Impact of Food Allergies

95 Pages·2015·2.11 MB·English

Faculty Disclosure
I have nothing to disclose.
Question #1
A 7-year-old boy with A. Intravenous fat
an enterocutaneous emulsion
fistula develops an
B. Amino acid
urticarial rash the day
solution
that he is started on
C. Pediatric
parenteral nutrition.
Multivitamin
All of the following
solution
constituents of his
D. Dextrose
parenteral nutrition
could cause the rash
EXCEPT:
Question #2:
An 18-month-old vegetarian A. Fat
girl with presumed milk and
B. Vitamin D
soy protein allergy is drinking
C. Energy
32 ounces of enriched
D. Zinc
almond milk per day. She
also eats rice, wheat, corn,
fruits, and vegetables but
does not consume any egg
or meat products. She does
not receive any vitamin or
mineral supplementation.
You are concerned about
her intake of all of the
following EXCEPT:
Question #3:
A 6-year-old Asian boy is seen A. Assessment of growth and
nutrient intake
by a dietitian for follow-up
nutritional assessment and B. Suggesting an age-
appropriate beverage
education. His parents report
he is allergic to milk, soy, and C. Recommending follow-up
with allergist as patient is
peanuts. He has a history of
tolerating milk and soy
anaphylaxis while eating
D. Suggesting food
peanut butter a year ago. His
challenge of peanut
current intake includes tofu stir-
butter at home
fry and milk chocolate candy
bars. Parents report he eats
these foods at least once a
week without any problems.
He does not drink a milk
substitute. All of the following
must be done or considered at
this visit EXCEPT:
Question #4
A 6-month-old breastfed A. This consistent with IgE-
infant has significant mediated anaphylaxis.
vomiting and diarrhea
B. This is most likely food
within hours of being given
protein-induced
a bottle of cow’s milk
enterocolitis syndrome
formula. His mother reports
C. Cow’s milk protein must
that this has happened
be eliminated from the
each time he has been fed
child’s diet
the formula. She denies any
D. In addition to
skin rashes. A serum lab for
breastfeeding, a protein
IgE directed against cow’s
hydrolysate formula
milk protein is negative. All
may be appropriate
of the following are true
about this child EXCEPT:
Learning Objectives
• Improve understanding of nutrition
management of children with multiple
food allergies
• Describe the nutrition assessment of
children with food allergies
• Understand the food and non-food
issues that may impact the provision of
nutrition support in children with food
allergy
Food Allergy – Concern?
• Increased public health concern in
Western World
• Greater problem in children than in
adults
• Associated with poorer nutrition
outcomes
What’s the story?
• “Telling Food Allergies From False Alarms” (The New York
Times)
• “Is Your Kid Truly Allergic? Tests Add to Food Confusion” (The
Wall Street Journal)
• “Adverse Reactions to Food: Allergies & Intolerance”
(Digestive Diseases)
• “’Allergic Girl’ teaches how to eat out with allergies”
(CNN.com)
• “This allergies hysteria is just nuts” (British Medical Journal)
• “Children at risk in food roulette” (ChicagoTribune.com)
• “Fear and Allergies in the Lunchroom” (Newsweek)
• “Food Allergen’s Attack” (Food Service Director)
• “Food Allergies Take a Toll on Families and Finances” (The
New York Times)
Food Allergens
Identified as a
protein or
glycoprotein
Food
Allergy
May be more
or less common Resist
depending on denaturation
the society or by heat or acid
ethnicity