Approaches To Establish Thresholds for Major Food Allergens and for Gluten in Food

Buchanan, Robert L.; Dennis, Sherri; Gendel, Steven M.; Acheson, David W. K.; Assimon, Sue Anne; Beru, Nega; Bolger, P. Michael; Carlson, David; Carvajal, Ricardo; Copp, Catherine; Falci, Kenneth J.; Garber, Eric A. E.; Harden, Elizabeth; Kane, Rhonda; Kvenberg, John E.; Luccioli, Stefano; Park, Douglas; Raybourne, Richard B.; Troxell, Terry C.; Vierk, Katherine

doi:10.4315/0362-028x-71.5.1043

Cited by 67 publications

(5 citation statements)

References 193 publications

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“…Tree nut allergy rates vary by geographical region and depend on the type of nuts consumed within that region, with ethnic differences reported in the prevalence of cashew nut, pistachio nut and almond allergy in the UK [ 8 ]. The true prevalence of tree nut allergies is unknown, but in the US the rate is estimated to be 0.2% and 0.5% for children and adults, respectively [ 9 ]. A recent review by McWilliam et al [ 10 ] estimated tree nut to cause around 0–0.19% of food allergies across the world.…”

Section: Prevalencementioning

confidence: 99%

Almond Allergy: An Overview on Prevalence, Thresholds, Regulations and Allergen Detection

Mandalari

Mackie

2018

Nutrients

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Food allergy has been on the increase for many years. The prevalence of allergy to different foods varies widely depending on type of food, frequency of consumption and geographic location. Data from the literature suggests that the prevalence of tree nut allergy is of the order of 1% in the general population. Almond is one such tree nut that is frequently eaten in many parts of the world and represents a potential allergenic hazard. Given the need to label products that contain allergens, a number of different methods of direct and indirect detection have been developed. However, in the absence of population-based threshold data, and given that almond allergy is rare, the sensitivity of the required detection is unknown and thus aims as low as possible. Typically, this is less than 1 ppm, which matches the thresholds that have been shown for other allergens. This review highlights the lack of quantitative data on prevalence and thresholds for almonds, which is limiting progress in consumer protection.

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Section: Prevalencementioning

confidence: 99%

Almond Allergy: An Overview on Prevalence, Thresholds, Regulations and Allergen Detection

Mandalari

Mackie

2018

Nutrients

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“…About 18–36% of the study participants had moderate to severe villous atrophy upon endoscopic and biopsy examination. The endoscopic examination is considered the gold standard invasive method for the diagnosis of CD ( 39 ). Compared with our findings, all 75 of the patients found positive with serological screening had prominent histological and endoscopic changes in the intestines in terms of villous atrophy ( 40 ).…”

Section: Discussionmentioning

confidence: 99%

Disease specific symptoms indices in patients with celiac disease—A hardly recognised entity

et al. 2022

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BackgroundCeliac disease (CD) was considered a rare disease before and was perceivably only limited to children but now affects almost 1–2% of the global population. This abrupt increase in prevalence is due to advancements in diagnostic criteria and medical facilities but still many countries lack the basic data that can assess the severity of this health issue. The present study was conducted with the aim to assess the common but rarely diagnosed condition with the identification of its underlying secondary ailments.Materials and methodsPatients visiting public sector hospitals were recruited and tested for clinical symptoms secondary to gluten-containing foods (wheat and barley, etc.), followed by serological testing for immunoglobulin A, tissue transglutaminase A, and anti-endomysial antibodies. Only seropositive candidates were included in the endoscopic and biopsy examination for the features of villous atrophy and intestinal cell damage. The secondary ailments including anemia, growth retardation, and gastrointestinal symptoms were also documented for the tested positive patients. The modified European Society of Pediatric Gastroenterology, Hepatology, and Nutrition (ESPGHAN) criterion was followed throughout the study.ResultsFrom 647 suspected cases from March 2018 to July 2019, 113 were confirmed with CD while 58% were female children and 42% were male children. The majority of them were from a lower class (75%) and 26% of them had a positive family history of CD. A total of 67% of patients with CD were underweight while wasting was observed in 38%, and 80% were stunted as well. Of the positively tested patients with CD, 49% had moderate anemia with 15% having severe anemia. Approximately 33% had hypoalbuminemia as well. The majority of them had a mild to severe range of gastrointestinal symptoms, such as abdominal pain, diarrhea, flatus, eructation, diarrhea, and steatorrhea.ConclusionThe study finding indicates an increased number of patients diagnosed with CD with an excessive sum of secondary ailments, such as anemia, growth failure, growth retardation, malnutrition, and gastrointestinal symptoms.

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“…Despite the use of endoscopies to collect biopsies and assess mucosal healing being the gold standard, it is an invasive, expensive, and impractical procedure for frequent monitoring of disease activity or severity [ 59 ]. There are a proportion of cases difficult to monitor and evaluate with biopsy because they have mild histological changes or there is a lack of concordance between serology and histology.…”

Section: Monitoring Of Gluten-free Diet Compliancementioning

confidence: 99%

Biomarkers to Monitor Gluten-Free Diet Compliance in Celiac Patients

et al. 2017

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Gluten-free diet (GFD) is the only treatment for celiac disease (CD). There is a general consensus that strict GFD adherence in CD patients leads to full clinical and histological remission accompanied by improvement in quality of life and reduced long-term complications. Despite the importance of monitoring the GFD, there are no clear guidelines for assessing the outcome or for exploring its adherence. Available methods are insufficiently accurate to identify occasional gluten exposure that may cause intestinal mucosal damage. Serological tests are highly sensitive and specific for diagnosis, but do not predict recovery and are not useful for follow-up. The use of serial endoscopies, it is invasive and impractical for frequent monitoring, and dietary interview can be subjective. Therefore, the detection of gluten immunogenic peptides (GIP) in feces and urine have been proposed as new non-invasive biomarkers to detect gluten intake and verify GFD compliance in CD patients. These simple immunoassays in human samples could overcome some key unresolved scientific and clinical problems in CD management. It is a significant advance that opens up new possibilities for the clinicians to evaluate the CD treatment, GFD compliance, and improvement in the quality of life of CD patients.

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Approaches To Establish Thresholds for Major Food Allergens and for Gluten in Food

Cited by 67 publications

References 193 publications

Almond Allergy: An Overview on Prevalence, Thresholds, Regulations and Allergen Detection

Almond Allergy: An Overview on Prevalence, Thresholds, Regulations and Allergen Detection

Disease specific symptoms indices in patients with celiac disease—A hardly recognised entity

Biomarkers to Monitor Gluten-Free Diet Compliance in Celiac Patients

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