPen Jr (0.3 and 0.15 mg epinephrine) Auto-Injectors are for the emergency treatment of life-threatening allergic reactions (anaphylaxis) caused by allergens, exercise, or unknown triggers; and for people who are at increased risk for these reactions. EpiPen and EpiPen Jr are intended for immediate self-administration as emergency supportive therapy only. Seek immediate emergency medical treatment after use.

0LEASE SEE BRIEF SUMMARY OF THE FULL 0RESCRIBING )NFORMATION ON ADJACENT PAGe.

Visit epipen.com or call (855) 2-EPIPEN for more information. Talk to your health care professional to see if EpiPen or EpiPen Jr Auto-Injector is right for you. DEYÂŽ and the Dey logo are registered trademarks of Dey Pharma, L.P. EpiPenÂŽ, EpiPenÂŽ Jr, EpiPen 2-PakÂŽ, and EpiPen Jr 2-PakÂŽ are registered trademarks of Mylan Inc. licensed exclusively to its wholly-owned subsidiary, Dey Pharma, L.P. ÂŠ 2011. Dey Pharma, L.P. All rights reserved. 07/11 EPI11-1026

Life happens. Be prepared.

BRIEF SUMMARY OF PATIENT INFORMATION Please read this information before using EpiPenÂŽ Auto-Injector. Consult the Patient Insert for complete patient information. This information does not take the place of talking with your healthcare professional about EpiPen. If you have any questions about EpiPen ask your healthcare professional. IMPORTANT INFORMATION The patient and caregiver should read this information carefully before using EpiPenÂŽ or EpiPenÂŽ Jr AutoInjector. Please be prepared! Read the entire insert before an emergency occurs! EpiPenÂŽ and EpiPenÂŽ Jr Auto-Injectors are disposable, prefilled automatic injection devices for use during allergic emergencies. They contain a single dose of epinephrine which you inject into your outer thigh. EpiPenÂŽ and EpiPenÂŽ Jr Auto-Injector contain no latex. The EpiPenÂŽ and EpiPenÂŽ Jr Auto-Injectors are intended for people who have been prescribed this medication by their physician. Itâ&#x20AC;&#x2122;s important that you have this emergency medicine with you at all times. If you need additional units to keep at work, school, etc, please talk to your doctor. This information does not take the place of talking with your doctor about your medical condition or your treatment. What is the most important information I should know about EpiPenÂŽ and EpiPenÂŽ Jr Auto-Injector? When you have allergic reaction (anaphylaxis) use the EpiPenÂŽ or EpiPenÂŽ Jr Auto-Injector right away and immediately go to your doctor or emergency room for more medical treatment. s )T IS IMPORTANT NOT TO BE AFRAID TO USE THE %PI0ENÂŽ or EpiPenÂŽ Jr Auto-Injector for emergency treatment of allergic reactions (anaphylaxis). For most people, injection of the EpiPenÂŽ or EpiPenÂŽ Jr Auto-Injector in the thigh does not hurt, and use of the EpiPenÂŽ or EpiPenÂŽ Jr Auto-Injector early at the start of such allergic reactions is important to help prevent the allergic reaction from becoming worse. s )NJECT %PI0ENÂŽ or EpiPenÂŽ Jr Auto-Injector into the middle of the outer side of the thigh (upper leg). s %PINEPHRINE THE ACTIVE INGREDIENT IN %PI0ENÂŽ and EpiPenÂŽ Jr Auto-Injectors is used to treat life-threatening allergic reactions (anaphylaxis). You should use this medication only if your doctor has prescribed it for allergic emergencies. Such emergencies may occur from insect stings or bites, foods, drugs, latex, other allergens, exercise induced anaphylaxis, or unknown causes. s -AKE SURE TO TELL YOUR DOCTOR ABOUT ALL YOUR MEDICAL conditions and allergies. s !LWAYS GET MEDICAL TREATMENT IMMEDIATELY AFTER using EpiPenÂŽ or EpiPenÂŽ Jr Auto-Injector. Since you cannot predict when a life-threatening allergic reaction may occur, carry the EpiPenÂŽ or EpiPenÂŽ Jr Auto-Injector with you at all times. What is EpiPenÂŽ/EpiPenÂŽ Jr Auto-Injector? The EpiPenÂŽ and EpiPenÂŽ Jr Auto-Injectors are products used for the emergency injection of epinephrine. Epinephrine is a medicine used for life-threatening allergic reactions such as severe swelling, breathing problems, or loss of blood pressure. Allergic reactions can be caused by stinging and biting insects, allergy injections, food, medicines, exercise, or unknown causes. Life-threatening allergic reactions may show up as closing of your breathing airways, wheezing, sneezing, hoarseness, hives, itching, swelling, skin redness, fast heartbeat, weak pulse, feeling very anxious, confusion, stomach pain, losing control of urine or bowel movements (incontinence), faintness, or â&#x20AC;&#x153;passing outâ&#x20AC;? (unconsciousness).

The EpiPenÂŽ Auto-Injector (0.3 mg) is generally intended for patients who weigh 66 pounds or more (30 kilograms or more). The EpiPenÂŽ Jr Auto-Injector (0.15 mg) is generally intended for patients who weigh approximately 33 to 66 pounds (15 to 30 kilograms). Who should not use EpiPenÂŽ/EpiPenÂŽ Jr Auto-Injector? There are no absolute contraindications to the use of EpiPenÂŽ and EpiPenÂŽ Jr Auto-Injector in a life-threatening allergic reaction. People with certain medical conditions have a higher chance of having serious side effects from EpiPenÂŽ or EpiPenÂŽ Jr Auto-Injector. Tell your doctor and pharmacist about all your medical conditions, but especially if you: s (AVE HEART DISEASE OR HIGH BLOOD PRESSURE s (AVE DIABETES s (AVE THYROID CONDITIONS s !RE PREGNANT Tell your doctor about all the medicines you take, including prescription and non-prescription medicines, vitamins and herbal supplements. Inform your doctor of all known allergies. Some medicines may cause serious side effects if taken while you use EpiPenÂŽ/EpiPenÂŽ Jr Auto-Injector. Some medicines may affect how EpiPenÂŽ/EpiPenÂŽ Jr Auto-Injector works. EpiPenÂŽ or EpiPenÂŽ Jr Auto-Injector may affect how your other medicines work. What should I avoid while using EpiPenÂŽ/EpiPenÂŽ Jr Auto-Injector? s .%6%2 054 4(5-" &).'%23 /2 (!.$ /6%2 /2!.'% 4)0 .%6%2 02%33 /2 053( /2!.'% 4)0 7)4( 4(5-" &).'%23 /2 (!.$ The needle comes out of orange tip. Accidental injection into finger, hands or feet may result in loss of blood flow to these areas. If this happens, go immediately to the nearest emergency room. s $O NOT INJECT %PI0ENÂŽ or EpiPenÂŽ Jr Auto-Injector into the buttock or any other part of the body, other than the middle of the outer side of your thigh (upper leg). s $O NOT INJECT %PI0ENÂŽ or EpiPenÂŽ Jr Auto-Injector into a vein. s $O NOT DROP CARRIER TUBE OR AUTO INJECTOR )F CARRIER tube or auto-injector is dropped, inspect for damage AND LEAKAGE $ISCARD AUTO INJECTOR AND CARRIER TUBE and replace if damage or leakage is noticed or suspected. What are the possible side effects of EpiPenÂŽ/ EpiPenÂŽ Jr Auto-Injector? Too much epinephrine can cause dangerous high blood pressure or stroke. If you take certain medicines, you may develop serious life-threatening side effects from the epinephrine in EpiPenÂŽ/EpiPenÂŽ Jr Auto-Injector. Be sure to tell your doctor all the medicines you take, especially medicines for asthma. Patients with certain medical conditions, or who take certain medicines, may get more side effects from EpiPenÂŽ/EpiPenÂŽ Jr Auto-Injector or the side effects may last longer. This includes patients who take certain types of medicines for asthma, allergies, depression, low thyroid, high blood pressure, and heart disease. Patients with heart disease may feel chest pain (angina). EpiPenÂŽ/EpiPenÂŽ Jr Auto-Injector (epinephrine) can cause the following reactions. Some reactions can be serious. They usually go away with rest. Please notify your doctor if you experience any of these. Common side effects of EpiPenÂŽ/EpiPenÂŽ Jr Auto-In-

jector include: s &ASTER IRREGULAR WRONG OR hPOUNDINGv HEARTBEAT s 3WEATING s .AUSEA AND VOMITING s "REATHING PROBLEMS s 0ALENESS s $IZZINESS s 7EAKNESS OR SHAKINESS s (EADACHE s &EELINGS OF OVER EXCITEMENT NERVOUSNESS OR ANXIETY These are not all the possible side effects of EpiPenÂŽ/ EpiPenÂŽ Jr Auto-Injector. For more information, ask your doctor or pharmacist. Call your doctor for medical advice about side effects. 9OU MAY REPORT SIDE EFFECTS TO &$! AT &$! (OW SHOULD ) STORE %PI0ENÂŽ/EpiPenÂŽ Jr Auto-Injector? s +EEP THE %PI0ENÂŽ and EpiPenÂŽ Jr Auto-Injector nearby and ready for use at all times. s 3TORE AT ÂŞ# ÂŞ & EXCURSIONS PERMITTED TO ÂŞ # ÂŞ# ÂŞ& ÂŞ & 3EE 530 #ONTROLLED 2OOM 4EMperature). Contains no latex. Protect from light. s $O ./4 store in refrigerator. s $O ./4 expose to extreme cold or heat. For examPLE DO ./4 STORE IN YOUR VEHICLE S GLOVE BOX s %XAMINE CONTENTS IN CLEAR WINDOW OF AUTO INJECTOR periodically. If the solution is discolored or contains solid particles (precipitate), replace the unit. Solution should be clear. s Always keep your EpiPenÂŽ or EpiPenÂŽ Jr AutoInjector in the carrier tube with the blue safety release on until you need to use it. Your auto-injector has an expiration date. s %XAMPLE h$%# v $ECEMBER s 2EPLACE IT BEFORE THE EXPIRATION DATE To dispose of the expired units s %XPIRED AUTO INJECTORS MUST BE DISPOSED OF PROPERLY s 4O DISPOSE OF AN EXPIRED AUTO INJECTOR AND CARRIER TUBE TAKE THEM TO YOUR DOCTOR S OFlCE OR A HOSPITAL FOR proper disposal. s 5SED AUTO INJECTOR WITH EXTENDED NEEDLE COVER WILL not fit in carrier tube.

)--%$)!4%,9 !&4%2 53%

s 'O IMMEDIATELY TO THE NEAREST HOSPITAL emergency room or call 911. You may need further medical attention. Take your used auto-injector with you. s 4ELL THE DOCTOR THAT YOU HAVE RECEIVED AN INJECTION of epinephrine in your thigh. s 'IVE YOUR USED %PI0ENÂŽ/EpiPenÂŽ Jr Auto-Injector to the doctor for inspection and proper disposal.

$O NOT ATTEMPT TO TAKE THE AUTO INJECTOR APART

-ANUFACTURED FOR $EY 0HARMA , 0 BY -ERIDIAN -EDICAL 4ECHNOLOGIESÂŠ )NC #OLUMBIA -$ USA. A subsidiary of King PharmaceuticalsÂŽ Inc. EpiPenÂŽ is a registered trademark of Mylan, Inc. licensed exclusively to its whollyÂˇowned affiliate, $EY 0HARMA , 0 $ESIGN AND 5TILITY PATENTS APPLIED FOR #ARRIER 4UBE and Auto-Injector design platform. #

Allergic

AGW MEDIA INC. Peter Wilmshurst

Living

PUBLISHER / ADVERTISING DIRECTOR

SUMMER 2012 VOLUME 2, ISSUE 2

www.allergicliving.com

peter@allergicliving.com 416-766-4273 Erin Stevenson OFFICE MANAGER

Gwen Smith

info@allergicliving.com 1-888-771-7747

EDITOR

Claire Gagné

Giselle Sabatini

SENIOR EDITOR

ART DIRECTOR

Simon Clarke

Travis Brown

Erin Stevenson

FOOD EDITOR

TECHNICAL DIRECTOR

WEBSITE COORDINATOR

Jenny Kales, Pamela Lee

Patrick Bennett

Susan Clemens

ASSOCIATE EDITORS

RESEARCH

WEB FORUM MODERATOR

SUBSCRIPTIONS

www.allergicliving.com (“subscribe/renew”) or contact: info@allergicliving.com 1-888-771-7747 P.O. Box 1042 Niagara Falls, NY 14304 Allergic Living™ is published four times a year (spring, summer, fall, winter). By subscription: $19.99 for 1 year; newsstand price $5.95. Working in cooperation with:

MEDICAL CONTRIBUTORS

Dr. Clifford Bassett, Medical Director, Allergy & Asthma Care of New York; Dr. Paul Ehrlich, President, New York Allergy & Asthma Society, New York; Dr. Hemant Sharma, Associate Chief, Division of Allergy and Immunology, Children’s National Medical Center, Washington; Dr. Scott Sicherer, Chief, Division of Allergy and Immunology, Mount Sinai School of Medicine, New York; Dr. Sandra Skotnicki, Bay Dermatology Centre, Toronto. EXPERT CONTRIBUTORS

Maria Acebal, CEO, FAAN; Alice Bast, President, NFCA; Shelley Case, RD; Gina Clowes, Allergymoms.com WRITERS AND PHOTOGRAPHERS

Susan Ashukian, Mary Esselman, Lisa Fitterman, Alisa Fleming, Janet French, Chris Gonzaga, Shauna James Ahern, Jaclyn Law, Sloane Miller, Mireille Schwartz, Sarah Scott, Davey Thompson, Jennifer Van Evra

The articles in Allergic Living are meant to inform readers, but in no way constitute diagnosis or medical advice. See your physician or specialist for advice. The publisher accepts no responsibility for advertiser claims. Copyright AGW Media Inc. No part of this magazine may be reproduced without permission.

V W Q X D H S 1R V X W Q H H 1R WU H P E O U R S 1R

Follow SunButter on Facebook.com/sunbutter Twitter.com/sunbutter4life

6XQ%XWWHU FRP We grind specially selected US grown sunflower seeds into a nutritionally packed spread thatâ&#x20AC;&#x2122;s a direct replacement for peanut butter.

ALLERGY SHOTS

BeachParty Grab the sunhats, it’s time for some serious fun by the water. We’ve got the fashionable picnic gear that’s just perfect for your allergysafe or gluten-free picnic lunch. Have a fabulous day! –Jenny Kales

Picnic Perfect

Go Green

You’ll love the eco-friendly Newberry Picnic Basket from Picnic Time. Tucked inside the lined, plaid interior of this attractive willow carrier is a reusable dinner service for four, a deluxe corkscrew and salt and pepper set. Just add gourmet goodies. $129.95, see www.picnicworld.net.

Enjoy a family outing with the colorful Collapsible Picnic Basket from Crate and Barrel. The insulated bag folds flat for space-saving storage and is waterproof, PEVA-lined and PVC free. $34.95/18.5 W x 11.5 D x 10.5 H. See www.crateandbarrel.com.

Retro Chic

Chill Out

The 1950s-inspired Picnic Cooler from Crate and Barrel may well be the coolest on the beach. Roomy and easy-to-carry, this steel tote sports a locking handle, convenient bottle opener, and chrome accents and shiny finish (reminiscent of a classic car). $62.95/14 W x 9 D x 11.5 H. See www.crateandbarrel.com.

Keep your favorite free-from foods cold (or hot) with Vacuum Insulated Food Jars from Thermos. The portable size is perfect for a picnic tote. With their sleek stainless steel designs and two convenient sizes, you’ll want to take these versatile jars everywhere. BPA-free. $21.99/10 oz; $24.99/16 oz at Target stores or see www.thermos.com.

SUNNING SAFELY HEY, BABY Award-winning Super Sensitive Sunscreen from California Baby is fragrance-free and formulated for delicate skin with no PABA or chemicals. Plus it’s free of peanuts, gluten, soy and dairy. Eco-friendly and 100% organic, this water-resistant sunscreen is perfect for all ages. $19.99/ 9 oz at Target stores and www.californiababy.com.

GOOD SCENTS SENSITIVE SIDE Keep the sun in check with Sensitive Skin SPF 60 Sunscreen from Vanicream. Gentle and non-irritating, this PABA-free sun defense protects ultra-sensitive skin without chemicals, fragrance or preservatives. Also free of gluten and nut oils with extra-effective UV blocking from zinc oxide. $16.99/4 oz in Walgreens stores or see www.drugstore.com.

Protect your skin with Natural Very Emollient Sunscreen in Pure Lavender SPF 45 from Alba Botanica. This lightly fragranced, organic, UVblocking formula soothes and moisturizes with ingredients like green tea extract, aloe and chamomile. It’s water-proof, gluten-free, peanut-free and 100% vegan, with no parabens or PABA. $10.99/4 oz in stores or see www.albabotanica.com.

ALLERGIC LIVING | SUMMER 2012

ALLERGY SHOTS

ROADTRIP! Crank up the tunes and check out some of our favorite allergy-friendly, GF snacks for your summer driving adventure. –Jenny Kales

Lentil Love

Nacho Heaven

New Plentils from Enjoy Life Foods get their crispy texture and savory flavor from a hearthealthy blend of lentils, rice and potato starch. Available in four taste-tempting varieties including Margherita Pizza and Light Sea Salt, Plentils are gluten-free and free of the top 8 most common food allergens. $3.99/4 oz For stores, see http://plentils.com.

Beanfields’ new Nacho Bean and Rice Chips offer an allergy-friendly take on a snack time classic. Made from a delicious blend of fiber-rich beans and rice, the chips are free of gluten and the top 8 most common food allergens, plus no fat, cholesterol or GMOs. We think the chips that snapped up “Best of Show” at the Natural Products Expo West this year are worth a few crumbs on the car floor. $3.49/6 oz. For retailers or to order online see http://beanfieldssnacks.com.

Funky Fruit Tasty Twist

For a kid-friendly sweet treat, pack along Funky Monkey Snacks. These organic, non-GMO fruit snacks are freeze-dried for a unique texture and crunch, and made in a free-from facility with none of the top 8 food allergens or gluten. Try seven fun flavors including Applemon (apple and cinnamon) and Carnaval Mix (banana, pineapple, apple and papaya). Also, no sugar or preservatives added. $2.49/1 oz. For stores see www.Funkymonkeysnacks.com.

Gluten-free Ener-G Wylde Pretzels are made from an appealing blend of potato, corn and rice flour for yummy taste and texture. A great take-along treat, they’re also free of dairy, soy, peanut, tree nut and egg. May contain sesame. $2.19/113 g in select stores; see www.ener-g.com for retailers.

Gourmet Grains A scrumptious spin on the traditional chip, Gourmet Brown Rice Crisps from Riceworks have a crisp crunch from being baked, and then fried in fat-free sunflower or safflower oil. Free of gluten, wheat, peanuts, tree nuts and eggs and made from a wholesome brown rice base. Five flavors including Salsa Fresca and Parmesan. Contains sesame. $2.99/156 g in stores nationwide. $2.99/5.5 oz. See www.riceworks.com. 12 ALLERGIC LIVING | SUMMER 2012

SUMMER’S DELIGHT At the height of summer, beat the heat with Philly Swirl’s Swirl Stix. The ingredients of each swirl of fat-free Italian ice create a deliciously refreshing frozen treat that’s free from the top 8 most common food allergens and gluten. Enjoy six mouth-watering flavors such as Orange Dream, Banana Split and Rainbow. $2.99/ 12 (21 oz) pops in stores nationwide. See www.phillyswirl.com.

ALLERGY SHOTS

SAY CHEESE, WITHOUT THE COW Turn up the volume on sandwiches and wraps with Daiya Wedges, an exciting new sliceable dairy-free cheese alternative in three delish flavors: Jack, Cheddar and Jalapeno Havarti. These wonderful wedges are free as well of soy, gluten, eggs, peanuts and tree nuts; they do contain coconut (not considered a tree nut by most allergists). $4.99/ 7.1 oz at natural foods stores. See www.daiyafoods.com. New Vegan Shreds from Galaxy Nutritional Foods add authentic-tasting flavor to your favorite recipes; try them with burritos or melted on pizza. Completely dairy-free (casein-free and lactose-free), soy-free and gluten-free, these great-tasting shreds are available in two flavors: Mozzarella and Mexican. $3.99/8 oz. At natural foods stores; see www.GalaxyFoods.com. –Jenny Kales

FRESH CAR SMELL W

hen pollen, smog and mildew get trapped in the small space of a car, that spells bad news for passengers with asthma or allergies. To the rescue: the Philips GoPure automotive clean air system, an affordable portable air purifier that boasts a three-stage air filtering process that eliminates harmful gases, pollen, mildew, bacteria, smoke (never in the car!) and dust. It also removes that hazardous “new car smell” composed of toxic VOCs. The device mounts easily on a dash or seatback and the filter is a breeze to change. Just install and enjoy the ride. $199 US at Amazon.com. –Erin Stevenson

TEEN SKIN WIN Following are great products for youngadult skin prone to eczema. Patch test to find the right one for you. Send VMV Hypoallergenics your skin patch test results and they’ll send back a customized list of safe products. Red Better Flare-up Balm ($50/0.88 oz) and Red Better Daily Therapy Moisturizer ($34/4 oz) reduce redness, flaking and irritation without using steroids. See www.vmvhypoallergenics.com.

Physician’s Formula’s new line for sensitive, red skin is clinically proven to help skin health. Includes: Redness Relief Cleanser $11.95/5 oz), Redness Correcting Moisturizer ($19.95/1.7 oz), Redness Relief Moisturizer ($19.95/1.7 oz) and Instant Skin Calming Spray, ($19.95/4 oz). Available at Walmart.

Sudocrem is sold as a diaper cream, but it works for eczema and acne, too. Thick creams like this act as a protective barrier. $7.99/125 g at www.ledahealth.ca. Also at Amazon.com.

British-based Simple’s affordable line ($4.97-$9.99) has a wide assortment of products from Moisturizing Facial Wash to Vital Vitamin Day cream with SPF15, with no dyes, perfumes or harsh irritants. Available at Walmart and Target.

The Seaweed Bath Company employs the healing effects of seaweed and natural oils. Well worth a try are the Wildly Natural Seaweed Powder Baths ($19.89/16.8 oz.) and Wildly Natural Seaweed Butters ($12.89/2 oz). See www.theseaweedbathco.com. –Pamela Lee ALLERGIC LIVING | SUMMER 2012

‘I Thought I Had Control’ After years of strained breathing and missing out in life, adults with asthma discover the incredible freedom of disease management. by CLAIRE GAGNÉ

14 ALLERGIC LIVING | SUMMER 2012

Photo: KELLY KERR

s young as 4 years old, Eric Himan remembers not being able to catch his breath. At night, he would go see his grandmother – Himan was raised by his father and his grandparents after his mom died when he was very young. She would give him a “cough-syrup” type of medication and rub his back until he fell back to sleep. Himan’s father was in the military and when the boy was about 7 years old, the family moved to Hawaii. He clearly recalls stepping off the airplane and a lei being placed around his neck. “Within a minute I dropped to my knees because my chest hurt so bad,” he says. His family began screaming: “Get that lei off of him!” Today, Himan is 33 and an accomplished singersongwriter based in Tulsa, Oklahoma. He has seven studio releases under his belt and plays at bars and festivals across the country. Himan has always admired large, powerful voices – he’s a fan of Aretha Franklin and the Black Crowes – and his own voice is sweetly strong. But because of his asthma, getting his sensitive lyrics out with the strength and soul he wants is something Himan has had to work hard at; he pushes himself. His touring schedule is exhausting, and his asthma flares when he’s tired. Until recently, he would step

Eric Himan (left) is no longer singing the asthma blues; Kathy Anderson is back to cycling and all her sports.

away from his band in the middle of a show, hide, and take a puff from his inhaler. This changed however, when Himan learned his asthma could be better managed. “I thought it was under control,” he says. But he learned he was taking the reliever inhaler too often, and relying on it too heavily, especially to get through a performance. Himan’s situation is a common one. Many people “think” they have their asthma under control, until they learn what true control is. Sometimes that means seeing a specialist who teaches them that they’re reaching for the reliever inhaler too frequently. Often, patients are so used to symptoms – coughing at night, having breathing difficulty during exercise and even severe attacks that land them in the hospital – that they don’t even realize things could be better. This is why Dr. Paul Garbe, director of the National Asthma Control Program at the Centers for Disease Control and Prevention, says a key aspect to asthma control is “seeing a physician for the assessment of severity of your disease, so they can determine the right medications.” The next step is regular visits to that doctor so he or she can monitor your ability to control your disease by avoiding the triggers that bring on symptoms and taking your medications properly. As 60-year-old Kathy Anderson has learned, having lived with asthma for 58 years, asthma control is also a journey. Throughout her life, there have been many instances where she controlled her asthma, and just as many where asthma controlled her. Reflecting back on her childhood, she says, “it was a completely different disease back then.” She carried an “inhaler” – a seveninch glass tube with a hand pump on the bottom – with her to grade school, wrapped in a handkerchief and placed in a purse. “I had a permanent pass to skip gym class,” says Anderson, and as controller inhalers weren’t available back in the 1960s, she often took oral steroids. Her parents moved from Pittsburgh to Arizona when she was in the eighth grade, hoping the dryer climate would help, but even there she would land in the hospital twice a year. In one attack, both her lungs collapsed, and the doctors didn’t think she was going to make it.

Kathy Anderson ran into a perfect storm of bad health: a bacterial infection in her lung, exposure to a lot of mold on a trip, and she developed whooping cough. “I was pretty sick for five years.”

After college, Anderson moved to New Jersey and “this was when the medications started changing,” she says, and her hospital visits became infrequent. As she approached age the age of 40, she became active, running and doing small triathlons. “I had 15 asthma-free years,” she says, “that coincides pretty much with the advent of the combined controllers.” Anderson is referring to medications that combine inhaled corticosteroids, which reduce inflammation, with long-acting beta-2 agonists, which open up the airways. But fast-forward to 2005, and Anderson’s asthma was thrown out of control in her mid-50s. Now living in Alaska, she experienced a “perfect storm” of health issues: she got a bacterial infection in her lung and then, to make matters worse, on a fishing trip she stayed in a damp lodge and was exposed to a lot of mold, her biggest trigger. That same year, she developed whooping cough. “I ended up pretty sick for about five years,” she says. Anderson’s asthma symptoms caused her lung to collapse regularly, and she had to give up her favorite activities: cross-country skiing, downhill skiing, running, kayaking and hiking. Her allergist sent her to see a specialist at National Jewish Health in Denver who treated the bacterial infection and prescribed Xolair, a medication that’s taken by injection for people with severe-persistent allergic asthma. Her symptoms have greatly improved, and she’s back to taking part in all her activities. Anderson credits modern medications for her asthma control. “Thank goodness for science, it’s made a tremendous difference in my life.” Modern medicine also gets the thumb’s up from Caitlin Harvey, a 27-year-old who lives just north of Montreal. Harvey was often sick with asthma as a child, and would visit the doctor’s office a few times a month for Ventolin treatments with a nebulizer. When she got older, she saw specialists at The Montreal Children’s Hospital, but the medication they had her on just never seemed to make a difference, and she gave up on it in her teens. “I thought I was doomed to spend my whole life waking up ALLERGIC LIVING | SUMMER 2012

coughing in the middle of the night or having someone haul me to the ER at all hours of the night because my rescue inhaler just never seemed to work,” she says. As a self-supporting college student, Harvey was prescribed a combination-drug Advair inhaler, but when she went to fill the prescription and saw the $100-plus price tag, she walked away. Aside from the cost, “I didn’t think it would actually work.” It wasn’t until Harvey was prescribed it again, this time covered under her soon-to-be husband’s drug insurance, that she finally started taking the medication. “I suddenly could breathe,” she says. Harvey stopped waking up coughing in the middle of the night, and she started exercising. Now the girl who was always lagging behind in gym class is a mother of three who takes karate classes and is enrolled in her first five-kilometer run. Her doctor has given her an asthma action plan, a set of written instructions that tell a patient when to increase the dose of their controller inhaler, or when it’s time to go to the hospital. Now Harvey selfregulates her asthma, increasing her dose when she feels a cold coming on, and whenever her symptoms are increasing. “It has been amazing,” she says. It’s this empowerment to manage asthma that Dr. Travis Stork, host of the television talk show “The Doctors” and a practicing emergency room physician, believes is key in living with the disease in a healthy way. “Asthma is an illness that you need to get really good management of to prevent severe and potentially lifethreatening attacks, and I think a lot of people may be naïve about what their triggers are. They might not realize that using their rescue inhaler two or three times a day means they don’t have the control they need,” he says. Stork grew up with asthma, but it’s the time he has spent in the emergency department that has really opened his eyes to the severity of the disease and the need for proper management. “For some people, asthma is just a nuisance, but for a lot of people it’s truly a life-threatening illness every day of their life.” Stork is involved in a traveling awareness campaign called The Asthma Express (the Asthma and Allergy Foundation of America and two pharmaceutical companies are partners on the project). He hopes the program will encourage people to really understand what triggers their asthma or their child’s, and to speak to a doctor about getting it under control. “For some, it may be as simple as allergen avoidance. For other people, it’s inhalers, for others, it’s a combination of medicines,” he says. “The relationship with your doctor is essential. You shouldn’t be short of breath every night before you go to bed; you shouldn’t be using your rescue inhalers five times a day. I think a lot of people are just living with poorly controlled asthma – but there are so many options out there.” Sarah Hendrickson, a 37-year old from Baltimore, feels her asthma has always been fairly well controlled – she took allergy shots as a kid and was able to play soccer as a child right through college. But recently she’s taken a next step forward: really focusing on asthma control as a lifestyle. “Healthy living is extremely important,” says Hendrickson. “It’s everything from diet, not smoking, not being around dogs that have a lot of dander, not being around cats and not being around triggers.” Hendrickson is allergic to grass and is extremely sensitive to harsh cleaning supplies, which she avoids. She exercises regularly and feels that in doing so, her legs are stronger and her lungs are stronger. 16 ALLERGIC LIVING | SUMMER 2012

Dr. Travis Stork of “The Doctors” TV show grew up with asthma, but it’s his time spent in the emergency room that has opened his eyes to the need for much better asthma management. “For some people, asthma is just a nuisance. But for a lot of people it is truly a life-threatening illness every day of their life.”

Dr. Travis Stork is a practicing ER physician as well as TV host.

FROM SICK BED TO SPORTS FIELD lisa and Michael Delia learned about asthma control not for themselves – neither has asthma – but for their son Brandon. The boy had had a dry cough since birth, but not knowing much about asthma, the couple assumed it was allergies or a cold. Then one night when Brandon was a little over a year, Elisa went to check on her son in bed and found him short of breath, his chest drawing in, and his lips turning blue. His parents rushed the boy to the emergency room, where he was diagnosed with the RSV respiratory virus, and admitted for 2½ weeks. It was after conversations with staff at the hospital that Elisa spoke to her family physician about asthma. She was given a prescription for a reliever inhaler. Still, Brandon would cough and have difficulty breathing, and for the next year, the family would travel back and forth to the emergency room. “He had an episode, we’d give him albuterol,” says his mother. “He didn’t have any maintenance drugs.” Getting a specialist involved was life-changing. Brandon was put on controller medication, and his family

The Delias with Brandon and Jaxson. Seeing a specialist was life-changing.

was given an action plan for how to manage his asthma. Brandon could even take part in sports without his parents’ constant fear of a severe attack. “We understood: if we give two puffs before he plays soccer, if we give two puffs before he plays football, he won’t drop dead on the field,” says Elisa. Brandon is now an active 9-year-

“I feel like if I am having a problem with breathing, when I run by people mowing the lawn, I feel like I can control it more because my body is stronger.” Hendrickson is training for her first full marathon in Chicago in October. She plans to cross the finish line with her arms above her head, reliever inhaler proudly in her hand. “I think if you have a focus on [controlling your asthma], and actually do what your doctor tells you to do, you can live and breathe normally,” she says. Recognizing that as a musician with asthma, he could help spread the word about asthma control, singer Himan recently offered his time to the American Lung Association and developed a public service announcement with the organization. But it was only through this collaboration that he ultimately learned that his

old, who plays rugby, football, baseball and snowboards in winter. His younger brother, Jaxson, age 3, also has asthma. But when the Delias got Jaxson’s diagnosis, they were prepared. The boy is on controller medication and is also an active child. “We are a very outdoors family. It’s really unbelievable to be able to do all of these things,” says Delia.

own asthma could be better managed. After speaking with his doctor, he is now on Singulair, an oral medication for asthma and allergies, and takes his reliever inhaler with a spacer, which has made it a lot more effective. “I definitely can see a difference,” he says. Himan is now performing two hours straight, getting through concerts “fairly easily”, without losing his voice from needing to shout out whatever his lungs had left. Now that he’s in control of his asthma, his show can go on. Write to editor@allergicliving.com to tell us your asthma control story. Or share it at Facebook.com/allergicliving. For Asthma Express dates in Chicago and Dallas, see www.asthmaexpress.com ALLERGIC LIVING | SUMMER 2012

FIRST PERSON

This Allergic Life with Jo Frost

Job: Parenting expert, TV’s “Nanny Jo” Lives with: multiple food allergies, environmental allergies and asthma Resides in: California

18 ALLERGIC LIVING | SUMMER 2012

Jo, first, what allergies do you have? I’m allergic to all nuts, peanuts, crustaceans and rye. I have asthma and that’s triggered by tobacco, severe changes in weather, pollen, strong household cleaning products, mold, animal dander, lilies. And with perfumes, anything very flowery is a problem for me. As Nanny Jo, we think of you coming to the rescue of parents with serious discipline problems with young kids. But that means going into other people’s homes. What challenges have you faced doing that? I’m really upfront with my allergies. So households remove all foods that could be dangerous for me. The main one is peanut butter – as you do love a peanut butter and jelly sandwich in this country! The PB & Js are out, the kids can’t eat nuts, in some cases, parents do smoke, so I ask them if they can refrain from smoking around me.

Photography: JEFF NEWTON

We know her best as Nanny Jo on TV’s former “Supernanny” TV show. From 2004 to late 2010, Jo Frost brought order to households where parents had lost control by helping moms and dads learn parenting skills like discipline and follow-through. Nanny Jo’s firm, fair and always consistent parenting techniques (including the famous “naughty step” for timeouts) paid off in incredibly improved behavior and closer bonds for the families on the show. But as viewers in almost 100 countries tuned in to see Frost bring peaceful resolution to another household gone wild, few realized that the world’s top nanny was having to do her own strict daily managing – of food, pet and environmental allergies. Jo Frost recently spoke to Allergic Living Editor Gwen Smith about how she juggles her busy lifestyle – which includes a new show for the TLC Network and a lot of travel – while keeping her asthma and serious allergies under careful control.

Pets get removed as well. A production company makes sure a house is cleaned before I go in it, in case there’s dog hair hanging around or cat hair all over. When you’re helping families for TV, how long are you in a home? Just over two weeks, and I’m in their home for about 16 hours a day. Honestly though, [allergy accommodations] have never been an issue. I’ve been in my career as a parental expert for 25 years and have to say, I’ve been incredibly embraced by the American public. The families know I’m trying to help, so I’m given a lot of love. When I go in and say, “I know the kids love peanut butter but I’m allergic to it and I want to be able to kiss and cuddle your kids freely,” they’ll say, “we want you hugging and loving our kids, too.” I’ve had a couple of occasions where the kids have gotten upset because the pets had to go to a friend’s house. But I say, “Nanny JoJo has a severe allergy so that if I’m near the animals, they will make me very ill, and I’ll end up in the hospital”. And then they say, “oh no”. You talk to the children and they’ll say, “OK then Nanny Jo-Jo”. Outside of your work, how do you find accommodations for allergies these days. I have to say that overall, this country lacks a compassion for those with severe allergies. Where do you feel that the most? I am somebody who’s tried very hard to have management of this [asthma and allergies] with the correct medications and awareness. My most unfortunate experience with my allergies has been with American Airlines. [She mentions good traveling experiences with both United and Virgin Airlines.] My unfortunate experience was that I was met with a crew who had zero empathy toward my condition. When I offered as a solution that I could ask other passengers personally if they would refrain from eating nuts, they told me: “You cannot do that,” and that if I did they would have to get security to take me off the plane. At that point I had passengers who overheard and came up to me saying, “we totally understand and don’t worry, we won’t be eating nuts.” The crew then said the only way I could fly on this aircraft was if I was to give up my first-class ticket and sit in the back cabin, as they wouldn’t be serving nuts there. It was like it was this selfindulgent fad, as if I’d invented it to maintain some kind of attention-seeking. It was absolutely awful. I was on my way to visit a family, who desperately needed help. I didn’t want a family to suffer as result, so I gave up my seat to this man [in economy]. We swapped seats. There was this lady with her daughter who said, “you’ve got the patience of a saint”. But the crew continued gossiping about me in the front cabin. They looked at me as if I thought I was entitled. I’m just looking to be treated like anyone with a severe allergy: with dignity and compassion. I felt that this situation had been handled appallingly so I asked if I could see a customer service representative once I got the gate. I told them this story. They listened, and I got a lot of sympathy and they said it was unacceptable, they apologized on behalf of the Allergic Living asked American Airlines whether they would follow up with Jo Frost regarding this flight. The airline responded: “AA Customer Relations is looking into the information provided by Ms. Frost, and will do their best to address her concerns.”

crew, and said they would follow up. But I’ve still yet to hear from them, and that was over three months ago [as of late May]. I’m a very solutions-oriented person, but I was met with this defensive attitude. It was: “no, no and that’s our policy, and no.” If you had the chance to speak to an airline CEO on this topic, what would you say? I would say that I do understand that they want to accommodate light snacks on a flight. But I would really urge them to look at the many alternatives that there are as snacks. We’re talking about anaphylaxis here. If we can become more aware in public places: airplanes, schools and with the labeling of products, maybe we can get America to look differently at those who have life-threatening medical conditions like anaphylaxis. We should look to prevent situations. We’re spending billions of dollars dealing with issues in the aftermath rather than looking at how we prevent. Have you experienced anaphylaxis? Yes, I have. The worst I’ve dealt with left me in hospital for a couple of days and my blood pressure went really low. [This incident happened two years ago, brought on by a restaurant meal.] I had been told, very confidently, that were no nuts in a particular meal, and there were. It left me never in the same place again. I have allergies and asthma management under control; I carry an EpiPen, I have my inhalers for my asthma, which I take. What has changed is my ability to trust those who may not be fully informed. You have to read between the lines. [At a restaurant] if they say, ‘I think so,’ that is not – “I know so”. Now in a restaurant, I ask: “Are you sure?” and “Can I see the chef?” because I have to be in control of my life and responsible for my life, so I will do what’s necessary to do that. I don’t see myself as a sufferer and I don’t see it as a disability. I just know there are certain things that I can’t do. For instance, I would love to go horseback riding, but I can’t; it’s life or death. [As a child, Frost had a very bad reaction to horses that required emergency treatment.] So there are things you can do and things you can’t. For instance, I waterski and cycle, things like that. I’m not surprised to hear your attitude, as you always do seem like a positive person. I think it’s a mindset. From a very young age, I had eczema, allergy and asthma, and I was raised [in England] by parents who didn’t see this as a handicap. I was incredibly involved in sports. I had asthma, but I ran the 100-metre sprint at school and played nationally a game called netball – similar to basketball – I did the long jump. I still cycle and love swimming. You say that I sound confident as a grown woman, but it does start young. It’s important for parents of allergic children to recognize the seriousness but to keep your explanations really simple and to teach your children to make decisions that impact their quality of life and the safety of their life. Tell us a little about your new show for the TLC Network. People know me for dealing with [children’s] unruly behavior, discipline, implementing rules and following through. But the idea with my new show for the TLC Network is to take the focus to the whole family and how we how we can become more mindful as a ALLERGIC LIVING | SUMMER 2012

FIRST PERSON family and help and support each other more. We’ve got women working, blended families, adoption, families in the military. Then we’ve got 21st century issues like bullying, teens and technology and girls, self-image and what’s portrayed in the media. I have the opportunity to stretch at TLC, which is amazing. Helping is what I’m really passionate about. I feel very blessed that we have families courageous enough to have me come into their homes and talk about their issues and do that with a couple of cameras and sound guys. If it wasn’t for those families, we would not be helping millions around the world. It’s very empowering when families realize that. It’s an emotional journey but it’s very fulfilling for everybody. When does the program begin airing? We’re looking at the show coming out before the end of the year. So exciting times! And I would love for families to come forward with issues like dealing with asthma or food allergies. If I’m able to help families who do reach out, then I’m able to extend that to a much wider base of families who have these conditions. [*If you would like to apply, see the note at the end of the article.] You mention bullying. Two U.S. studies show that about one-third of kids with food allergies have faced teasing or bullying, including having allergens waved in front of them. What’s your advice for families in such circumstances? Bullying is bullying and all forms of harassment have to be taken to a school authority to take care of that. Bullying that involves peanut or another food that a child is allergic to is a life-threatening situation and we need teachers to be more aware of this. We need for our children to feel they can go to the adults, who can be trusted to take care of this. If we leave children feeling that things will not be handled, then children try to handle it themselves, in the best way they possibly can. That’s an enormous amount of stress and pressure on a child who actually doesn’t know what to do to make things better. If you’re waving [a food allergen] around, it’s bullying. There needs to be open dialogue at PTA meetings and parents and teachers coming together to understand the importance of it, as we would in any case where there’s bullying and harassment. What would you say to a teen refusing to carry an autoinjector or asthma inhaler for fear of seeming ‘different’? I hope to get the opportunity to deal with this on the new show because there are a lot of teens who feel that it’s not cool to carry an EpiPen or asthma meds. I would really talk to that teenager about responsibility and being accountable for your own life. For parents, it’s about talking to your child on a level of gaining more maturity and understanding of the condition they have. Give them information to read; the more they know, the more it’s in their own hands. It will give them the confidence to brush off what somebody else is saying. Empower them, let them know that their medication is there as a backup plan, not as a hindrance. Which is harder: managing allergies or getting toddlers prone to tantrums to behave? Both are challenging and in order to manage either requires knowing what is happening and how to handle the circumstances and 20 ALLERGIC LIVING | SUMMER 2012

“Talk to your child on the level of gaining more maturity about the condition they have. Empower them, let them know that their medications are there as a backup plan, not a hindrance.” what’s the plan, so that you’re feeling in control in those circumstances. As a parent, you’re in control in terms of how you choose to raise your child and we hope you do the best that you possibly can. As a person with allergies, you aim for control and you do hope that the rest of the world catches up in terms of understanding and compassion so that we will start to see food ingredients on restaurant menus and better accommodations on airlines. Do your staff or friends know what to do for you in an allergy emergency? Yes. My executive assistant Cynthia knows how to administer my auto-injector and so does my significant other. In my very close circle, nobody eats peanuts, nuts, nobody has the enjoyment [laughs] of eating lobster or crab. I joke with Darrin [her boyfriend]: ‘If you’re going out with the lads after basketball, go for a Thai [meal]. He would love to own dogs, but sorry, no dogs. I often say, “I’m going to buy you a big tortoise”. [laughs] Note: To have your family considered for Jo Frost’s new show on TLC, keep an eye on www.jofrost.com or @jo_frost on Twitter for details on how to apply.

30% OF PEOPLE LIVE WITH FOOD SENSITIVITIES

Only ONE brand offers a full product line that is made especially for you. Gluten-Free Free from the Top 8 allergens

Allergy-Friendly you can Trust. Taste you will Love! Certified Gluten-Free

www.enjoylifefoods.com

twitter.com/elfceo

Free From Top 8 Allergens

facebook.com/enjoylifefoods

Non-GMO

The only complete product line that allows 100 Million Americans living with food intolerances to eat freely. All Natural

Kosher Certified

Halal Certified

DOCTORS’ Q & A

The Food Allergy Experts DR. SICHERER

Dr. Scott Sicherer and Dr. Hemant Sharma take on readers’ questions.

My daughter is severely nut allergic (she’s had three anaphylactic episodes, including one accidental cashew exposure that required hospital admission) and she has asthma. She’s also 13 and the dating years are almost here. What will she need to tell a boy about kissing a nut-allergic girl?

DR. SHARMA

With kissing, teens need to discuss their food allergies in advance.

DR. SICHERER

A food that was recently eaten can be passed in saliva, via kissing or sharing straws or utensils, to a person with food allergies. About 10 percent of adults with food allergies describe having had an allergic reaction from kissing. The concern is not about a peck on the cheek, which might simply induce an itchy spot, but rather about mouth-to-mouth kissing with a potential for exchange of saliva. To study this issue, our clinic had people without allergies eat peanut butter, and then tested their saliva for peanut proteins. The amount of peanut protein decreased to undetectable levels in about an hour for most, but not all participants. Brushing teeth, rinsing out the mouth or chewing gum was helpful in reducing levels, but even this didn’t completely remove all protein residue. Waiting several hours and then eating a peanut-free meal was the most effective way to ensure that no relevant amount of peanut was left in their saliva. Although our study is helpful in evaluating general approaches, there is a small risk that a tiny amount of a food may be lodged between the teeth or in braces and be released later. Also, we only studied peanut butter and not other foods. Because of the risks, it is important for people with food allergy to discuss their allergy in detail with their partner. Intimate kissing without regard for the diet is risky. For a teenager, this means no spontaneous kissing at a party, for example. Your daughter must discuss her allergy, in advance, with anyone she will be kissing. While avoiding the food for many hours, eating a safe meal and also brushing and rinsing prior to kissing is likely to 22 ALLERGIC LIVING | SUMMER 2012

reduce the risks, another very safe approach would be to have her partner avoid the same foods. My patients tell me that their boyfriends or girlfriends think it is worth the avoidance in order to kiss.

Is it safe for my child with milk allergies to have goat’s milk or goat’s cheese?

DR. SHARMA

This is a great question, and one that many parents of children with cow’s milk allergy have as they search for a suitable substitute for cow’s milk. Unfortunately, because goat’s milk protein is similar in structure to cow’s milk protein, more

Photo: iStockphoto.com / 101DALMATIANS

than 90 percent of the time, the immune system will mistake the two and cause a reaction to goat’s milk or goat’s cheese in someone with a cow’s milk allergy. So goat’s milk is not a safe alternative to cow’s milk, and for the same reason, neither are sheep’s milk or buffalo’s milk. You can discuss with your child’s allergist what might be an acceptable cow’s milk substitute. An option for an infant would be an extensively hydrolyzed, cow’s milk-based formula, in which the cow’s milk protein is extensively broken down, making it less recognizable by the immune system and less likely to cause a reaction. Since these formulas are also good sources of nutrients, many allergists will recommend children on restricted diets remain on them beyond the age of one year. Once ready to wean from a formula, options at that point might include soy milk or rice milk, assuming your child does not also have allergies to those foods. To be sure that all nutritional requirements are being met, it definitely is a good idea to discuss your options with allergist or a dietitian.

THE TOP 8 FOOD TRIGGERS

allergy. I’d never heard of this flour or this bean. Can you tell me how lupine relates to peanut allergy? DR. SICHERER

Lupine or lupin is a bean, and is therefore related to peanut, which is also a legume. Lupines may be prepared in a variety of ways, eaten whole or dried to create flour that can be used for breads or pastas. Lupine • Peanuts flour is sometimes used in gluten-free foods. It • Tree Nuts (e.g. walnut, is possible to be allergic to lupine and not cashew, pecan) peanut or visa versa. Based upon a few studies, • Milk it appears that roughly 30 to 50 percent of peo• Shellfish (e.g. shrimp ple with peanut allergy will have a positive lobster, crab) allergy test to lupine. • Fish (e.g. cod, salmon, tuna) However, not everyone with a positive test • Egg reacts when they eat it. Based on a few studies performed outside of the United States, the • Soy risk of allergy to lupine among persons with • Wheat peanut allergy is approximately 20 percent. The additional worrisome finding is that lupine allergy can be severe, like peanut. Therefore, unless a peryour child’s son with peanut allergy is cleared to eat lupine through allergy testing, possibly including a medically supervised food challenge, We will be traveling to France and Spain in July and my I suggest avoidance. Also, it would be wise to carry a translation sister-in-law (who’s in the food industry) says to watch card that mentions both a peanut and lupine allergy (even if the out for “lupine flour” in bread because of our son’s peanut latter is later disproved in testing).

These foods cause most serious food allergy reactions:

Welcome to

Allergic Living! Allergic Living is the new health and lifestyle magazine created specifically for those living with allergies, asthma and celiac disease. Like this sample edition, every issue is full of engaging, in-depth articles, advice from top experts and superb allergy-safe recipes.

Subscribe Today Get Allergic Living delivered to your door! Continental U.S. rates: $29.99 – 2 years / 8 issues $19.99 – 1 year / 4 issues

Go to: www.Allergicliving.com/subscribe

DOCTORS’ Q & A

My daughter, who’s 4, was diagnosed with peanut allergy shortly before her third birthday after experiencing a rash around her mouth when she ate a peanut butter cup. Her blood test for peanut showed an antibody level of 4.85, and it was 3.82 a year later. Her allergist suggests a food challenge in a year if her blood test result drops below the 2 level. Given that the blood test can provide a negative result when an individual has an allergy, how does a dropping number reveal that an allergy is being outgrown? It’s my understanding that the blood test results do not indicate the severity of an allergy, but just the probability that the allergy exists. It’s not easy to follow how the tests suggest that a child is outgrowing a peanut allergy.

HOW TO SPOT FOOD ALLERGY food allergy occurs when a person’s immune system identifies proteins in a food as an allergen and begins to produce antibodies – called immunoglobulin E or IgE – against that food (e.g. tree nuts or milk). These antibodies attach themselves to mast cells in the body, and when the person again eats the allergenic food, the proteins from it become attached to the IgE antibodies. This causes the mast cells to release histamine and other chemicals. These chemicals cause the symptoms of allergy.

DR. SHARMA

THE SYMPTOMS

The interpretation of food-allergy blood test results is definitely not easy, and your confusion is shared by many parents, as well as many experts in the field! This question highlights some of the limitations of our available testing. You are absolutely correct that IgE antibody levels correlate with the likelihood of having a reaction, but they do not necessarily predict how severe that reaction might be. For example, two people with the same exact peanut IgE level may have very different reactions to an exposure to peanut. You are also right that, in up to 10 percent of cases, a peanut IgE level can be negative even when someone has a peanut allergy. That is why an oral food challenge is necessary to rule out a peanut allergy definitively. Your allergist’s recommendation to proceed with an oral food challenge once your daughter’s peanut IgE level drops below 2 kU/L is based on research showing that the chance of passing a peanut challenge is greater than 50 percent at levels less than 2. Studies have also shown that declining results on testing, while not perfect predictors, are much better indicators that a food allergy has resolved than, for example, the presence of other allergic diseases, the age at diagnosis, or the severity of prior reactions. There is research under way to identify better tests, ones that will more accurately predict which people with a food allergy would be most likely to suffer a severe reaction. For example, a test that could separate serious peanut allergy from a milder form could help allergists decide when to pursue a food challenge. An article in the spring edition of Allergic Living described one such test, called component testing, which has recently become available for peanut allergy. A conventional blood test for peanut might give imprecise results because it measures IgE to all components of the peanut protein. In contrast, component testing measures IgE levels to several specific peanut proteins (called components). This information might help to predict the severity of a peanut allergy since Ara h1, 2 and 3 proteins are associated with anaphylaxis, while other components are associated only with oral allergy syndrome. OAS is a form of food allergy associated with pollen allergies; it causes milder allergic symptoms confined to the mouth and throat. More studies are under way to better understand component testing, and research should continue to refine our testing methods for food allergy.

Not everyone will get all symptoms, and reaction severity varies widely.

24 ALLERGIC LIVING | SUMMER 2012

The symptoms may include: • • • • • • • •

Tingling in the mouth Swelling of the tongue and throat Itchy skin, hives or skin redness Breathing difficulty, wheezing Abdominal cramps Vomiting Faintness due to a sudden drop in blood pressure In a severe anaphylactic reaction, the allergic person can lose consciousness and is at risk of death.

Anaphylaxis This is a serious form of allergic reaction that occurs rapidly and can be fatal. It is essential that those with food or insect sting allergies carry an epinephrine autoinjector, so treatment can be given promptly while arranging to get to emergency care (call 911 for ambulance). –Staff Reviewed by Dr. Scott Sicherer

Is it true that food allergies to shrimp or peanuts will get worse with every accidental exposure? I had my first (quite bad) reaction to shrimp at 25 years of age, and this worries me. DR. SICHERER

No, it is not true. It is a common myth that allergic reactions automatically become worse with each exposure. However, the correct answer is still worrisome. The severity of future reactions is unpredictable. It could be the same, less or more severe. There are many factors that determine severity of a food-allergic reaction, including the type of food, the amount eaten, whether you have asthma, your state of health at

the time you ingested the food, how sensitive you are, etc. Unfortunately, if you have already experienced a severe reaction, it certainly could happen again. It is important to talk to your doctor about how to avoid the allergen(s), when and how to self-inject epinephrine and the need for emergency care in the event of an accidental ingestion.

My husband and I had been advised to delay introducing our son to peanuts and seafood until about 4 years of age. Recently, we learned that the new recommendations favor earlier introduction of these foods, so we gave our son, now 3 years old, a quarter of a teaspoon of peanut butter. After eating it, he got abdominal pains and threw up. We now have tests scheduled with an allergist. But what about seafood? Should I wait for the test results before introducing? Is he at higher risk of an allergy to seafood if he’s allergic to peanuts? DR. SHARMA

In general, since fish and shellfish do not share any structural similarity with peanut, there is no risk of “cross-reactivity,” or reactions due to the immune system mistaking seafood for peanut. That being said, the risk of food allergy is slightly higher, compared to the general population, when someone already has shown signs of allergy, such as another food allergy, asthma, hay fever or eczema. For that reason, it may be worthwhile holding off on introducing seafood until you have seen the allergist. Many allergists will perform a simple skin or blood test in a child with a suspected peanut allergy who has not yet eaten another major food allergen, such as fish or shellfish. A negative result on that screening test would strongly suggest that your son isn’t allergic to seafood, allowing fish and shellfish to then be safely introduced.

Dr. Sicherer is a practicing allergist, clinical researcher and Professor of Pediatrics. He is Chief of the Division of Allergy and Immunology, Jaffe Food Allergy Institute, at the Mount Sinai Medical School of Medicine in New York. He is also the author of Understanding and Managing Your Child’s Food Allergies. Dr. Sharma is an allergist, clinical researcher and Assistant Professor of Pediatrics. He is Associate Chief of the Division of Allergy and Immunology at Children’s National Medical Center in Washington, D.C. and Director of the Food Allergy Program. He is also the site director for the National Institutes of Health Allergy and Immunology fellowship program.

You want information. You have questions. You need somewhere to turn for help. Call us.

FAAN Member HOTLINE (800) 929-4040

Note: This column is meant as general guidance and is not to be interpreted as diagnosis and treatment of individual patient conditions. For such specific medical advice, visit an allergist.

To submit a question, write to editor@allergicliving.com. Write “Food Allergy Experts” in the subject line. And please try to keep your question brief.

The trusted source for food allergies THE FOOD ALLERGY & ANAPHYLAXIS NETWORK www.foodallergy.org

Celiac &Your

Love Life Is your sex drive lacking and passion fading into the past? This could be a symptom of celiac disease. by LISA FITTERMAN

hil Zimbardo wants to talk about sex. More precisely, he wants to talk about the utter misery of losing interest in it. As a life-long lover of women, he was at a loss when it happened to him, a Dr. Phil, a prominent psychologist more used to seminars on mental health than dealing with his own, an author and speaker – a guest, even, on the TV talk show hosted by that other Dr. Phil. In his early 70s, Zimbardo was hit by a perfect storm of symptoms that included extreme fatigue, a bloated belly, constipation and the constant, embarrassing need to pass gas. Zimbardo knew it wasn’t just age-related, and his doctors were mystified. Maybe it was irritable bowel syndrome, they suggested, or excessive gas syndrome, which seemed little more than a catch-all term for a condition they couldn’t fix, no matter how many colonic treatments and anti-flatulence medications he was prescribed. As his body betrayed him, Zimbardo grew depressed to the point that he lost interest in all things sensual and sexual. This was astounding since he’d always adored women: gorgeous, plain, curvy and not. Sex with his wife of nearly 40 years had become something he did out of duty; he “serviced her,” pretending to enjoy it because he was not able to be a full and willing participant. At the same time, he was aware that he was a faker, a guy who was crumbling on the inside as everything

26 ALLERGIC LIVING | SUMMER 2012

he had taken for granted about himself – his wit, his sexuality and his very masculinity – was erased. It was sheer torment. Then a friend suggested that Zimbardo might have what she’d just been diagnosed with: celiac disease, an autoimmune condition that affects an estimated one in 100 people in North America. He had a vague idea of what it was – the body’s virulent reaction to gluten, a protein in wheat, rye, barley and many oat products, which damages the villi, the small, fingerlike projections in the wall of the small intestine that help nutrients pass into the body. In turn, this compromises or prevents the absorption of important nutrients such as vitamins, phosphates and minerals. “What do I have to lose?” he asked himself. Zimbardo made an appointment with a gastroenterologist, got his blood tested for the antibodies associated with celiac disease and then later had an intestinal biopsy to confirm the diagnosis. All of a sudden, he had a reason for his constipation, tiredness, gas, depression and the resulting sexual dysfunction, and a way to turn things around: eliminate gluten from his diet. “No one talks about the sex part in celiac disease,” says Zimbardo, now a professor emeritus at Stanford University in California. “No one tells you that your sex drive can shut down and that your very manhood can be challenged. As a psychologist, I’m always analyzing behavior and I just could not understand what has happening to me until I was diagnosed.”

ALLERGIC LIVING | SUMMER 2012

He has a point. People often find it hard to talk about sex, period, never mind how it relates to celiac disease. While the symptoms associated with the disease run the gamut from diarrhea and stomach cramping to osteoporosis, weight loss and weakened tooth enamel, it’s as if any discussion of the S-word has been shoved behind closed doors, to be whispered about, if at all. With the digestive distress before a gluten-free diet is adopted, “you’re probably not going to feel really sexy, and you wonder if you’ll ever get your sexy back,” says Alice Bast, founder and president of the National Foundation for Celiac Awareness (NFCA). “Even after people are diagnosed, they don’t ask their doctors about something as simple as kissing,” she says. “But it’s a real concern. What do you do if the person you are about to kiss has just eaten gluten?” Last year, Bast asked that question of a panel of specialists at the International Celiac Symposium in Oslo, Norway. “They were, like, ‘what?’”she recalls. “I said: ‘kissing’. They didn’t know what to say because they’d never dealt with this before. But people do ask filled out anonymous questionnaires that asked things such as me. They ask me all sorts of things they won’t ask their doctors.” how often they had intercourse, if they experienced any pain durA 5-foot, 9-inch dynamo who weighed a mere 100 pounds ing sex and if they had problems reaching orgasm. After 12 when she was diagnosed 18 years ago, Bast started the NFCA to months of living gluten-free, they filled the questionnaire out educate people and provide a forum for people with celiac disagain. To better interpret the data, their answers were compared to ease. She says people ask her many questions when it comes to those of 51 people without the disease. celiac disease and their sex lives. Like The results were clear. The people with whether semen can contain gluten, and if untreated celiac disease had “significantly” the sex drive is affected by vitamin, horless intercourse than those in the control mone imbalances and plain old gas. (The group, and fewer of them were satisfied with answers: probably not and absolutely.) their sex lives. And after 12 months of treatMindful of the panel’s confused response ment, their sex lives had improved in every to what she considered a simple question, way – a lot. While Ciacci has no plans to do a Bast and her NFCA colleagues put together further study, a few experts such as Dr. Peter a short video called “Sex and the Celiac.” It’s Green, the founder of the Celiac Disease about how sneaky, undiagnosed celiac disCenter at Columbia University, are aware of ease could be “fixing your funk” or “making the issues around a healthy sex life with celiyour mojo a no-go.” With about 5,000 ac disease. He isn’t shy about asking his online views to date, it’s a bona fide hit. And patients how often they’re having sex, espeit has common sense advice for people who cially when issues of fertility are involved. suspect they have the disease: make an Sheila Crowe, a gastroenterologist and appointment with a physician pronto. medical professor at the University of Phil Zimbardo: transformed by diet “When in doubt check it out,” Bast says in California, San Diego, acknowledges there is the video. “If your libido is lacking, take the celiac symptom too little data about sex lives and celiac disease, and that gastroenchecklist and get your sexual side back in the game.” terologists are not trained to think about sex when they are checking out symptoms such as constipation or diarrhea. “We’ll ask about genital health and urinary function, about menstrual mid all the research into celiac disease, from its cycles and cramps and infertility – but sexuality? It’s not on my provenance to possible treatments, Allergic Living radar screen,” she says. “Maybe it should be. Maybe the average was able to find only one small study that has gastroenterologist should be asking about sexuality as a matter of focused on the level of sexual satisfaction among course.” people with the condition. Published in 1998, it At the same time, she cautions that talking about sex drive was conducted in Italy, the land of love and pasta, and it involved means having to overcome social mores and fears, and to delve 55 patients with celiac disease: 24 men and 31 women between the into an issue that may be caused by a myriad of physical and psyages of 18 and 65. chological factors, including depression. With undiagnosed celiac “Sometimes, I heard women complaining about troubles in disease, notes Crowe: “People are fatigued. They lack energy, they their sex lives and sometimes, they would speak of how sex had may be underweight, which affects endocrine function, and they gotten better after changing to a gluten-free diet,” says lead may suffer depression due to it all. Women may stop have having author Carolina Ciacci, a gastroenterologist and professor of their periods. Any chronic illness can impact our sexuality. We all medicine at the University of Naples Federico II. “It was clear that need to be aware that it’s not as simple as: ‘Not tonight, dear, I have a study was merited.” a headache.’” Before they embarked on gluten-free diets, the participants

“No one talks about the sex part in celiac disease,” says Phil Zimbardo, a prominent psychologist and professor emeritus at Stanford University. “No one tells you that your sex drive can shut down and that your very manhood can be challenged.”

28 ALLERGIC LIVING | SUMMER 2012

Worth the wait. The tempting aroma of freshly baked bread fills your kitchen, filling you with the anticipation of your first warm, buttery bite. At long last, you can enjoy all the tastes you’ve been craving, thanks to a new line of certified gluten-free mixes from King Arthur Flour. It’s the feast for the senses you’ve been waiting for. # 3 & " % t . 6 ' ' * / 4 t # 3 0 8 / * & 4 t ' - 0 6 3 t $ 0 0 , * & 4 1" / $ " , & 4 t : & - - 0 8 $ " , & t $ ) 0 $ 0 - "5 & $ " , &

Learn more about our complete line of new gluten-free mixes at kingarthurflour.com/glutenfree

Green and Crowe stress that specialists should be more sensitive to these issues. Recently, for example, a woman in her 30s was referred to Crowe for an opinion on her celiac symptoms. The woman asked point blank if she could have sex with her husband after he had eaten food containing gluten. “It was the first time I had ever been asked,” Crowe says with a laugh. “I told her that what her husband eats isn’t going to cause problems since gluten has to be ingested into your body.” When it comes to kissing, Crowe says there isn’t scientific evidence that enough gluten would be left in the mouth to cause a problem for the partner with celiac disease. But Bast of the NFCA counsels caution all the same. No matter how unromantic it seems, she recommends being careful about kissing and having your partner brush and rinse. It’s better to be safe than sorry.

hile Bast doesn’t like to dwell on how she felt before being diagnosed with celiac disease, she acknowledges that sex was the last thing on her mind. “I thought that I had cancer and was dying. Everywhere we went, my life revolved around eating a minimal amount of food and trying to stay out of the bathroom,” she says. Even after she was diagnosed, change didn’t happen quickly because she was so malnourished and had been through so much, including multiple miscarriages and a stillbirth. In fact, when it came to sex, the change was so imperceptible, she didn’t even realize that after years of avoiding intimacy, she had begun to enjoy it again. It was a subconscious thing more than anything, some-

thing that somehow seemed normal again, from the act of putting her arms around long-suffering, patient husband and – gasp! – initiating an encounter. “Once I had the diet down, I got it all under control,” Bast says. “When I began to talk about it with others, I realized that I wasn’t alone.” In San Francisco, Zimbardo cut gluten from his diet and started taking anti-inflammatories and probiotics in order to get his gut’s flora back into shape. It took a year to undo the damage and get his mojo back, both sexual and otherwise. Now 79, he and his wife will celebrate their 40th anniversary on August 10 by renewing their wedding vows at the same Stanford University church where they married, and in the presence of their three children and grandchildren. Zimbardo shudders as he recalls losing his sexual drive and sense of self as his body changed, as his belly grew, as he burped and passed gas as food failed to pass properly through his intestines. He has a message for those suffering from symptoms: Get thee to a doctor because the first thing you want to do is look at the distinct possibility you have celiac disease. “Changing my diet was nothing short of transformative,” he says. “Now, I can’t wait to be 80. “I get impatient with people who say, ‘Oh my God, you’re still doing it.’ Of course I am! And I plan to do it as long as I can. Sex should be a central part of your life, no matter your age.” To share your views on this article, write to: editor@allergicliving.com The NFCA’s video can be viewed on Youtube.com; search Sex and the Celiac: The Movie.

Your child trusts you. Who are you going to trust?

www.bobsredmill.com | 1.800.349.2173

MADE IN THE U.S.A.

Trust Bob. Trust Bob’s Red Mill. Our gluten free and casein free production facility and rigorous onsite product testing make our products as safe as they are irresistible and easy to prepare. What’s more, we now give you two new reasons to celebrate – our decadent and delicious Gluten Free Vanilla Cake Mix and Gluten Free Shortbread Cookie Mix. Look for them and our more than 70 gluten free, casein free products at your favorite grocer or bobsredmill.com.

CELIAC CENTRAL | ALICE BAST

playtime to reinforce good practices of gluten-free living.

Nurturing Knowledge

NEVER TOO EARLY TO START From grocery games to toy food parties and tending the garden, nurture your child’s gluten-free awareness. he gluten-free diet is confusing for anyone of any age. So it’s tempting to spare your child the details. Instead, you choose her food. You talk to her teachers. You grill the server. While the precautions are both necessary and reassuring, keeping your child on a “need-to-know” basis won’t help in the long run. In my family, I’m the only one with celiac disease. When I got diagnosed, I wanted to make sure my daughters understood why mommy could no longer eat certain things. They grew up eating quinoa before it was popular. They learned why they couldn’t order a pizza at home like their friends did. It made home life easier, and a lot safer for me. It also helped my daughters develop a healthy approach to food, and for one of them, an interest in the medical field. I’m not suggesting you sit your child down and dole out a lengthy course on gluten, antibodies and cross-contamination. Lessons, like medicine, work best in doses. Summer is a perfect time to administer these little drops of knowledge. You have plenty of quality time together, just don’t approach the learning like a lecture. School’s out for summer, which means your kids can only tolerate one thing: fun.

Photo: iStockphoto.com / CHRISTOPHER FUTCHER

Grocery Games Games have the remarkable ability to teach while they entertain. These days, most games revolve around an iPad and apps, but the last time I checked, SpongeBob has yet to meet a gluten-free friend. So, the old school approach it is.

Your child’s first nutrition lessons don’t have to be limited to gluten-free details. Talking about more general topics like how food helps our bodies to grow and why we need different vitamins and minerals can actually set a framework that makes the gluten-free stuff easier to, well, digest. A great way to reinforce those ideas is to involve your child in a summer garden. Plant a few vegetables in your backyard, or grow tomatoes in a pot. As the seedlings grow, talk about the plants’ nutritional needs, like water and sun. When they’re big and beautiful, go online and look up the vitamins and nutrients in each vegetable – including what they do for the body. If you don’t have a green thumb, then let the grocery store do your harvesting. Build a salad that uses a different fruit or vegetable for each color of the rainbow. You can also cut vegetables into animal shapes (we all remember “Ants on a Log”). Ask your child to pick out a salad dressing in the store. That way, you can tie in a quick gluten-free lesson while their interest is high. You can also look up recipes for summery dinners and treats. Read each recipe together and point out which ingredients are safe and which are off-limits. Choose a fun gluten-free recipe and get cooking!

Educate, Don’t Intimidate Turn a trip to the grocery store into a scavenger hunt by asking your child to find products that match images you printed on a sheet of paper. Or, hold up containers of similar products – one gluten-containing, one gluten-free – and ask your child to tell the difference. You can even make coupon clipping an educational activity. Ask your child to circle five products that are safe to eat from a grocery store circular. Plastic play foods can be especially useful when starting to teach a child with celiac disease or non-celiac gluten sensitivity the rules to the gluten-free diet. Take turns “making dinner” for each other. If your child reaches for bread, ask if it’s glutenfree. If turkey with gravy is on the “menu,” remind the “waiter” that gravy sometimes contains flour, which is a no-no. Use this

With each conversation about nutrition or gluten-free food, remember that learning is a process. If your child reaches for a breaded chicken finger or huffs and puffs when you read a label, don’t despair. The good news is, by talking with your kids, you’ll learn exactly where their knowledge stands. Can they pick out a safe snack? Do they know which questions to ask at a restaurant? Even resistance can be a sign, like knowing that she’s not ready to speak up when her friends are around. Most of all, let them know how proud you are with their progress. Just like in school, kids need a gold star when it comes to gluten-free awareness. Alice Bast is the Founder and President of NFCA (National Foundation for Celiac Awareness). Find kid-friendly gluten-free recipes, educational games and personal stories at www.CeliacCentral.org/kids. ALLERGIC LIVING | SUMMER 2012

/VTL -PS[YH[PVU 7YVK\J[Z /VTL -PS[YH[PVU 7YVK\J[Z

H Helps elps ccreate reate a he healthier althier hhome. ome.

be floating floating in in the the air air tthat hatt yyou AAllergens llergens ssuch uch aass ppollen ollen may may be ou and and your your family family breathe. breathe. 速 FFiltrete iltrete Ai Airr C Cleaning charged to to attract attract and and ca capture pture aairborne irborne leaning Filters Filters from from 3M 3M are are electrostatically* electrostatically* charged al allergens lergens llike ike hhousehold ousehold dust, dust, ppollen ollen aand nd llint int from from tthe he air air ppassing assing tthrough hrough tthe he fil filter. ter.

Create a healthier home with Filtrete速 Filters.

SAVE SAVE $

600

by by mail-in m ail - i n rebate rebate

When you Air Cleaning Cleaning When you buy buy 2 Filtrete Filtrete速 Air Filters with with a Microparticle Micropar ticle Performance Per formance Filters Rating (MPR) ( MPR ) of of 1500 1500 or or greater. greater. Rating O Offer ffer eexpires xpires D December ecember 331, 1, 22012. 012.

TToo gget et your your rrebate ebate nnow, ow, visit visit FFiltrete.com/rebate iltrete.com /rebate * Electrostatic filters are most effective when the filter is clean and new. 息 20 2012 12 3M. 3M and Filtrete are trademarks of 3M. This offer cannot be combined with any other rebate, unless specified.

HEALTHY HOME

so when you find it, the first thing you need to do is pinpoint the moisture source and stop it. “The key to mold control is moisture control,” says Laureen Burton, a chemist and toxicologist with the Indoor Environments Division of the U.S. Environmental Protection Agency. “People think, ‘I don’t even need to look at where this came from because I’ve wiped it up.’ But if you don’t fix the moisture, that mold will be coming back.” So where to start sleuthing? Chances are, there’s one of a few usual suspects at work: a leaky roof or siding, cracks in the home’s foundation, clogged or broken rain gutters, improperly sealed windows, inadequate insulation, a plumbing leak, a seeping washing machine or refrigerator, high indoor humidity or condensation. Sometimes the source is easy to pinpoint, like a sweaty pipe under a kitchen sink, pooling water near a foundation or a beaten-up old skylight. Other times, you may smell mold but have no idea where it’s coming from; in those instances, you may need to call in the pros.

HOW TO CLEAN UP

GET A HOLD ON MOLD

If you’ve got allergies or asthma, mold in the home is bad news. Fortunately, Allergic Living’s handy how-to guide will spare you from the spores.

Photo: KATE KUNZ / Corbis

by JENNIFER VAN EVRA t’s the houseguest you never want – and one of the toughest to send packing. Especially in damp climates, indoor mold is one of the most common and stubborn problems – and for people with allergies and asthma, breathing in those microscopic spores day in and day out can spell serious trouble. Whether it’s lurking around window

ledges, spreading under basement carpets or seeping through drywall under that leaky sink, it’s got to go. So how to tackle this growing problem?

WHERE’S THE WET? There’s no point in trying to get rid of mold until you figure out where it’s getting its food. Mold can’t grow without water,

You’ve cut off the moisture source, put the mold on notice, and now it’s time for the clean-up. But how you do that depends entirely on where you find the mold and how much you have. According to EPA guidelines, if the affected area is larger than 10 square feet (roughly three feet by three feet), or it was caused by sewage or other contaminated water, you’ll want to call in mold remediation professionals. But if it’s limited to a smaller area, or it’s on a hard surface, chances are you can tackle it yourself – so long as you follow a few key steps.

• Out With The Mold Many think that spritzing mold with a chlorine bleach solution will do the trick – but bleach can be problematic for people with asthma, and even dead mold can trigger reactions in those with allergies. Also, you could end up adding even more moisture to the area and actually promoting mold growth. Same goes with painting or caulking over it: it will only come back. So what’s the real solution? Small amounts of mold on hard surfaces such as tile can be wiped off with basic detergent and water, or in more serious cases with a non-toxic mold cleaner, ALLERGIC LIVING | SUMMER 2012

HEALTHY HOME

• Its Right Place Molds love to set up shop in new locales. That’s why it’s especially important that, during the clean-up process, you prevent them from traveling to other areas of the home where they can find moisture and get growing again. For jobs that require more than wiping off, use tarps or plastic to seal the area so the tiny spores can’t spread. Also make sure that any nearby air ducts are sealed and that the heating or air conditioning systems are off; otherwise you run the risk of

Big jobs call for experts in protective gear.

blasting spores into other rooms. If you’re removing any moldy materials, just make sure to bag them up before you traipse them through the house; and once the affected area is dried out, give it the onceover with a HEPA vacuum, then discard the bag. If you think you might have mold in your air system, spend a little extra and have your ducts cleaned.

• Protect Yourself Remember that mold can trigger symptoms even in people who don’t have allergies, so Dr. Ginger Chew, an epidemiologist with the U.S. Centers for Disease Control and Prevention, recommends that anyone doing the removal always protect

MOLD: NOTHING TO SNEEZE AT olds are fungi that exist almost everywhere in the outdoors – and inside, they’re a common component of household dust. But mold can become a nightmare when there’s a large amount and it’s busily forming colonies in your home. Like any pollens, dust and other airborne allergens, mold can cause a host of reactions in people who are sensitized, from itchy, watery eyes to sinus problems to full-blown asthma. But according to Dr.

34 ALLERGIC LIVING | SUMMER 2012

Ginger Chew, an epidemiologist with the U.S. Centers for Disease Control and Prevention, besides triggering allergic reactions, molds can also cause breathing problems and other irritant effects in people who are not allergic. In rare circumstances some molds can be infectious or toxic; and as they are growing, these spores can produce microbial volatile organic compounds, or mVOCs, which can trigger the same kinds of reactions as VOCs

• Wash It Off You’ve conquered the mold – but like any formidable opponent, it’s going to do its best to come back. That’s why it’s especially important that, when you’re finished, you wash the clothes you were wearing, and hop in a shower to send all those mold spores down the drain. “Washing the mold spores from your hair is a good idea, because if you don’t, they can be transferred to your bed, or the sofa, or the child’s bed,” says Chew, who emphasizes that surfaces don’t need to be wet for mold to grow. In fact, even a mattress with a tiny layer of moisture can be enough to kick start a new colony. “It can be just a thin layer of moisture that is invisible to the human eye. That’s one of the reasons that mold grows

that off-gas from paints and other household chemicals. Those tiny VOCs can hitch rides around your home – and even slip right out of wall cavities and into your home. “VOCs can permeate through porous surfaces very easily because they are volatile,” Chew explains. “And a lot of the things we think are non-porous really aren’t – like drywall.” So how much exposure to these homewreckers is OK? There are guidelines and international standards, but Chew says levels that are deemed “safe” can still pose serious problems for those with mold allergies or sensitivities – and an individual’s

condition can get worse with prolonged exposure. “People who are allergic or have asthma mount a quicker and more intense immune response and become sensitive to even smaller concentrations. So it’s a moving target,” says Chew, who explains that the irritant-type reactions (such as pneumonitis or lung tissue inflammation) are usually associated with people who get big hits of mold on the job, and on a regular basis. But if a family keeps having to re-caulk a moldy bathtub or is ignoring a mold problem altogether, “it can also be happening in a home.”

Photo: EPA, courtesy of Chin Yang, Ph.D.

then carefully dried to prevent regrowth. You can do the same for more porous materials like drywall – so long as the mold is limited to the surface, and hasn’t made its way right through. Once mold has set up shop in the nooks and crannies of carpets, ceiling tiles, drywall and other materials, there’s a good chance the affected areas will need to be scrapped – although steam cleaning and allowing fabrics to dry completely can save carpets and upholstery. And if you think you only have a spot of mold near a baseboard, and then peel back a piece of wallpaper or wood paneling and see it’s coated in black, your DIY spirit should take a back seat and let the professional mold remediators take over.

themselves with an N95 mask, gloves and goggles. Those with allergies and asthma should avoid the affected area altogether – especially kids. “It’s a case-by-case thing, but for a major rip-out of a moldy sink or cabinet, for example, I think allergic or asthmatic children should be as far away as possible,” she says. “And you’ll probably want to cover the furniture, because wherever the spores land, even if it’s dry at the time, given enough moisture and nutrients they could start growing there, too.”

HEALTHY HOME

If you could see the air in your home,

on walls, especially in climates where you have a big difference between the temperature inside and out,” she says.

you’d hold your breath!

The Check-Up Mold can reappear if the dampness isn’t quite completely eliminated, and sometimes when homes go from being improperly sealed to airtight, moisture can get trapped in unexpected areas. Burton recommends that, after any renovation or remediation, homeowners keep their eyes and noses peeled, and act quickly if they notice any signs of moisture or mold. Still, she emphasizes that most often, the pesky fungi simply take full advantage of human neglect. “Usually it comes from someone not dealing with the problem when it started. They had a leak, they patched it, put the wall back up and it was still leaking in behind. Or they had an issue and just painted over it. I can’t think of a story I’ve heard that didn’t start with a moisture problem that could have been controlled from the beginning,” Burton says. “The biggest thing is: once you find it, you fix it.”

had hopedat that the Breathe would with our “IWe was skeptical first, butEZnow it’s been overhelp six months allergies as allergy meds only help to No a limited extent. and my boys are doing better than ever! allergies from Further, I have consistently suffered from a chronic, the weather, no wheezing or coughing just two small hacking cough for a long time. Since our EZ Breathe has boys of energy and life.not I’m experienced thoroughly convinced beenfull in operation I have even onethat severe my boys’ lungs not irritated by floatingMoreover, particles that attack and myare cough has disappeared. the would cause them to become sick and I owe that musty normally smell in our basement has been completely eliminated. EZEZ Breathe a great investment! clean air to my Breatheissystem!” – S. Danielson - EZ Breathe Customer

It’s simple... eliminate the triggers, eliminate allergy and asthma symptoms.

Want to nip that growing problem in the bud? Here’s some helpful advice: • Clean up any leaks or spills right away. If moisture is removed within 24-48 hours of appearing, mold is unlikely to grow. • Check your roof and repair or replace it immediately if you detect a leak; also repair any cracks or openings in your siding, and make sure your rain gutters are clear of debris and functioning properly. • Make sure the ground around your home slopes away from the building, not toward it.

EZ Breathe asthma and allergy advantages • Removes harmful triggers: pollutants, mold spores, pet dander, etc.

• Properly insulate your walls; this will help keep condensation from forming on your interior walls. • If you see condensation around windows or on walls or pipes, dry the wet surface and reduce the moisture source. If you have condensation, it could be a sign of high indoor humidity.

• Maintains healthy humidity levels (below 50%) • Reduces irritating airborne particles • Creates whole home air exchange

• Keep indoor humidity low, ideally between 30 and 50 percent. You can find humidity meters at most hardware stores. Low Moisture, Clean Air, Healthy Home. C

“Indoor air is 3-5 times more polluted than outdoor air”

Tips to Thwart Mold

UL ®

LISTED 24MU E245128

-U.S. Environmental Protection Agency

We exhale…so you can inhale www.ezBreathe.com • 866.822.7328

Ventilation Fan Model:400 31W Electric Rating:120V, 60Hz,

• Properly vent appliances that produce moisture, including clothes dryers and stoves. • Run a bathroom fan when showering, and a range hood when cooking or running the dishwasher. If you don’t have fans, open windows.

FAAN VIEWS | MARIA ACEBAL not think of kids with food allergies as “disabled”, they are when it comes to this law. A well-known settlement agreement between the Department of Justice and La Petite Academy*, a nationwide child-care provider, sheds light on this situation. In that case, La Petite had been refusing to administer epinephrine auto-injectors to the young kids in its care with food allergies. The settlement agreement under the ADA required La Petite to implement a policy that staff would administer an epinephrine auto-injector if treating a child with a severe allergic reaction. If camp administrators told me they would only help Nina “self-administer” her epinephrine in an emergency, I would not stand for it. I would hope that educating the director and senior staff on best practices for food allergy management would lead to a change. If it didn’t, I would send a written complaint to the Department of Justice’s Disability Rights Section (instructions for filing a complaint can be found on the ADA website). Bottom line: I would not feel my daughter was safe attending a camp with such a policy. In schools, day cares, and summer camps, our kids Camp can be a wonderful time, but it needs to be safe. need to know that in an ees are told not to administer epinephrine emergency the adults caring for them will directly to a child in need and instead to not hesitate to give them the medicine they make the child hold the auto-injector, so may need in order to survive. FAAN is here that he or she is technically self-adminis- to help with the education all teachers, tering the medication. At most, employees counselors and caregivers need in order to are instructed to “guide the hand” of the confidently care for kids with food allergies. If you know of an organization that child experiencing anaphylaxis. Many food allergy families feel this could benefit from our expertise, ask them refusal to administer life-saving medication to check out our free online course at is tantamount to barring kids with food www.allergyready.com or to visit our main allergies from enrolling in a camp. I think website. It may just help save a life. they’re right. The first time I heard about a camp doing this, I didn’t believe it. Surely Maria Acebal is the CEO of FAAN (Food there was some misunderstanding. A camp Allergy & Anaphylaxis Network) an organican’t legally do this, can they? zation dedicated to serving families with In my view, the answer is a resounding food allergies. She received her JD from Yale “no.” Title III of the Americans with Law School and practiced law before joining Disabilities Act (ADA) protects all individ- the non-profit sector. For resources on schools uals from being discriminated against and food allergies or to purchase a FAAN because of their disability in “places of pub- membership, visit www.foodallergy.org. lic accommodations,” which camps are. And while in everyday language we may *See the agreement at www.ada.gov/lapetite.htm

NOT A CAMP FOR MY CHILD We can change wrongheaded “guiding hand” policies at summer camps. e’ve all heard the expression “a mother’s work is never done,” and as the mother of three young kids, I couldn’t agree more. But what rings even truer for me is “there’s never a day off for a food allergy mom.” My work as mom to 10-year-old Nina – the oldest of my three kids and the only one with a food allergy – is never “done” in a way that it is for my younger two, Daniella, age 8, and Mateo, age 3. For Daniella and Mateo, a playdate is just a playdate. A field trip is a field trip. A summer camp is an exciting new opportunity: a time to make friends, spend time outdoors and learn new skills. For Nina, it’s a potential minefield. How do I make sure she has safe foods to eat? Who will step in if something goes wrong? Who will know where her epinephrine is? Who can I trust to not hesitate to use it? Most importantly: what do I do to make sure I get her back home safe and sound? Summer camps make me more nervous than school, field trips, play dates and other activities because, in my experience, the counselors are often very young and the days are not always very structured. There’s more movement from one activity to another, less routine, less experienced supervision – it all leaves room for error. Most troubling of all is an emerging trend I’ve noticed in the last couple of years that I hadn’t encountered in my previous six years working on food allergy safety: the reluctance of some summer camps to administer an epinephrine autoinjector, the only life-saving medication available to our kids with food allergies. Known as the “guiding hand policy”, many food allergy families have encountered summer camp programs that have adopted a practice whereby their employ-

Photo: iiStockphoto.com / kali9

ALLERGIC LIVING | SUMMER 2012

LATEST INFORMATION

NewsFlash

that any child or adult who has food allergies is safe.” Specifically, Lehr mentioned continuing to fund research into oral immunotherapy, an experimental treatment in which patients eat minuscule and then increasingly larger amounts of the food they are allergic to, in order to gain tolerance. The new CEO also hopes that by continuing to educate the public and people with food allergies, the organization can “help reduce the incidence of hospital visits and prevent needless deaths.” The leaders of the pre-merger organizations, Mary Jane Marchisotto of FAI and Maria Acebal of FAAN, John Lehr, Maria Acebal and retain senior management posiMary Jane Marchisotto of the tions, working alongside Lehr. merging allergy organization. Historically, FAI has had a strong focus on funding research to find a cure for food allergies, while FAAN has concentrated its efforts on patient education and advocacy for school policies and state guidelines. However, there was some duplication of effort. The hope is that the combined group will be more efficient. This year, there won’t be a lot of visible changes to calendars of events or programming that is already in place. “The changes that people will see will likely come next year,” says Lehr. “There are two things I’m most interested The main office will be Fairfax, with in. One is advancing research toward a regional offices in New York and Chicago, cure, and I think there’s a lot that can be currently the location of FAI’s offices. done on that front. Second is to make sure

Food Allergy Groups Unite in Quest for Cure by CLAIRE GAGNÉ he two leading food allergy associations are joining forces to create one powerhouse organization seeking to improve the lives of people with food allergies. The Food Allergy & Anaphylaxis Network (FAAN) and the Food Allergy Initiative (FAI) will unite under a new name and logo (to be announced shortly) and begin operating as one organization after they receive regulatory approval for the merger. The new organization will be led by John Lehr, the former president and CEO of CureSearch for Children’s Cancer. Speaking from FAAN’s Fairfax, Virginia offices, Lehr is clear on the focus for the merged organization.

In Brief Asthmatic Seniors Research published in the Annals of Allergy, Asthma & Immunology found that only 53 per cent of asthmatics over the age of 60 took prescribed inhalers on a regular basis. The findings are significant, as the death rate for people with asthma over the age of 65 is 14 times higher than that of younger patients. “It is alarming that such a large percentage of older people with asthma are letting their disease go untreated, especially since this can lead to other health problems,” the 38 ALLERGIC LIVING | SUMMER 2012

study author said in a release. Allergic rhinitis, arthritis and diabetes were found to be more common in study participants with asthma than in those without.

Asthma Stats New data from the Centers for Disease Control and Prevention shows 25.7 million Americans (18.7 million adults and 7 million children) have asthma. Other key U.S. stats include: • 1 in 11 children have asthma; 1 in 12 adults have asthma. • black children are twice as likely to have asthma as white children. • 1 in 5 children went to the emergency room for asthma in 2009.

Allergy Shot in a Pill Immunotherapy treatments to ragweed and grass allergy may be available in tablet form as early as next year, according to Merck & Co. The company says results from a Phase III clinical trial – the final phase before a company can apply for approval of a new drug – showed its tablet significantly reduced symptoms of ragweed allergies. A previous study showed the same for its grass allergy tablet. These drugs target the underlying disease mechanism, not just the symptoms. Traditionally, if people wanted to reduce their sensitivity to pollen allergens, they would need to go to their allergist’s office for “allergy shots” over a number of years.

Migraines Linked to Celiac by LISA FERLAINO aving chronic migraines could be a sign of celiac disease, according to a new study from researchers in New York. After studies in Europe showed a link between celiac disease and a high prevalence of migraine headaches, Dr. Alexandra Dimitrova, a neurological resident at Columbia University Medical Center, under the supervision of Dr. Peter Green from the Celiac Disease Center at that university, decided to investigate whether the same held true in the U.S. The researchers found that 30 per cent of the patients they studied with celiac disease reported chronic migraines (14 or more per month). For the study, the researchers analyzed the intensity and frequency of headaches of 502 people with celiac disease, gluten sensitivity, irritable bowel disease, as well as a control group. They also looked at daily habits, such as coffee and alcohol consumption. Those with celiac disease reported the most frequent and intense migraines. Since it often takes years before someone is diagnosed with celiac disease, migraines could be a clue: “I would test any patient not responsive to appropriate migraine medical therapy administered by a neurologist,” says Dimitrova. The good news is that both the European and U.S. research suggests that a gluten-free diet can reduce the number and severity of migraines. More work needs to be done, says Dimitrova, including a study in which diet and eating habits are looked at in-depth to determine the impact on migraines.

AMISH KIDS LESS ALLERGIC t has been known for a number of years that kids who grow up on a farm have fewer allergies and a lesser chance of developing asthma. Now new research is showing that there’s something about growing up on an Amish farm, specifically, that further increases protection against these diseases. Researchers compared kids who lived on farms in the Amish community of about 25,000 in Indiana with kids who lived on farms in Switzerland, as well as Swiss kids from cities. (The Indiana Amish community migrated from Switzerland about 200 years ago, so there is genetic similarity.) On the Amish farms, 5.2 per cent of the children had asthma and 7.2 per cent tested positive to skin prick tests for environmental allergens. The rate of asthma and allergic sensitization on Swiss farms was 6.8 per cent and 25.2 per cent. In the Swiss city kids, rates were even higher: 11.3 per cent were reported to have asthma, and 44.2 per cent were sensitized to allergens. (Sensitization does not necessarily mean a person will have allergy symptoms.) Researchers did not have an explanation for the lower rate of sensitization in the Amish children, but said that many families in the community live on working farms, all have horses that are used for transportation, many drink raw milk, they don’t have electricity at home and they have large families. –Claire Gagné

The tablets may still need to be taken over a number of years, but this can be done at home.

Photo: AFP / Getty Images

3 Shots Only Researchers in Switzerland say they’ve found a way to reduce the number of injections needed for immunotherapy to just three shots. In the study, cat allergen was modified and injected directly into the lymph nodes. After three injections over two months, the patients who got injections gained tolerance to cat dander, while those on a placebo did not. Typically, immunotherapy injections are taken weekly or monthly over three to five years. The study, published

in the Journal of Allergy and Clinical Immunology, had a small sample size and was meant to determine the safety of the shots.

Preventing Eczema A study has found that taking heatkilled bacteria in infancy may prevent eczema. Researchers in Europe looked at more than 600 infants who were at risk of eczema due to one parent being “atopic” – the tendency to be allergic. Ten per cent of those who took the bacteria in a solution from five weeks old to seven months old developed eczema, compared to 20 per cent of the group who got a placebo. –C.G.

ALLERGIC LIVING | SUMMER 2012

LATEST INFORMATION

Texas Gets Allergy Guidelines by CLAIRE GAGNÉ hen students in Texas head back to classes in the fall, they can expect their school district to have a policy in place on dealing with students with food allergies. Exactly what’s in that policy, however, is up to the individual districts. “We wanted to avoid the guidelines having requirements because every school district knows their needs best,” says Ray Martinez, chief of staff to Texas Senator Judith Zaffirini and the father of an 8-year-old boy with food allergies. The senator authored a bill, signed into law in June 2011, that requires all of the state’s school districts and charter schools to implement food allergy policies.

Food allergy families lobbied the state legislature in Austin in 2011 for schools bill SB27.

It charged the Department of State Health Services, along with a committee of parents, school representatives, food allergy groups and medical organizations, to develop guidelines, which were released in May, on which school districts must base policies. Districts have until August 1 to develop policies. Mike Lade, vice-chair of FAAN’s board of directors who was on the guidelines committee, says getting this kind of legislation in Texas is a coup. “Texas is still the Wild West,” he says.

“No local school district wants to be told: ‘Thou shalt do this.’” The guidelines contain information on everything from the symptoms of an allergic reaction to training for school staff and teachers, guidance on reducing the risk of allergen exposure, sample forms, action plans and more. For Martinez, having the guidelines in place means his son can continue through the school system with support for his allergies. “It has been a constant source of concern for us to make sure that we feel the appropriate protocols are in place,” he says.

We e kn know 60 million. Including uding the t ones you care about most – your family ly and friends with asthma, allergic rhinitis, food allergies gies and g an more. Through ough 60 years of education, advocacy and research, arch, we’ve w been fighting to overcome the limits caused sed by these diseases at home, school and work. But we nee need your help to do more. Please make a tax-deductible deduct donation today at aafa a.org/donate g/ or call all 1-800-7-ASTHMA. 1-80

for life without thout llimits™

Domino’s Dustup hat happens when you launch a gluten-free pizza crust that’s not suitable for people with celiac disease? As Domino’s Pizza found out, you light up the blogosphere and anger a community representing three million Americans. When Domino’s announced the crust in May it made clear that: while the crust is made without gluten, cross-contamination with gluten could occur at its stores, so it was not recommended for those with celiac disease. That raised the ire of those whose health depends on a strictly gluten-free diet. “Domino’s has decided it wants to cash in ... but they don’t want to spend the money that it would take to make their pizzas truly gluten-free and safe for celiacs,” wrote Scott Adams on Celiac.com. The reaction was so pronounced that the National Foundation for Celiac Awareness, which had given the crust an “amber” designation under its GREAT Kitchens program (meaning that ingredients are gluten-free and the staff has basic training, but customers should exercise their own judgment before eating), suspended its amber designation and announced it was reviewing how best to alert the community to cross-contamination risks. Domino’s has no plans to change its crust or promotion: “We created a gluten-free crust,” Domino’s spokesperson said. “We have no airborne flour in our stores. Due to the chance that there could be cross-contamination, we opted to err on the side of safety and honesty, and let people know that we don’t recommend this product for people with celiac disease.” –C.G.

When Can Kids Self-Inject? any allergists expect children to take responsibility for recognizing signs of anaphylaxis and the self-injection of epinephrine by ages 12 to 14, report the authors of a study that surveyed 88 American allergists. While the timing of when allergists expected the transfer of responsibility from parent to child to occur varied, many expected that, by the ages 9 through 11, children would be able to describe some anaphylaxis symptoms, recognize the need for epinephrine, and show they could self-inject using a trainer. By 12 to 14, 79 per cent of allergists said children should be able to self-inject epinephrine. In the study, published in the Annals of Allergy, Asthma and Immunology, allergists most often cited being able to self-inject with a trainer, being able to describe reasons to inject and having a high risk of anaphylaxis as factors for transferring the responsibility to the child. –C.G.

Healthy air on the go. Introducing Philips GoPur Introducing GoPuree Automotive Automotive Air Purification System – a medical-grade air purifier er ffor or yyour our vvehicle. ehicle.

GoPure is a rrevolutionary GoPure evolutionar y new new wa way ayy to purify the air inside your your vvehicle. ehicle. A 3-stage filtering pr process rocess ocess help helps reduce reduce bad odors and eliminates es 99.97% of pollutants,, viruses s,, germs,, bacteria,, harmful viruses, ou the cleanest air yyou’ve ou’ve eever ver gasses,, dust, dust,, and pollen,, to giv givee yyou had while driving. FFor or mor formation ormation call:: 800-257-6054 800 257 605 or visit: moree inf information www w.philipsgopurre.com www.philipsgopure.com

DOCTOR’S Q & A

Ask the Allergy & Asthma Expert

DR. CLIFFORD BASSETT

Dr. Clifford Bassett responds to reader questions. I had asthma as a kid, but seemed to outgrow it. I’m 33 now, and I’ve developed a cough, and have felt tight in the chest around my girlfriend’s cat. Can asthma come back?

We know that asthma tends to persist from childhood through adulthood. A person may not have symptoms for a while, but it is a chronic disease and symptoms may resurface at any time due to triggers such as allergies, exercise, infection or other respiratory irritants. The majority of adults with asthma

have underlying allergies, thus a proper evaluation is necessary. Skin testing at your allergist’s office can help determine your allergic triggers and whether being exposed to the cat is causing the tightness in your chest. A computerized breathing test, also known as a lung function test or spirometry, can more accurately and objectively look at your small and large airways to see if asthma is present. If it is in fact asthma, your doctor will prescribe appropriate asthma controller and/or rescue medications as well as discuss ways to modify your environment based on your allergic triggers.

We’ve been planning a camping trip from Colorado to Oregon, but now our child has been diagnosed with moderate persistent asthma. Beyond using his inhalers, are there any special precautions you would recommend?

Camping, biking and outdoor sports are possible for most asthmatic individuals. To have a safe and fun-filled trip it is essential to see your allergist or asthma specialist for an “asthma check-up” prior to leaving home. Using a peak flow meter to monitor your child’s asthma condition

We can help. We d, danderr,, chemicals Mites, mold, and other triggers can make your home dangerous. We’re the only ones who test environmental control products in the lab to find the most suitable choices for you. Look for Certified asthma & allergy friendly™ products to make your home a better place to live. or call 1-800-7-ASTHMA g/ org/certified Visit aafa.o for a current product guide today.

forr life without limits™

WHAT IS ASTHMA? Allergic asthma is a chronic inflammatory disorder of the airways and is triggered by allergens such as animal dander, dust mites, pollen or mold. Some people also have non-allergic asthma, set off by irritants including cigarette smoke, pollution and chemical fumes. Not everyone will get all symptoms, and not every asthmatic will wheeze.

is a valuable way to recognize any sudden changes that will require adjustment of your typical asthma regimen and use of prescribed medications. It is important to plan ahead and have all daily and rescue medications on hand. Also, if your child uses a nebulizer, make sure you have a battery-powered one to use when no electricity is immediately available. Traveling to higher altitudes (with cooler air and/or less oxygen at

The Symptoms • Chronic coughing • Shortness of breath • Wheezing • Tightness in the chest • Shallow, rapid breathing • Breathing difficulty at night, causing sleep disturbance • In a severe attack, the person will find breathing very difficult; he may have trouble speaking or concentrating; and he may have a bluish tinge to the lips and face. Reviewed by Dr. Clifford Bassett.

extreme altitudes) can lead to a spike in asthma symptoms, hence having a discussion with your allergist or asthma specialist prior to your trip is key. I have pollen and mold allergies – and a constant stuffed up nose. I largely breathe out of my mouth. Does it actually matter if you breathe through your mouth instead of your nose?

Free Monthly E-letter Every month, Allergic Living’s leading health journalists create NewsReport – the best food allergy and gluten-free newsletter available online. Stay up to speed on breakthrough research, great allergy advice and articles.

click here

Nose or nasal breathing is the optimal way to breathe for a number of reasons. The nose is designed to filter and warm the air entering it, providing a first line of defense against infection (colds, viruses, etc.) and the sinuses act to humidify the air before it enters the lungs. Seeing an allergist to evaluate and reduce or manage your allergic triggers will assist you in reducing your chronic nasal congestion and thus have the ability to breathe through your nose once again!

Dr. Clifford Bassett, an allergist and asthma specialist, is the Medical Director of Allergy & Asthma Care of New York (www.allergyreliefnyc.com). A fellow of the American College and Academy of Allergy, Asthma and Immunology, he is also on the faculty of NYU School of Medicine and Long Island College Hospital/SUNY. He has served as an educational consultant to AAFA. Note: This column is meant as general information and guidance and is not to be interpreted as diagnosis and treatment of individual patient conditions. For such specific medical advice, visit an allergist or pulmonologist.

CELIAC EXPERT | SHELLEY CASE

HOT SUMMER READING

A lazy day in summer is a great time to brush up on celiac disease and the gluten-free diet. Let me share some of my favorite books. Celiac Disease for Dummies by Dr. Ian Blumer and Dr. Sheila Crowe This is an easy-to-read book written for those with celiac disease and their family members. It has practical information including symptoms, diagnostic tests, associated conditions, complications, treatment, nutritional considerations, complimentary therapies, research about potential new treatments, and more. Real Life with Celiac Disease: Troubleshooting and Thriving Gluten Free by Melinda Dennis, RD and Dr. Daniel Leffler Health professionals and those with celiac disease will find this book, which features a wide variety of topics about celiac disease, gluten sensitivity and the gluten-free diet, highly informative. It includes case studies from the authors (from the Celiac Center at Boston’s Beth Israel Deaconess Medical Center) and more than 50 celiac experts, along with recommended treatment options and lifestyle changes. Complete Gluten-Free Diet and Nutrition Guide by Alexandra Anca, RD and Theresa Santandrea-Cull Dietitian Alexandra Anca teamed up with baking instructor Theresa SantandreaCull to produce this informative guide

that features an overview of celiac disease and detailed information about the gluten-free diet: foods allowed and to avoid, shopping tips, substitutions, healthy eating, a 30-day meal plan and over 100 recipes with nutritional analysis. People Before Profit by Ken Koopman This is a heart-warming story of a true entrepreneur, Bob Moore, founder of Bob’s Red Mill. Starting out from humble beginnings, Bob and his wife Charlee persevered through numerous setbacks, including a fire that destroyed their first mill, and rebuilt Bob’s Red Mill into the well-respected international whole grain company it is today. With passion, yet humility, strong ethics and faith, Moore’s story is truly inspiring and a must-read. Easy Gluten-Free: Expert Nutrition Advice with More than 100 Recipes by Tricia Thompson, RD and Marlisa Brown, RD Written by celiac expert dietitians, this book features information about glutenfree ingredients, label reading and nutrition strategies. It includes a 28-day meal plan and recipes with nutritional analysis. The recipes are divided into: quick-and-easy (less than 30 minutes) and creative (special dishes), and many of the recipes are made with whole grains and flours.

The Definitive Gluten-Free Guide Here’s what you’ll find in the new Gluten-Free Diet: • • • • • • •

Detailed food and ingredient information. Creative ideas for meals and snacks. Gluten-free recipes with nutritional analysis. Prevention of cross-contamination advice. Practical strategies for healthy gluten-free living. Tips for eating out. Breaking news about oats, including position statements from organizations around the world.

44 ALLERGIC LIVING | SUMMER 2012

Gluten-Free Diet: A Comprehensive Resource Guide by Shelley Case, RD Of course I’m biased, but had to include it! See my advertisement below for complete info on the book. 1000 Gluten-Free Recipes by Carol Fenster I love all the cookbooks by gluten-free culinary expert Carol Fenster. But this is my favorite since it’s loaded with a range of delicious recipes using common ingredients that the whole family will enjoy. Many of the recipes are conveniently highlighted as quick-to-make or vegetarian. Whether you are on a gluten-free diet or not, I highly recommend. Complete Gluten-Free Cookbook by Donna Washburn and Heather Butt These home economists have developed recipes that are easy to follow and use a variety of nutritious gluten-free flours, nuts, beans and seeds. There are wonderful recipes for appetizers, salads, soups, side dishes and entrees. However, it is the extensive number of delicious breads, quick breads and desserts, along with a section on bread machines, that makes this cookbook a real winner. Everyday Gluten-Free Slow Cooking by Kimberly Mayone and Kitty Broihier, RD The authors have developed 140 flavorful recipes for breakfast, lunch and dinner using whole grains and other common ingredients. More than 100 of the recipes are dairy-free or can be adapted using substitutions.

Shelley Case, RD, is an international celiac nutrition expert, consulting dietitian and the author of Gluten-Free Diet: A Comprehensive Resource Guide. For more articles and information, see www.glutenfreediet.ca.

Order your copy today. www.glutenfreediet.ca

• New food and GF labeling regulations in the U.S., Canada, Europe and Australia/NZ, as well as the international Codex Alimentarius. • Over 3,100 gluten-free specialty products listed by company name, product name and package size. • Directory of more than 270 U.S., Canadian and international companies, with manufacturers of GF products, GF bakeries and GF stores & distributors.

No worries, all yummies. So Delicious® Dairy Free is dedicated to bringing deliciousness to your dairy-free days. We offer an array of products that delight your family and bring you peace of mind.

You’re SO gonna love this.™

Find allergen information, recipes, and coupons at SoDeliciousDairyFree.com.

NO DAIRY, NO GLUTEN | ALISA FLEMING

Photo: HANNAH KAMINSKY

Strawberries ’n Cream Watermelon Pops atermelon and strawberry have evolved to be one of my favorite fruit combinations. Plus, the riper the fruit, the sweeter the pops, so this cool recipe is ideal to enjoy in the heat of summer. Feel free to reduce the honey in the watermelon and strawberry blend if your fruit is particularly ripe, but be aware that the finished pops will taste a little less sweet once frozen.

Ingredients Fruit Layers

• 1⁄4 lb ripe, seedless watermelon flesh 1 (about ⁄2 cup of puree) 1 • ⁄2 cup (or 2.5 ounces) fresh or frozen ripe strawberries, halved • 1 tbsp honey • 1⁄4 tsp fresh lime juice

Vanilla Cream 1 • ⁄2 cup coconut cream* [see “Advice On” page 48] or full fat canned coconut* milk • 1 tbsp honey • 1⁄4 tsp vanilla extract

ALLERGIC LIVING | SUMMER 2012

NO DAIRY, NO GLUTEN | ALISA FLEMING Method

• Combine the watermelon, strawberries, 1 tbsp of honey, and lime juice in a blender. Puree until smooth. Pour into a glass measuring cup, and quickly rinse the blender jar. • Combine the coconut cream or coconut milk, remaining 1 tbsp of honey and the vanilla in the blender. Puree until smooth. • Pour the fruit blend into 4 to 6 pop 1 molds until they are roughly ⁄3 full. Freeze the pops for 30 minutes. • Remove the pops from the freezer,

and divide the vanilla cream among the pops to make the second layer. Freeze the pops for 30 minutes. • Remove the pops from the freezer, and pour the remaining fruit blend over the pops to make the third layer. Place the popsicle sticks into the pops, and freeze the pops for 1 to 2 hours, or until completely frozen. Makes 4 to 6 Pops Recipe Variations

• Quick Blended Cream Pops: For a super fast two-step recipe, skip the layers and simply blend all of the ingredients together.

Fill the pop molds and chill in the freezer for 2 hours or until they are solid. • Strawberry Cream Variation: For fruitier pops, blend two ripe strawberries into the vanilla cream before pouring it into the molds. *A Note on Coconut

Coconut is technically a fruit. While most allergists do not consider it a tree nut, if you are nut allergic, ask your doctor if coconut is safe for you. Alisa Fleming is the author of Go Dairy Free: The Guide and Cookbook for Milk Allergies, Lactose Intolerance and Casein Free Living, and founder and chief editor of the website Godairyfree.org.

ADVICE ON:

Substituting Cream in Dessert Recipes

ALISA RECOMMENDS:

BOLD Organics Frozen Pizzas The effortless summer pizza party has returned! Though there have been some attempts in recent years at allergy-friendly frozen pizzas, BOLD Organics Gluten-Free and Dairy-Free Frozen Pizzas exceeded my expectations with high quality pizzas that leave competitors in their dust. My husband proclaimed their gluten-free crusts to be “better than the real thing,” and we were both astonished by the generous amount of organic toppings included on both the meat and vegetarian pizzas. Since buying a frozen pizza is truly a treat, I also love that BOLD Organics pays attention to the details, sourcing non-GMO ingredients, and crafting a homemade taste without preservatives or nitrates. Available in Vegan Cheese, Veggie Lovers, Meat Lovers and Deluxe varieties, all of the BOLD Organics pizzas are gluten-free, egg-free, nut-free, and made with an organic soy-based, dairyfree cheese alternative. For more information on the pizzas, see: www.bold-organics.com

48 ALLERGIC LIVING | SUMMER 2012

My go-to substitute for heavy cream in sweet recipes is coconut cream. Despite the name, coconut cream contains no dairy. It’s made purely from pureed coconut, but has a rich, creamy texture. Like dairy cream, coconut cream is high in saturated fat, allowing it to solidify at cooler temperatures. Thus, coconut cream can be whipped, and maintains a rich and creamy texture when frozen. Coconut cream is surprisingly easy to locate; you’ll find it in the Asian foods section of most grocery stores under the guise of canned coconut milk. Coconut cream is simply the rich part of full-fat coconut milk. As the coconut milk rests, the cream rises to the top to form a very thick layer that can be scooped out like soft ice cream. In fact, the sign of a good canned coconut milk is one that separates into a watery base with up to 3/4 cup of “stand a fork in it” cream on top. During warmer months, chill the coconut milk in the refrigerator for a few hours to assist in the separation. –A.F.

deliciously dairy free no matter how you slice it

Daiya Wedges Same delicious experience in a whole new style! New Daiya Wedges are ready to just slice and enjoy, no cooking or melting required! Perfect on your favorite sandwich or as a bite-size snack, and still deliciously free of dairy (lactose & casein), soy, gluten, and other common allergens. With three new flavors — Jalapeño Garlic Havarti, Jack, and Cheddar — the only decision left is which one to slice into first!

dairy free

gluten free

soy free

Vegan

Pareve

So Many Chefs Are Getting It “You have to avoid glue?” has been replaced by: “Would you like our gluten-free menu?” How far we’ve come in 7 years. rushed with hunger, I walked into the Italian restaurant where I would soon be speaking. Honored to be talking about the state of cookbook publishing in this country, I knew this would be a good afternoon. But after leading a writing workshop all morning, with nothing but a few pieces of cheese and a cup of coffee for sustenance, I was nearly faint with the need for food. My in-caseof-emergency snack stash was empty. So was my stomach. Seven years ago, when I was first diagnosed with celiac sprue, this circumstance would have turned into a real nightmare. Happy to finally be well, back then I still despaired of ever eating in a restaurant again. The chit-chat in the online forums read like a constant tsk-tsk for anyone contemplating eating food made by the hands of a chef. “They don’t understand crosscontamination. You’re risking your health by even eating a plain salad and bringing your own dressing.” It wasn’t just a dour negativity ruling these conversations. Most restaurant servers looked at me with wondering eyes if I said I needed to eat gluten-free. One confused woman asked me: “You have to avoid glue? Why would we put glue in our food?” Scared of growing sick, I didn’t eat in many restaurants my first year of being glutenfree. It felt impossible. My, how things have changed. In the past seven years, I have seen the awareness of what gluten is and why so many folks need to avoid it rise exponentially. Almost every coffee shop I stop in has at least one gluten-free muffin or packaged sweet treat. Big food companies like Hormel or Frito-Lay have “gluten-free” written in capitals on their packages of sliced turkey or potato chips. Major maga-

50 ALLERGIC LIVING | SUMMER 2012

Many chefs are welcoming gluten-free diners.

zines have realized, en masse, that they need to address the gluten-free diet. In their articles, the snide suggestions of fad dieting have started to fade into resigned understanding. The need for good glutenfree food is, happily, here to stay. For me, good food is the root of it all. If I’m going to have a disease or disorder, give me the one where the only cure is eating really great food. Once I began seeking out gluten-free foods seven years ago, I found there weren’t many packaged foods that could feed me. After I inspected the labels on the side of food packages, I grew exhausted reading the list of chemicals and additives. Even if I figured the product was gluten-free, I didn’t want to eat it any more. So I began to cook with real food. I

went to farmers’ markets for fresh asparagus or plump raspberries. I sought out the stores that supplied local produce and good-quality meat. Each evening brought a new experiment in the kitchen, a dance with ingredients and a hot stove, music playing, all my senses fired. This is how I found my life. So the rise of gluten-free processed foods in the past seven years feels like a complex progression. Those who make food for the supermarket understand the profit potential if they make TV dinners, frozen pizzas and sugary treats that are gluten-free. I’m thankful for the choices, especially in airports or places where I’m caught unprepared. But it saddens me that it’s now possible to trade a gluten-filled packaged-foods existence for a gluten-free packaged-foods existence. However, I am nothing but thrilled with how well many restaurants have learned to feed their gluten-free customers. After all, chefs love to play with good ingredients and to give their customers that joy in the belly. And those of us with celiac disease or gluten sensitivity are a very grateful audience. When I walk into a new place, immediately made hungry by the smells simmering in the kitchen, I grow a little teary if the server says: “Of course we can take care of you. Would you like to see our gluten-free menu?” Though I still ask a few questions to see if they really get it.) Seven years into this glutenfree journey, at that Italian restaurant where I stood woozy from hunger, I asked the server if she could feed me gluten-free. So much had changed that she just waved her hand happily and said, “Oh yeah.” The smoky taste of that tender calamari, drizzled in rosemary-lemon aioli, inspired me to try making some for myself at home. Good food begets more good food. But the fact that eating that dish safely was so inordinately easy made me want to take the hand of that woman seven years ago and say, “Don’t worry, sweetie. You will eat well in restaurants again.” Shauna James Ahern’s and Daniel Ahern’s first cookbook is Gluten-Free Girl and the Chef, published by John Wiley & Sons.

Photo: iStockphoto.com / STEVE DEBENPORT

GLUTEN-FREE GIRL | SHAUNA JAMES AHERN

Welcome to

Allergic Living! Allergic Living is the new health and lifestyle magazine created specifically for those living with allergies, asthma and celiac disease. • Engaging, in-depth articles. • First-person stories. • The latest medical breakthroughs. • Advice from top experts. • Delicious, allergy-safe and gluten-free recipes. This magazine has it all, and then some. Allergic Living’s mission is to provide the best, most relevant and most thoroughly researched coverage of allergies, asthma and gluten sensitivity. You simply won’t find this information in other media.

Subscribe Today Get the new Allergic Living delivered to your mailbox at our affordable rates.

Go to:

$29.99 – 2 years / 8 issues $19.99 – 1 year / 4 issues

Allergicliving.com/subscribe

 Subscribe online: Follow the steps to order online.  Subscribe by mail: Click the “Pay by Check” button for a mail-in form. Questions? 1-888-771-7747 or info@allergicliving.com

Stormy Skies Inconsistent allergy policies are leaving travelers stressed and angry. What can be done? by GWEN SMITH

52 ALLERGIC LIVING | SUMMER 2012

Photo: (plane) iStockphoto.com / MARCHCATTLE

r. Brett Greenberger vividly recalls the dream vacation that imploded. Three years ago, the Baltimore psychiatrist and his wife Emily, a social worker, planned a Caribbean getaway for the family – including their three kids and his parents. Since their daughter Lily, then 5, has serious allergies to peanuts and nuts, the couple researched staying in a condo on the Leeward Island of St. Kitts, figuring they could do their own cooking and ensure the food was safe. They looked into flights. The times worked well with American Airlines, which doesn’t serve peanuts, so the next step was to inquire whether nuts would be served on these particular routes. “We were assured they would not be,” says Greenberger. So they booked the seats and prepaid the condo. On their travel day, the flight from Baltimore to Miami went well. The family checked in at the ticket counter in Miami – just to confirm that nuts wouldn’t be served on the flight to St. Kitts. The first hint of trouble came when a supervisor responded that this was up to the crew. When the Greenbergers headed to the entranceway of the plane and began to speak to a flight attendant about Lily’s allergies and previous assurances, she told them that nuts were being baked, as they spoke, in the front ovens to be served in first class. The couple immediately noticed the strong aroma. Next, the pilot and gate supervisor were there, telling them that the snack service could not be changed and further, the pilot felt their child and her serious allergies presented a flight risk to the whole plane. With Lily now sobbing, the Greenbergers say they were not allowed to board. So could they get another flight? Not to the Caribbean. The airline’s representatives said they could fly them elsewhere but heated nuts would be served in first class on all St. Kitts flights. “Multiple people from the airline said there would be no issue with nuts, then one individual and the pilot made the decision not to accommodate or problem-solve in any way. It was just not fair,” says Greenberger. These are turbulent times for North Americans traveling with peanut or nut allergies. On the upward bounce, some airlines are taking positive steps forward. JetBlue and Southwest Airlines often receive positive reviews for allergy awareness, and Canadian airline WestJet has become the shining star of food accommodations. (WestJet doesn’t serve peanut or nut snacks and, to reduce the risk of residue, its crews will make an announcement asking fellow passengers to refrain from eating nut or peanut snacks.) But on the stomach-flipping downward bounce, the negative stories and tales of inconsistent promises about allergy accommodations abound. In Allergic Living’s view, they are becoming more frequent. One of the big problems is that some airlines’ own staff members seem unaware of their employer’s exact policy on food allergies. In a 2008 study from the University of California at Davis, researchers phoned several airlines three times and asked the same questions, including: “Would you be willing to remove peanuts or tree nuts from a flight?” Airlines responded consistently only 31 per cent of the time. Anecdotally, this situation persists with some carriers. On board, it’s the same story: some cabin crews will serve alternative snacks and make a P.A. announcement that there is someone on board with a nut or peanut allergy and ask passengers not eat those foods. But customers often don’t realize that, at most airlines, these are the sympathetic actions of an individual crew, not a policy you can rely on.

One of the big problems is that some airlines’ own staff members seem unaware of their employer’s precise policy on food allergies.

If you’ve been promised an accommodation, mention it to airline agents.

In a tough economic climate, large carriers like United and American Airlines have also become attached to the prestige value of tree nuts (usually almonds and cashews) to attract the highpaying customers in the first-class section. “The warm nuts are something we can offer the premium passenger to make the travel experience better and to help differentiate our product,” says American’s spokesman Ed Martelle. While food allergy consumers need airlines to be overt about their practices regarding peanuts and nuts especially – since they are common snacks and potent allergens – some airline websites offer only a terse allergy policy. Offering consumers adequate online information is helpful – and cost-effective. Case in point, the Greenbergers ended up with a full refund on their seven flights. *** The idea of reducing the risk of reaction at 35,000 feet often seems like a no-brainer to those living with food allergies. But there are those who strongly object, and not just those who like their nut snacks. From the peanut grower to the big confectioner, there are lobby groups that say there’s no proof that peanuts or nuts in an airline cabin cause severe reactions. This came up in late 2010, when the Department of Transportation (DOT) proposed banning the serving of peanuts on planes. DOT backed away from such a ruling because of a law, passed in 1999, that demands a peerreviewed study that shows “severe reactions by passengers to peanuts as a result of contact with very small airborne peanut particles” before any peanut-restricting edict can be issued. But on a smaller scale, there is, in fact, evidence of risk. Three studies have examined air travel and found that, based on passengers’ reports, there have been peanut and tree nut reactions. ALLERGIC LIVING | SUMMER 2012

In the University of California study of 471 people known to have severe peanut, nut or seed allergies, almost 10 percent reported experiencing a reaction. Of significant concern in a 2009 study from the University of Michigan was that one-third of the reactions were consistent with anaphylaxis. Dr. Matthew Greenhawt, an allergist and author of the Michigan research, says that a more rigorous study “would require diligent in-flight assessment of how peanut or tree nut particles may distribute within a pressurized cabin, how different cabin configurations may alter this, and how these dynamics may be affected by different aircraft models.” That’s tough data to come by, especially since the airlines haven’t been open to that kind of aircraft scrutiny. Greenhawt says that while proof beyond self-reporting is ideal, “the passenger reports continue to pour in and should not be dismissed.” Organizations like the Food Allergy & Anaphylaxis Network and Allergic Living also receive e-mail accounts of reactions on flights. While most of them are mild, all of them are troubling when at such a distance from a hospital. *** It’s interesting that while sectors of the food industry raise doubts about the seriousness of allergy risks, Allergic Living actually sees an increase in allergic passengers being questioned about whether they are “fit to fly” – the airline term for being healthy enough for air travel. In the Greenbergers case, “it was like Lily was the perpetrator of the problem,” says Emily. (It should be noted that Martelle says American’s view is that “there are discrepancies between what the Greenbergers are now saying and what they said during the event.”) Anne Thompson, co-founder of Illinois’ MOCHA support group, relates that her son Andrew almost lost his seat due to his peanut and nut allergies. Last year the high school student, an elite rower, was heading to a national regatta. Andrew checked in with United at O’Hare International, just to confirm that no peanuts would be served (that is United’s policy). The agent was concerned, since the airline “couldn’t guarantee” there would be no nuts in the cabin. The teen phoned his mother in a panic – the agent might not let him board. He was allowed on – but by no means was it a given. Also boarding at O’Hare last fall was Amy Wicker and her family. Wicker told United flight attendants on the Phoenix-bound flight that her daughter has severe tree nut and peanut allergies. She’d done this in past and found crews willing to change snacks or make an announcement that there was a child with nut allergies on board. This time, Wicker was told that warmed nuts were being served in first class, with cashews being baked in the front and almonds in the back. When she asked if an alternative could be served, the reply was: “Ma’am, if you don’t feel comfortable flying, you’re welcome to get off the plane.” Appalled that a snack seemed to trump a child’s health, Wicker gave her daughter a pre-emptive dose of Benadryl for a tense, three-hour flight. Air Canada instituted a policy in late 2010 in which a passenger can request a “buffer zone” of three nut-free rows, but to qualify for it, you need a doctor to complete a medical form. There have been incidences of the airline’s staff telling allergic passengers that they can’t board without such clearance – a misinterpretation. The new policy says you need the medical form if you want the allergy buffer zone, but not if you simply wish to take your seat. All the gut-wrenching over whether people with allergies will be “allowed” to fly, makes Gina Clowes’ blood boil. After taking a flight where nuts were being heated, Clowes, the founder of the 54 ALLERGIC LIVING | SUMMER 2012

The teen phoned his mother in a panic. The agent might not let him board because of his allergies; he might miss his competition. He was allowed on, but it wasn’t a given. Allergymoms.com website and a columnist for this magazine, asked the family allergist whether that environment was safe for her son, who’s highly allergic. While Greenhawt’s view is that such warming poses little risk for airborne reactions, Clowes’ allergist counseled not to chance it in her son’s case. As the family had already booked flights with American out of Pittsburgh, she phoned the airline’s disability desk to see if it was possible to forego heating the nuts. At first she was told to just ask at the gate. When Clowes pressed for a firmer answer, “he said, ‘I don’t know if your son can fly, I’m going to require a letter from your doctor that says he’s safe to fly.’ I said: ‘I’m going to require you to put that in writing.’” Clowes blogged about the incident, generating 10,000 views. The airline got in touch with a solution: the family was put on an early flight where nuts wouldn’t be served. Wicker’s experience got her fired up about the rights of allergic travelers. The former TV reporter has now launched Allergysafetravel.com and has begun speaking to airline executives about the need for accommodations. She and Thompson are both of the view that some airlines simply may not be informed enough about the issues that passengers with serious allergies come up against with the nut-snack culture in our skies. American, for instance, moves about 250,000 passengers every day. With that kind of traffic, it’s hard for food allergies to get on the radar. “There is such an education opportunity with the airline industry,” says Thompson. Wicker asks: “Has anyone sat down with the airlines to say, ‘this is a big and growing issue’? A complete ban on nuts isn’t necessary, but what can we do to work together? I think the solution is there.” [FYI, Allergic Living agrees, and will be launching a reader participation airline initiative at the end of summer.] The big airlines need to hear reasoned arguments and more about the demand for change. “We don’t always advocate for this health condition in a very serious way,” says Clowes. Her blog post generated hundreds of messages about reactions or bad treatment, “but people are not reporting incidents. Write to the airline; file your complaint with DOT online. The form takes five minutes.” Even the Greenbergers, who salvaged their vacation by driving to Disney World, are hopeful about the outlook for more accommodations in the air. “The generation of people with food allergies is growing up and they’re going to be the business people of the future,” says Brett Greenberger. “Those are the customers who matter to the airlines.” our “Comparing Airlines Chart” for the policies of 12 airlines. Â • See www.allergicliving.com/airlines • Gluten-free meals on the airlines: to eat or not to eat? www.allergicliving.com/planefood

PARENTING COACH | GINA CLOWES

FLYING WITH ALLERGIES Here are the essential precautions to take to ensure safe summer travels.

Take-off • When you get to the gate, inform the agent that you are traveling with a child with food allergies and that you would like to pre-board. • On the plane, ask your child to sit down first. Wipe down the armrests, the window shade, the buttons for the lights and, most importantly, the seat tray. Wipe your hands and have your child wipe his. Before he eats, spread a napkin over your child’s tray table and place food or snacks on the paper plates. • In the event of an allergic reaction, first treat the child and then immediately notify the flight attendant. This is important as even minor reactions have the potential to escalate quickly. Medical professionals are often on board and can assist in the event of an emergency.

hen a child has food allergies, traveling by air can be nerveracking, yet it’s often the only way for our children to visit grandparents, go on family vacations, and see the world. With a little work, even families with allergies can find friendly skies.

Planning the Trip • Talk to your child’s allergist about any special precautions you may need to take. Make sure prescriptions are up-to-date and ask for a letter stating that you need to carry certain medications and special foods when you travel. • Review the online allergy policies of the airlines that fly to your destination. For example, if you’re dealing with peanut or nut allergies, look for an airline that does not serve them. Passengers will still carry on these snacks but your child’s likelihood of exposure will be reduced. • Call potential airlines to clarify policies. For example, an airline might note that they serve tree nuts in first class, but not mention that they actually warm up loose mixed nuts in the kitchen area. Some airlines that serve peanuts, like Southwest Airlines, are reliable about serving an alternative (peanut- and nut-free) snacks to all passengers upon request. • Before you purchase the tickets, be sure you’re clear on exactly what the airline is willing to do, and keep notes on conversations. Some airlines will provide a “buffer zone” where they will ask passengers around you not to eat the allergenic food. Many will let you pre-board to wipe down seats (in case of food residue). With the exception of JetBlue, most airlines today will not make an announcement asking passengers to refrain from eating nuts, peanuts or other allergens.

• Pack enough food for twice as long as your flight, as flights can be held on runways for hours. Never eat the airline food. This is not a time to take chances. • Remember that yogurts, applesauce and puddings are considered liquids by the Transportation Security Administration. If you pack a cooler, use hard plastic freezer packs as squishy bags may be confiscated. • Pack plenty of wet wipes, Kleenex, napkins, plastic utensils and small paper plates. Consider a blanket or sheet to cover the seat.

Fly early, when nuts aren’t likely served.

Safely Landed Leaving requests for accommodations to discussions with the gate agent or crew can lead to problems. (If you do encounter trouble at the gate, ask to speak with the airline’s customer relations officer (CRO). Write down his or her name, and calmly explain your issue.) • Whenever possible, book the first flight of the day or at least an early flight, as airplanes receive a thorough cleaning at the end of the day. Try to book a direct flight so that you’re not dealing with multiple planes and crews.

Bring on Board • Pack your child’s medications (including at least two epinephrine auto-injectors) in their original packaging, along with a signed emergency plan and the letter from your physician. Never pack your child’s medication in the luggage that you plan to check. Keep it with you at all times, and do not store it in the overhead bin.

• Some airlines go out of their way to accommodate our special needs: take the time to let them know with a quick e-mail thanking them for the excellent customer service. • If you feel you have been the victim of discrimination because of a food allergy or if you or your child experienced an allergic reaction while in flight, you can and should file a complaint with the Department of Transportation. “Allergy” is one of 13 disability categories they track, and it’s important that they know how often these issues arise. http://airconsumer.ost.dot.gov/ escomplaint/es.cfm. Also always let the airline know. Wishing you a safe trip – bon voyage! Gina Clowes is a certified master life coach specializing in the needs of parents of children with food allergies. She is the founder of the online support group Allergymoms.com, serving thousands worldwide. ALLERGIC LIVING | SUMMER 2012

56 ALLERGIC LIVING | SUMMER 2012

What My Kids Taught Me As

AnAllergist No amount of medical training could have prepared me for having children with multiple food allergies. by Sarah Boudreau-Romano

Photography: ANDREA MANDEL

can tell you exactly where I was when the field of allergy and immunology first stole my heart. I was in my first year of medical school sitting in an overly cool classroom taking notes as fast as any human hand could. My pathology lecture was just ending and immunology was up next. I rubbed my sore fingers and prepared to write down, verbatim, the next lecture. But shortly after my professor started to speak, I realized that I had completely stopped taking notes. I had allowed myself to be drawn into the story that she was weaving, a story of T cells and B cells and their physical and chemical conversations with each other. It was amazing. Little did I know that she was introducing me to a cast of cellular characters that would soon become not only important for me to pass my next immunology test, but also to complete my subsequent fellowship training and to my understanding of the mechanism of food allergy, an immunological disease that would affect three of my four children. In 2005, after completing a pediatric residency, I started my fellowship in the field of allergy and immunology at the

Childrenâ&#x20AC;&#x2122;s Memorial Hospital in Chicago. I had a 7-weekold baby boy at home so I was knee-deep in motherhood, but I was ready. I was excited to finally be seeing patients with the allergic and immunological disorders that I had been so interested in during medical school. These diseases, including chronic sinusitis, seasonal allergies, and immune deficiencies, were all challenging and interesting, but what drew me in the most was food allergy. There was something so cruel and senseless about a disease that denies a child a bakery cookie â&#x20AC;&#x201C; it made me want to break its code. As fellows, we were taught to take a detailed history of the allergic reaction from the patient and the parent, paying exquisite attention to what food was ingested, the timing of the ingestion in relationship to the symptoms and what symptoms occurred. Patient histories would often become complicated, a fusion of facts and feelings. We would then perform skin-prick testing with the suspected food protein and draw blood for the same allergen. Combining the history and the results of the testing, a diagnosis was made. We would review an allergen avoidance sheet with the family, explaining the importance of reading food labels, and discuss an emergency health-care plan, teaching the ALLERGIC LIVING | SUMMER 2012

families how to recognize and treat an allergic reaction. We provided them with a short list of support services and asked them to follow up in one year. It was a good system, at least as far as I knew. By the end of my first year of fellowship, we had twin boys (yes, we had three boys in 13 months!) and one of them, Gino, literally had hives on his skin only a few days after he was born. He would soon be covered in itchy, bleeding eczema and more often than not, vomit, so I made an appointment with an allergist. I provided her with a detailed history of my son’s reactions that was, of course, muddled with facts and feelings. His skin-prick test and his blood test to cow’s milk were both positive and the allergist told my husband and me that our son was allergic to cow’s milk. As this diagnosis fell from her lips, the same diagnosis that so often fell from mine, I experienced how it felt on the other side. It was a powerful blow. I was on the wrong side of this appointment, a side I never dreamed I’d be on. I was not the allergist that day, instead, I became the mother of a child with food allergy. After we reviewed the perfunctory literature, I got my one-year send-off and then, I panicked. I wanted our allergist to come back in the room. I had so many questions left to ask. But I was an allergist, so how could I have so many questions? I only knew one thing – that I needed more time with her. I felt alone and anxious. As a fellow, I’d never quite understood it when parents cried at the end of our appointments. The diagnosis and treatment was a matter of fact. You avoid the food and you avoid the reaction. But now, on the other side, I understood. It was about how in the world you were going to avoid the food and what on Earth would happen if you didn’t. I walked out of the office saddened that, previous to this appointment, I had not really known what food allergy families go through and devastated that I had to learn it like this. It felt like I was like starting over, both personally and professionally. When I walked into my house after the appointment, I went directly to the kitchen. I have always believed that our home should be a safe haven for my children, so I began my quest to rid the house of milk. I started reading labels. As I read every label on every box of food in my kitchen, I turned numb. I threw away pudding, cheese, sticks of butter, bags of chips and boxes of cookies until my cabinets and refrigerator were nearly bare. No one warned me how hard it would be to go back into my kitchen for the first time. After putting the boys to sleep, I went to the grocery store. As I wandered the aisles trying to find food without any milk ingredients, I noticed that my usually overflowing cart was sparse. I knelt on the ground to read the ingredients of a rice drink and caught a 58 ALLERGIC LIVING | SUMMER 2012

As a mom who’s “been there”, Boudreau-Romano wants to help with the issues facing allergy families.

glimpse of a pint of ice cream in another mother’s cart. A feeling that I rarely had felt in my life overwhelmed me. As I fought back tears, I realized what it was. Jealousy. I was truly jealous, deep to my core and then, immediately, ashamed. I wanted her cart. I wanted her convenience. I wanted pizza and ice cream, cheese sticks and yogurt. And I was ashamed that my desire for her food made me feel disdain toward her. No one told me that the grocery store could be this painful. When my head rested on my pillow that night, I remember a long pause in my breathing during which all of the costs of this diagnosis hit me. I could not believe this was happening. And for the first time that day, I actually let myself think about the unthinkable: my beautiful, sweet child could actually die from eating the wrong food. A wave of anguish swept over me. No one told me about this moment, either. It was several months later on a pretty summer afternoon when it nearly did happen. I was on call, so my parents were at our house helping with the boys. I was so excited to see the kids when I got home from work that I let them eat a little treat before dinner:

It was not even a minute after his first bite when my dad yelled out my name and carried Gino to me. When I took him in my arms, I felt his weight; it is the strongest memory I have of that moment. He was completely limp in my arms. I screamed for the EpiPen Jr. as he began to turn blue. homemade allergy-safe cookies. It was not even a minute after his first bite when my dad yelled out my name and carried Gino to me. When I took him in my arms, I felt his weight; it is the strongest memory I have of that moment. He wasn’t holding any of it on his own. He was completely limp in my arms. His coloring grew pale and grey, and he began to turn blue around his lips, so I screamed for the EpiPen Jr. Even though I can put teeny tiny umbilical lines into two-pound babies without a tremor, with my own child, I was shaking so much that I could hardly remove the gigantic gray cap from the EpiPen Jr. When I finally did, I jabbed it into his thigh with a thud and counted to 10. Gino began vomiting profusely, mucus was bubbling out of his nose, and he was turning more and more blue. I could feel myself losing him and I believed that he was dying in my arms - dying from a cookie. Specifically, it would turn out, not from milk, but from the egg in that cookie. Thankfully, the epinephrine began to work. His coloring returned and I felt an overwhelming sense of relief as he started to open his eyes again. That night in the hospital, I remember crying and clutching to Gino for dear life, and thanking God that I could. After this reaction, the list of foods Gino had to avoid due to serious reactions began to grow and grow until it included milk, egg, wheat, corn, oat, barley, grape, mustard, sesame, green pea, pinto beans, lentil beans, garlic, chicken, turkey, peanut, tree nuts, fish and shellfish. Gino’s twin brother, Milo, has severe allergic reactions to soy and egg. Our youngest, Lucy, had anaphylaxis to milk at four months old requiring two doses of epinephrine. I spent most of the first several years of life raising children with multiple life-threatening food allergies feeling woefully unprepared. I felt alone, scared and confused. I often think about why I felt this way and what could have been done to lessen those feelings. I feel that we, as allergists, need a better way to more thoroughly address the real-life issues that so often plague the lives of food allergy families. There must be a stronger link between food allergy families and the allergist’s office. What would this look like? Maybe it’s a mandatory second appointment with the allergist or a nurse, or a one-on-one family

meeting with a veteran food allergy family during which they share their favorite sources of information, recipes, tips and support services. Perhaps it’s a follow-up phone call the evening after a food challenge or group meetings run by the allergist’s office for his or her patients. Since the completion of my fellowship, I have not gone back to seeing patients in the clinic and I have struggled to find the best way for me to serve the food allergic community. In the future I would love to be a part of a follow-up appointment as both the allergist and the veteran food allergy mom, but until I can make this concept a reality back in the hospital or through consultation, I started a blog in an attempt to do this virtually. Through this blog I provide education and advocacy, first-hand experience and mostly, friendship. When I began to fall apart in this allergic life, it was with the support from my family, my medical colleagues, and other food-allergic families that I was able to be put back together again. I want to be one of the people who help to revive and strengthen other food allergy families. I want them to remember exactly where they were when their heart, once broken by food allergy, finally started to heal. Sarah Boudreau-Romano’s blog is Theallergistmom.com. Three of her four children are allergic to multiple foods. Their combined list is: milk, eggs, peanuts, tree nuts, soy, wheat, oat, corn, green peas, beans, mustard, sesame, fish, shellfish, grapes, cranberry and bananas.

Want More

Allergic Living?

Breaking news and blog posts in our News Report. E-mailed monthly.

FOOD | SAFE EATING

60 ALLERGIC LIVING | SUMMER 2012

Bestof the Med The Mediterranean diet is splendid for good health. But as Chef Simon shows, the taste is fantastico, too. Recipes by Simon Clarke Photography by Chris Gonzaga

(Left) Spaghetti With Capers And Arugula; (right) Stuffed Grape Leaves, With Quinoa And Mint and Eggplant Hummus

ALLERGIC LIVING | SUMMER 2012

FOOD | SAFE EATING

Stuffed Grape Leaves, With Quinoa And Mint SERVES 6-8 Free of: gluten and all top allergens Ingredients

1 jar of grape leaves (about 30 leaves), drained 1 cup raw quinoa 2 cups vegetable stock [Look for allergen-free, GF brand] 2 cups tomatoes, diced 1 ⁄2 cup red onion, minced 1 ⁄2 cup currants 1 small bunch mint leaves, chopped 1 tbsp cumin 2 tbsp olive oil 2 tbsp lemon juice salt and pepper Method 1. In a medium saucepan, cook quinoa in

Watermelon And Herb Salad

vegetable stock. Use medium heat until liquid is absorbed and quinoa is cooked through. Let cool. 2. In a large bowl, add cooked quinoa and remaining ingredients (except grape leaves). Stir well, and taste test seasoning. 3. Lay the grape leaves out on a flat surface. Place about 2 tbsp of filling onto the center of each leaf. 4. Fold over one side lengthwise, then the other. Roll from the bottom to form a bundle. Each should resemble a short, fat cigar. 5. Continue until all the filling is used up. (A great job for involving the kids!) 6. Serve with our hummus and olives.

3. Scoop eggplant flesh into a food processor and discard skin. 4. Add all remaining ingredients. Pulse until smooth and combined well. 5. Place hummus in dipping bowl, and serve with gluten-free garlic toasts or vegetable sticks.

Eggplant Hummus

SERVES 4-6 Free of: gluten and all top allergens

SERVES 6-8 Free of: gluten and all top allergens

Ingredients

1 eggplant, halved lengthwise 1 14 oz can white beans, rinsed 4 cloves garlic, roasted 1 ⁄2 cup parsley, chopped 1⁄ 4 cup lemon juice 2 tbsp olive oil salt and pepper Method 1. Heat oven to 400° F. 2. Place eggplant halves onto a baking

sheet, cut side up. Roast 22-24 minutes until cooked through. Cool. 62 ALLERGIC LIVING | SUMMER 2012

Warm Spaghetti With Capers And Arugula

2 8 oz packages rice or quinoa spaghetti* 1 two-inch thick slice of bresaola* or pancetta, diced 1 small red onion, diced 2 cups cherry tomatoes, halved 1 ⁄2 cup capers, rinsed 1 cup olives, pitted 1 cup purple basil 2 large handfuls of arugula 2 tbsp olive oil salt and pepper Method 1. Cook the pasta in salted water,

per instructions. Set aside.

2. Place bresaola or pancetta in a large

sauté pan. Cook 2-4 minutes over medium-high heat until golden brown. 3. Add onion and cook until translucent, about 3 minutes. 4. Place tomatoes, capers and olives into pan, sautéing and stirring 3-4 minutes. 5. Remove from heat. Add basil and arugula and cooked pasta to the mixture. Toss together well. 6. Serve in bowls, drizzle with olive oil and season with salt and pepper. *Notes

We used GoGo Quinoa spaghetti; bresaola is a cured beef product similar to pancetta. For vegetarian: omit meat and replace with ¼ cup olive oil.

Watermelon And Herb Salad SERVES 4-6 Free of: gluten and all top allergens Ingredients 1 ⁄2

watermelon 2 cups assorted tomatoes*, chopped 1 cup cucumber, diced

1 avocado, diced cup each, fresh basil, mint and chives, chopped ¼ cup fresh lime juice ¼ cup olive oil salt and pepper

1 ⁄2

Method 1. Remove skin from watermelon and

dice the flesh. Place into large bowl, along with other vegetables and herbs. 2. In a measuring cup, stir together lime juice, oil and salt and pepper. 3. Pour dressing over salad, toss well, and serve. *Note: Try contrasting colors and shapes of summer’s great bounty of tomatoes.

Red Pepper Pockets SERVES 4-6 Free of: gluten and all top allergens Ingredients

4 large red peppers, halved, seeds removed 1⁄ 4 cup olive oil 1 small sweet onion, diced 4 garlic scapes or 4 cloves garlic, minced 2 ⁄3 lb ground lamb* 1 cup kalamata olives, pitted and cut in half 1 bunch basil 1 cup dairy-free mozzarella shreds [or feta cheese if not dairy-free] salt and pepper

Method 1. Pre-heat barbecue on medium-high. 2. Rub outside of peppers with 2 tbsp

of the olive oil, and grill, skin side down, 6-8 minutes. Remove and set aside. 3. Meanwhile, in a large sauté pan, heat remaining olive oil over medium. Add onions and garlic and cook 4-5 minutes. 4. Add ground lamb to pan, and cook 6-8 minutes, stirring often. 5. Next, toss in olives, basil, salt and pepper and combine well. 6. Spoon mixture into pepper halves, top with non-dairy cheese shreds and serve. *For vegetarian: omit the lamb and 1

add 1 ⁄2 cups of diced zucchini.

Red Pepper Pockets

ALLERGIC LIVING | SUMMER 2012

FOOD | SAFE EATING

Med Style Sweet & Spicy Chicken Wings SERVES 4-6 Free of: gluten and all top allergens Ingredients

4 1 1 1 1 1

lbs chicken wings tbsp ground cumin tsp garlic powder tsp ground cinnamon tbsp salt tsp cayenne 1⁄ 4 cup allergy-safe vegetable oil 1 ⁄2 cup summer blossom honey 1 tbsp lemon zest Method 1. In a large bowl, stir together cumin, garlic

powder, cinnamon, salt, cayenne and oil. 2. Add chicken wings to bowl and coat with spice rub. Cover and refrigerate. 3. Pre-heat barbecue on medium-high. 4. In a small bowl, mix honey and lemon zest together. Set aside. 5. Lightly oil the grill. Cook wings on grill for about 12-14 minutes, turning often, until cooked through. 6. Brush honey lemon glaze over wings until coated. Continue to cook for 2-4 minutes. 7. Transfer to a platter and serve with cut carrots and celery.

Sweet And Spicy Chicken Wings

Lemon And Garlic Potato Wedges SERVES 4-6 Free of: gluten and all top allergens Ingredients

6 large Yukon gold potatoes cup olive oil cup lemon zest 2 cloves garlic, minced 1 ⁄2 cup fresh parsley, chopped salt and pepper 1⁄ 4 1⁄ 4

Method 1. Heat oven to 400° F. 2. Cut potatoes lengthwise into wedges.

Add to a large bowl, and toss with the oil. 3. Place wedges onto a baking sheet in a single layer. Roast 15 minutes until partially cooked. 4. Remove potatoes from oven, mix in remaining ingredients, and spread out in a single layer again. Roast a further 15 minutes or until cooked through. 5. Place wedges in basket, and serve warm. 64 ALLERGIC LIVING | SUMMER 2012

Lemon And Garlic Potato Wedges

Orange Polenta Cake

Method 1. Heat oven to 350º F. Grease an 8-inch

Serves 6-8 Free of: gluten and all top allergens

spring form cake pan and line with parchment paper. 2. In a medium bowl, combine corn flour, corn meal, coconut and baking powder. 3. In a small bowl, whisk together olive oil and half the orange juice and zest. 4. In a stand mixer, on medium, beat 1 cup of sugar and the eggs (or replacer) 3-4 minutes – until the mixture is creamy yellow and roughly doubled in volume. 5. Now alternate adding half the flour mixture and half the olive oil mixture to the mixing bowl. Stir gently on low speed, but fully incorporate each addition.

Ingredients 1 1 ⁄2 cup corn flour 1 ⁄2 cup fine corn meal 3 1 ⁄4 cup finely shredded

coconut* ½ tsp gluten-free baking powder 3 ⁄4 cup olive oil finely grated rind and juice of 2 oranges 1 + 1⁄4 cup golden superfine(caster) sugar 2 eggs or equivalent egg replacer

6. Pour into the cake pan and bake for 30 minutes or until a toothpick comes out with a few moist crumbs. Let cool on baking rack for 10 minutes. Release spring on pan and cool to room temperature. 7. Combine remaining half of orange juice and zest with remaining 1⁄4 cup of sugar in a small saucepan. Heat until sugar has melted and there is a syrupy consistency. Ladle over cake and serve. *Note: While most allergists do not con-

sider coconut a tree nut, if there are nut allergies, ask your doctor if coconut is safe. Also watch out for brands with nut “may contain” warnings on the label.

A NOTE ABOUT OUR RECIPES In the Allergic Living kitchen, we strive to create appetizing recipes that avoid the top allergens and gluten. Given the nature of food allergies – that one person’s poison is another’s staple – we occasionally use one of these ingredients, but suggest a substitution.

ALLERGIC LIVING | SUMMER 2012

Arielle Sodowick’s exhilirating dive in New Zealand.

OUR STORY

It’s Her Life As my dairy-allergic daughter proves her independence, I’ve had to learn to let go. by MELISSA SODOWICK

y 20-year-old daughter, Arielle, who was spending a semester in Australia and taking a side trip, sent me the link to her itinerary for New Zealand. “Extreme Adventures” appeared at the top of the page, followed by a list of activities on the tour. I held my breath as I read the descriptions, to the effect of: “Travel through river canyons at 100 kilometers per hour in a jet boat!” “Bring your courage along as we bungee jump over Queenstown!” “Fall out of a plane from 14,000 feet over magnificent scenery.” I stopped there. “Are you crazy?” I emailed back. “I hope these activities cost extra, and you can’t afford them.” “Everything is included except for skydiving,” she replied, inserting a smiley emoticon. Not only did I think she was nuts for considering jumping off a mountaintop attached to a rubber band or parachuting from a plane, but also for sharing this information with me. Having grown up watching me deal with her severe milk allergy, she knew I was wired to worry. When dining out, I’d interrupt while she was ordering, urging the waiter to check the dish’s ingredients before she

66 ALLERGIC LIVING | SUMMER 2012

had a chance to ask herself. Once the meal arrived, I’d lean over her plate to inspect the food for any trace of butter or cheese. But that anxiety was nothing compared to what I felt after Arielle, at age 16, had an anaphylactic reaction requiring three doses of epinephrine and hours of monitoring in the emergency room. From that day on, whenever she was headed out to meet friends, I’d stop her at the door and ask where she’d be eating and if she had her medications with her. She’d glare back at me. “You can’t keep me in a bubble for the rest of my life.” *** She was right. Ultimately, I wanted what she wanted – for her to enjoy the same activities and freedoms as any teen. I worked on backing off, and reminded myself that she had always been careful: checking labels, alerting servers and managers to her allergy and passing up a food when she couldn’t be certain whether it contained dairy. With planning and proper precautions, she spent two weeks without incident in Provence through a high school exchange program. (Full disclosure: my husband and I followed her to France. We stayed

approximately 30 miles from her home base and never saw her, but felt reassured that we were only a car ride away in case of an emergency.) Arielle’s transition to college went smoothly, too. She found plenty of safe foods in the dining hall and learned to cook when she moved off campus in her sophomore year. When she pleaded with us to study business in Australia, it was hard to say no. *** Arielle texted us when she arrived in New Zealand and then five days later. “Just went skydiving from 15,000 feet! It was amazing!” My heart raced. I texted back: “OMG! U really did it!” Our exchange was brief, since she was on the road. She said she’d fill us in on the jump when she returned to Brisbane. Knowing she was now safe on the ground, I felt calmer. In the days that followed, I pictured my daughter falling through the sky in tandem with an instructor. I thought about her fearlessness. I considered that perhaps when you’ve experienced real fear – an itchy tongue that in seconds becomes something worse, like the tightening of your throat – you have fewer imagined fears. Or maybe you become determined to live life to the fullest, traveling halfway around the world, surfing, glacier hiking, bungee jumping and skydiving. Back in Brisbane, Arielle called us through Skype to video chat. After sharing the highlights from her trip, she asked, “Want to see the skydiving video?” We watched her take off on a twin-engine plane with a few of her travel companions. Then came the jump. Geared up in a silver jumpsuit, helmet and goggles, she went free-falling through clouds. In a close-up, she was smiling, exhilarated. Suddenly, I was overcome with awe as well as joy for her. I wondered if she could see me tearing up through the pixilation of long-distance video. Then I noticed Bon Jovi’s “It’s My Life” playing with the footage. I listened to the words: My heart is like an open highway Like Frankie said, “I did it my way” I just want to live while I’m alive ’Cause it’s my life. It was the perfect anthem for Arielle. Melissa Sodowick is a freelance writer who lives in Washington Crossing, Pennsylvania. To comment: editor@allergicliving.com.

R Register egister or Donat Donate eT Today! oda o y!

www.foodallergywalk.org www.foodallergywalk.org —————————— ——— —— —— — ——— —— ——————— —— — National Sponsors ——— —— — ———————— ——— ——— —— —— ————————

Presenting Sponsor

Platinum Sponsor

Gold Sponsor

The Food Allergy & Anaphylaxis hylaxis Network (F FAAN AANTM) is a 501(c)(3) nonprofit organization

“Before Allegra®, I felt trapped by my allergies.

After Allegra, I’m free.”

Find us on:

Visit Allegra.com

There’s only one Allegra. Nothing else is both fast* and non-drowsy. It has the power to relieve your toughest symptoms for 24 hours. Effective even at 8 times high pollen levels.**

After Allegra®, Have It All. *Starts working in one hour. Applies to first dose only. Among OTC branded antihistamines. Use as directed. **In controlled environment studies using pollen deemed high by the National Allergy Bureau.