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GI\ttract\tin\tthe\tabsence\tof\nany\tsecondary\tcauses\tfor\tthe\teosinophils,\tand\tthe\tetiology\tand\tpathophysiology\tare\tunclear.\tThe\tstomach\nand\tduodenum\tare\tmost\tcommonly\taffected,\tbut\tit\tcan\tinvolve\tany\tsegment\tincluding\tthe\trectum.\nSymptoms\tvary\tdepending\ton\tthe\tportion\tof\tthe\tGI\ttract\tinvolved,\tand\tthe\tlocalized\tor\twidespread
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infiltration\tby\teosinophils.\tAbdominal\tpain\tand\tnausea\tand\tvomiting\tare\tthe\tmost\n\tfrequent\tpresenting\nsymptoms\tin\tchildren\tand\tadults.\tAdolescents\tmay\tpresent\twith\tgrowth\tretardation,\tfailure\tto\tthrive,\tand\ndelayed\tpuberty\tor\tamenorrhea.\nEGE\tcan\toccur\tat\tany\tage,\tbut\tit\tis\tmost\tcommonly\tseen\tin\tthose\t30\tto\t40\tyears\tof\tage,\tand\tis\tpossibly
|
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] |
more\tprevalent\tin\tfemales\t(\nZhang\tand\tLi,\t2017\n;\t\nAlhmoud\tet\tal,\t2016\n).\tSymptoms\tcan\teasily\tbe\tmistaken\nfor\tother\tfunctional\tGI\tdisorders.\n\tIn\tpatients\twith\tGI\tsymptoms\tand\ta\thistory\tof\tatopic\tconditions\tsuch\tas\nasthma,\tatopic\tdermatitis,\tallergic\trhinitis,\tor\tPFAS\tthere\tis\thigh\tdegree\tof\tclinical\tsuspicion\tof\tEGE\n(\nZhang\tand\tLi,\t2017\n,
|
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] |
(\nZhang\tand\tLi,\t2017\n,\t\nNASEM,\t2017\n).\tTests\tfor\tallergen-specific\tIgE\tare\tof\tno\tvalue\tin\tthe\tidentification\tof\noffending\tfoods.\nThere\tis\tno\tconsensus\ton\tthe\toptimal\ttreatment\tstrategy\tfor\tEGE\tbecause\tof\ta\tlack\tof\tlarge,\nrandomized,\n\tcontrolled\ttrials\tto\tclearly\testablish\tstandard\tguidelines\t(\nZhang\tand\tLi,\t2017\n).\tHowever,
|
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] |
Zhang\tand\tLi,\t2017\n).\tHowever,\nsince\ta\thigh\tproportion\tof\tcases\tof\tEGE\tare\tassociated\twith\tfood\tallergy,\tan\telimination\tor\telemental\tdiet\ncan\tbe\trecommended\tas\ta\tfirst\tstep.\tThe\tuse\tof\tdietary\ttreatment\tnot\tonly\thas\tbeen\teffective\tin\treducing\nthe\tneed\tfor\tcorticosteroids,\tbut\talso\thas\timproved\tthe\tpoor\tgrowth\tassociated\twith\tthe\tdisease.
|
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] |
A\tproposed\ttherapeutic\tstrategy\tis\tto\tfirst\thave\tthe\tpatient\tfollow\tan\telimination\tdiet\tavoiding\tspecific\nairborne\tand\tfood\tallergens.\tIf\tthis\tis\tnot\tfeasible\tor\tfails\tto\tachieve\timprovement,\tthen\tglucocorticoid\ntherapy\tis\trecommended,\tincluding\tstarting\twith\ttopical\tdelivery\tand\tthen\tconsidering\tsystemic\tdelivery\n(\nZhang\tand\tLi,\t2017\n).
|
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] |
(\nZhang\tand\tLi,\t2017\n).\nElimination\tdiet\ttherapy\twould\tbe\tsimilar\tto\tthat\tfor\tEoE,\n\tbeginning\twith\tan\telemental\tdiet\tif\tpossible\n(exclusive\tfeeding\twith\tamino\tacid–based\tformulas)\tor\tthe\tempiric\tstep\tup\t2-4-6-food\telimination\tdiets.\nSee\t\nBox\t25.4\n\tfor\tguidelines\tfor\teliminating\tthese\tfoods\tfrom\tthe\tdiet.\tHowever,\tthe\thigh\tlevel\tof
|
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restriction\tand\tneed\tfor\tmultiple\tendoscopies\thave\thampered\tthe\timplementation\tof\telimination\tdiets\tin\nclinical\tpractice.\tCorticosteroids\tcontinue\tto\n\tbe\ta\twidely\tused,\tclinically\teffective\ttreatment.\nFood\tprotein–induced\tenterocolitis\tsyndrome\t(FPIES)\nAnother\tnon–IgE-meditated\timmune\treaction\tto\tfood\tis
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Another\tnon–IgE-meditated\timmune\treaction\tto\tfood\tis\t\nfood\tprotein–induced\tenterocolitis\tsyndrome\n(FPIES),\n\twith\tthe\tmajor\tcriterion\tbeing\tvomiting\t1\tto\t4\thours\tafter\tingestion\tof\ta\tfood\tbut\twith\tthe\nabsence\tof\tIgE-mediated\tskin\tor\trespiratory\tsymptoms.\tFPIES\tis\tcharacterized\tby\tdelayed\trepetitive
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vomiting\t(up\tto\t10\ttimes\tin\tan\tepisode)\tafter\tingestion\tof\tthe\tfood,\tand\tthe\tinfant\tis\tpale,\tlethargic,\tand\nlimp.\tSevere\tdehydration\tand\thypovolemic\tshock\tmay\toccur,\tand\tthere\tmay\tbe\tan\tepisode\tof\tdiarrhea\t1\tto\n5\thours\tlater.\tSymptoms\tusually\tresolve\twithin\t24\thours\tand\tthe\tchild\tis\twell\tin\tbetween\tepisodes
|
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] |
(\nLeonard\tet\tal,\t2018\n).\nChronic\tFPIES\tis\tcharacterized\tby\tchronic\tor\tintermittent\tdelayed\n\tvomiting,\tusually\tin\tinfants\tless\tthan\n4\tmonths\tof\tage\twho\tare\tconsuming\tcow’s\tmilk\tor\tsoy\tformula\tregularly.\tThe\tinfant\talso\texhibits\tchronic\ndiarrhea,\tpoor\tweight\tgain,\tand\tpossibly\tfailure\tto\tthrive.\tChronic\tFPIES\tis\tusually\tdiagnosed\tafter\tan
|
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] |
episode\tof\tacute\tFPIES\twhen\ta\thistory\tconfirms\tthat\tthe\tsymptoms\thave\tbeen\tchronic.\tWhen\tthe\ttrigger\nfood\tis\tremoved,\tthe\tchronic\tFPIES\tresolves,\tbut\n\tcan\treappear\tas\tan\tacute\tepisode\twhen\tthe\tfood\tis\neaten\tagain,\tusually\taccidentally.\tOral\tfood\tchallenges\t(\nTable\t25.4\n)\tmay\tbe\tneeded\tif\tthe\tdiagnosis\tis\tnot\nclear.\nTABLE\t25.4
|
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0.014146449975669384,
0.0806172788143158,
0.04259346425533295,
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0.019963059574365616,
0.021029600873589516,
0.04899252951145172,
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0.05213474854826927,
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0.0588420070707798,
0.06783787161111832,
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0.02103256620466709,
0.08854971826076508,
0.08556906133890152,
0.044389862567186356,
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] |
Table\t25.4\n)\tmay\tbe\tneeded\tif\tthe\tdiagnosis\tis\tnot\nclear.\nTABLE\t25.4\nAllergen\tAvoidance\tGuidelines\nSources\nOther\tTerms\nNutrients\nInvolved\nAlternatives\nMilk\n*\nButter/many\tmargarines\nor\tfat\tspreads,\tcheese,\nany\tmammalian\tmilk\n(cow/sheep/goat),\nevaporated/condensed\nmilk,\tcream,\tghee,\nyogurt,\tice\tcreams,\ncustard,\tdairy\ndesserts,\tand\nmanufactured\tfood
|
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] |
yogurt,\tice\tcreams,\ncustard,\tdairy\ndesserts,\tand\nmanufactured\tfood\nusing\tany\tmilk-based\ningredient\nCasein,\tcaseinates,\tcurd,\nlactoglobulin,\tlactose,\nmilk\tsolids,\twhey,\nbuttermilk,\tmilk\tsugar,\nwhey\tsugar,\n\twhey\nsyrup\tsweetener\nVitamin\tA,\tvitamin\nD,\triboflavin,\npantothenic\nacid,\ncyanocobalamin,\ncalcium,\nmagnesium,\nphosphate\nUnder\t2\tyears:
|
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acid,\ncyanocobalamin,\ncalcium,\nmagnesium,\nphosphate\nUnder\t2\tyears:\nExtensively\nhydrolyzed\n(casein/whey)\nHydrolyzed\trice\nformulas\n#\nAmino\tacid–based\nformulas\n##\nOver\t2\tyears\nCalcium-enriched,\nmilk-free\nalternative\ndrinks\tmay\tbe\nconsidered:\n•\t\nRice\tmilk\t(in\nsome\tcountries\nrice\tnot\tallowed\n<4.5\tyears\tdue\tto\nhigh\tarsenic\ncontent)\n•\t\nSoy\tmilk\n•
|
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<4.5\tyears\tdue\tto\nhigh\tarsenic\ncontent)\n•\t\nSoy\tmilk\n•\t\nOat\tmilk\n•\t\nChufa\tmilk\n•\t\nPotato\tmilk\n•\t\nAlmond\tmilk\n•\t\nCoconut\tmilk\n•\t\nPea\tmilk\nOther\tfoods:\nMilk-free\tversions\nof\tspreading\nfats/margarine,\ncheese,\nyogurts,\tice\ncream,\tand\ncream\nEgg\n**\nEgg\twhite\tand\tyolk,\ncakes,\tbiscuits,\nspecialty\tbreads,\nmayonnaise\nAlbumin,\tdried\tegg,\tegg
|
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] |
cakes,\tbiscuits,\nspecialty\tbreads,\nmayonnaise\nAlbumin,\tdried\tegg,\tegg\npowder,\tegg\tprotein,\nfrozen\tegg,\tglobulin,\nlecithin,\tlivetin,\novalbumin,\tovomucin,\novovitellin,\npasteurized\n\tegg,\nvitellin\nRiboflavin,\tbiotin,\nprotein,\tvitamin\nA,\ncyanocobalamin,\nvitamin\tD,\nvitamin\tE,\npantothenic\nacid,\tselenium,\niodine,\tfolate\nEgg\treplacers\nAdjust\trecipes
|
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] |
acid,\tselenium,\niodine,\tfolate\nEgg\treplacers\nAdjust\trecipes\nwith\textra\nliquid\tor\tfruit\npurees\nVariety\tof\tegg-\nfree\tproducts\nsuch\tas\nmayonnaise,\ncakes,\tmuffins,\npuddings,\tand\nomelet\tmix\nWheat\n***\nBread,\tbreakfast\tcereals,\npasta,\tcakes,\tbiscuits,\ncrackers,\tcold\tcooked\nmeat,\tpies,\tbatter,\nflour,\n\tcake\tflour,\nenriched\tflour,\thigh-\ngluten\tflour,\thigh-
|
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] |
flour,\n\tcake\tflour,\nenriched\tflour,\thigh-\ngluten\tflour,\thigh-\nprotein\tflour,\tgraham\nflour,\tsemolina,\ncouscous,\tbottled\nsauces\tand\tgravies\nBran,\tcereal\tfiller,\tfarina,\nfarro,\tstarch,\twheat,\ndurum\twheat,\nsemolina,\tspelt,\nkamut,\twheat\tbran,\nwheat\tgluten,\twheat\nstarch,\twheat\tgerm\noil,\thydrolyzed\twheat\nprotein,\ttriticale,\nbulgur\twheat,\teinkorn
|
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foods,\tbarley,\nrye,\tand\nregular\toats\nmay\tbe\ntolerated\tby\nsome\nindividuals\nwith\twheat\nallergy\tor\nintolerance;\nhowever,\tthey
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contain\tgluten\nGluten-free\toats\nmay\tbe\ntolerated\tby\nsome\nindividuals\nwith\tceliac\ndisease\nUse\tof\talternative\ngrains\tshould\nbe\nindividualized\nand\tbased\ton\ntolerance\tas\ndetermined\tby\nclinician\tand/or\ndietitian.\nFish\nAll\ttypes\tof\twhite\tand\nfatty\tfish,\tanchovy,\n(Worcestershire\nsauce),\taspic,\tCaesar\nsalad,\tGentleman’s\nRelish,\tkedgeree,
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sauce),\taspic,\tCaesar\nsalad,\tGentleman’s\nRelish,\tkedgeree,\ncaponata,\tfish\tsauce,\npaella,\tbouillabaisse,\ngumbo\nSome\tpeople\tmay\ntolerate\tcanned\nfish\nFish\toil\tcapsules\tmay\ncause\treactions\tin\nhighly\tsensitized\nindividuals\nSurimi\nCaviar\nAll\tfish:\n\tprotein,\niodine\nFish\tbones:\ncalcium,\nphosphorus,\nfluoride\nFatty\tfish:\nvitamins\tA\nand\tD,\nomega-3
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-0.046020958572626114,
0.04277683049440384,
0.07273497432470322,
-0.0642913430929184,
-0.04472244530916214,
0.051228564232587814,
0.035851553082466125,
0.009528761729598045,
0.0015902700833976269,
-0.0107130641117692,
-0.09997903555631638,
-0.08986441791057587,
0.0689549520611763,
-0.07182389497756958,
-0.07543748617172241,
-0.04261545091867447,
-0.02795630693435669,
-0.04749351739883423,
-0.003776645753532648,
0.0758436918258667,
0.00493677007034421,
0.033813197165727615,
-0.02799108251929283,
0.004311060532927513,
-0.03983364626765251,
0.031582366675138474,
0.06607366353273392,
-0.0817091315984726,
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0.0138999093323946,
0.07685814797878265,
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0.002962718950584531,
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0.051711540669202805,
0.012305318377912045,
-0.011423262767493725,
-0.01629377342760563,
0.1087406650185585,
0.010534555651247501,
-0.08673252165317535,
0.015880471095442772,
0.03780297935009003,
-0.012613741680979729,
-0.017522411420941353,
-0.05142580345273018,
0.07038835436105728,
0.07667119801044464,
0.008900215849280357,
-0.005385929252952337,
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0.006681444589048624,
0.11356983333826065,
0.07434917241334915,
-0.0044516632333397865
] |
calcium,\nphosphorus,\nfluoride\nFatty\tfish:\nvitamins\tA\nand\tD,\nomega-3\nfatty\tacids\nShellfish\nCrayfish,\tcrab,\tlobster,\nshrimp,\tprawns\nSimilar\tnutrients\tto\nwhite\tfish.\nCrab\tand\nmussels:\ngood\tsources\nof\tomega-3,\nselenium,\tzinc,\niodine,\tand\ncopper\nMollusks\nClams,\tmussels,\toysters,\noctopus,\tsquid,\tsnails,\nscallops\nHealth\tfood\tpreparations
|
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0.06065055727958679,
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0.038012366741895676,
0.09789814054965973,
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0.029969653114676476,
0.00495580118149519,
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0.019246522337198257,
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0.03919027000665665,
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0.07978464663028717,
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0.05007869377732277,
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0.021895473822951317,
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0.0552796833217144,
0.06140323355793953,
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0.08709307760000229,
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0.07430567592382431,
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0.11692697554826736,
0.039517927914857864,
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0.0031254009809345007,
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0.0225637499243021,
0.06512767821550369,
0.06796852499246597,
0.009854687377810478
] |
octopus,\tsquid,\tsnails,\nscallops\nHealth\tfood\tpreparations\nsuch\tas\tgreen-lipped\nmussel\n\textract,\toyster\nsauce\nVarying\tamounts\tof\nprotein\n(scallop),\ncalcium\t(clam),\nzinc\t(oysters),\nand\tiron\t(clam)\nPeanut\n****\nPeanuts,\tdefatted\npeanuts,\tpeanut\nflakes,\texpeller-\npressed\tpeanut\toil,\npeanut\tflour,\tpeanut\nbutter,\tpeanut\tsnacks,\nsatay\tsauce
|
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peanut\tflour,\tpeanut\nbutter,\tpeanut\tsnacks,\nsatay\tsauce\nMay\tcontain\tpeanut:\nsprouts,\nconfectionery,\nfrozen\tdesserts,\nAsian\tdishes\n(Indonesian,\nMalaysian,\tThai,\nand\tChinese),\ttrail\nmix,\tenergy\tor\nsports\tbars,\n\trice\ncrackers,\tcereal\nbars,\tcookies,\nbrownies,\tnut\ntoppings\ton\tice\ncream,\nvegetarian/vegan\nfoods,\tbreakfast\ncereals,\tpesto\nsauce\tmay
|
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] |
cream,\nvegetarian/vegan\nfoods,\tbreakfast\ncereals,\tpesto\nsauce\tmay\nsometimes\tcontain\npeanut\nArachis\toil,\thypogeaia,\npeanut\tprotein,\ngroundnut,\tearth\tnut,\nmonkey\tnut,\nmandelonas,\tmixed\nnuts\nVitamin\tE,\tniacin,\nmagnesium\nTree\tnut\nAlmond,\nhazelnut,\nwalnut,\ncashew\nnut,\tpecan\nSimilar\tfoods\tas\tpeanut\nAmaretto\tcontains\nalmond\tflavor\nWorcester\tsauce
|
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Amaretto\tcontains\nalmond\tflavor\nWorcester\tsauce\n(walnuts)\nKorma\tsauce\nHazelnut:\tfilbert,\tcob\tnut\nMacadamia:\nQueensland\tnut,\ncandle\tnut\nPecan:\tHickory\tnut\nNote:\tNutmeg,\nDepends\ton\ttype\tof\nnut
|
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nut,\tBrazil\nnut,\npistachio\nnut,\nmacadamia\nnut,\nQueensland\nnut\n(almonds)\ncoconut,\tpine\tnut,\nand\tpalm\tnut\tare\nnot\tclassified\tas\nnuts\nSesame\tseed\nSesame\tseeds,\tsesame\noil,\thalva,\ttahini,\nhummus,\tseeded\nbread/rolls,\tgomashio,\nAsian\tfoods\n\tmade\twith\nsesame\toil,\tGreek,\nIranian,\tLebanese,\nand\tTurkish\tfood,\nAqua\tLibra\tis\nsometimes\tmade\twith\nsesame
|
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and\tTurkish\tfood,\nAqua\tLibra\tis\nsometimes\tmade\twith\nsesame\nGomasio—sesame\tseed\nand\tsalt\tseasoning\nProtein,\tfats,\nvitamin\tE,\ncalcium,\npotassium,\nphosphorus,\nvitamin\tB\tand\niron\nAvoidance\thas\nno\nsignificant\neffect\ton\nnutrition\nCelery/celeriac\nPrimary\tallergy:\tcelery\nand\tceleriac\tin\tits\traw,\ncooked,\tjuiced,\ncanned,\tand\tdried\n(celery\tspice)\tform\nFiber
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cooked,\tjuiced,\ncanned,\tand\tdried\n(celery\tspice)\tform\nFiber\nAvoidance\thas\nno\nsignificant\neffect\ton\nnutrition\nIn\tPFAS\tand\tLTPS,\ndried\ncelery/celeriac\nmay\tbe\ttolerated\nMustard\nMustard\nMustard\tseed\nCurry\tpowder\nPizza\nSauces,\tmarinades,\ndressings\nMainly\tfat\tand\nprotein\nAvoidance\thas\nno\nsignificant\neffect\ton\nnutrition\nSoy\n*****
|
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0.012405565939843655,
0.05050662159919739,
0.06869709491729736,
-0.02675873227417469,
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0.022831911221146584,
0.06629326939582825,
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0.00744175910949707,
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0.01860189624130726,
0.060747601091861725,
0.07408798485994339,
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0.0362047515809536,
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0.08326830714941025,
0.05376516655087471,
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0.0702086016535759,
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0.08220116794109344,
0.0500166118144989,
0.07438533753156662,
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] |
protein\nAvoidance\thas\nno\nsignificant\neffect\ton\nnutrition\nSoy\n*****\nSoy\tbeans,\tsoy\tflour,\tsoy\nnuts,\tsoy\tsauce,\tshoyu\nsauce,\tsoy\tproducts\n(soy\tcheese,\tsoy\tfiber,\nsoy\tice\tcream),\tmeat\nsubstitutes,\n\tbreads,\nvegetarian/vegan\nfoods,\tAsian\tcuisine,\nprocessed\tmeat\t(e.g.,\nhot\tdogs),\tpeanut\nbutter,\tfoods\tlabeled\nas\t“diet”\tand\t“high-\nprotein”\tor\t“low-fat,”
|
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] |
butter,\tfoods\tlabeled\nas\t“diet”\tand\t“high-\nprotein”\tor\t“low-fat,”\nsport\tor\tenergy\tbars\nEdamame\nTofu\nMiso\nNatto\nSoy\nprotein/gum/starch\nTexturized\t(or\nhydrolyzed)\nvegetable\tprotein\nSoy\tflavoring\nSoy\tlecithin\nChee-fan\nKetjap\nThiamin,\triboflavin,\npyridoxine,\nfolate,\tcalcium,\nphosphorus,\nmagnesium,\niron,\n\tzinc,\nprotein,\tfiber\nCow’s\tmilk
|
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phosphorus,\nmagnesium,\niron,\n\tzinc,\nprotein,\tfiber\nCow’s\tmilk\nRice\tmilk\t(in\tsome\ncountries\trice\nnot\tallowed\n<4.5\tyears\tdue\nto\thigh\tarsenic\ncontent)\nOat\tmilk\nChufa\tmilk\nPotato\tmilk\nAlmond\tmilk\nCoconut\tmilk\nPea\tmilk\nMeat,\tfish,\npoultry,\tor\nother\tsoy-free\nvegetarian\nalternatives\nLupin\nOften\tused\tin\tEurope\tin\npastries,\tbread,\tpizza,\nand\tlupin-seeded
|
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0.03427558392286301,
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0.1184474378824234,
-0.020385468378663063
] |
Often\tused\tin\tEurope\tin\npastries,\tbread,\tpizza,\nand\tlupin-seeded\nbreads\nProtein,\tfat,\tfiber,\nthiamin,\nriboflavin\tand\nvitamin\tE\nAvoidance\n\thas\nno\nsignificant\neffect\ton\nnutrition\n*\nGoat\tand\tsheep\tmilk\tproteins\tare\tsimilar\tto\tcow\tmilk\tprotein,\tand\tthose\twith\tcow\tmilk\tallergy\tcould\texperience\tsimilar\tsymptoms\twith\tingestion\tof\tthese
|
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] |
alternatives.\tAll\tmammalian\tmilk\tshould\tbe\tavoided\tinitially.\tGoat\tmilk\tis\tnot\trecommended\tas\ta\tcow\tmilk\tsubstitute\tbecause\tit\thas\ta\thigh\trenal\tsolute\tload\nand\tis\tvery\tlow\tin\tfolic\tacid\tcompared\twith\n\tcow\tmilk.\n**
|
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] |
and\tis\tvery\tlow\tin\tfolic\tacid\tcompared\twith\n\tcow\tmilk.\n**\n\t\nPeople\twith\tallergy\tto\tchicken\tegg\tmay\talso\tbe\tallergic\tto\tother\ttypes\tof\teggs,\tsuch\tas\tgoose,\tturkey,\tduck,\tor\tquail\teggs.\tAll\tshould\tbe\tavoided\tinitially.\n***
|
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] |
***\n\t\nNote\tthat\tnonfood\tproducts\tsuch\tas\tcosmetics,\tsupplements,\tand\tmedications\tcan\tcontain\twheat\tingredients\tand\tmay\tcause\tan\tadverse\treaction.\n****\n\t\nThere\tis\ta\thigh\trisk\tof\tcontamination\tof\tutensils\twhen\teating\tout\tat\tAsian,\n\tChinese,\tMexican,\tThai,\tMediterranean,\tand\tIndian\trestaurants.\tNonfood
|
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products\tsuch\tas\tcosmetics,\tsupplements,\tand\tmedications\tcan\tcontain\tpeanut\tingredients\tand\tmay\tcause\tan\tadverse\treaction.\n*****\n\t\nSeveral\tstudies\tindicate\tthat\tindividuals\twho\tare\tsoy\tallergic\tfrequently\ttolerate\tsoy\tlecithin\tand\tsoy\toil.\tThere\tis\ta\thigh\trisk\tof\tsoy\tcross-contamination\nwhen\teating\tout,\tespecially\tat\tAsian\trestaurants.
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] |
when\teating\tout,\tespecially\tat\tAsian\trestaurants.\n\tNonfood\tproducts\tsuch\tas\tcosmetics,\tsupplements,\tand\tmedications\tcan\tcontain\tsoy\tingredients.\n#\nPartially\thydrolyzed:\tnonhypoallergenic;\tcontains\tpartially\tdigested\tproteins\tthat\thave\ta\tmolecular\tweight\tgreater\tthan\textensively\thydrolyzed\tformula.\tMay
|
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] |
cause\ta\treaction\tin\tone\tthird\tto\tone\thalf\tof\tindividuals\twith\ta\tcow’s\tmilk\tprotein\tallergy.\n##\nFree\tamino\tacid–based\tinfant\tformula:\thypoallergenic;\n\tpeptide-free\tformula\tthat\tcontains\tessential\tand\tnonessential\tamino\tacids.\tUsually\ttolerated\tby\nthose\tallergic\tto\textensively\thydrolyzed\tformulas.\nLTPS\n,\tLipid\ttransfer\tprotein\tsyndrome;\t\nPFAS
|
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] |
LTPS\n,\tLipid\ttransfer\tprotein\tsyndrome;\t\nPFAS\n,\tpollen-food\tallergy\tsyndrome.\nSources:\tVenter\tC,\tGroetch\tM,\tNetting\tM,\tMeyer\tR:\tA\tpatient-specific\tapproach\tto\tdevelop\tan\texclusion\tdiet\tto\tmanage\tfood\tallergy\tin\tinfants\tand\tchildren,\nClin\tExp\tAllergy\n\t48:121,\t2018.\nJoneja\tJV:\t\nThe\tHealth\tProfessional’s\tGuide\tto\tFood\tAllergies\tand\tIntolerances
|
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] |
The\tHealth\tProfessional’s\tGuide\tto\tFood\tAllergies\tand\tIntolerances\n,\tChicago,\t2013,\tAcademy\tof\tNutrition\tand\tDietetics.\nFPIES\tusually\tpresents\tin\tinfants\twhen\tformula\tor\tsolid\tfoods\tare\tintroduced\tbetween\t2\tand\t7\tmonths
|
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of\tage.\tInfants\tless\tthan\t2\tmonths\tof\tage\tdiagnosed\twith\tcow’s\tmilk\tor\tsoy\tFPIES\tare\tmore\tlikely\tto\npresent\twith\tdiarrhea,\tbloody\tstools,\tand\tfailure\n\tto\tthrive,\tin\taddition\tto\tvomiting,\tcompared\twith\tthose\npresenting\tlater\t(\nNowak-Węgrzyn\tet\tal,\t2017\n).\tA\tJapanese\tcohort\treported\tFPIES\tsymptoms\tin\t10%\tof
|
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] |
).\tA\tJapanese\tcohort\treported\tFPIES\tsymptoms\tin\t10%\tof\ninfants\tafter\tbreastfeeding,\tpresumably\tbecause\tof\tthe\tproblematic\tfood\tprotein\tin\tthe\tbreastmilk\tfrom\nmaternal\tingestion.\tSimilarly\tan\tAustralian\treport\tfound\tthis\tin\t5%\tof\tinfants\t(\nNomura\tet\tal,\t2011\n;\t\nMehr\net\tal,\t2017\n).\nSymptoms\tconsistent
|
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] |
Nomura\tet\tal,\t2011\n;\t\nMehr\net\tal,\t2017\n).\nSymptoms\tconsistent\n\twith\tFPIES\tmay\tpresent\tin\tolder\tchildren\tand\tadults\twith\tdelayed\tvomiting,\toften\nafter\tthe\tingestion\tof\tfish,\tshellfish,\tor\tegg\t(\nLeonard\tet\tal,\t2018\n).\tStudies\tfrom\tvarious\tcountries\tshow
|
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] |
Leonard\tet\tal,\t2018\n).\tStudies\tfrom\tvarious\tcountries\tshow\nthat\tthe\tmost\tcommon\tfood\ttriggers\tare\tcow’s\tmilk,\tsoy,\tand\tgrains\t(oats/rice)\tin\tthe\tUnited\tStates\tand\nSouth\tKorea,\tfish\tin\tItaly\tand\tSpain,\tand\trice\tin\tAustralia\t(\nMehr\tet\tal,\t2017\n).\nThe\tpathophysiology\tof\tFPIES\n\tis\tnot\twell\tunderstood,\tbut\tit\tis\tthought\tthat\ta\treaction\tto\ta\tconsumed
|
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food\tprotein\tleads\tto\tgut\tinflammation,\twhich\tcauses\tincreased\tintestinal\tpermeability\tand\ta\tfluid\tshift\nresulting\tin\tvomiting,\tdiarrhea,\tabdominal\tpain,\tand\tpossibly\tshock\t(\nLeonard\tet\tal,\t2018\n).\tFood-specific\nIgE\tantibodies\thave\tno\tvalue\tin\tthe\tdiagnosis;\ta\tthorough\thistory\tfollowed\twith\ta\tspecific\tfood\telimination\ndiet\tand
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diet\tand\n\tan\toral\tfood\tchallenge\t(OFC)\tof\tthe\tsuspected\tfood\tunder\tmedical\tsupervision\tis\tthe\tonly\tway\tat\npresent\tto\tmake\ta\tFPIES\tdiagnosis.\tIt\tis\tchallenging\tbecause\tFPIES\tmimics\tmany\tother\tGI\tinflammatory\ndisorders.\nTreatment\tof\tFPIES\tfocuses\ton\tremoval\tof\tthe\toffending\tfood(s)\tand\tmanagement\tof\tvomiting,
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] |
dehydration,\tand\tshock.\tFor\tinfants\twith\tcow’s\tmilk\tor\tsoy\tFPIES,\tbreastfeeding\tor\tuse\tof\tan\textensively\nhydrolyzed\tcasein\tformula\tis\tencouraged.\tIf\tcow’s\tmilk\tor\tsoy\tFPIES\texists\tin\tthe\tformula-fed\tinfant,\nsupervised\tintroduction\tof\tone\tor\tthe\tother\t(soy\tor\tcow’s\tmilk)\tformula\tcan\tbe\tconsidered.\tSee\t\nTable\t25.4
|
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0.07294163852930069,
0.07802602648735046,
-0.07295209169387817,
-0.029993226751685143,
0.08537024259567261,
-0.009406731463968754,
-0.00863522756844759,
-0.007616272196173668,
0.11696100234985352,
0.017347926273941994,
-0.0014903389383107424,
-0.05133194848895073,
0.015323763713240623,
0.0723268985748291,
0.0357864685356617,
-0.025246484205126762,
0.013579127378761768,
0.00006158011819934472,
0.04313977062702179,
0.10969366133213043,
-0.008542499504983425
] |
Table\t25.4\nfor\tcow’s\tmilk-free\tand\tsoy-free\tformulas.\tMaternal\tavoidance\tof\ta\tbreastfeeding\tinfant’s\tFPIES\ttriggers\nis\tnot\trecommended\tif\tthe\tinfant\tis\tthriving\tand\tasymptomatic\t(\nNowak-Węgrzyn\tet\tal,\t2017\n).\tMothers\nshould\tavoid\ttrigger\tfood(s)\tif\ta\treaction\toccurs\tafter\tbreastfeeding\tor\tif\tthe\tinfant\tis\tfailing\tto\tthrive.\tIf
|
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0.016296233981847763,
0.029693489894270897,
0.05536935105919838,
0.05946420133113861,
0.0029213321395218372
] |
symptoms\tstill\tdo\tnot\tresolve,\tdiscontinuing\tbreastfeeding\tand\tintroducing\tan\textensively\thydrolyzed\nformula\t(EHF)\tshould\tbe\tconsidered.\tSee\tNowak-Węgrzyn\tet\tal\t(2017)\tfor\tfeeding\tguidelines.\nNutritional\tadequacy,\tfeeding\tskill\tdevelopment,\tand\tdiet\texpansion\tis\tvital\tto\tany\n\tinfant’s\tnutrition\tand
|
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0.04845946282148361
] |
infant’s\tnutrition\tand\ndevelopment,\tespecially\tin\tthose\twith\tmultiple\tfood\tFPIES\tor\tfeeding\tissues.\tFPIES\tpatients\tshould\tbe\nmonitored\tregularly\tfor\tthe\tdevelopment\tof\ttolerance\tand\teventually\tdiet\texpansion,\twith\tmedically\nsupervised\toral\tfood\tchallenges\t(\nTable\t25.5\n).\nTABLE\t25.5\nFood\tChallenge\tProtocols\nDouble-blind,\nplacebo-\ncontrolled\nfood
|
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0.028603095561265945
] |
Food\tChallenge\tProtocols\nDouble-blind,\nplacebo-\ncontrolled\nfood\nchallenge\nAllergen\tis\tdisguised\tand\tgiven\torally\n\tand\npatient\tmonitored\tfor\treaction;\tpatient\nand\tphysician\tblinded;\talso\ttested\twith\nplacebo.\n“Gold\tstandard”\tfor\tfood\tallergy\ttesting.\nSingle-blind\nfood\nchallenge\nSuspect\tfood\tis\tdisguised\tfrom\tpatient
|
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Single-blind\nfood\nchallenge\nSuspect\tfood\tis\tdisguised\tfrom\tpatient\nand\torally\tgiven\tby\tphysician\tin\ta\nclinical\tsetting.\nLess\ttime-consuming\tthan\tDBPCFC;\tmay\tbe\tused\nin\tinstances\tin\twhich\tpatient\texperiences\nsymptoms\tsecondary\tto\tfear\tor\taversion\tto\nsuspect\tfood.\nOpen\toral\tfood\nchallenge\nSuspect\tfood\tis\torally\tgiven\tto\tpatient\tin
|
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Open\toral\tfood\nchallenge\nSuspect\tfood\tis\torally\tgiven\tto\tpatient\tin\nundisguised,\tnatural\tform\tin\tgradual\ndoses\tunder\tmedical\tsupervision.\nLess\ttime-consuming\tthan\tDBPCFC;\tshould\tnot\tbe\nused\tin\tinstances\tin\twhich\tpatient\texperiences\nsymptoms\tsecondary\tto\tfear\tor\taversion\tto\nsuspect\tfood.\nFood\tprotein–induced\tproctitis\tor\tproctocolitis\t(FPIP)\nIn
|
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] |
Food\tprotein–induced\tproctitis\tor\tproctocolitis\t(FPIP)\nIn\t\nfood\tprotein–induced\tproctocolitis\tor\tproctitis\tor\t(FPIP)\n,\tbloody\tand\tmucus-laden\tstools\tare\tseen\nin\tan\totherwise\tapparently\thealthy\tbaby,\toften\tat\tabout\t2\tmonths\tof\tage.\tParents\tare\tconcerned\twhen
|
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they\tsee\tflecks\tof\tblood\tin\ttheir\tbaby’s\tstool,\tbut\tit\tis\tusually\tslight\tand\tfurther\tdevelopment\tof\tanemia\tis\nrare.\tCommon\ttrigger\tfoods\tare\tcow’s\tmilk\tprotein\tor\tsoy\tprotein\tfrom\tinfant\tformula,\tand\ttheir\tremoval\nfrom\tthe\tinfant’s\tdiet\tusually\n\tsolves\tthe\tproblem.\tIn\tthe\tcase\tof\tthe\tbreastfed\tinfant,\tthe\tmother\tshould
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0.11331691592931747,
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0.010238501243293285,
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0.024209000170230865,
0.04109294340014458,
0.07051417231559753,
0.09510401636362076,
-0.010905046947300434
] |
remove\tthese\tfoods\tfrom\tthe\tdiet\tand\tcontinue\tto\tbreastfeed.\tFor\tthe\tformula-fed\tinfant,\tit\tbecomes\nnecessary\tto\tswitch\tto\tan\tEHF,\tsuch\tas\tany\tof\tthose\tlisted\tin\t\nTable\t25.4\n.\tHowever,\tsometimes\tthe\tinfant\nrequires\tan\telemental\tformula,\texamples\tof\twhich\tare\talso\tlisted\tin\t\nTable\t25.4\n\tand\tin\t\nChapter\t15\n.\tThe\nbleeding\tusually
|
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] |
Table\t25.4\n\tand\tin\t\nChapter\t15\n.\tThe\nbleeding\tusually\n\tdisappears\twithin\t3\tdays\tof\timplementing\ta\tformula\tchange\tor\tchange\tin\tthe\nbreastfeeding\tmother’s\tdiet.\tIn\tmost\tcases\tthe\tFPIP\tresolves\titself\tby\tthe\ttime\tthe\tbaby\tis\t1\tto\t2\tyears\nold,\tand\toffending\tfoods\tcan\tbe\tintroduced\twith\tmonitoring\tof\tthe\tbaby’s\tstool\tfor\tblood\t(\nMeyer\tet\tal,\n2018\n;
|
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] |
Meyer\tet\tal,\n2018\n;\t\nNASEM,\t2017\n).\nFood\tintolerances\nFood\tintolerances\n\tare\tadverse\treactions\tto\tfood\tthat\tresult\tin\tclinical\n\tsymptoms\tcaused\tby\nnonimmunologic\tmechanisms\tincluding\tmicrobial,\tpharmacologic,\tGI,\tmetabolic,\tpsychological\tand\nbehavioral,\tor\tidiosyncratic.\tThey\tare\tbelieved\tto\tbe\tfar\tmore\tcommon\tthan\tfood\tallergies\tand\tare\tusually
|
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] |
triggered\tby\tsmall-molecular\tweight\tchemical\tsubstances\tsuch\tas\tfood\tadditives\tand\tbiologically\tactive\ncomponents\tof\tfood\tsuch\tas\tbiogenic\tamines.\tSymptoms\tinduced\tby\tfood\tintolerances\n\tare\toften\tsimilar\tto\nthose\tof\tfood\tallergy\tand\tmay\tinclude\tGI,\tcutaneous,\trespiratory,\tand\tneurologic\tmanifestations.
|
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] |
Clinically,\tit\tis\timportant\tto\tdistinguish\tfood\tintolerance\tfrom\timmune-mediated\tfood\tallergy\tbecause\tfood\nallergies\tcan\tcause\tlife-threatening\tanaphylactic\treactions,\twhereas\tfood\tintolerances\tdo\tnot\t(see\t\nTable\n25.2\n).\nGastrointestinal\tmanifestations
|
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] |
Lactose\tintolerance\nIntolerance\n\tto\tthe\tdisaccharide\tlactose\tis\tthe\tmost\tcommon\tadverse\treaction\tto\tfood,\tand\tmost\tcases\nresult\tfrom\ta\tgenetically\tinfluenced\treduction\tof\tintestinal\tlactase.\tIt\tis\testimated\tthat\tabout\t70%\tof\tthe\nworld’s\tpopulation\thas\tlow\tproduction\tof\tlactase\t(hypolactasia)\t(\nUgidos-Rodríguez\tet\tal,\t2018\n).\tSymptoms
|
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] |
Ugidos-Rodríguez\tet\tal,\t2018\n).\tSymptoms\nof\tlactose\tintolerance,\tabdominal\tbloating\tand\tcramping,\tflatulence,\tand\tdiarrhea,\tusually\tappear\n\tseveral\nhours\t(even\tup\tto\t24)\tafter\tlactose\tingestion\tand\tlast\tfor\tseveral\thours.\tBecause\tsome\tof\tthe\tGI\tsymptoms
|
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] |
are\tsimilar,\tlactose\tintolerance\tis\toften\tconfused\twith\tallergy\tto\tcow’s\tmilk.\tHowever,\tmost\tindividuals\nwho\tare\tallergic\tto\tcow’s\tmilk\talso\thave\tsymptoms\tin\tother\torgan\tsystems,\tincluding\tthe\trespiratory\ntract,\tskin,\tand,\tin\tsevere\tcases,\tsystemic\tanaphylactic\treactions.\tDeficiencies\n\tof\tlactase\tand\tother
|
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] |
intestine\tbacterial\tovergrowth\t(SIBO).\tSee\t\nChapter\t27\n\tfor\tmore\tinformation\tabout\tFODMAPs.\nGluten\tintolerance\nNonceliac\tgluten\tintolerance\t(or\tsensitivity)\n\tis\ta\tcondition\tthat\tis\tbeing\tdiagnosed\tmore\tfrequently.\tIt\tis\nbest\tdefined\tas\tintestinal\tor\textraintestinal\tsymptoms\tthat\toccur\twhen\tgluten-containing\tgrains\tare
|
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] |
included\tin\tthe\tdiet,\twhich\tresolve\twhen\tthe\toffending\tgrains\tare\tremoved\tfrom\tthe\tdiet.\tIt\tcan\teasily\tbe\nconfused\twith\ta\tfood\tallergy,\tbut\tit\tis\tnot\tan\tallergic\treaction,\tat\tleast\tnot\tbased\ton\tour\tpresent\nunderstanding\t(\nDeGeeter\tand\tGuandalini,\t2018\n).\tIt\tremains\tcontroversial\twhether\tgluten\tproteins\tfound
|
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).\tIt\tremains\tcontroversial\twhether\tgluten\tproteins\tfound\nin\twheat,\trye,\tand\tbarley\tare\tthe\tcause\tof\tsymptoms\tfor\tthose\twith\tgluten\tintolerance.\nThere\tis\tsome\tresearch\tsuggesting\tthat\tfructan\tintolerance\tmay\tbe\tthe\tcause\tof\tsymptoms\tfor\tsome\npeople,\tnot\tthe\tgluten\tproteins\t(\nIgbinedion\tet\tal,\t2017\n).\tBecause\tof\tthis,\tthe\tterm\tnonceliac\twheat
|
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] |
Igbinedion\tet\tal,\t2017\n).\tBecause\tof\tthis,\tthe\tterm\tnonceliac\twheat\nsensitivity\t(NCWS)\tis\toften\tused\tto\tdescribe\tthis\tcondition.\n\tThis\tis\tdifferent\tthan\tthe\tother\tgluten-related\ndisorder,\tceliac\tdisease,\twhich\tis\tan\tautoimmune\treaction\tthat\toccurs\tin\tthe\tpresence\tof\tgluten\tproteins\nin\tthe\tdiet.\tSee\t\nChapter\t27
|
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] |
in\tthe\tdiet.\tSee\t\nChapter\t27\n\tfor\ta\tdiscussion\tof\tceliac\tdisease\tand\tits\tdietary\tmanagement.\nPharmacologic\nAn\tadverse\treaction\tto\ta\tfood\tmay\tbe\tthe\tresult\tof\ta\tresponse\tto\ta\tpharmacologically\tactive\tcomponent\tin\nthat\tfood.\tA\twide\trange\tof\tallergy-like\n\tsymptoms\tcan\tresult\tfrom\tingestion\tof\tbiogenic\tamines\tsuch\tas
|
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] |
symptoms\tcan\tresult\tfrom\tingestion\tof\tbiogenic\tamines\tsuch\tas\nhistamine\tand\ttyramine.\tSalicylates,\tmonosodium\tglutamate,\tor\tfood\tadditives\tsuch\tas\tbenzoates\tcan\talso\ncause\treactions.\nHistamine\nHistamine\n\tis\ta\tbiogenic\tamine\tproduced\tendogenously\twith\tvery\timportant\tfunctions.\tIt\tis\treleased\tas
|
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the\tfirst\tinflammatory\tmediator\tin\tan\tallergic\treaction\tor\tin\ta\tphysical\tdefense\treaction.\tWhen\tit\n\tis\nreleased\tand\treaches\ta\tcertain\tlevel,\tit\tcan\tcause\tvasodilation,\terythema,\tincreased\tpermeability\tof\tcell\nmembranes,\tdigestive\ttract\tupset,\tpruritus\t(itching),\turticaria\t(hives),\tangioedema\t(tissue\tswelling),
|
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] |
hypotension,\ttachycardia\t(heart\tracing),\tchest\tpain,\tnasal\tcongestion\t(rhinitis),\trunny\tnose\t(rhinorrhea),\nconjunctivitis\t(watery,\treddened,\tirritated\teyes),\theadache,\tpanic,\tfatigue,\tconfusion,\n\tand\tirritability.\nEveryone\thas\ta\tlevel\tof\thistamine\tthat\tis\ttolerated,\tand\twhen\tthat\tlevel\tis\texceeded\tin\tthe\tbody\tthe
|
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] |
symptoms\tof\texcessive\thistamine\tdevelop.\tBasal\tlevels\tof\t0.3\tto\t1\tng/mL\tare\tconsidered\tnormal\t(\nJoneja,\n2017\n).\tIndividuals\tcan\thave\tincreased\tlevels\tof\thistamine\tdue\tto\tstress,\thormonal\tchanges,\tand\tGI\nimpairment,\tincluding\tinflammation\tor\tinfection.\tSome\tpeople\tare\tmore\tsensitive\n\tto\thistamine\tthan
|
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] |
to\thistamine\tthan\nothers,\tusually\tbecause\tof\ta\tgenetically\tdetermined\tinability\tto\tcatabolize\tor\tbreak\tdown\thistamine\tfast\nenough\tto\tkeep\tthe\tlevels\tlow\tso\tthat\thistamine-induced\tsymptoms\tare\tnot\ttriggered.\tOne\tpercent\tof\tthe\nU.S.\tpopulation\tsuffers\tfrom\thistamine\tintolerance,\tand\t80%\tof\tthose\tsufferers\tare\tmiddle-aged\t(\nMaintz\nand\tNovak,\t2007\n).
|
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Maintz\nand\tNovak,\t2007\n).\nSymptoms\tof\texcessive\thistamine\tmay\tbe\tindistinguishable\n\tfrom\tthose\tof\tfood\tallergy\tbecause\tof\nhistamine’s\tmediator\tfunction\tin\tallergic\treactions.\tHowever,\thistamine\tintolerance\tdoes\tnot\thave\tan\tIgE-\nbased\tmechanism\tas\tfood\tallergy\tdoes.\tIn\thistamine\tintolerance\tthere\tis\texcessive\thistamine\tfor\tthe
|
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following\treasons:\t(1)\tcertain\tfoods\tnaturally\tcontain\tlarge\tamounts\tof\thistamine,\tor\tits\tprecursor\nhistidine\t(which\tthrough\tfermentation\tbecomes\thistamine),\n\twhich\tthen\tcauses\ta\treaction\tin\tthe\thistamine\nsensitive\tindividual;\t(2)\tsome\tindividuals\tare\tnot\table\tto\tdeactivate\tor\tmetabolize\thistamine\tin\ta\ttimely
|
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] |
manner\tbecause\tof\ta\tdeficiency\tof\tthe\tenzymes\t\ndiamine\toxidase\t(DAO)\n\tor\t\nhistamine-N-\nmethyltransferase\t(HNMT)\n;\tor\t(3)\tthere\tis\tthe\tpresence\tof\tother\tamines\tthat\talso\tinfluence\tthe\nhistamine\treaction.\nFoods\twith\ta\thigh\thistamine\tcontent\tinclude\tfermented\n\tfoods,\tsauerkraut,\taged\tcheeses,\tprocessed
|
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foods,\tsauerkraut,\taged\tcheeses,\tprocessed\nmeats\tand\tfish,\talcoholic\tbeverages\t(beer\tand\twine),\tand\tleftovers.\tStrawberries,\tcitrus\tfruits,\tpineapple,\ntomatoes,\tspinach,\tegg\twhites,\tfish,\tshellfish,\tand\tsome\tfood\tadditives\t(e.g.,\ttartrazine)\tand\tpreservatives
|
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] |
(e.g.,\tbenzoates)\tstimulate\thistamine\trelease\tfrom\tmast\tcells.\tThe\tmechanisms\tfor\tthis\treaction\tare\tnot\nclear.\tHistamine\tintolerance\n\tor\tsensitivity\tmay\tbe\tsuspected\twhen\tan\tallergic\tcause\tfor\tsymptoms\thas\nbeen\truled\tout\t(\nJoneja,\t2017\n).\tWith\ttrue\thistamine\tintolerance,\ttreatment\twith\ta\thistamine-restricted\tdiet\n(\nBox\t25.5
|
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] |
(\nBox\t25.5\n)\tcan\tbe\tvery\thelpful.\tThe\tdiet\tshould\tbe\timplemented\tfor\t6\tweeks,\twith\tthe\tpatient\tkeeping\nrecords\tof\tintake\tand\tsymptoms\tfollowed\tby\tevaluation\tof\tprogress\tin\treduction\tin\tsymptoms.\nBOX\t25.5\nHistamine-Restricted\n\t\nDiet
|
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] |
General\tdescription\nThis\teating\tplan\tis\tdesigned\tto\tremove\tfoods\tthat\tcontain\thigh\tlevels\tof\thistamine\tand\tfoods\tand\tfood\nadditives\tthat\trelease\thistamine\tin\tthe\tbody.\tIt\tis\ta\ttest\tdiet\tfor\tpeople\twith\thigh\thistamine\tlevels\tand\nassociated\tsymptoms\tfor\twhich\tother\ttreatments\thave\tbeen\tof\tlittle\tvalue.\nFood\tsources\tof\thistamine
|
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] |
Food\tsources\tof\thistamine\nHistamine\tis\tpresent\tin\tlarge\tquantities\tin\tfermented\tfoods.\n\tMicrobial\tenzymes\tconvert\tthe\tamino\nacid\thistidine\t(present\tas\ta\tconstituent\tof\tall\tproteins)\tto\thistamine\tin\ta\tbiochemical\tprocess\tknown\tas\ndecarboxylation.\nAny\tfoods\tthat\thave\tbeen\tsubjected\tto\tmicrobial\tfermentation\tin\ttheir\tmanufacture,\tfor\texample:
|
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Continental\tsausages\tsuch\tas\tbologna,\tsalami,\tpepperoni,\twieners,\tmost\tcheeses,\tsoy\tsauce,\tmiso,\nsauerkraut,\talcoholic\tbeverages,\t“dealcoholized”\n\tbeverages,\tand\tvinegars\tcontain\thistamine.\nFoods\tthat\thave\tbeen\texposed\tto\tmicrobial\tcontamination\twill\tcontain\thistamine:\tthe\tlevel\tis
|
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0.11519494652748108,
0.02927706204354763,
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0.002123891143128276,
0.050465960055589676,
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0.026526283472776413,
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0.041484564542770386,
0.06620541214942932,
0.05816510319709778,
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] |
determined\tby\tthe\trapidity\tof\taction\tof\tmicrobial\tmetabolism.\tHistamine\tlevels\twill\trise\tto\ta\treactive\nlevel\tlong\tbefore\tany\tsigns\tof\tspoilage\toccur\tin\tthe\tfood.\tThis\tis\tparticularly\timportant\tin\tfish\tand\nshellfish.\tBacteria\tin\tthe\tgut\twill\tstart\tto\tconvert\thistidine\n\tto\thistamine\tas\tsoon\tas\tthe\tfish\tdies.\tThe
|
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0.021853307262063026,
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0.04515159875154495,
0.05496329814195633,
0.007696717511862516,
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0.037743642926216125,
0.02917124703526497,
0.10012159496545792,
0.08429760485887527,
-0.0038807247765362263
] |
to\thistamine\tas\tsoon\tas\tthe\tfish\tdies.\tThe\nlonger\tthe\tfish\tremains\tungutted,\tthe\thigher\tthe\tlevel\tof\thistamine\tin\tthe\tflesh.\nSome\tfoods,\tsuch\tas\teggplant\t(aubergine),\tpumpkin,\ttomato,\tolives,\tand\tspinach,\tcontain\thigh\tlevels\nof\thistamine\tnaturally.
|
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of\thistamine\tnaturally.\nIn\taddition,\ta\tnumber\tof\tfood\tadditives\tsuch\tas\tcertain\tfood\tdyes\t(e.g.\ttartrazine)\tand\tpreservatives\n(e.g.\tbenzoates)\tare\tknown\tto\tmediate\tthe\trelease\n\tof\thistamine.\tSome\tof\tthese,\tfor\texample,\nbenzoates,\toccur\tnaturally\tin\tfoods,\tespecially\tfruits,\tand\thave\tthe\tsame\tability\tto\trelease\thistamine\tas\nthe\tfood\tadditive.
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] |
the\tfood\tadditive.\nThe\thistamine-restricted\tdiet\texcludes\tall\tthe\tfoods,\twhich\tare\tknown\tto\tcontain\thigh\tlevels\tof\nhistamine,\tand\tchemicals\tthat\tcan\trelease\thistamine\twhen\tthey\tenter\tthe\tbody.\nHistamine-restricted\tdiet\nAvoid\tthe\tfollowing\tfoods\n\tduring\tthe\t4\tweek\ttrial\telimination\tperiod.\nMeat,\tpoultry,\tfish\n•
|
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] |
during\tthe\t4\tweek\ttrial\telimination\tperiod.\nMeat,\tpoultry,\tfish\n•\t\nFish\tand\tshellfish\twhether\tfresh,\tfrozen,\tsmoked,\tor\tcanned,\tif\tprocessing\tis\tunknown\n•\t\nIf\tthe\tfish\tis\tfreshly\tcaught,\tgutted\tand\tcooked\twithin\t½\thour,\tit\tmay\tbe\teaten\n•\t\nEgg\n•\t\nA\tsmall\tquantity\tof\tcooked\tegg\tin\ta\tbaked\tproduct\tsuch\tas\tpancakes,\tmuffins,\tor\tcakes\tis\nallowed\n•
|
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] |
allowed\n•\t\nProcessed,\tsmoked,\tand\tfermented\tmeats\n\tsuch\tas\tluncheon\tmeat,\tsausage,\thot\tdog\tor\twiener,\nbologna,\tsalami,\tpepperoni,\tsmoked\tham,\tcured\tbacon\nMilk\tand\tmilk\tproducts\n•\t\nAll\tfermented\tmilk\tproducts,\tincluding:\n•\t\nCheese:\n•\t\nAny\tkind\tof\tfermented\tcheese\tsuch\tas\tcheddar,\tColby,\tblue\tcheese,\tBrie,\tCamembert,\nfeta,\tRomano,\tand\tso\ton.\n•
|
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0.016726091504096985
] |
feta,\tRomano,\tand\tso\ton.\n•\t\nCheese\tproducts\tsuch\tas\tprocessed\tcheese,\tcheese\tslices,\tcheese\tspreads\n•\t\nCottage\tcheese\n•\t\nRicotta\tcheese\tmade\twith\tmicrobial\tculture\t(read\tlabel)\n•\t\nYogurt\n•\t\nButtermilk\n•\t\nKefir\n•\t\nAny\tmilk\tproduct\tthat\tis\tcurdled\trather\tthan\tfermented\tis\tallowed\t(e.g.,\tpaneer)\nFruits\n•\t\nCitrus\t(orange,\tgrapefruit,\tlemon,\tlime)\n•
|
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] |
Fruits\n•\t\nCitrus\t(orange,\tgrapefruit,\tlemon,\tlime)\n•\t\nCherries\n•\t\nStrawberries\n•\t\nApricots\n•\t\nRaspberries\n•\t\nPineapple\n•\t\nCranberries\n•\t\nPrunes\n•\t\nLoganberries\n•\t\nDates\n•\t\nRaisins\n•\t\nCurrants\t(fresh\tor\tdried)\nVegetables\n•\t\nTomatoes,\ttomato\tsauces,\tketchup\n•\t\nSpinach\n•\t\nEggplant\n•\t\nPumpkin\n•\t\nOlives\n•
|
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] |
•\t\nSpinach\n•\t\nEggplant\n•\t\nPumpkin\n•\t\nOlives\n•\t\nPickles,\trelishes,\tand\tother\tfoods\tcontaining\tvinegar
|
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] |
Food\tadditives\n•\t\nTartrazine\tand\tother\tartificial\tfood\tcolors\n•\t\nPreservatives,\tespecially\tbenzoates,\tsulfites,\tand\tbutylated\thydroxyanisole\t(BHA),\tbutylated\nhydroxytoluene\t(BHT)\n•\t\nNote:\tMany\tmedications\tand\tvitamin\tpills\tcontain\tthese\n\tadditives;\task\tyour\tpharmacist\tto\nrecommend\tadditive-free\tsupplements\tand\tmedications\nSeasonings\n•\t\nCinnamon\n•
|
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Seasonings\n•\t\nCinnamon\n•\t\nCloves\n•\t\nThyme\n•\t\nChili\tpowder\n•\t\nAnise\n•\t\nVinegar\t(except\tdistilled)\n•\t\nCurry\tpowder\n•\t\nNutmeg\nMiscellaneous\n•\t\nFermented\tsoy\tproducts\t(such\tas\tsoy\tsauce,\tmiso)\n•\t\nFermented\tfoods\t(such\tas\tsauerkraut)\n•\t\nTea\t(regular\tor\tgreen)\n•\t\nChocolate,\tcocoa,\tand\tcola\tdrinks\n•\t\nAlcoholic\tbeverages\tof\tall\ttypes\n•
|
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0.0326029472053051,
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0.054181765764951706,
0.04601228982210159,
0.0744742825627327,
0.019964614883065224
] |
•\t\nAlcoholic\tbeverages\tof\tall\ttypes\n•\t\n“Dealcoholized”\tbeverages\t(e.g.,\tbeer,\tale,\twine,\tetc.)\nThis\tdiet\texcludes\tall:\n•\t\nFoods\twith\tnaturally\thigh\tlevels\tof\thistamine\n•\t\nFermented\tfoods\n•\t\nArtificial\tfood\tcolors,\tespecially\ttartrazine\n•\t\nBenzoates\tincluding\tfood\tsources\tof\tbenzoates,\tbenzoic\tacid,\tand\tsodium\tbenzoate\n•\t\nSulfites\n•\t\nBHA\tand\tBHT
|
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] |
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