Allergies LIVING WITH
ANNABEL LANGBEIN’S GLUTEN-FREE FAVOURITES
THE SOOTHING PROPERTIES OF HERBS GIVEAWAYS FREE WITH COMPLIMENTS FROM YOUR PHARMACIST OR HEALTH PROFESSIONAL
THREE GREAT competitions – see inside
eczema advice + healthy painting + better breathing
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LIVING WITH ALLERGIES PUBLISHER Published by Hawkhurst Media Services Ltd PO Box 25679, St Heliers, Auckland 1740 Director: Kerry McKenzie 09 528 7103 or 0275 969 979 ADVERTISING Advertising Sales: Debbie Bishop 021 340 360 email@example.com BUY A MAGAZINE Visit our website www.livingwithallergies.co.nz 09 528 7103 firstname.lastname@example.org G www.facebook.com/ livingwithallergiesmagazine
LIVING WITH ALLERGIES SPRING 2016
ALLERGY AWARE 2 News and Views
4 Dairy free and healthy
HEALTHY HOMES 6 Minimising VOCs
PRODUCTION Editor: Sara Carbery email@example.com Design: Rose Miller at Kraftwork firstname.lastname@example.org Proofreader: Stella Clark
PRINTER McCollams Print
13 Surviving the Sneezin’ Season
10 Eye spy… allergens
NATURAL HEALTH 16 Herbal healing
ECZEMA Disclaimer: Every effort is made to ensure accuracy but Living with Allergies accepts no liability for errors of fact or opinion. Information in this publication is not intended to replace advice by your health professional. If in doubt check with your allergy specialist, GP, nurse, dietitian or other health care professional.
19 Soothing the itch
24 RESPIRATORY HEALTH
Editorial and advertising material does not necessarily reflect the views of the Editor or publisher. Advertising in Living with Allergies does not constitute endorsement of any product. Living with Allergies is an independent publication and is in no way affiliated with or endorsed by the charity Allergy New Zealand. © All rights reserved. No article in whole or part should be reprinted without permission of the Editor.
22 Learning to breathe better
FOOD AND RECIPES 24 Annabel shares the love
32 Useful snippets
Look out for three great reader competitions throughout the magazine. See inside for how to enter or go to www.livingwithallergies.co.nz
allergy aware GOOD NEWS FOR THUMB-SUCKERS Children who suck their thumbs or bite their nails may be less likely to develop allergies, according to a new University of Otago study. The finding emerges from the long-running Dunedin Multidisciplinary Study, which has followed the progress of 1,037 participants born in 1972-1973 into adulthood. The study, which appears in the August issue of the US journal Pediatrics, suggests that childhood exposure to microbial organisms through thumb-sucking and nail-biting reduces the risk of developing allergies. Study lead author Professor Bob Hancox says children who both bit their nails and sucked their thumbs had an even lower risk of allergy (31%). “The findings support the “hygiene hypothesis”, which suggests that being exposed to microbes as a child reduces your risk of developing allergies.” Despite these findings, Professor Hancox and his co-authors don’t suggest that children should be encouraged to take up these habits. Source: www.otago.ac.nz.
5 Quick Facts about Urticaria The word ‘urticaria’, more commonly known as hives, is derived from the European stinging nettle Urtica dioica. If you’ve ever been stung by a nettle you’ll understand why – both produce similar symptoms including a red, itchy rash.
Urticaria can be triggered by a variety of things, including food, allergens, medicines and environmental factors. However, a trigger is only identified in about 50% of cases.
One in five of us will get urticaria at some stage in our lives.
While it can sometimes last longer than six weeks, most cases thankfully only last a few hours to a couple of days.
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Urticaria is most commonly treated with antihistamines.
Tell and Kiss Who wants to spoil the romance by discussing food before they kiss? For people with severe food allergies, however, this question is a matter of life and death. According to an American study, 5% of food allergy sufferers have experienced an allergic reaction after a kiss. “Food allergens can remain in the saliva even hours after eating,” explains Professor Dr Torsten Zuberbier, Chairman of the European Centre for Allergy Research Foundation (ECARF). “These allergens can be unintentionally transferred through kissing.” ECARF advises those at risk of anaphylaxis due to food allergies to: • Discuss your food allergy before you kiss. • Make sure your partner has not eaten anything in the past 24 hours containing allergens that could be harmful to you. • If in doubt, play it safe and postpone kissing for another time. • Keep your emergency kit with you at all times. • If you are the parent of a teenager with a severe food allergy, initiate a conversation about the transfer of allergens through kissing. Source: www.ecarf.org.
Need relief from dry, itchy skin? Comvita has a full range of Medihoney® products for natural relief from dry, itchy skin. The formulations are certified natural, fragrance free, soap free and dermatologically tested. Enriched with medical grade honey, oat extract and nourishing plant butters, these products help to replenish dry skin for a healthier you. We have one full set of Comvita’s certified natural Medihoney® Range to give away, including the Soap Free Wash, Moisturising Lotion, Derma Cream, Skintensive™ Cream and Antibacterial Wound Gel™ (total RRP $96.75). Comvita.co.nz/medihoney Enter online at www.livingwithallergies.co.nz or email email@example.com with MEDIHONEY in the subject line. Entries close 30 November 2016.
Dairy free yoghurt NoMoo proudly produce their new range of Dairy Free Yoghurts in their modern dedicated facility in Motueka, Nelson. Containing the goodness of non-GMO whole bean soy milk, coconut cream, real fruit and live probiotic cultures, they don’t contain preservatives, artificial flavouring or colouring. NoMoo don’t make products containing cow’s milk, nuts, eggs or gluten either, so you can be sure their yoghurt is free of these common allergens too. Available at selected supermarkets and retailers or email: firstname.lastname@example.org
DAIRY FREE YOGHURT
LIVING WITH ALLERGIES Spring 2016 3
Dairy free and worried you might be missing out on vital nutrients? Nutrition Consultant Sarah Elliot answers your dietary questions.
DAIRY FREE & HEALTHY Sarah Elliott is a Nutrition Consultant and Registered Dietitian with FoodSavvy specialising in the dietary management of digestive issues, food allergies and intolerances. See www.foodsavvy.co.nz 4 LIVING WITH ALLERGIES Spring 2016
Q: Does following a dairy free diet leave us vulnerable to nutritional deficiencies? It can do, as New Zealanders typically obtain the majority of their calcium from dairy products. If you are removing dairy from your diet it is important you substitute with other high calcium foods. Vitamin D is fairly hard to find in our diet, and dairy products are one of the few food sources of this vital nutrient. There has been increasing concern around the number of New Zealanders becoming vitamin D deficient, in particular over the winter months. Our skin produces up to 80% of our vitamin D when exposed to the sun. However this is reduced when we heed much-needed sun smart messages. In those not getting enough ‘healthy’ sun exposure, dairy products – or good alternatives – can be pretty important. Dairy products provide a good amount of protein too, but luckily there are many other foods that can do the job.
Q: Why are calcium and vitamin D so important? Calcium is essential for strong healthy bones and teeth, and the proper functioning of our heart. Along with other nutrients, a low intake is associated with osteoporosis (thinning of the bone). Our serum calcium (calcium found in our blood) is very tightly regulated and doesn’t change with our diet. So unfortunately a simple blood test can’t tell us if we’re deficient or not. Vitamin D is another key nutrient in bone health. A low level in the body causes an increased risk of bone fractures. It is also important for a healthy immune system, regulating cell growth and in reducing inflammation. If you get little sun and are concerned you might be deficient, your vitamin D levels can be checked by your GP via a blood test. Q: If we’re following a dairy free diet, how do we ensure we’re getting all the nutrients we need? Fortunately there are many great milk alternatives on the market. There is calcium fortified almond milk, soy
milk, rice milk, oat milk and more! Two other foods which can compete with dairy’s high calcium levels are firm tofu and canned fish with bones (such as sardines or salmon). Many other foods have smaller amounts of calcium, and are important to include in your diet, as they all contribute to your daily needs. These include kale, broccoli, almonds, Chinese cabbage, oranges, rhubarb, tahini and fortified cereals. If you enjoy oily fish, such as salmon and mackerel, you’re in luck. They are the richest dietary source of vitamin D. Other foods containing vitamin D include eggs and lean meat. Some margarines, milks and yoghurts are vitamin D-fortified. Q: Anything special parents need to be aware of if their child is following a dairy free diet? Ensure you replace dairy with a fortified milk alternative. If your child isn’t a fan of firm tofu or sardines, then they will need at least two glasses of fortified milk per day. You can add this to smoothies, custard, mashed potato, cereal or when you’re making porridge.
LIVING WITH ALLERGIES Spring 2016 5
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6 LIVING WITH ALLERGIES Spring 2016
Spring is a great time to dust off the DIY gear and treat your home to a fresh coat of paint. But before you prise open the tin, here are a few things to think about, particularly if someone in your family suffers from allergies.
OCs, short for Volatile Organic Compounds, are baddies you need to watch out for. They’re chemicals used to produce a range of products, including paints, paint strippers, wood preservatives, aerosol sprays, cleansers, disinfectants, air fresheners, automotive products, hobby supplies, building materials and furnishings. In the case of paint, VOCs are released as the paint dries and cures. Once the paint is fully cured, it stops releasing any VOCs.
1 WHAT’S THE PROBLEM WITH VOCS? Most issues with paint and VOCs are caused by traditional solvent borne paints with high VOCs being used in enclosed areas, with insufficient ventilation. Therefore it makes good sense health-wise to use waterborne paints that have low or no VOCs and ensure you have plenty of air moving through the room you’re painting. Improving indoor air quality in this way can help prevent headaches, asthma, nausea, dizziness, respiratory complaints, allergic reactions, and canimprove general well-being, as well as providing a better working environment for the painter.
Check out our tips for healthy painting habits over the page…
INTERESTING FACT Early humans discovered paint tens of thousands of years ago when they realised that combining ground coloured rocks, earth and minerals with egg or animal fat produced a coloured substance. These early paints were used to draw pictures on rocks and in caves.
LIVING WITH ALLERGIES Spring 2016 7
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TOP PAINTING TIPS
Steer clear of solvent borne paints and spray paints. Choose low- or no- VOC waterborne paints instead. Don’t assume ‘natural paints’ are safer than synthetic paints. VOC release can be high in ‘natural’ paints, and a synthetically designed and produced paint can often be a healthier choice. Look for paints carrying the ‘Environmental Choice’ logo, New Zealand’s official environmental label. Initiated and endorsed by the New Zealand Government, Environmental Choice is
Available only from Resene.
WHAT PAINT SHOULD I CHOOSE?
0800 RESENE (737 363) www.resene.co.nz
8 LIVING WITH ALLERGIES Spring 2016
Low VOC waterborne paints generally have 80-90% less VOCs than traditional solvent borne products, so switching from solvent borne to waterborne is the way to go. Some waterborne paints are even VOC Free.
independently operated, and recognises the increasing effort of manufacturers to reduce the environmental impact of their products. Ensure there is good ventilation during and after painting. This will help clear the air and also help the paint to cure better. On a still day, installing a fan and, in cooler weather, a heater can help to circulate the air and cure the paint. Read the safety guidelines and wear the appropriate protective equipment for the product you are using.
If you are particularly sensitive to odours or solvents, consider hiring (or begging!) someone to do the painting for you. Choose a long lasting product to minimise the amount of maintenance and repainting required. Painting large areas during pregnancy isn’t recommended. The issue isn’t the paint as much as the stretching up and down and moving up and down ladders. If you’re pregnant, it’s best to stick to small projects using waterborne paints. Hire a
painter or ask a family member or friend to tackle the big jobs for you. Finally, take care when shopping to ensure you are choosing low VOC products – whatever these may be. While we tend to associate VOCs with paint, most of us will have only minimal exposure to VOCs from paint, but a much greater exposure to VOCs through the other products we use, such as hairspray, deodorants and normal household cleaning products.
LIVING WITH ALLERGIES Spring 2016 9
allergic conjunctivitis If you suffer from allergic conjunctivitis, also known as allergic eye, or ‘pinkeye’, you’ll be all too familiar with the symptoms: red, watery, itchy eyes with possibly some swelling of the eyelids and crusting overnight. Not fun! But what exactly causes allergic conjunctivitis and what brings relief? Eye specialist Dr Malcolm McKellar explains.
EYE SPY … ALLERGENS
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Step One: Allergens, such as pollen, land on the surface of the eye and bind to IgE receptors. The most important reaction is with mast cells, the specialised body cells found in mucosa, such as the moist surface of the eye, nasal passages and lungs. These mast cells serve as a first response, alerting the immune system to the arrival of foreign material. INTERESTING FACT The response in allergy is really an error, as the mast cells’ main purpose is to alert the body to the arrival of parasites that can cause infection.
Step Two: Mast Cell Degranulation. When the allergens bind to the IgE receptors, granules of histamine inside the mast cells are released locally. At this point the body’s response is amplified – just a few allergen molecules result in the release of vast quantities of histamine. Histamine increases local blood flow and triggers the formation and release of literally hundreds of chemicals. These substances alter the way blood vessels behave, mobilise white blood cells, irritate nerves and result in increased mucous production. The end result in patients with allergic conjunctivitis is swelling of the surface of the eye and eyelids, redness, itchiness and tearing. The allergic reaction can be mild or life-threatening. In some people the response is short lived, in others there is ongoing chronic inflammation.
How Various Treatments Work Anti-allergy medications change the way the body responds to the presence of allergens; lubricant drops and eye rinses wash away allergens before binding can occur; mast cell stabilisers prevent the release of histamine; antihistamines block the binding and action of histamine; vasoconstrictors reverse the dilation of blood vessels and reduce the leakage of fluid from the vessels into the surrounding tissue; and steroids act at multiple points in the chemical cascade.
DR MCKELLAR’S TOP FIVE TIPS •
Prick testing is seldom helpful as allergy sufferers usually know what triggers their symptoms and most can’t (or choose not to) avoid these triggers.
Oral medicines rarely help eye symptoms but are worth trying briefly. Most people need eye drop therapy.
Cool compresses can provide soothing relief. Keep a wet facecloth in a plastic bag in the fridge for an instant balm. Also try washing your eyes with refrigerated artificial tears.
Cromolux is a very safe long-term over-thecounter treatment but it takes two weeks to work. Don’t give up on it too soon.
Short-term pulse treatment with steroids is often needed at peak allergy times and is generally safe. Long term steroid use requires close monitoring.
Dr Malcolm McKellar is an optometrist and ophthalmologist based in Christchurch. www.drmalcolmmckellar.co.nz
LIVING WITH ALLERGIES Spring 2016 11
Build your immunity and help yourself ease the symptoms of hayfever!
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Surviving the Sneezin’ Season Traditionally considered a mild complaint, it is now widely recognised that hayfever can have a significant impact on quality of life, so it pays to go into ‘the sneezin’ season’ armed with expert knowledge.
AYFEVER is a term used for allergic
rhinoconjunctivitis occurring in spring and summer. As the name suggests, it is principally caused by grasses, although tree pollen can contribute a little, for a few weeks in late August only. Many people go to a pharmacy when they have symptoms and take whatever is recommended on an ‘as required basis’. This is fine, if you only have occasional or mild symptoms, but if you suffer from moderate or quite frequent symptoms, this is definitely a sub-standard approach to treatment.
Immunologist and Allergy Specialist Dr Andrew Baker shares his top five tips for managing hayfever over the page.
LIVING WITH ALLERGIES Spring 2016 13
TOP TIPS FOR HAYFEVER
Consider an ongoing treatment plan. In other words, use some treatment at the start of every day from September to February, in a proactive preventative approach. This is much more effective than trying to rescue the situation once you’re plagued by symptoms. The most important cornerstone of an ongoing treatment plan is the regular use of a steroid nasal spray. Brands such as flixonase are used as a local treatment, to help both the nose and the eyes, with minimal absorption (1%) into the rest of the body. Quality of life can be transformed if a steroid nasal spray is used daily during spring and summer. Steroid sprays are slow to start working so don’t expect to feel better straight away. Use it daily from September to February, and then decide at the end of the season whether it helped or not.
Seek evidence-based advice from a specialist health professional, such as an immunologist. The number of people who are given substandard advice is unfortunately very high. Frequently, the details of how treatment is administered make all the difference to getting your quality of life back. Desensitisation, also known as immunotherapy, or allergen immunotherapy, is the best treatment for hayfever (and for all forms of rhinitis, such as dustmite or pet allergies). The only treatment that can decrease the underlying allergic tendency, the effects of desensitisation can be life-changing in terms of quality of life. There are different forms of desensitisation, including daily tablets or liquid taken under the tongue, and monthly injections. All treatments run for 3-5 years, and the benefits continue for a number of years after the treatment finishes.
Finally, take antihistamines before big exposures to grass pollen, for example if you’re planning a walk in the country on a windy day in November. Cetirizine tends to be more effective than loratadine, but cetirizine can make around 10% of people drowsy. Also, keep the car air intake vents on recycle on peak hayfever days, such as windy days in October, November and December. It is important to note though, that you don’t need to be around grass to get hayfever. Grass pollen can be blown for hundreds of kilometres on the wind, so even if you live in an apartment in the centre of Auckland, and suffer from hayfever, the cause will be grass! Dr Andrew Baker is an Immunologist and Allergy Specialist at Waitemata Allergy Clinic on Auckland’s North Shore. See www. allergyspecialistdoctor.co.nz.
GIVEAWAY – WIN 1 of 3 White Mallow Packs
100% Certified Natural & Organic, Weleda White Mallow Baby Derma products are fragrance free and soothe hypersensitive skin, ideal for those susceptible to eczema. We have three Weleda White Mallow packs to give away – each pack contains one each of White Mallow Body Lotion 200ml, White Mallow Face Cream 50ml & White Mallow Nappy Change Cream 50ml – valued at $69.70 RRP. View the range at www.weleda.co.nz. Enter online at www.livingwithallergies.co.nz or email email@example.com with WELEDA in the subject line. Entries close 30 November 2016. 14 LIVING WITH ALLERGIES Spring 2016
Nip Spring Allergens in the Bud
Works in just 15 minutes
Do you love the idea of getting out into nature or petting a cat but hate the reality of irritating pollen, grass and fur? Are simple tasks like going out for a walk or cuddling your pet fraught with the anxiety of a reaction to allergens? Clinicians Allerstop is the first dietary supplement available over the counter for allergen support and is suitable for the entire family to use, including children and pregnant or breastfeeding women. Allerstop is a completely natural formula that works rapidly to provide support for your body’s response to indoor and outdoor allergens such as mould, dust mites, pet hair, grasses and pollen. Allerstop’s ingredients are proven to be effective and the fast release formulation means allergen support will occur within 15 minutes. Clinicians, a research-based New Zealand natural health company, has developed the unique formula in Allerstop using a specialised protein found in quail eggs, an ingredient the company has exclusive rights to use in this country. “This specialised protein was originally discovered in the 1970s in France where research allergist Dr Bruttmann found a powdered quail egg formula supported the body’s response to environmental irritants,” explains Clinicians’ Naturopath Jane Cronin. “These irritants contain enzymes that, when inhaled, irritate the lining of the nasal passages. Allerstop contains bio-active proteins that block irritants before they affect the nasal passage.” Clinicians Allerstop is available from all good pharmacies and health stores. To find out more, go to www.clinicians.co.nz. LIVING WITH ALLERGIES Spring 2016 15
Medical Herbalist and Naturopath Rebekah Paddy introduces us to some popular herbs that may be useful additions to your medicine cabinet.
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S A MEDICAL
herbalist I will often use herbs as part of a treatment protocol with my clients. With the support of minerals and correct strains of gut flora, conditions such as eczema, hayfever, asthma and recurrent winter illness may be greatly helped through the use of certain herbs. Western herbalists usually make up liquid tinctures with a blend of five or six different herbs; Chinese herbalists may have up to twenty herbs in one formulation. The beauty of working with liquid herbs is that the remedies are tailormade for the patient, and can work not just on the major presenting complaint, but on other issues. For example, someone may need support with compromised immunity but also for fatigue or anxiety. These issues can all be addressed with one herbal tincture. Herbs also have the amazing ability to have multiple actions, so one herb can be used to strengthen immunity and support adrenal health for resilience and energy. Here is a summary of some popular herbs you may like to add to your repertoire.
Echinacea: Probably one of the best known and most studied herbs, Echinacea is known as an ‘immune modulator’ which means it has the ability to balance the immune system. If there is over-reaction (such as in auto immune conditions, or allergies) it will calm. If immunity is lowered, Echinacea can stimulate to build strength. As an aid for common colds and winter viruses, this is the first ‘go to’ herb. Echinacea helps build resistance to infection, viral and bacterial illness and supports the lymphatic system. Upper respiratory conditions such as rhinitis and tonsillitis do very well with Echinacea, which has been shown in studies to help not only when there is infection present, but also when used preventatively. As an anti-inflammatory agent, Echinacea is often used to support eczema which requires calming of the immune system, lymphatic support and reduction of inflammation. Chamomile: Well-known as a tea, this herb has traditionally been used for its anti-anxiety, anti-inflammatory, digestive calming, and wound healing properties. It is therefore a first choice for any condition that involves both the nervous and immune systems.
In studies, Chamomile extract has demonstrated activity against a number of common bacteria including E coli, Staphylococcus aureus and group B Streptococcus, all pervasive bacteria that often need treatment with antibiotics. Certain constituents in the herb, when used in high doses, have also been shown to reduce histamine release; therefore Chamomile is indicated in allergic, inflammatory conditions. In a number of studies, Chamomile creams have been shown to be favourable in the treatment of eczema. Chamomile is considered a very safe and gentle herb and is an excellent choice when treating children. Licorice Root: Not the same stuff we buy at the dairy! Licorice has many applications with immunity, including helping to soothe the mucus membranes in the digestive and respiratory tract. It is therefore indicated in reflux, where food allergies are present, and in conditions such as asthma. Licorice is recognised as both an ‘expectorant’ and a ‘demulcent’ so it calms an irritated and persistent cough, and encourages the cough to be ‘productive’ (to bring mucus up), when infection is present.
Elderflower: Traditionally, Elderflower berries were used to make cordial, wine or tea and this herb is a mainstay of the Western pharmacopeia, used as an immune stimulant for its anti-viral and anti-bacterial properties. It is often prescribed when there is low immunity and the presence of persistent nasal or chest catarrh, as with the common cold. This herb can be used as a general tonic ongoing throughout winter. SEEK ADVICE The Internet is often used to self-medicate, and while there can be a place for this, going to a trained Medical Herbalist (www.nzamh.org.nz) means you can get the very best out of herbs and all they offer. A number of herbs are sold singly or in combination at pharmacies and health shops. Always ask for advice when buying herbs as, with any medications, there may be contraindications with other medications you are taking, or your health status. Once you have learnt what herbs are best for you or your family, it is great to have these as part of your healing toolkit so you can start dosing up at the first sign of allergy or illness. Rebekah Paddy is a Naturopath, Medical Herbalist and Director, at Mother-Well Holistic Health in Auckland. Tel 09 630 0067 www.mother-well.co.nz
LIVING WITH ALLERGIES Spring 2016 17
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Share Nature. Share Life.
eczema Eczema is an itchy reality for many children and a bane for their parents. While there is no cure for this all too common skin condition, eczema can be effectively treated with expert advice, a sound management plan and a good dose of parental perseverance. Here are some tips to help soothe the scratching.
SOOTHING THE ITCH
HAT’S UP DOC?
Consult with a GP or specialist who can supervise your child’s treatment with regular follow-ups. All treatments are approached on a case by case basis, but doctors will usually prescribe emollient moisturisers to hydrate the skin; steroid ointments to prevent and control inflammation; antihistamines to treat itching and antibiotics to deal with any infection, a common cause of admission to hospital, particularly with younger babies. Don’t be afraid to ask
your doctor any questions you might have, no matter how insignificant you think they are. You need to be armed with as much information as possible to prevent and treat flare ups. Concerned About Steroids? If you’re worried about using steroid-based creams, discuss your concerns with your doctor. While some steroid-based creams are strong, others (such as 1% hydrocortisone) are actually very weak and almost certainly do not cause skin thinning.
LIVING WITH ALLERGIES Spring 2016 19
SOOTHING THE ITCH Moisturise, moisturise, moisturise You will need to use plenty of moisturising cream – more than you think, more often than you think – even when a flare up has settled down. Ask your doctor for guidance on this. Bathroom Basics Avoid all soaps, cleansers and perfumed products such as bubble bath. Stick to a simple soap substitute such as Sorbolene 10% glycerine. After bathing in tepid (not hot) water, pat your child’s skin dry with a soft towel and moisturise skin within three minutes. Banish scratching Scratching is the number one enemy of eczema so get your child involved in managing their eczema from a young age. The sooner they can make the connection between ‘itch’ and ‘cream’, rather than ‘itch’ and ‘scratch’, the better. Children as young as 14 months can recognise that moisturising relieves the itch and bring you their cream when they feel itchy.
Food, glorious food Minimise triggers but don’t pin your hopes on this being a cure-all. If you suspect food might be a trigger, be wary of depriving your child nutritionally through food restrictions. Only a minority of children benefit from dietary restrictions so make sure all the basic, simple treatments are in place – and talk to your doctor – before you go down this route.
Playtime Likewise, be careful not to deprive your child developmentally through limiting access to irritants such as sand and water. Rather than saying no altogether, maybe allow your child to play with sand and water for a short time, using moisturising cream before and after to minimise the negative effects. Be wary too of using mittens too much to stop your baby scratching. Babies need to be able to explore and learn with their hands. (Do keep fingernails short though.) 20 LIVING WITH ALLERGIES Spring 2016
Laundry lowdown Choose 100% cotton bedding and clothing (avoid wool or synthetics) and remove tags to prevent irritation. Wash all new clothes and bedding before use to remove any chemicals used during manufacture. Use a gentle laundry product and rinse clothes and bedding at least twice to remove all traces of detergent. Avoid bleaches and fabric softeners.
Prevention is better than cure When a flare up improves, a plan for preventive treatment needs to be put in place to stop recurrent flares. This might be as simple as avoiding all soaps and using moisturiser twice a day, or you could consider instigating ‘steroid cream weekends’, where you apply steroid cream twice weekly as a preventive measure. Talk to your doctor about what might work best for your child.
ID YOU KNOW that respiratory disease is New Zealand’s third leading cause of death? It affects one in six Kiwis (700,000 people) and costs the country $5.5 billion per annum. These startling figures have motivated the Asthma & Respiratory Foundation to launch ‘Breathe Better September’, a national movement for New Zealanders to show their support for better breathing and healthy lungs. There are lots of ways you can get involved, including signing the online photo petition, ordering a free Breathe Better September pack, making a donation, fundraising or spreading the word on social media. Go to www. breathebetterseptember. co.nz to find out more.
Watch out for more Lifestyle, Healthcare and Environment tips coming your way during Breathe Better September. See www. breathebetterseptember. co.nz for more info.
22 LIVING WITH ALLERGIES Spring 2016
TOP TIPS FOR BREATHING BETTER Whether or not you live with a respiratory condition, there are plenty of things you can do to improve your breathing. Here are some simple steps you and your family can take to keep your lungs healthy: • Aim to get 30 minutes of physical exercise each day. Physical activity improves lung capacity and blood flow, and helps your muscles, joints and circulation work as efficiently as possible. Plus people who are active usually find they have less asthma and cope better when they do have it. • Be smokefree. Cigarette smoke contains 4000 harmful chemicals, reduces your lung function and damages your airways. For people with respiratory disease, it also makes them wheezy and their condition harder to control, increasing their need for medication. • Maintain a healthy diet by eating foods low in fat and sugar. If you are overweight you will benefit from weight loss to ease the load on your lungs and muscles. • Many houses are damp and cold, leading to more colds and flu which aggravate respiratory conditions. The temperature of
your home should be at least 18 degrees Celsius. Below 16 degrees there is an increased risk of respiratory disease. • Install insulation, particularly in the ceiling. 40% of heat can be lost through an uninsulated ceiling, and 10% through the floor. • Use a healthy form of heating such as a flued gas heater or heat pump. • Reduce indoor moisture by using extractor fans and opening windows, by putting lids on pots when cooking, drying clothes outside and airing your house on fine days. • Remove mould or mildew from walls, shower curtains, etc. with a fungicide e.g. very diluted household bleach. • Limit the use of strongsmelling cleaners, air fresheners and flysprays. • Keep dust to a minimum – dust with a damp cloth and vacuum regularly. • See your GP if your breathing is suddenly impacting your daily activities or worrying you in any way. Symptoms might include coughing, wheezing, increased phlegm, shortness of breath or tightness in the chest.
Neocate Advance BROWNIE BITES FREE
Free from allergens: Wheat, Cows Milk, Peanuts and Tree nuts, and Soy
TIME REQUIRED: 40MINS
2 cups cooked Black Beans, drained of all liquid ½ cup granulated Sugar of choice ⅓ cup Cocoa Powder or Carob Powder 8 scoops Neocate Advance* 1 tbsp. Oil 1½ tbsp. Egg Replacer mixed with 3 tbsp. of Warm Water 1½ tsp Vanilla Extract, real or imitation (optional) Non-stick oil spray
Preheat oven to 180˚C. Coat muffin tin with non-stick oil spray. Place all ingredients in a blender/ food processor. Blend until smooth. Pour enough batter into each muffin case to fill about halfway. Bake 22-28 minutes, or until a skewer inserted into the centre of the muffin comes out clean. Allow muffins to cool in muffin tin for at least 5 minutes, then transfer muffins to a baking rack to cool.
*Always use the scoop provided in the Neocate tin.
Specifically formulated for toddlers and children with persistent food allergy. Neocate Advance Vanilla tastes great and can be a perfect addition to a nutritionally balanced diet.
TIPS • If using canned black beans, you will need two 100g cans. • Makes about 30 mini brownies, depending on size of muffin tin/case • Opening oven door during baking may cause brownies to collapse.
FOR ALLERGY FREE RECIPES AS WELL AS TIPS AND RESOURCES GO TO: WWW.NEOCATEVILLAGE.CO.NZ Neocate Advance Vanilla is a food for special medical purposes for the dietary management of children with cows’ milk allergy or other conditions where an amino acid based formula is required. Always use under medical supervision. Nutricia Ltd, 124 Favona Road, Favona, Auckland 2024, New Zealand. Clinical Care Line: 0800 636 228
food and recipes
SHARE THE LOVE
24 LIVING WITH ALLERGIES Spring 2016
Annabel’s Top Tips for Allergy-Friendly Cooking
Annabel Langbein needs no introduction. New Zealand’s favourite cookbook author and publisher is also a familiar face on our screens thanks to her popular series, The Free Range Cook.
N THE LATEST of her seasonal publications, Share the Love,
Annabel brings together more than 120 soul‑warming eating ideas, many of which are gluten-free. Although she has included gluten-free options in her cookbooks for a long time, Annabel’s interest in cooking delicious GF food was given added impetus recently when her son Sean was diagnosed with coeliac disease. Here she shares a couple of heart-warming recipes everyone will love.
Pictured: Lamb and White Bean Cassoulet. See the recipe on page 28.
Annabel Langbein A Free Range Life: Share the Love (Annabel Langbein Media, RRP $24.95) is available at supermarkets, Paper Plus, the Warehouse and good bookstores, or direct from her website www.annabel-langbein.com.
We have two copies of Share the Love to give away. Enter online at www.livingwithallergies.co.nz or email firstname.lastname@example.org with SHARE THE LOVE in the subject line. Entries close 30 November.
There’s never been a better time to be gluten-free, with good gluten-free flours and baking blends easily accessible in most supermarkets. Find a brand that you like and get to know its properties – often you can substitute directly for gluten flour, but if your blend does not contain a binder such as xanthan gum you may need to add this for recipes such as bread. ALWAYS check the labels on stocks, sauces and other ingredients. Gluten-free versions of most common ingredients can be found at specialist stores and even supermarkets these days, but gluten lurks in surprising places and manufacturers sometimes update their formulas without notification. In this potluck world, if you’re having a guest with life-threatening allergies, such as peanut anaphylaxis, make sure you tell all your other guests so they don’t unwittingly turn up with their favourite chicken satay dish. Finally, instead of thinking of your intolerance or allergy as a restriction, think of it as an opportunity to experience a wider variety of foods. For example if you’re substituting gluten with pulses, other grains and vegetables you’re probably eating a far wider variety of real foods and a far healthier diet than someone who eats toast for breakfast, a sandwich or pie for lunch and pasta for dinner.
LIVING WITH ALLERGIES Spring 2016 25
These recipes are extracted from Annabel Langbein A Free Range Life: Share the Love (Annabel Langbein Media, $24.95), available from Paper Plus, the Warehouse and all good supermarkets and bookshops. For more great Annabel Langbein recipes visit annabel-langbein.com.
26 LIVING WITH ALLERGIES Spring 2016
ANNABEL LANGBEIN’S GLUTEN-FREE ORANGE AND ALMOND CAKE This makes a wonderful prep-ahead dessert, served with crème fraiche or yoghurt. Leave the fruity glaze off the top if you prefer and just dust with icing sugar or slather with a cream cheese icing for a great gluten-free party cake. Prep 20 mins Cook 40 mins Serves 10-12 GF V 300g butter, melted 1½ cups caster sugar 4 eggs 1 tsp vanilla extract 3½ cups ground almonds 1 cup fine polenta 1 tsp gluten-free baking powder finely grated zest of 1 lemon and 2 oranges ¼ cup orange juice
GLAZED CITRUS TOPPING 1 orange and 1 lemon, unpeeled and sliced as thinly as possible ¾ cup sugar ¾ cup water Preheat oven to 160°C fanbake. Grease the sides of a 23cmdiameter springform cake tin and line the base with baking paper. In a mixing bowl, whisk together butter, sugar, eggs and vanilla extract. Mix in ground almonds, polenta, baking powder, zests and orange juice. Transfer to prepared tin and bake until the top is deeply golden and bounces back when lightly pressed (about 40 minutes).
✓Gluten Free ✓Chemical free ✓No added water
Allow to cool in the tin before turning out. The unglazed cake will keep in a covered container in the fridge for up to five days. To prepare the Glazed Citrus Topping, place the citrus slices in a pot, cover with boiling water, stand for 5 minutes then drain. Repeat once more to remove any bitterness from the citrus. Add sugar and water and bring to a simmer, swirling to dissolve sugar. Simmer until the liquid has almost evaporated (10-15 minutes) or until syrupy. Spoon fruit and syrup over cake just prior to serving.
NZ’s Largest Range of Organic Gluten Free Foods
Our bacon is smoked over manuka wood and contains only pork, sea salt and brown sugar. Available at all good supermarkets. FACTORY SHOP CONTACT US 46c Porana Road Glenfield Auckland Ph. 09 443 2980 www.hendersonsbacon.com
www.ieproduce.com P: +649 4880211 E: email@example.com 1 Barrys Point Rd, Takapuna LIVING WITH ALLERGIES Spring 2016 27
ANNABEL LANGBEIN’S LAMB AND WHITE BEAN CASSOULET This hearty meal is perfect for a potluck because you can prepare it a day ahead, chill it until needed, transport it cold in the pot and just bring it back to a boil before adding the peas. It also freezes well. You can swap out the lamb for pork shoulder, rabbit legs or bonein chicken thigh quarters. Prep 15 mins Cook 3¼ hours Serves 6-8 DF GF
About 1.5kg boneless lamb shoulder, or 6 lamb drums or shanks salt and ground black pepper, to taste 3 x 400g cans butter beans or 4½ cups cooked white beans, rinsed and drained 400g can cherry or chopped tomatoes 320g can artichoke hearts, drained, or 6-8 cooked small artichoke hearts, halved (optional) 2 cups gluten-free chicken stock 1 cup white wine 6 pickling onions or shallots, peeled and halved crosswise 3 cloves garlic, finely crushed 2 bay leaves 2 stalks celery, cut into thin batons about 6cm long
28 LIVING WITH ALLERGIES Spring 2016
finely grated zest of 1 lemon 2 tsp thyme leaves 2 cups fresh or defrosted frozen peas Preheat oven to 220°C fanbake. Place lamb in a large roasting dish that will hold it snugly in a single layer. Season well then roast until lightly browned (about 45 minutes). Remove dish from oven and reduce oven temperature to 160°C. Lift out the lamb and set aside. Drain fat and discard. Return lamb to dish, add all other ingredients except peas, cover dish tightly (use tinfoil if you do not have a lid) and cook until tender (about 2¼ hours). Stir in peas and return to oven for 15 minutes to heat through.
Our unique range of dairy free yoghurts tick so many boxes: @ Dairyfree
@ Lactose free @Gluten free
Try one of our other delicious flavours! Available at selected NZ supermarkets and retailers. Ask your local if they stock NoMoo yoghurts.
@Live probiotic cultures
@ No preservatives*
@ No artificial colours
@ No artificial flavours
@Vegetarian and vegan* *Orchard Apricot flavour may contain bee pollen (from the honey) and contains sulphites (from when the apricots are processed post harvest).
Allergy Guide Dexem – more than just relief from eczema Dexem Repair helps eczema in 3 ways: Soothes: Moisturises and conditions the skin to help relieve itching and aid healing. Restores: Skin friendly pH provides an optimal environment for skin healing and normalisation of skin health. Protects: Containing the natural bacteria blocker 2QR, Dexem Repair helps prevent bacterial infection on and around the eczema site. Always read the label and follow the instructions. Do not use if you are sensitive to one or more of the ingredients. For external use only. If symptoms persist, please see a healthcare professional. Distributed by Air Flow Products Limited, Wellington. 0800 247 356 www.air-flow.co.nz. TAPS CH4745 RRP from $14.99. Dexem Repair – cream and scalp – are only available from Pharmacies. For more information visit dexem.co.nz
VOC-free paint to suit all tastes
Freshen up your next paint job with Resene Zylone Sheen VOC Free, which combines a popular low sheen finish without the unwanted volatile organic compounds (VOCs) for better indoor air quality. Improved air quality can help prevent headaches, asthma, nausea, respiratory complaints and allergic reactions. And to suit all tastes, Resene Zylone Sheen VOC Free is available in a wide range of popular Resene colours using Resene non VOC tinters. Sensitive Choice approved and available from Resene ColorShops and resellers, www.resene.co.nz/ colorshops
30 LIVING WITH ALLERGIES Spring 2016
ADVICE, BENEFITS & CHOICES Long lasting hydration for eczema-prone skin RESTORADERM™ Skin Restoring Moisturiser is suitable for anyone aged three months or older with dry, itchy skin symptoms commonly associated with eczema or atopic dermatitis. It is easily absorbed and restores moisture to help repair the skin’s barrier. Use after cleansing with soap-free, fragrant-free and emollient-rich RESTORADERM™ Skin Restoring Body Wash. Both products contain Filaggrin breakdown products, shown to be depleted in eczema-prone skin. Available at major pharmacies nationwide.
DIY carpet cleaning for a clean and healthy home Rug Doctor’s DIY equipment covers it all. From whole floor cleans, to spills, mattress cleaning, stairs and upholstery (chairs, couches and vehicles). Cleaning your carpet regularly not only maximises the life of your carpet, it is also very important for the health of your family, eliminating fleas, cockroach eggs and dust mites, giving you a clean and healthy home. To find out more, visit www.rugdoctor.co.nz or call 0800 800 245
Natural allergy support
Clinicians AllerStop is a unique natural formula that responds rapidly when allergy support is needed. In under 15 minutes, allergy support from indoor and outdoor allergens such as moulds, dust mites, pet dander, grasses and pollens can be achieved with no side effects. AllerStop contains specialised proteins isolated from quail eggs, and was discovered in the 1970s in France, where research allergist Dr G. Bruttmann found a powdered quail egg formula provided natural support for the body’s response to environmental irritants. Available from pharmacies and health food stores. Find us on Facebook and go to Clinicians.co.nz
$ 300 2 worth over
USEFUL SNIPPETS We’ve enjoyed putting together this issue of Living with Allergies and have learnt some interesting things along the way. Here are some of them …
That children who suck their thumb or bite their nails may be less likely to develop allergies. PAGE 2
That firm tofu and canned fish with bones – such as sardines and salmon – are the richest sources of calcium for those following a dairy free diet. PAGE 5
That grass pollen can be blown for hundreds of kilometres on the wind, so even if you live in an apartment in the centre of a big city – and suffer from hayfever – the cause will still be grass! PAGE 14
That a wet facecloth kept in a plastic bag in the fridge makes for a soothing compress for sufferers of allergic conjunctivitis. PAGE 11
That New Zealand has a register of trained Medical Herbalists (www.nzamh.org.nz). Worth checking out if you’re interested in adding herbs to your treatment regime. PAGE 17 That only a minority of children with eczema will benefit from dietary restrictions. PAGE 20
That the release of Volatile Organic Compounds can be high in ‘natural’ paints, and a synthetically designed and produced low- or no-VOC paint can often be a healthier choice. PAGE 8
32 LIVING WITH ALLERGIES Spring 2016
LEVRIX FOR HAYFEVER & ALLERGY RELIEF Fast acting, long lasting, double action formula Levrix is an anti-allergic agent for the treatment of the symptoms associated with allergic conditions such as: • Hayfever, including associated eye complaints • Chronic allergic rhinitis, e.g. allergy to house dust mites & animal dander • Hives (urticaria) Levrix provides rapid and significant relief from Hives (Urticaria). Symptoms stay significantly improved after treatment has stopped.1 Itching from Mosquito bites reduced by 60% within 15 minutes by taking a single Levrix tablet and you get long lasting relief.2 Only available at Pharmacy 1: Levocetirizine in the treatment of chronic idiopathic Urticaria: a randomized, double-blind, placebo controlled study. Eustachio Nettis , M.D. ET AL. University of Bari, Italy, 70124 2: Levocetirizine for Treatment of Immediate and Delayed Mosquito Bite Reactions. Ari Karppinen ET AL.
Levrix is indicated for the relief of symptoms of seasonal and perennial allergic rhinitis and urticaria (hives). Always read the package insert carefully and use only as directed. If symptoms persist see your healthcare professional. Pregnant or breast-feeding women, or those with kidney problems should seek medical advice before using Levrix. Pharmabroker Sales Ltd, 106 Bush Road, Albany, Auckland. Freephone 0508 664 455. TAPS PP8537
Treat your allergic rhinitis not just your symptoms A grass pollen immunotherapy tablet - a real solution for your allergic rhinitis1,2 • One tablet per day • For adults and children 5yrs & over • Take seasonally - before & during pollen season • Proven effective after the first season3,4
Talk to your healthcare professional today
100 IR & 300 IR or 300 IR sublingual tablets Oralair is an unfunded prescription medicine. Always use strictly as directed. Ask your doctor if Oralair is right for you. Oralair has risk and benefits. If symptoms continue or you have side effects, see your healthcare professional. Normal doctors fees will apply For futher information on Oralair contact your doctor or healthcare professional or view the Consumer Medicine Information (CMI) go to www.medsafe.govt.nz/consumers/cmi/cmiform.asp Stallergenes Australia Pty Ltd Suite 2408 4 Daydream Street Warriewood NSW 2102 Distributed in New Zealand by EBOS Group Ltd 108 Wrights Rd Addington Christchurch Ph: +64 (0) 9 4153 267 Fax: 0800 262 262 Stallergenes & Oralair are registered trademarks of Stallergenes SA STG12115 TAPSPP5855 REFERENCES: 1. AUST R 167565 - ORALAIR Initiation Treatment & AUST R 167566 - ORALAIR Continuation treatment. 2. Approved Oralair product information. 3. (VO34.04 study): Didier A. optimal dose, efficacy and safety of once-daily sublingual immunotherapy with a 5-grass pollen tablet for seasonal allergic rhinitis. J Allergy Clin Immunol 2007;120:1338-45. 4. (VO52.06 study): Whan U.et al. Efficacy and safety of 5-grass pollen sublingual immunotherapy tablets in paediatric allergic rhinoconjuntivitis.J Allergy Cin Immunol 2009;123:160-6.