Allergies LIVING WITH
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The allergy epidemic Why are allergies among children rising globally?
ECZEMA TRIGGERS Diagnosing fragrance allergy HEALTHY HOME Target mould & dust mites
MAN’S BEST FRIEND When pets make you sneeze
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GIVEAWAYS 6 great reader competitions – see inside
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LIVING WITH ALLERGIES AUTUMN-WINTER 2014
ALLERGY AWARE 4 News and views
FOOD ALLERGY 6 The global toll of food allergy
COVER STORY 8 When pets make you sneeze
10 Mums launch national allergy support group
ECZEMA 13 Diagnosing fragrance allergy
HEALTHY HOME 16 Donâ€™t monkey about with mould 31 The five best ways to remove dust mites
TREATMENT 18 Regional allergy clinic offers new model of care
EYE ALLERGIES 20 Using eye drops
Look out for six great reader competitions throughout the magazine. See inside for how to enter or go to www.livingwithallergies.co.nz
LIVING WITH ALLERGIES Editor: Caroline Wood Email: firstname.lastname@example.org Design: Rose Miller at Kraftwork Proofreader: Stella Clark
ADVERTISING Sales manager: Debbie Bishop Phone: 09 589 1054 or 021 340 360 Email: email@example.com SUBSCRIPTIONS Subscribe online at www.livingwithallergies.co.nz Phone: 09 589 1054 Email: firstname.lastname@example.org PRINTER McCollams Print PUBLISHER Published three times a year by Hawkhurst Media Services Ltd PO Box 25679, St Heliers, Auckland 1740 Phone: 09 589 1054
ANAPHYLAXIS 22 Adrenaline autoinjector campaign
EXPERT VIEW 24 Q&A with Dr Susan Prescott Member of the Magazine Publishers Association. Member of the Audit Bureau of Circulation ISSN: 2324-2213
GLUTEN-FREE LIVING 27 A guide to the best gluten-free food blogs
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.
ASTHMA 32 Green-lipped mussel extract: a potential treatment for asthma? 40 Spot the signs of a serious asthma attack
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. ÂŠ All rights reserved. No article in whole or part should be reprinted without permission of the Editor. 2 LIVING WITH ALLERGIES Autumn-Winter 2014
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NEWS AND VIEWS Allergy study tracks 3,500 young children
The dramatic increase in asthma and allergy rate among young children may be linked to environmental factors, according to a Canadian researcher. The Canadian Health Infant Longitudinal Development (CHILD) study is keeping track of 3,500 children born after 2010 in five cities across Canada. “It’s happening too quickly for it to be a simple problem of genetics. Our genes don’t evolve that fast, so it’s got to be something in our environment,” CHILD study researcher Meghan Azad told CTV News in March. Researchers hope the study, which is due to be completed in two years, will shed light on the increase in allergy, asthma and other diseases. See www.canadianchildstudy.ca.
Canadian study aims to shed light on the causes of allergy in children Promising treatment for multiple food allergies
An asthma drug called Omalizumab accelerates the process of desensitising patients with multiple food allergies, says a team from Stanford University School of Medicine. The same team has also published research to show that people with multiple food allergies can be desensitised to several foods at the same time. The two studies, both phase 1 safety trials, provide evidence that a promising new method for treating people for multiple food allergies works. The study, led by Kari Nadeau, was published online in the journal Allergy, Asthma & Clinical Immunology in February. See www.med.stanford.edu.
4 LIVING WITH ALLERGIES Autumn-Winter 2014
Coeliac awareness week
Celebrities, experts and ordinary Kiwis are getting behind this year’s Coeliac Awareness Week from May 19-25. They will share their experiences and encourage greater understanding of the disease. See www.coeliac.org.nz.
Histamine cancer link
Antihistamines could one day be used to develop new cancer therapies, according to a US study. Researchers have found that histamine, a component of the immune system that responds to allergens, plays a role in protecting tumours from the immune system. By blocking the production of histamine in animal models, researchers were able to interrupt a process that promotes melanoma growth. The study, led by Daniel Conrad of Virginia Commonwealth University, was published in the Journal of Leukocyte Biology in December. See www.jleukbio.org.
Hay fever patients live longer
At last some good news if you have allergic rhinitis – you might well outlive the rest of us! Patients with allergic rhinitis (hay fever) have a decreased risk of heart attack, stroke and all-cause mortality, says lead investigator Dr Angelina Crans Yoon, of the Department of Allergy and Clinical Immunology at the Kaiser Permanent Los Angeles Medical Center. The team studied US health data and found people with allergic rhinitis were less likely to suffer cardiovascular events. The same study, which was published in March, found asthma patients have a higher risk of heart disease but not stroke or all-cause mortality. See annualmeeting.aaaai.org.
Soft toys harbour pet allergens
Children’s soft toys contain three times more pet allergens than mattresses and should be washed once a week, say New Zealand researchers. They also found detectable cat and dog allergens on toys in homes without animals. The University of Otago study, which is the first to confirm that soft toys are a source of pet allergens, as well as dust mites, was published in the Journal of Asthma in December. Lead investigator Dr Rob Siebers said the findings were important for children who regularly sleep with a soft toy close to their nose and mouth. He recommended a weekly wash of a child’s snuggly to remove allergens, particularly for children with asthma.
Staph causes eczema itch
Researchers have shown for the first time what causes eczema to itch. Staphylococcal bacteria normally found on the skin produce a slime-like substance called biofilm, which blocks the sweat ducts. The blockage activates molecules in the immune system known to cause itching and inflammation, according to a US study led by Dr Herbert Allen, of Philadelphia’s Drexel University College of Medicine. The research was published in February in the online edition of JAMA Dermatology.
Peanut therapy success
A new form of immunotherapy for peanut allergy found it was successful in more than 84 per cent of children. The phase 2 trial in the UK – the largest of its kind worldwide – used oral immunotherapy in increasingly larger amounts on a regular basis to build up tolerance. The study involved young people aged 7–16 years eating daily doses of peanut protein over four to six months. By the end of the trial, 84-96 per cent of the children could safely eat 800mg of peanut protein (roughly five peanuts). The research was led by Dr Andrew Clark, of the University of Cambridge, and published in The Lancet in January. Dr Clark says further studies in the wider population are needed. See www.cam.ac.uk. LIVING WITH ALLERGIES Autumn-Winter 2014 5
THE GLOBAL TOLL OF FOOD ALLERGY Food allergy in children is a significant health issue that is likely to increase globally over the next decade, according to a new worldwide survey.
has emerged as an unanticipated ‘second wave’ of the allergy epidemic following the rising global burden of asthma, rhinitis and eczema. Food allergies and eczema are now two of the most common chronic non-communicable diseases in children worldwide. Despite the widespread prevalence of food allergies, many countries lack quality data on their prevalence and impact. A recent global survey looked at existing data on patterns of food allergy among children in 89 developed and developing countries. It showed a worrying rise in the number of children with food allergy. In some developed economies, one in 10 infants has a challenge-proven IgE-mediated food allergy, following a significant increase in the past decade. Similar trends are now apparent in the developing countries of Asia and other regions. For example
The global survey shows that in some developed economies, one in 10 infants has a challenge-proven food allergy in China the prevalence of proven food allergy is around seven per cent in pre-schoolers, comparable to reported prevalence in European regions. The study was published in the World Allergy Organization Journal in December 2013. The authors conclude: “This survey highlights food allergy as a significant paediatric health issue that
6 LIVING WITH ALLERGIES Autumn-Winter 2014
is likely to increase globally in the coming decade. The survey also reveals the paucity of quality data in many regions and the need to obtain more accurate information about food allergy prevalence and impact, even in developed countries.” The study calls for more research into food allergy, calling it a ‘neglected area of allergy research’. They say it is important to anticipate the growing impact and need for better allergy services in order to cope with this rising global issue. *A global survey of changing patterns of food allergy burden in children, Susan L Prescott et al, see www.waojournal. org/content/6/1/21. The study’s lead author, Dr Susan Prescott, is a paediatric allergist and immunologist at Princess Margaret Hospital for Children in Perth, Australia. See page 24 for a Q&A with Dr Susan Prescott about the causes of the rapid rise in allergy.
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WHEN PETS MAKE YOU SICK
Cat and dog allergies can be difficult to diagnose because of their close link to dust mite sensitivity. Caroline Wood goes in search of answers for why our furry friends can make us sneeze.
S A TEENAGER
Jonathon lived with Sphinx, his family’s much-loved black cat, who spend most of its time indoors and slept in his bedroom. He showed no symptoms of cat allergy. Then he left home for university and at some point became severely allergic to cats, despite having grown up with one. Now 30 years later he only has to enter a room where a cat has been and within minutes his eyes and nose are streaming, he is
sneezing uncontrollably, his chest tightens up and he will be wheezing within the hour. This scenario is very common, says allergy specialist Dr Andrew Baker, of Waitemata Allergy Clinic in Auckland. “Some people can be desensitised by their own pet just by living with the animal constantly, so they don’t react. But when they move away to university, or into their own home, they react to the cat or dog for the first time.”
8 LIVING WITH ALLERGIES Autumn-Winter 2014
The allergens Allergic individuals react to the proteins in the dander (dead skin), saliva or sebum secreted by an animal’s hair follicles to protect fur and skin. The microscopic proteins become airborne and are inhaled as tiny particles that can cause allergic symptoms. Cats and dogs cause the most problems, followed by horses, rabbits, guinea pigs and cows. Dr Baker says pet allergies can be difficult to diagnose because some people who think they are allergic to their cat or dog are actually allergic to dust mites. In many cases they may be allergic to both an animal and dust mites. “Cats and dogs carry a lot of dust mites on them and sometimes people are reacting to the dust on the cat or dog. It would be less common for someone to just react to a cat or dog, he says. “It’s important to get properly tested and diagnosed. Allergy tests are helpful but do not completely prove a diagnosis. Instead allergists
rely on a combination of skin prick or blood tests and a comprehensive case history of the patient’s clinical symptoms and whether they occur year round or intermittently, to pinpoint the cause.” Symptoms The range and severity of symptoms varies and includes an itchy, runny nose, sneezing, irritated watery eyes, wheezing and shortness of breath, eczema and hives. Some people will get asthma around pets. The best way to avoid an allergic reaction is to keep away from the animals that cause you a problem. Keep pets out of the house as much as possible and don’t let them in bedrooms, advises Dr Baker. Immunotherapy Desensitisation treatment is an option for some people and is usually done in conjunction with dust mite desensitisation for best results. Dr Baker says about 85 per cent of patients – about 5 in 6 – benefit
from immunotherapy. The treatment involves giving increasingly higher doses of the problematic pet’s protein and can take up to five years. “The response is most often a significant decrease in the frequency and severity of symptoms, which is longstanding even for years after the treatment finishes. A few patients get a complete cure,” adds Dr Baker.
vet before doing this. • Vacuuming carpets and upholstery twice a week. • Removing dust. See page 31 for the five most effective ways to remove dust mites - this will help with pet allergens too. * Dr Andrew Baker can be contacted via www.waitemataallergy.co.nz.
Controlling pet allergens Pet allergens can remain in the home for many months after the animal responsible has moved out. It can take three months of regular intensive cleaning before cat allergens are removed, says Asthma New Zealand. Steam cleaning curtains, carpet and furniture is the best way to remove pet allergens. Other tips for controlling pet allergens include: • Keeping animals out of the house or, if that is not possible, out of the bedroom. • Washing pets once a week – check with your
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MUMS LAUNCH ONLINE ALLERGY SUPPORT GROUP Using the power of social networking, hundreds of Kiwis are connecting, talking, supporting, encouraging and campaigning for a more allergyfriendly world. Shari Hammond talks to the founding members of Allergy Support New Zealand, the first group of its kind in the country.
IVE WOMEN from
across New Zealand decided they wanted to help families with allergies by creating a social network group on Facebook. It’s a place where people can share ideas, ask questions or simply view posts and learn as they go. The founding members are a pretty modest bunch, who would downplay what they have created, but hundreds of parents of children living with allergies have already signed up and many have posted online how grateful they are for the group. Lisa Welbourne and Cherie Kaushal, of Auckland, Sue Culver and Helen Richardson, of Wellington,
and Lindsey Bartholomew, of Blenheim, have never met as a group. They have 10 children with an excess of 50 allergies between them and their immediate families, so they know a thing or two about living with allergies. They forged a great friendship online and collectively they saw a need to create a place where complete strangers could share the highs and lows of living with allergies. In late December 2013 they set to work and launched a closed Facebook group – Allergy Support New Zealand. At the time of writing nearly 800 people had joined the group. Whether you’re in search of a cake recipe, have spotted a new product on
“When your lifelong friends don’t quite grasp living with allergies, it’s reassuring to know there are some kind, understanding strangers who will help you out.” AUTHOR SHARI HAMMOND, WHO HAS JOINED ALLERGY SUPPORT NZ
10 LIVING WITH ALLERGIES Autumn-Winter 2014
We have three elegant Sodastream Pure Drinks Makers plus syrup packs to give away so you can make sparkling water and flavoured sparkling beverages at home. Each is worth over $200 RRP. Enter online at www.livingwithallergies.co.nz or email firstname.lastname@example.org with SODASTREAM in the subject line. Entries close 15 August 2014. the supermarket shelf, your child has just been diagnosed with allergies or you suspect something ‘isn’t right’, you can share with others on the site. Perhaps you want to vent that your mother-in-law created a meringue tower for Christmas for your eggallergic child, or express your frustrations hearing someone say ‘a little bit won’t hurt’, or share a great highlight – my child passed a food challenge today, whoo hoo!, Allergy Support New Zealand members will understand and assist. Why is the Allergy Support New Zealand page important? Sue Culver explains: “It is important because it’s available 24/7 to everyone. We have all ‘been there’ at some point in our journey. We know and understand what others are going through. Many people come to the page lost and overwhelmed and don’t know what to do next, or where to go. We know what that is like, and we all help each other.” Lisa Welbourne says that she got involved because she wanted to help other
parents navigate their way through living with allergies. “I wish people would stop downplaying the seriousness of allergies. It is our responsibility to spread the word to those who don't understand. We deserve compassion and understanding and a two-way discussion.” Helen Richardson recently started a campaign asking the Ministry of Health to review funding for adrenaline auto-injectors (see page 22). She hopes the support group will continue to grow and in the future will include more specific allergy advice, as well as campaigning for a better deal for people living with allergies. She said: “There is so much more that could be done to improve the dayto-day reality of individuals and families living with severe allergic disease. It is invaluable to have a space where people can share what has worked or hasn’t worked so well for them. As a parent of a toddler with allergies, I have learned so much from other parents and cannot
stress enough how important that has been for me.” Another aim of the support group is to help parents cope with the anxiety and isolation of living with allergies. Lindsey Bartholemew explains: “You are not alone in your journey, the group gives you ways of managing, when all you feel like doing is giving up. It is also a safe place to vent, where people actually get you and what you are going through.” Cherie Kaushal says it is also important to be able to share positive allergy experiences with like-minded people. “I felt totally isolated as an allergy parent but I have met some amazing people and gained some wonderful support from the people I have met through this page.” *Allergy Support New Zealand is a closed group for individuals affected by allergies. Go to facebook. com and search for “Allergy Support New Zealand”. You can then log a request to join the group.
LIVING WITH ALLERGIES Autumn-Winter 2014 11
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DIAGNOSING FRAGRANCE ALLERGY If you think your eczema is caused by a fragrance allergy, it is important to get a confirmed diagnosis. We ask dermatologist Dr Ian Coutts about fragrance allergy and how it is identified and treated.
iagnosing the cause of an eczema rash is an art as well as a science, with perhaps a bit of detective work thrown in. Every patient is different and dermatologists use a combination of patient history, patch testing, blood tests, and the location and frequency of the rash to make a diagnosis. If a patient walks in with a rash on their hands and face, or their feet, it points to a possible allergy and this must be confirmed by patch testing. If the evidence suggests fragrance allergy, patients may be encouraged to bring in the products they think they are allergic to so they can be patch tested with them. This can take time and it can be difficult to get a definitive diagnosis, but it’s important to get right because the best prevention is a lifetime of avoidance – using fragrancefree products and staying away from anything that may contain the fragrance. “It is important people get properly diagnosed because some people think they are allergic to fragrance but
may not be,” says Wellington dermatologist Dr Ian Coutts. “A lot of people are misdiagnosed. People generally don’t know what they are allergic to and some may be wrong about what is causing the problem. “A typical scenario for someone with fragrance allergy might be someone who is atopic and may have had eczema, asthma and hay fever as a child, then they get a deterioration in their eczema as an adult. Or it may be their eczema has become regionalised, for example it only appears on their hands and face. They will come in and say my eczema is getting bad, what can I do? You can’t include or exclude any allergy, so we may have to do patch testing, which will hopefully give some answers.” A dermatologist should be able to give patients a proper clinical diagnosis: is it allergic contact dermatitis (eczema) caused by a fragrance, or other allergen? Or is it irritant dermatitis (eczema), which doesn’t involve an allergic response? A previous positive reaction during patch testing may or may not be relevant to the current eczema problem. Someone who LIVING WITH ALLERGIES Autumn-Winter 2014 13
eczema Nine chemicals responsible for most fragrance allergy
Fragrance mix – eight of the most common fragrance allergens
More than 5,000 fragrances are used in everyday products like perfumes, cosmetics, deodorants, laundry detergents, soaps, drinks and toothpaste. Eight fragrances make up ‘fragrance mix’, which is used by dermatologists to patch test for fragrance allergy. Together with Balsam of Peru they cause 75 per cent of all fragrance allergy cases.
Cinnamic alcohol Cinnamic aldehyde Eugenol Isoeugenol
Balsam of Peru is a sticky sap that smells of vanilla and cinnamon and comes from the bark of the Myroxylon tree. It is a common allergen used in a wide variety of perfumes, cosmetics, sunblock, baby powders, spices, soft drinks, flavoured teas and medicinal products.
was patch tested negative to a fragrance allergen in 2010 may still develop that allergen or another one in 2014. “A common one is someone saying I can’t be allergic to hair dye because I have used it for 20 years. But that person has become sensitised to it,” says Dr Coutts. “It’s not an exact science. It’s time consuming and hard to do well, which is why it’s important to see a dermatologist for a proper diagnosis,” he added. The best prevention if you have a diagnosed fragrance allergy is to avoid any product containing fragrance – look for fragrance-free 14 LIVING WITH ALLERGIES Autumn-Winter 2014
Geraniol Alpha amyl cinnamic alcohol Hydroxycitronellal Oak moss absolute
or perfume-free on the label. Exercise caution when using any plant-based natural cosmetics as they can contain allergens too. The treatment is the same as for any acute eczema rash – moisture, topical corticosteroids and treatment of secondary infections. The Australasian Society of Clinical Immunology and Allergy has recently updated its excellent guide to eczema and its treatment, see www.allergy.org.au. * You can contact Dr Coutts at NZ Dermatology & Skin Cancer, in Wellington, see www.nzdermatology.co.nz or call 04 3800 125.
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DON’T MONKEY ABOUT WITH MOULD One in three New Zealand homes has a mould problem, which can cause serious health issues in sensitive individuals. Caroline Wood looks at the best ways to prevent mould in the home.
OULD is a type of
fungus, which can look like green, grey, brown, black, white or red growth or stains on walls, ceilings, window frames and other surfaces. Mould releases thousands of tiny invisible spores into the air, which are breathed in causing asthma and allergies in some people. Doctors don’t know how many people have a mould allergy in New Zealand as many may be going undiagnosed. Symptoms are similar to hay fever, such as a runny or stuffy nose, sneezing, cough, postnasal drip, and itchy watery eyes. Mould can also trigger dangerous asthma attacks. Mould needs moisture to live. If you have a serious mould problem, check for a water leak first as that may be the cause. Otherwise condensation – dampness on walls, windows, ceilings and floors – is the most common cause of excess moisture and mould. Condensation is caused when warm wet
air touches cold surfaces, causing water to form. There is a lot you can do to prevent mould. Here are 10 questions to ask yourself when thinking about reducing moisture (and mould) in your home.
Ventilation: Do you open windows and doors for at least one to two hours a day to increase air circulation - even in the middle of winter? Keep beds and furniture pulled slightly away from walls (especially external walls) so air can circulate. Leave wardrobes slightly open for ventilation.
Condensation: Do you have moisture on windows and other surfaces first thing in the morning? It’s important to wipe off the condensation as soon as you can. Reduce the source of the condensation, for example, open a window in the bathroom when showering and install an extractor fan if you don’t have one.
16 LIVING WITH ALLERGIES Autumn-Winter 2014
Heating: Are you using an unflued gas fire? They create a lot of moisture in the house. Use a dry source of heat such as a heat pump, electric heater or woodburner. The World Health Organisation recommends homes are kept at a minimum of 18˚C for good health. Open curtains early in the morning and close them when the sun goes down to keep the heat in.
Insulation: Is your home insulated and is existing insulation in good condition? Insulation will help keep your home warmer and less likely to produce condensation. Most heat is lost through the ceiling so insulate it first, then the floor, windows and external walls.
Double glazing: Have you considered installing double glazing to reduce window condensation and improve your home’s heat retention properties? Explore retrofitting options – reusing existing wooden window frames – for a more costeffective solution. You can do it one room at a time to see the difference it makes.
Washing: Do you leave damp clothes inside to dry? Try to hang them outside when you can. Open windows when using a clothes drier so moisture can escape and make sure it is vented to the outside.
Cooking: Do you always keep lids on pots when cooking and use the hob’s extractor fan or open windows when cooking food? Check fridge seals and the drip tray as they can be heavily contaminated with mould. Throw away any mouldy fruit.
Showering: Do you always remember to use the extractor fan while showering and/or open a window to let the steam out? Wash your shower curtain every few weeks and make sure the kids leave it hanging inside the shower/bath so water doesn’t drip on the floor.
Maintenance: Have you checked for water leaks in areas with an existing mould problem? Anti-mould paints are useful when decorating to prevent mould build up on walls and other surfaces. Check humidifiers, vapourisers and air conditioners with water storage units as they can become a source of airborne mould spores. Clean out gutters regularly.
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Outside: Do you keep the garden free of leaves, which harbour mould? In damp areas see if you can prune overhanging branches to let in sunlight and air. Get someone else to turn and spread compost or use a mask if you have to.
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Vinegar a simple way to kill mould
White vinegar is the best way to kill or clean up mould, according to Housing New Zealand, which has a useful guide to mould on its website. Apply white vinegar directly onto the mould using a spray bottle, or wipe it on using a clean cloth. If necessary, use an old toothbrush to get into corners. Leave it for a few days to take effect and then wipe off the dead mould with soap and water, using a clean cloth.
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REGIONAL CLINIC OFFERS NEW MODEL OF CARE
The number of people with allergies is rising in New Zealand but there are few specialist allergy services outside the main cities, especially for adults. A team of doctors and nurses is hoping to plug that gap in Nelson and Marlborough, as Caroline Wood reports.
with allergies are struggling to access specialist care if they live in regional New Zealand. They may be experiencing a reduced quality of life, or serious health problem because they cannot see an allergy
specialist for proper diagnosis and access to the latest desensitisation treatments. Accessing specialist allergy care can be extremely difficult in regions such as Hawke’s Bay, Taranaki, Bay of Plenty, Central Otago and Nelson, says Dr James Chisnall, a Motueka GP with a special interest in allergy. “It can be very hard to get allergy care in parts of the country. Here in the Nelson region there is an excellent paediatric service for children but no adult allergy service. It’s variable around the country,” he says. Dr Chisnall, who has just completed postgraduate allergy training in Sydney, wants to plug the gap.
He has teamed up with local paediatrician Dr Garth Smith (also completing postgraduate training in allergy) and two experienced nurses Pam Manley and Jacquie Westenra to open a private specialist clinic for adults and children called Allergy Solutions. It serves the Nelson and Marlborough region. The team aims to provide accurate diagnosis and evidence-based treatment for a wide range of allergic conditions. Local GPs can refer patients to the clinic for diagnostic testing, including skin prick and blood tests. Children and adults can receive desensitisation treatment for venom (bee/wasp) allergy and aeroallergens, such as house dust mite or grass, which may be causing hay fever, sinus disease or asthma. The team is also working with local dietitians to provide sound dietary advice.
GP specialist Dr James Chisnall, seen here with his children, wants to offer a new model of allergy care for adults and children in the Nelson region. 18 LIVING WITH ALLERGIES Autumn-Winter 2014
A step up in care The idea is to provide a new kind of allergy service for the region – more specialised than a GP but not as high a level as that provided by the country’s few specialist allergists/immunologists, who see the most complex and difficult cases and are struggling to meet demand, says Dr Chisnall. “We know there is a need for allergy services locally but we know this need is not being met, or it is being met but by alternative health practitioners. We want to provide people with another option, he said. “We are not fully fledged immunologists or allergists but we are doctors with a special interest and postgraduate qualifications in allergy, and we can manage most allergic diseases. We have close links with specialists in Auckland and Wellington and can seek their advice and input if needed. “It’s unique because we’ve started it together, doctors and nurses working as a team. It’s an exciting model
because I think a lot of allergy care should be delivered by nurses, for example skin prick testing, patient education and eczema care.” Regional allergy hubs If the clinic is successful, Dr Chisnall hopes other GPs and nurses with a special interest in allergy may want to reproduce the model in other parts of the country. He is helping set up a national group of GPs with a special interest in allergies. “In the future I would like to see a network of GPs with extra allergy training that other GPs in their region can refer to and get support from. “Allergies are getting so common and allergy specialists have been struggling for years with the number of patients. The answer, in my opinion, is to get structured processes that would see more GPs getting more involved in allergy care. The danger is if we do it in an ad hoc way. There have to be sound processes and support in place, the care must be evidence-based and we need
to make sure that those at the top of the field, New Zealand’s small group of specialist immunologists/ allergists, are involved and have input into GP education and support.” Dr Chisnall, who also works as a GP specialist at Greenwood Health Centre in Motueka, became interested in allergies after seeing so many patients with allergies in his general practice. “Proper allergy care can make a big difference to people. There are a whole lot of people out there who think they have an allergy and they don’t, they have an intolerance. And there are people with significant allergies, who don’t realise they could be more effectively treated by desensitisation treatment,” he added. *Allergy Solutions opened in April and is based at Lower Queen Street Health, in Richmond, near Nelson. See www.allergysolutions.co.nz.
GIVEAWAY The new BISSELL PowerFresh™ steam mop makes quick and easy work of cleaning up sticky floors, plus it is approved by the Asthma Foundation’s Sensitive Choice programme. We have one PowerFresh™ mop (RRP $329.95) to give away. To be in to win, enter online at www.livingwithallergies.co.nz or email giveaways@ livingwithallergies.co.nz with BISSELL in the subject line. Entries close 15 August 2014.
LIVING WITH ALLERGIES Autumn-Winter 2014 19
USING EYE DROPS Artificial tears and allergy eye drops are used to treat symptoms of eye allergies. Consultant opthalmologist Dr Malcolm McKellar explains the best way to apply eye drops. There are two main ways to instill eye drops into your eye. Standing or sitting This method is best performed with the help of a mirror. • Remove the eyedrop bottle lid and have the bottle ready in one hand. • Pull the lower eyelid gently down with your other hand to make a small 'pocket'. • Bring the tip of the bottle over the pocket taking care not to touch the tip on your eye or eyelid. • Squeeze gently, letting the drop fall into the pocket without the bottle tip touching your eye or eyelid.
Lying down This method can be performed lying on a bed, couch or the floor. • Remove the eyedrop bottle lid and have the bottle ready nearby. • Lie facing the ceiling. • Bring the bottle to hover over your eye. • Squeeze gently. Tricks and tips • Use adequate lighting. • Keeping your drops chilled makes it easier to feel when and where the drop lands. • If you are having trouble with medication, practise with a bottle of artificial tears. • One drop at a time is
20 LIVING WITH ALLERGIES Autumn-Winter 2014
more than enough, but instill another if you are unsure the first went in. • If you are using more than one type of eye drop, wait at least two minutes before instilling the second drop. This avoids the second drop washing away the first before the active drug is absorbed into the eye. To give eye drops to a child, follow the same steps. It may help to position yourself so that the side of the hand you’re using to give the drops is against the child’s forehead. Warm the bottle of drops in your hand before you start – this can help avoid the shock of a cold liquid going in the child’s eye.
EYE ALLERGY SYMPTOMS Eye allergies are caused by an allergic reaction of the eye. Causes include pollen, pets (animal allergens can be transferred to the eyes by the hands but can also be airborne) and dust.
• Itchy eyes with frequent rubbing • Increased tearing (watery eyes). • Red or pink eyes. • Mild swelling of the eyelids. • No discharge or a minimal sticky, stringy, mucus discharge. • No pain or fever.
Rinse your eyes with artificial tears or solutions such as Optrex. Cold compresses can be soothing, a wheat bag kept in the fridge works well. Avoid rubbing your eyes. If you only get symptoms from time to time, ask your optometrist or pharmacist for antihistamine eye drops. For more severe allergies, your optometrist, GP, or ophthalmologist can prescribe stronger medications.
*For more information on eye health go to: www.drmalcolmmckellar.co.nz
Go Derma Protect probiotics are clinically tested and safe to take in pregnancy to support mum’s and baby’s immune systems. We have 10 packs (RRP $29.90) to give away. To be in to win, enter online at www.livingwithallergies.co.nz. or email giveaways@ livingwithallergies.co.nz with GO DERMA in the subject line. Entries close 15 August 2014.
How to help reduce the allergy effects in your bedroom It is a common fact that feather and down bedding gives improved protection against dust mite allergy than polyester filled bedding (allergytoday magazine issue 40) due to the superior cover on the product. This makes it perfect for eczema sufferers. As well as an extensive range of new products made here in New Zealand for local conditions we can also recase your existing duvet. If the cover of your existing feather and down bedding is looking tired, call us. We offer a full recasing service for duvets, pillows and eiderdowns. • Buy direct from the manufacturer • Down and feather duvets, pillows and eiderdowns • Made in our Auckland based factory •A sk about our 24 hour recasing service for your existing feather and down bedding
Phone (09) 836 2109
or visit us on the web at www.duvetdirect.co.nz
making quality affordable
LIVING WITH ALLERGIES Autumn-Winter 2014 21
THOUSANDS SUPPORT ADRENALINE CAMPAIGN More than 8,000 people have signed a petition calling on the government to fund adrenaline auto-injectors for people living with life-threatening allergies. We talk to Wellington mum Helen Richardson, who launched the petition.
housands of Kiwis have joined a campaign urging the Minister of Health to consider fully funding a life-saving device that treats people with anaphylaxis. People with serious lifethreatening allergies are recommended to carry epinephrine (adrenaline) with them at all times so it can be administered in an emergency. Epinephrine auto-injectors are not subsidised in New Zealand and currently cost $170-180 for an adult and about $140 for a child. People generally need two auto-injectors, one for home and one for school/work. They need replacing every year because they have a
limited shelf life. Campaigners say many families are struggling to afford the cost of an epinephrine autoinjector on top of the additional expenses associated with living with severe allergic disease. In Australia and the Campaigner Helen Richardson with son Otto. UK people with serious allergies can have two fullyawareness about what it is funded epinephrine autolike living with severe allergy, injectors on prescription. especially anaphylaxis.” Helen Richardson launched Helen’s son Otto had an a petition in January calling on anaphylactic reaction when he the government to subsidise was 10 months old after eating epinephrine auto-injectors some hummus, containing in New Zealand. In the sesame. He is now two and first two months more than allergic to nuts, seeds, eggs, 8,000 people had signed it. dairy and soy. The family She plans to present the has an epinephrine autopetition to Parliament in injector on hand at all times. May to coincide with Allergy Anaphylaxis typically Awareness Week. She hopes causes a number of symptoms by then more than 10,000 including an itchy rash, people will have signed it. throat swelling, and low blood “My background is pressure. It can result in in social work and I was death if not treated promptly. concerned when I learned The most common causes that people were just not are certain foods, insect carrying adrenaline because stings and medications. they couldn’t afford it. I Estimates of anaphylaxis think as a matter of principle people should be given equal vary widely from 1 episode per 31,000 people per year up to treatment,” Helen says. 1 in 1,700 people per year. “The campaign is gaining its own momentum, it is good to see the issue being discussed * Go to www.change.org to sign the petition. and that is promoting greater
22 LIVING WITH ALLERGIES Autumn-Winter 2014
THE ALLERGY EPIDEMIC
A MYSTERY OF MODERN LIFE
R SUSAN PRESCOTT is an
“Although allergies may not have been taken seriously in the past, the scale and impact of this problem is now undeniable.” DR SUSAN PRESCOTT
internationallyrenowned specialist in childhood allergy and immunology. She works in a busy children’s hospital in Perth and is a cutting edge researcher with a special interest in early immune development. She was inspired to write her book The Allergy Epidemic: A Mystery of modern life in 2011 to help her patients and their families understand allergic disease. The book offers a clear and thought-provoking discussion of the science behind the current allergy epidemic. Dr Prescott looks at the reasons for the rapid increase in allergic disease worldwide and examines the importance of early life, genes and the environment. She also gives a detailed explanation of allergy in practice, including the diagnosis and treatment of food allergies, eczema, asthma, allergic rhinitis and other allergies.
24 LIVING WITH ALLERGIES Autumn-Winter 2014
All the proceeds from The Allergy Epidemic go directly to allergy research. Copies are available online from www.uwap.com.au (cost AU$29.95 plus $10 postage).
Q&A with Dr Susan Prescott How big is the problem? The World Allergy Organisation (WAO) estimates that up to 40 per cent of the world’s population now suffers from one or more allergic diseases, such as asthma, eczema, food allergy and allergic rhinitis. This translates to many hundreds of millions of people, making this a global public health problem of major proportions. Australia [and New Zealand] has one of the highest allergy rates in the world. In just 10 years there has been a five-fold rise in serious (anaphylactic) food allergies in preschoolers. As these younger generations reach adulthood, the burden of allergic diseases is expected to increase even more. Why is this happening? Allergy is part of an even bigger problem of a global rise in virtually all immune diseases. We see this pattern in every region of the world as they adopt the modern lifestyle. This is very clear evidence that our immune systems are highly vulnerable to modern environmental changes. What is going wrong with the immune system? The immune system is a complex and intricate network, which achieves a fine balance between ‘protection’ from threats (such as infection) and ‘tolerance’ to harmless things. Allergies and other immune diseases occur when the ‘balance’ is disrupted, so that we are more likely to make misdirected responses
to harmless things. In essence, we have disturbed the natural balance of our environment and we are now experiencing the impact on our own health. What are the environmental factors driving this? Our modern lifestyles differ in so many ways from traditional environments that it is hard to pin the blame on any one factor. Increasing ‘hygiene’ has been a lead candidate, but many other factors are known to have immune effects, such as modern environmental pollutants, reduced sunlight exposure (more screen time and indoor activities lower vitamin D levels) and modern dietary patterns (with less fresh fruits, vegetables, fibre, and omega 3 fats) which may promote inflammation. It is likely that a combination of these modern lifestyle changes is promoting many modern diseases, not just allergy. Why is allergy increasing so rapidly in very young infants? The latest Australian data indicate that around 10 per cent of one-year-old infants now have food allergy and even more have other symptoms such as eczema. The fact that first symptoms can occur within weeks of life, and that changes in the immune ‘balance’ can be detected at birth is clear evidence that the effects of environmental change begin very early in life, even in pregnancy.
What is epigenetics? Epigenetics is a new frontier of medicine that explains how gene expression is controlled, and how environmental exposures can change epigenetic control of gene expression to alter the risk of disease. Harnessing this ‘plasticity’ may also hold the key to reversing the problem through prevention strategies in early life. What are the latest treatments and can allergy be cured? There have been significant advances in the treatment of all allergic diseases and the latest approaches are all outlined in The Allergy Epidemic. In some patients immunotherapy (treatment of disease by inducing, enhancing, or suppressing an immune response) provides a solution to allergic disease, and there is intensive research to make this a safe option in a wider range of allergic conditions. Where is the research heading? Better understanding of the molecular processes in allergy is aimed at providing more effective targeted treatments for people with established allergic disease. But the ultimate goal is to reverse the epidemic and prevent allergies in the first place. To do this we need to define environmental strategies that restore an optimal ‘immune balance’ during early development. It is hoped that reducing early environmental risk factors may ultimately reduce the risk of many modern diseases.
LIVING WITH ALLERGIES Autumn-Winter 2014 25
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GO ONLINE FOR GLUTEN-FREE INSPIRATION Are you looking for that next great gluten-free recipe? Or need some extra inspiration in the kitchen? Rose Miller goes online in search of some of the best gluten-free blogs, recipes and resources.
oth my daughters are gluten intolerant, one also has a dairy allergy, and my partner is vegetarian – so there are times when I feel cooking for the whole family can be a real challenge. I enjoy using fresh, simple ingredients, including lots of fresh veges and herbs from my garden. I even recently invested in a henhouse and four chooks – the fresh eggs are wonderful! Like most of us, I have loads of recipe books. But more and more, I’m looking to the internet for recipe ideas. It could be laziness; it could be the love of finding something new and inspiring. It’s probably a bit of both. I always bookmark something particularly good, so now I have a nice collection of go-to places for great recipe ideas. My laziness also kicks in when it comes to shopping. I know there are plenty of gluten-free products in my local Wellington supermarkets, but I find a greater variety
online, and many items I’d never find on the supermarket shelves. Of course, if you live in a smaller town, you may not have access to many gluten-free products, so online shopping may be just the ticket. Here’s a selection of some of my favourite online recipe and shopping sites. RECIPES Gluten-Free Girl (and the Chef ) Gluten-Free Girl is Shauna James Ahern from the US. She was diagnosed coeliac in 2005 and felt compelled to share her journey online. ‘The Chef ’ is her husband of four years – her influence inspired him to completely overhaul his restaurant’s menu to make it gluten-free. They now run the website together, providing a mine of information, and most especially, a wealth of recipes. Gluten-Free Girl has published three recipe books, all available on Amazon.
Gluten-Free Goddess Gluten-Free Goddess is Karina Allrich from New Zealand and she runs a highly rated glutenfree food blog, launched in 2005. She discovered she was gluten intolerant in late 2001 – after a decade of unseemly, classic coeliac symptoms. Her guide to becoming glutenfree, included on the site, is comprehensive and really helpful. Her recipe book Gluten-Free Goddess – Best Loved Recipes is available on iTunes. http://glutenfreegoddess. blogspot.co.nz
Gluten-Free on a Shoestring This US-based site gets back to basics with a focus on breads and flour mixes – and on saving money. There’s a great guide to making your own flour blends for different purposes. Nicole Hunn, who began the blog in 2009, has published three recipe books, all available on Amazon. She started her journey in 2004,
LIVING WITH ALLERGIES Autumn-Winter 2014 27
gluten–free living when her son was diagnosed coeliac, and she found that gluten-free foods were either not available or were beyond her family’s budget.
Petite Kitchen Eleanor Ozich, from Auckland, tried a new approach to food when her four-year-old daughter was not responding to treatment for her severe eczema. After a visit to a naturopath, Eleanor began to follow the GAPS diet, eliminating grains, sugar, additives and preservatives from her whole family’s diet. She says this simple, clean approach to food turned her daughter’s health around, and her blog has become so successful that she’s become a regular contributing writer for the NZ Herald’s Viva magazine. Eleanor’s recently released recipe book My Petite Kitchen Cookbook is out in May and will be available via her blog. www.petite-kitchen.com
Gluten-Free for Good – the Art and Science of Healthy Living Run by nutritionist Melissa McLean Jory from Colorado, this blog is packed full of recipes and information on how to be gluten-free and healthy. It includes a fair whack of scientific background reading, for those who like to delve a bit deeper. www.glutenfreeforgood.com/blog
No Gluten No Problem Husband and wife team Pete and Kelli Bronski run this US-based blog. Pete was diagnosed coeliac in 2007, and their blog started the following year. Together, they’ve published three highly rated recipe books. http://noglutennoproblem. blogspot.co.nz
Zero-G Wheat and Gluten Free Zero-G sells an excellent bread mix, suitable for baking in a breadmaker (I know because I’ve tried it). Enter our reader giveaway on the next page, for the chance to try it out for yourself. http://zero-g.co.nz
Healtheries At the Healtheries site, you’ll find a gluten-free recipe index as well as a full outline of their products (you can rate their products too). You can also send questions online to their nutritionists and naturopaths – a real bonus. www.healtheries.co.nz
SHOPPING One Stop Gluten Free Shop As well as a myriad of gluten-free products, this online store, based in Tauranga, also caters for wheat, dairy, soy, nut, sugar, egg and yeast allergies.
Gluten Free Grocer This Auckland-based online store offers a large range of products, including its own home brand bags of gluten-free staples. Check out their specials for some great prices, too. They also have gift vouchers – a lovely treat for a gluten-free friend. www.glutenfreegrocer.co.nz
28 LIVING WITH ALLERGIES Autumn-Winter 2014
OTHER RESOURCES Gluten Free Land This New Zealand website was set up by Rory Shillington, of Christchurch. Rory started up the site in his spare time in 2009, a year after being diagnosed coeliac, when he was struggling to find gluten-free resources tailored for Kiwis. The site offers a guide to gluten-free foods, cafes and restaurants across the country. It’s user-driven with the ability to add and rate businesses that sell gluten-free fare. The more that people use it, the better it will become. It also includes recipes – you can upload your own and also rate other people’s. www.glutenfreeland.co.nz
Coeliac New Zealand Our local not-for-profit organisation for Kiwis who have been diagnosed with coeliac disease. Its site is great for anyone who has chosen to go gluten free and includes a guide called How to eat gluten-free. Also handy is a list of approved gluten-free products available in New Zealand. Coeliac New Zealand administers the “crossed grain” symbol which you will see on approved gluten-free food packaging. www.coeliac.co.nz
Gluten-Free Living Gluten-Free Living is an independent website run by Teresa Urquhart. You’ll find information about gluten-free products and businesses in New Zealand. You can join in and review products.
We have 10 bags of Zero-G Wholemeal bread mix to give away to our readers (RRP $9.99). Each 600g of Zero-G Mix makes over 1kg of high fibre bread that keeps fresh for three days without crumbling. Enter online at www.livingwithallergies.co.nz or email email@example.com with ZERO-G in the subject line. Entries close 15 August 2014.
Gluten Free Traveller US-based Laura Emmerson loves to travel and started her blog to help fellow glutenfree travellers find great places to eat while roaming the globe. And yes, she has been to New Zealand and we get the tick of approval. http://glutenfreetraveller.com
LIVING WITH ALLERGIES Autumn-Winter 2014 29
Making being gluten-free easy! Whether itâ€™s breakfast, lunch, snacking and dinner ideas, or creating some delicious gluten-free baking - you can count on Healtheries to help you make it easy.
Baking & Cooking
Look out for the Healtheries range of gluten-free products at your supermarket Get inspiration for easy-to-make gluten-free recipes at www.healtheries.co.nz
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THE FIVE BEST WAYS TO REMOVE DUST MITES Nurse educator Ann Wheat, from Asthma New Zealand, explains the five most effective ways to banish dust mites in the home.
Use barrier dust mite covers for pillows, mattress and duvet. Avoid sheepskins and wool in the bedroom or elsewhere as they can harbour dust mites.
Hot wash bed linen at 55ÂşC each week to kill dust mites and remove the allergens they produce. Tumble drying also helps destroy dust mites. If your washing machine doesnâ€™t wash that hot, change bedding each week and cold wash, which removes 90 per cent of allergens. Install vinyl/wood/tile flooring in the bedroom. Wet mop floors weekly and use a HEPA-filtered vacuum cleaner. Leave windows
open while vacuuming and for 20 minutes afterwards. Damp dust all surfaces two to three times each week. Leather and vinyl surfaces are generally less attractive to mites. Vacuum soft furnishings weekly and wash covers. Curtains can be vacuumed each month. Wash soft toys in hot water to remove dust mites. If this is not possible freeze them for 24 hours each fortnight and then cold wash.
LIVING WITH ALLERGIES Autumn-Winter 2014 31
A POTENTIAL TREATMENT FOR ASTHMA? A marine oil called Lyprinol, which is extracted from New Zealand’s greenlipped mussels, may help reduce asthma symptoms in some adults and children. Caroline Wood reports on a homegrown success story.
anti-inflammatory properties of a marine oil called Lyprinol®, which is extracted from New Zealand green-lipped mussels, may hold the key to developing new asthma treatments to help adults and children with the condition, according to a new study. Over the past three decades numerous studies have looked at the beneficial effects of fish oil supplements in treating a number of inflammatory conditions, including asthma. The interest in fish oil began in the 1980s after it was discovered the Inuit people of the Arctic far north had a low prevalence of asthma, arthritis
32 LIVING WITH ALLERGIES Autumn-Winter 2014
and heart disease. Researchers, such as DF Horrobin, hypothesised this may be due to their oily fish diet, which was high in the omega-3 fatty acids EPA and DHA. In a recent editorial in the Expert Review of Respiratory Medicine (December 2013) called ‘Omega-3 fatty acids: a potential treatment for asthma?’ authors Timothy Mickleborough and Martin Lindley reviewed a number of studies. They concluded that omega-3 fatty acids in fish oils may have beneficial effects in some people, although they noted that some studies didn’t show a positive effect. In the article, Mickleborough and Lindley described their
own study of the therapeutic potential of a different kind of marine oil extracted from New Zealand’s green-lipped mussels. Their study involved giving asthmatic patients a daily supplement of PCSO-524® (the active ingredient of Lyprinol), for three weeks. The results showed ‘significantly reduced airway inflammation and bronchodilator use and improved mean asthma scores’. They wrote: “Our study supports a number of other studies that have shown PCSO-524 is effective in treating human asthma and allergic inflammation and lung function…” They said the physiological mechanisms leading to the reduced airway inflammation and improved lung function were ‘unclear’ and noted that the levels of EPA and DHA in their study were very low. “The potent anti-inflammatory action of PCSO-524 may be due to the fact this extract contains up to 91 fatty acid components and contains furan acids, which have been shown to possess more potent anti-inflammatory activity than EPA,” they suggest. Mickleborough and Lindley claim as many as 50 per cent of patients do not benefit from currently available asthma medications. They say further large-scale clinical studies are needed to determine which patients are most likely to respond best to omega-3 fatty acid supplementation and the minimum effective dose and duration needed to show beneficial effects. Asthma New Zealand sells Lyprinol to its members via its Auckland shop and a few years ago carried out a clinical trial of PCSO-524, which involved 71 children with moderate to severe asthma. It found that it helped improve participants’ quality of life but did not reduce the amount of asthma medication they needed to take. Study leader Dr Jim Lello, medical adviser to Asthma New Zealand, said of the study, which was published in the Journal of Allergy and Clinical Immunology in 2012: “Although the primary outcome of steroid
sparing was not demonstrated, this was an ambitious target. Several secondary outcome measures (eg quality of life measures and reduction in exacerbations) showed trends that suggested benefit in this group of children with troublesome asthma.” Colleen Brady, whose son James was in the trial, said: “James’ breathing was far better and he could play the trumpet and saxophone with very little trouble.” Another parent of a child in the trial, Tom Bogdanowicz, said: “Noah was able to significantly reduce his asthma medication during the time he took Lyprinol.” Lyprinol is made from New Zealand mussels using a patented extraction process, which takes place in Nelson. More than 400,000 packs each month are sold worldwide. * Mickleborough and Lindley’s article can be viewed at www.expert-reviews.com.
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food and recipes
HEALING STARTS IN YOUR KITCHEN Has allergy or illness opened your eyes to a whole new world of food? Are you starting to question the food you and your family eat? Perhaps you are looking for homemade foods that nourish and heal? Shari Hammond found some answers when she attended René Archner’s Raw Treats Workshop in Hamilton last year.
ENÉ ARCHNER is an internationallyrenowned living foods chef famous for his award-winning cakes and desserts. He offers interactive workshops, food demonstrations and raw food chef training, and consults for clients in the hospitality industry on raw desserts and traditional food culturing methods. René’s decadent raw desserts including cheesecakes, haystack biscotti, and super fudge, can be sampled at the Wise Cicada Café in Auckland. Born in Berlin, Germany, René now lives in Warkworth. The workshop I attended was intended to support families living with food allergies, coeliac disease, autism, attention deficit disorder, indigestion, leaky gut syndrome and irritable bowel syndrome. It covered a wide variety of gluten-free and nourishing foods, including raw cakes and raw chocolate – yum. All ingredients were
organic, spray-free and gluten-free. René also offers advice on dairy and nut-free alternatives, any alternatives in fact, all you need to do is ask. The six-hour interactive workshop flew by. Six of us, aproned up, wrote notes then rolled up our sleeves and created all the recipes in the complimentary recipe booklet. Before we knew it, the meal was ready – a great way to finish and be inspired. I managed to go home and make my first batch of sauerkraut and get a bone broth going the following day. Six months ago, I couldn’t have told you what a bone broth or sauerkraut was. If you are worrying that your family may not be getting enough nutrients, particularly
34 LIVING WITH ALLERGIES Autumn-Winter 2014
René Archner demonstrates how to make sauerkraut
if you are on an elimination diet, look into a hands-on workshop such as René’s. You don’t have to be a masterchef to learn how to make homemade nourishing foods, such as bone broths, gluten-free bread, sauerkraut and brine pickles, coconut yoghurt – filled with nature’s healing qualities. “Healing starts in your kitchen,” says René. Yes it does, I wish I’d realised this sooner. Visit René’s website for many delicious recipes: www.renearchner.com
This recipe has become a staple in our kitchen and pantry. The sauerkraut will last for months once made. That’s what it originally was made for – to preserve the cabbage harvest over the winter months. With a little bit of help from the Lactobacillus acidophilus that lives naturally on cabbage, it turns the fermenting cabbage into a probiotic feast.
– RENÉ ARCHNER
Makes about 3 cups to 1 litre 1 head cabbage, shredded finely 2 tsp natural sea salt ¼ cup minced fresh dill or 1 tbsp dried 1 apple, peeled, cored and diced Method: 1 Massage the cabbage with the salt until the liquid starts to release. 2 Let the cabbage rest for 10 minutes and massage it again. Repeat as often as necessary until the cabbage is very juicy. Add the remaining ingredients. 3 Pack the mixture firmly into a large glass jar, crock, or bowl. Press the cabbage down until the liquid rises above it approximately 0.5cm. 4 If you are using a large jar for your kraut, place a weight on top of the cabbage, such as a jar filled with water or a plastic bag filled with filtered water.
Make sure to cover the jar with another plastic bag to keep any critters out. Place the jar in a bowl to catch any overflow of sauerkraut juice. Collect the juice in a jar in your fridge and add back to the finished kraut 5 Allow the kraut to ferment in your kitchen for at least 3 days. We line the jars up in the window (no direct sun though). Sauerkraut may be fermented for up to14 days, depending upon the desired degree of sourness. 6 Once the kraut is ready, store it in airtight glass jars in the refrigerator. It will keep
for several months. Have fun experimenting with sauerkraut! You can make variations with red cabbage, kale, grated carrots, parsnips, broccoli etc. You can also substitute dill for juniper berries or caraway to vary the flavour. Lacto-fermentation has been used for centuries to preserve seasonal vegetables. Fermented sauerkraut contains a lot of the same healthy probiotics as a bowl of yogurt.
GIVEAWAY We have 12 bags of Healtheries LSA (Linseed Sunflower Almond) Supergrains to give away (RRP$9.49). Great for smoothies, baking and cooking – visit www.healtheries.co.nz for delicious gluten free recipe ideas.
To be in to win, enter online at www.livingwithallergies.co.nz or email firstname.lastname@example.org with LSA SUPERGRAINS in the subject line. Entries close 15 August 2014. LIVING WITH ALLERGIES Autumn-Winter 2014 35
Allergy Guide Peace of mind for your taste buds Look out for Macro Organic Sauces from Countdown available in three delicious flavours – Sweet Chilli, BBQ and classic Tomato Sauce. They are gluten-free and made without any artificial colours, flavours and preservatives. Enjoy with total peace of mind, only at Countdown.
Breakthough for allergy sufferers The new e3 heat pumps from Fujitsu use new efficient technology to really help save on your heating bills. They also have advanced healthy air filters that collect allergens in the air, as well as ventilating the environment. That’s why Fujitsu are the only heat pumps to be recommended by Asthma New Zealand.
ADVICE, BENEFITS & CHOICES Safe and effective way to ward off flies this summer Keep pesky flies off your food using harmless, chemical-free technology. It really works – it’s harmless to touch and 100% guaranteed effective against flies! Great for: • BBQs • picnics •cafes • anywhere that you eat food outdoors. Only $24.95 plus P&P. www.shooaway.co.nz
To find out more, go to www.fujitsugeneral.co.nz
LASCo salami a great choice LASCo, the Lean Artisan Smokehouse Company, produces healthy, nutritious & affordable beef salami. LASCo salami is handmade the artisan way from pure NZ Beef. LASCo salami is 90% fat free, gluten, soy, dairy & pork free. No fillers, gelling agents or emulsifiers are used. Low levels of sodium, saturated fat and cholesterol make it a very healthy choice for the entire family. There are four flavours, available in 150g sliced packs and 200g chubs. Find at your local New World, Pak’n Save and selected 4 Square stores. For local stockists see www.nzsalami.co.nz
Long lasting hydration for eczema-prone skin RESTORADERM™ Skin Restoring Moisturiser is suited 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.
When you need fast allergy relief… Do you suffer from hayfever and other allergies? Lora-Tabs provides fast acting, non-drowsy treatment for hayfever, perennial allergic rhinitis, hives and other allergic skin disorders. Available in packs of 30 and 60 from all good pharmacies. Lora-Tabs is a pharmacy medicine used for the relief of allergies. Each tablet contains loratadine 10mg. Always read the label carefully and use strictly as directed. If symptoms persist or you have side effects, see your health professional. Mylan NZ Ltd, Auckland. TAPS DA0713JL-11
36 LIVING WITH ALLERGIES Autumn-Winter 2014
GO Derma Protect – for skin health
Nourish your skin naturally with Skinfood Body Bars
Clinical trials undertaken in New Zealand show that adults supplementing with Lactobacillus rhamnosus (strain HN001) supports the body’s immune response to allergens, which often cause skin complaints, and helps to protect against flare ups. Expectant mothers should take GO Derma Protect Probiotic rhamnosus during pregnancy and breastfeeding to support their baby’s developing immune defences for allergen-related skin issues and skin health. GO Derma Protect: RRP: $29.90 (30 VegeCaps) RRP: $42.90 (60 VegeCaps). Available at major pharmacies and health stores nationwide. www.gohealthynz.co.nz
To celebrate its new look and feel, Skinfood has lovingly created four delicious products for your skin. The all-new Skinfood Body Bars are formulated with natural ingredients to leave your skin feeling nourished, cleansed and revitalised – they’re also fragrance free, and suitable for sensitive skin! www.skinfood.co.nz
Supergrain your day! Healtheries LSA Supergrains is a blend of ground linseeds, sunflower seeds and almonds with added Black Chia, Buckwheat and Quinoa. Simply add a tablespoon to your favourite cereal or yoghurt, or add to baking mixes and casseroles for a tasty boost of essential nutrients and omega 3 fatty acids – and it’s wheat and gluten free! www.healtheries.co.nz
Zero-G breadmix: great taste, great texture Want a no-fuss bread mix that you can make in your breadmaker? Zero-G Wholemeal Breadmix is • Gluten Free • Dairy Free • Egg Free • Soy Free • No Wheat • No Potato, plus it tastes great and has a lovely texture. “Great tasting bread, holds together well for sandwiches, makes delicious toast and keeps well.Was very easy to make. I would recommend this bread mix to any gluten-free people.” – Trudi B. Order online at www.zero-g.co.nz for delivery to your door.
Clean Air Technology Nano titanium particles are very minute particles. These particles catch and neutralise allergens, mould, bacteria and odour molecules which are approximately 1,000 times larger. Hitachi Heat Pumps utilise two layers of advanced nano titanium filtration ensuring allergens, bacteria and odour molecules are removed from the air leaving you with a happier, healthier environment. Visit www.hitachiheatpumps.co.nz
Helping your family breathe easy The Nilfisk Extreme Complete is the world’s only domestic vacuum with a HEPA 14 filter which captures 99.995% of all dust particles bigger than 0.3 micron (1/500 the diameter of a human hair). Extreme filtration so you and your family can breathe easy. Visit www.nilfisk.com.au
TO ADVERTISE CONTACT DEBBIE BISHOP ON (09) 589 1054 OR 021 340 360 LIVING WITH ALLERGIES Summer 2013 37
✓Gluten Free ✓Chemical free ✓No added water
Keep pesky flies off your food using harmless,chemical-free technology.
It really works!
Our bacon is smoked over manuka wood and contains only pork, sea salt and brown sugar. Available at all good supermarkets.
Great for: - BBQs - picnics - cafes - anywhere that you eat food outdoors
FACTORY SHOP CONTACT US 46c Porana Road Glenfield Auckland Ph. 09 443 2980 www.hendersonsbacon.com
only $24.95 each plus P&P www.ShooAway.co.nz
Living with asthma and allergies? Make a Sensitive Choice® TH
RAL I A
A F ON O U N D AT I
SENSITIVE CHOICE SUPP OR T IN G A S T H M A CA RE
The Asthma Foundation’s Sensitive Choice® programme helps you identify companies that are committed to reducing asthma and allergy triggers.
4MyEarthNZ An eco friendly way to wrap your food – let your food be nude!
4MyEarthNZ has been recommended by Next, Wilderness, Sunday Star Times, Dominion Post, Home NZ, NZ House & Garden, Little Treasures, Good Mag, NZ Life & Leisure, Organic Magazine, NZ Today & many more!
www.4MyEarth.co.nz Marcia McWhirter email@example.com 027 333 5702
38 LIVING WITH ALLERGIES Autumn-Winter 2014
Eco Laundry Ball – save your skin, The Environment and money at the same time!! For more information or to order go to www.eco-laundryball.co.nz
Your Healthy Food Store
• Gluten Free • Dairy Free • Nut Free • Certified Organic Produce Open 7 days except Public Holidays
Shop 9, 215 Rosedale Rd Albany, Auckland 0800 567 888 www.naturallyorganic.co.nz
Advertisers! You can get your products and services in this section for as little as $150 + GST. Call Debbie Bishop on 09 589 1054 or 021 340 360 Email firstname.lastname@example.org www.livingwithallergies.co.nz
Paint without the headache Don’t put up with nasty odours and high VOC paints next time you redecorate. Make a healthy choice and choose from a full range of Environmental Choice approved paints from your local Resene ColorShop. Come in and see us for help with your decorating project.
0800 RESENE (737 363) www.resene.co.nz
LIVING WITH ALLERGIES Autumn-Winter 2014 39
SPOT THE SIGNS OF A SERIOUS ASTHMA ATTACK Do you know what to do if someone has a serious asthma attack? Here is a guide on how to deal with an asthma emergency. Asthma New Zealand provided this information, which is also available on its website, asthma-nz.org.nz.
N ASTHMA ATTACK can take
anything from a few minutes to a few days to develop. Coughing, wheezing or breathlessness can quickly worsen. During an asthma attack, young children may appear restless, unable to settle and may have problems eating due to shortness of breath. They may also have severe coughing and vomiting. Watch for the following symptoms, which are signs of an acute asthma attack requiring immediate action: • Severe shortness of breath (they are struggling to breathe). • Rapid shallow breathing. • Wheezing sound when
breathing in and out – if the wheezing stops with no improvement in symptoms it is an extreme EMERGENCY. • Chest tightness (it feels as if someone is sitting on chest). • Unable to speak more than one or two words per breath. • Distressed or feeling frightened. • Little or no improvement after using reliever medication (Bricanyl, Ventolin, Respigen or Salamol). • Areas at base of throat and between ribs ‘sucking in’ and out. • Blueness around the lips. • Hunching over. *Note: Not all of the symptoms above may be present.
If you, or anyone in your care, has any of the above signs, call an ambulance (dial 111) straight away and follow the 4-step Asthma Emergency Plan.
The 4-step Asthma Emergency Plan Step 1. Sit the person upright, and loosen any tight clothing. Stay with the person, remain calm and provide a reassuring attitude, try to stop them panicking. Step 2. Without delay give six separate puffs of a reliever (Ventolin, Respigen or Salamol). The medication is best given one puff at a time via a spacer device. Ask the person to take six breaths from the spacer after each puff of medication. If you don't have a spacer, you can use a paper cup, or even a dry plastic bottle, as a spacer. Otherwise use the puffer on its own. Step 3. Wait six minutes. Step 4. If there is little or no improvement, repeat steps 2 and 3. If there is still little or no improvement, continuously repeat steps 2 and 3 while waiting for the ambulance.
YOU CAN CUT OUT THIS GUIDE AND KEEP IT SOMEWHERE HANDY 40 LIVING WITH ALLERGIES Autumn-Winter 2014