Friday, February 26, 2010

Food Allergen Labeling, Part 1

When a family member has a food allergy, especially a life-threatening one, reading food labels becomes an obsession.  I don't think I purchase a single thing anymore without first reading the label.  Even if it's a product that I know to be safe, I still take a quick glance to make sure that the label hasn't changed to now include a cross-contamination warning.

I thought I'd spend some time discussing food allergen labeling. Even though, I've read labels faithfully now for almost 6 years, I recently learned something about the allergen labeling law that surprised me.

In January of 2006, the Food Allergen Labeling and Consumer Protection Act (FALCPA) went into effect.  Here's what it addreses:
  • Food manufacturers must disclose "major food allergens" to include milk, egg, wheat, soy, peanuts, tree nuts, fish and Crustacean shellfish.
  • The allergen must be identified by name, i.e., cashews, tuna, shrimp, etc.
  • A scientific ingredient like casein may be listed, but a more consumer friendly term, like milk, has to also be included.
What it doesn't address:
  • Allergens not considered major, for example, sesame seeds or cinnamon do not have to be listed and can be included in the terms "spices" or "natural flavors".
  • Non-crustacean shellfish like clam and squid are not included.
  • The "May Contain" advisory statement is voluntary.
That last one was the shocker for me.  For whatever reason, I've been under the impression for the last 6 years that labels had to include the "May Contain" statement and that a statement like "Manufactured in a Facility that also Processes Peanuts" was the voluntary one.

I didn't realize this until I recently contacted Pepperidge Farms about their products.  I was looking at one of their variety cookie products and was shocked to see that pecans was included in a very long list of ingredients, but there was no "May Contains" statement.  I e-mailed them questioning this, and they advised me that they were in complete compliance (I'll post their response at a later date).  Doubting them lead me to further research.

I can't believe all this time I thought a "May Contain" statement was a requirement.  In fact, as published in The Journal of Allergy and Clinical Immunology, an audit done in 2009 of 20,241 products showed that only 17% included an advisory statement.  Chocolate candy, cookies and baking mixes had the highest frequency.  Here's a chart (found in a report given to the FDA on the Use of Advisory Labeling of Allergens in Foods) indicating the products with the highest usage of an advisory statement.


A subset of this audit also indicated that there were over 25 different advisory terminologies, i.e., "May Contains", "Manufactured in a Facility", "Manufactured using the Same Equipment", etc.  No wonder we spend so much time reading labels at the grocery store.  And for me, contacting companies for clarification of their labels.  Wouldn't it be nice if there were some regulated standardizations!!

There is another study indicating consumers perceptions of risk associated with the various advisory terminologies which I will review in my next post.  In the meantime, I have a question for other parents of children with life-threatening food allergies.  What is your comfort level with food packaging labels?  Are you okay with products made on the same line?  What about in the same facility? And, if a manufacturer tells you it's safe, do you take their word for it without understanding their manufacturing process?  I've included a poll at the top of the blog for your answers.

Tuesday, February 23, 2010

Monthly Meal Planning Update

As mentioned in my last post, I decided to tackle the very arduous task of planning a monthly meal calendar.  Actually, I'm starting small and did just 2 weeks.  The actual decision as to what to fix for dinner was the easy part.  I took stock of what was in my freezer and pantry and then found recipes utilizing those items.  What's been difficult, and majorly time-consuming is going through each recipe, making a master grocery list, checking off what I already have and then dividing the remaining ingredients into individual grocery store lists based on which store carries what.  Sounds easy enough right?

Well, I made my monthly trip to Trader Joe's this morning with my list in hand.  Per list, I bought the can of organic kidney beans for the Crock Pot Barbecue Baked Beans that I am making as a side for our Saturday night hot dog dinner.  I forgot to write down the 3 cans I needed for tonight's Red Beans and Rice meal.  So....2nd official night into my monthly meal planning, and I'm already short a key ingredient!  How frustrating!!  Thank goodness I was able to raid my best friend and neighbor's pantry for my missing ingredients.

Tomorrow, I'm doing my Harris Teeter and Super Target shopping, hopefully for the only time this week and next week.  What are the odds that I'll get everything I need??

Sunday, February 21, 2010

Grocery Shopping Woes

Grocery Shopping is no longer easy.  Not that it's always been a walk in the park...especially those trips where both kids are with me.  But, now that I'm reading labels not only for peanut allergens, but also for GMO's, rBST, artificial colors, sweeteners, etc., it's become a major, time-consuming effort.  I've gotten pretty good about knowing what products meet our family guidelines.  It's just that I can't purchase them all at one store.  In fact, I now shop at seven different stores.

Our Sunday School class is doing the Crown Financial Study.  My husband and I have started to take a close look at our day to day expenses.  I was pleased to see that eating healthy hasn't increased our food expenditures by a huge amount.  What was shocking was to see that I had made over 21 trips to a grocery store in a one month period.  Quite frankly, I've got better things to do with my time!

Here's what's happening.  I love Trader Joe's.  The prices are very reasonable and their foods meet our healthy eating requirements.  However, because of Abigail's peanut allergy, I can't purchase any of their breads, the majority of their boxed products (cereal, snack bars, etc.), a good many of their baking items, a lot of their frozen items or any of their cookies or other sweet treats.  So, at Trader Joe's, I stock up on what I can, but that leaves a ton of items that I have to purchased elsewhere. They also have the best price on organic produce, but it's a 30 minute drive to the closest store so I only make the trip once a month.  That leaves me looking for everything else we need at the other 6 stores that I shop.

I should explain that the reason we haven't seen a huge increase in our food budget even though we are purchasing organic, natural and peanut free is because I shop at so many different stores.  For instance, I stop into Food Lion to purchase our Jone's Colas.  They're just $2.99 versus $4.99 at Harris Teeter.  Wal-Mart carries a few organic products and have the best prices on those items, but the selection is very limited.  I go to BJ's for diapers and paper products.  While Harris Teeter tends to be the most expensive on basics, they have the best selection and a few products that I can't find anywhere else.  Fresh Market has the best price on certain organic produce items, and Target has rGBH-free dairy items that I purchase when I can't get to Trader Joe's.  And, if a store does a special event with triple or double up to $1.99 coupons, I'm probably shopping there too.  Don't laugh (my husband does), but I've had to create a spreadsheet to keep track of all of this.

So, what to do?  This is going to be a stretch, but I'm going to try to plan a monthly menu.  I've started this weekend working on just a 2 week menu and will work my way up to doing a month at a time.  Considering that there are many evenings that I don't start figuring out what's for dinner until dinnertime, this is a big deal.  Hopefully, the payoff will be big.  My goal is to simplify my afternoons and decrease our food budget by purchasing in bulk.  Mostly though, I want to gain lots of time by eliminating the 3 to 4 trips I make each week to grocery stores.

There are a lot of resources on the internet.  Last night I found someone that put their meal calendars and shopping list templates online for upload.  It's a good starting place.  I also purchased a 5 ingredient crock pot cookbook.  My kind of cooking!  Now, I just need to take my menu and translate it into 6 different shopping lists!  Wish me luck!

Wednesday, February 17, 2010

The Allergy March

It's amazing the information you can find on the internet.  In doing some research, I found a clinical research trial that is currently being conducted at the Evelina Children's Hospital in London. It's called The LEAP Study, short for Learning Early About Peanut Allergy and is funded and sponsored by two US organizations, the Immune Tolerance Network and The National Institute of Allergy and Infectious Diseases.

Health officials in the US, UK and Canada advise parents not to introduce peanut butter to their childrens' diet until around age 2 as a way to decrease the chances of developing a sensitivity/allergy to peanuts.  Because our younger son is considered at risk for a peanut allergy based on family history, i.e., Abigail, we were told to wait even longer until he is 3. However, there are many countries where children eat peanut products from infancy on that do not show the high levels of peanut allergies as seen in Western countries. This study (which is now full) looks at these two schools of thought.  Here's an excerpt from their site:

The majority of children have their first allergic reaction to peanut between 14 and 24 months of age. Children suffering from eczema or who are allergic to egg are at highest risk - these children have a 20% chance of going on to develop a peanut allergy.

The LEAP Study involves 640 such high-risk children who were enrolled in the study when aged 4-10 months. Each child was randomly assigned to follow one of the two approaches – avoidance or consumption. Children in the avoidance group avoid eating peanut-containing foods until they reach the age of three. In the consumption group, parents are asked to feed their child an age-appropriate peanut snack three times per week (equivalent to about 6 grams of peanut protein per week). All participants receive allergy testing, dietary counseling, physical examinations and will be asked to provide occasional blood samples that will be used to examine differences in immune system development in each of the study groups.

The proportion of each group that develops peanut allergy by 5 years of age will be used to determine which approach - avoidance or consumption - works best for preventing peanut allergy. We anticipate that the study will reach completion in 2013, at which time the results will be analyzed and published.

There is some great informative on their site, and if you are dealing with a peanut allergy, it's very much worth checking out.  There is one topic that I wanted to point out.  The site discusses the "Allergy March", which is a term they use to explain how allergic diseases progress throughout a person's life.  According to the site, the Allergy March begins with eczema which is usually diagnosed within the first few months of life.  In 1/3 to 1/2 of children, eczema is linked to an underlying food allergy.  They go on to explain that food allergies appear in the first 3 years of life and that the development pattern of allergic diseases, the type

 

and age they occur, is the same in a large number of children. They do say that just because a child has eczema as an infant doesn't mean that they will go on to have a food allergy, but it does mean that they will have a higher risk of following this Allergic March.  In fact, 20% of children with eczema do develop a peanut allergy.

I find this very interesting.  Both my children had eczema as infants.  I put a tiny amount of peanut butter on Abigail's lips at around 18 months of age.  Less than 15 minutes later, her nose was pouring and she had hives.  At around 2 to 3, she had numerous trips to the doctors for wheezing and ended up on Albuterol and Pulmicort.  We were just one diagnosis away from Asthma when she appeared to out-grow it.  We had our younger son tested at 18 months for food allergies.  His blood test showed negative to everything.  We allow him to eat foods that are manufactured in the same plant with peanut products, but at 2 1/2, he's still not had anything with peanuts as an ingredient.  As an infant, he was very prone to ear infections and ended up with tubes.  He now constantly has either a runny nose or is clearing his throat because of drainage.  My gut tells me it's food related, but I can't prove it without doing an elimination diet.

I will be following this study closely.  The results will come too late to benefit my family, but it will still be interesting to know if all along we've been doing the wrong thing by avoiding all peanut products in the infancy stage.

Sunday, February 14, 2010

Valentine's Day

We don't go all out for Valentine's Day.  I have a few decorations I put up, my wonderful husband always gives me roses, usually pink, we exchange cards and the kids get a small treat.  This year we also made Valentine cookies. 

I found this incredible sugar cookie recipe (peanut safe of course) on the internet last fall and use it every holiday to make cookies for the kids to decorate.  I found it on someone's blog, but I didn't bookmark it so unfortunately I can't give her credit.  I'm guessing though that her name is Rhonda because they're called Rhonda's Sugar Cookies. Here's the recipe (I use all organic ingredients):

3 cups all-purpose flour
1/2 teaspoon baking soda
1/4 teaspoon salt
1 cup butter
2 eggs
1 cup sugar
1 teaspoon vanilla

In a large bowl, sift together the flour, baking soda and salt.  Add the butter and mix it like you would a pie crust.  In another bowl, beat eggs.  Add the sugar and vanilla and beat well.  Pour this mixture in the bowl with the dry ingredients and blend.  The dough will be a little crumbly, but I usually just knead it a little with my hands.

This recipe doesn't require you to refrigerate the dough, so it's ready to either roll out and cut with cookie cutters or shape into balls and flatten with a fork or glass dipped in sugar.  The recipe calls for you to cook on an ungreased cookie sheet; however, I've recently discovered parchment paper and swear by it!  Bake cookies at 350 degrees for approximately 9 minutes.  Remove from pan and place on wire rack to cool.  After they cookies have cooled, store them in an air-tight container.  They also freeze well.

Happy Valentines Day!  We've got some cookies to eat!

Tuesday, February 9, 2010

14th Visit to Duke

We went to the Duke Clinical Research Unit yesterday.  It was our 14th trip, and our first visit of 2010.  We're in the maintenance phase so the purpose of our visit was not to get a dosage increase, but for our 3rd round of testing.  It was a short visit, but a full one. Abigail had a skin prick test, about 7 vials of blood drawn and a saliva sample taken.  All that warranted 3 escalator rides, 1 for each test, when we were done!

Let me start by saying that Abigail did absolutely fabulous!!  Not one complaint!  I did think it was cute when Abigail asked the nurse if she would only stick her once (last time it took 2 tries).  She also watched and even helped change out the vials.  I was very impressed and very proud.  I should also thank the nurses.  They're pros and their no nonsense approach really helps.

Abigail's skin prick test results were much worse than the time before.  I do remember being told to expect the results to get worse before they get better so I'm not sure why the results of her 2nd prick test were much better than the 1st or the 3rd.  I also had the opportunity to talk with our doctor about the food challenges.  They've done 10 so far.  He couldn't share specific results with me, but he did say that they were feeling good about what they were seeing.  He also told me that based on what they were seeing, there was no plan to make any modifications to the study protocol.

There were a couple of other eventful happenings at this visit.  I was able to meet another mom that I've been communicating with for several weeks.  Her daughter was at Duke for her very first visit.  She and I have been e-mailing back and forth discussing all aspects of the trial.  She's had lots of questions, and I was able to give her a good amount of information.  I'm hoping our discussions have been helpful as her family starts the journey to becoming peanut allergy free!

Another really cool part of our visit to Duke was that my mom came with us.  Abigail and I loved having her spend the morning with us.  After our appointment, we took Abigail to a birthday lunch at CiCi's Pizza and surprised her by having both my dad and sister meet us there.  By the way, none of CiCi's products contain peanuts, are made with peanut oil or processed in a plant with peanuts.

All in all, it was a great trip.  We don't have another appointment scheduled until the first of April when we go to discuss the details of our food challenge in May.  We've got a long way to go yet, but I'm overcome with how blessed we are to be a part of this trial.

Saturday, February 6, 2010

Happy Birthday Abigail!

 
Happy 7th Birthday Abigail!

Yesterday was Abigail's 7th birthday.  It was a big day involving sweet treats, gifts, parties and lots of little girls running around our house screaming!

The day started by taking treats to school.  This is always tricky because the sweets have to be store bought.  I've found a grocery store that carries cupcakes from Freed's Bakery which are peanut/tree nut safe.  However, due to a conflict, we had to bring our treat at morning snack.  Abigail wanted doughnuts.  Well, as already posted, neither Krispy Kreme nor Dunkin Doughnuts are safe.  I was stumped at what to bring, but finally remembered the "Sweet 16" powdered doughnuts.

After school, Abigail got her first American Girl Doll.  I'm glad she's not too "old" for dolls yet. We invited 6 of her friends over for a pajama party.  They each came in their PJ's and brought their doll and pillow.  I put down a bunch of quilts and pillows on the floor, made a canopy of streamers, pink, of course, and had hoped that they would hang out, have a fashion show with their dolls, watch a movie, do a craft, eat some pizza and cake, and so forth.  Boy, was I wrong!  Seven girls, aged 6 and 7...whew..they were way too hyped up to "hang out".  It was crazy!  And, quite frankly, I was glad when the party ended, and everyone went home.

As usual, I made her birthday cake, and as usual, didn't finish it until about an hour before the party started.  Having a peanut allergy means that stopping by a local grocery store and purchasing a cake is not an option.  Nor is ordering a cake from most specialty bakeries.  Luckily, my mom used to decorate cakes so I have her expertise and a lot of her old cake supplies at my disposal.  Given the pajama party theme, I made "sleeping bag" cakes for each of the girls and a larger cake for the family.  I couldn't bear to buy a boxed mix after all our new eating changes so I made a scratch chocolate cake using organic ingredients.  It was the first time using the recipe, and it tasted great, but it was a disaster trying to get the cakes out of the pans.  They all stuck, and I had to "glue" them back together with frosting.  Every year as I struggle to make the perfect cake, I think...why?  I don't think that Abigail is old enough to appreciate the work that goes into her cakes.  Every year I'm wishing I could just order a cake and be done with it.  But then I think that even if she wasn't allergic to peanuts, I'd still want to make her cake.  Maybe one day, I'll have the opportunity to make that choice!

So, darling Abigail, Happy Birthday!  I love you!
 
                                       

Tuesday, February 2, 2010

Healthy Change #10: Avoid Genetically Modified Foods

Well, I've put off writing the 10th and final change in my "Ten Changes to Make for Healthier Living" series as long as possible.  It's now the first of February, and I can no longer procrastinate. For me, it's the hardest of all the changes, not just writing about, but also following. I barely have a handle on this change myself.

Change #10:  Avoid Genetically Modified Foods

In order to make crops more resistant to disease, weeds and pest, more tolerant to drought and cold weather and more nutritious, many have been genetically modified.  Genetically Modified (GM) Food has been unnaturally altered by inserting genetic fragments (DNA) from one organism to another. According to the World Health Organization, the inserted DNA is usually from a different species. The genes can be taken from bacteria, viruses, insects, animals and even humans. 

Other than the fact that we are not eating food in it's true form, why avoid foods that have been genetically modified? According to the Academy of Environmental Medicine, "GM foods pose a serious health risk in the areas of toxicology, allergy and immune function, reproductive health, and metabolic, physiologic and genetic health and are without benefit."  Just last month, The Huffington Post wrote of a study linking GM food to organ failure.

But beyond the food we eat, there is a serious impact to the environment.  The Center for Food Safety (CFS) outlines the environmental impacts to include an "uncontrolled biological pollution, threatening numerous microbial, plant and animal species with extinction, and a potential contamination of all non-genetically engineered life forms with novel and possibly hazardous genetic material."

The US doesn't require food manufacturers to label GMO products so it's difficult to know which foods have been altered.  I've read that there is an estimated 30,000 foods found on grocery store shelves that contain a GM ingredient or 75% of processed foods in the US.  DisabledWorld.com reported that from 1995 to 2005, total worldwide land surface growing GMO crops increased from 4.2 million acres to 222 million acres.

There are many GM foods, but five account for the highest volume of food and food ingredients.  The CFS reports that "currently, up to 85 percent of US corn is genetically engineered as are 91 percent of soybeans and 88 percent of cotton (cottonseed oil is used in food products)." Canola is one of the top five, and newly added is sugar beets.  Some examples of these GMO products:

Corn - corn flour, meal, oil, starch & syrup, sweetners (fructose, glucose), modified food starch
Soy - soy flour, lecithin, vegetable oil, soy beverages, tofu
Cotton - cottonseed oil
Canola - canola oil
Sugar Beets - any sweetener not labeled 100% cane sugar, evaporated cane juice or organic sugar

Unless the product package specifies that the food is non-GMO, then you can assume that if it has one of these ingredients, then it's been genetically modified.  The best list of GMO crops I've found is on DisabledWorld.com.  Here's an incredible Non-GMO Shopping Guide.  It lists products by brands, includes brands that do use GMO ingredients and lists a ton of "hidden" GMO ingredients.

What's most difficult for me, is that I can't seem to avoid GMO foods without making drastic and unwanted changes to our shopping and eating habits.  In fact, it makes me downright angry to find out that we've been human guinea pigs for years now, and that I've unknowingly feed my family these foods.  It's possible that the soy formula and milk that Abigail drank from 7 months of age to the age of 2 could very well be the cause of her peanut allergy.  Since 1996, when GMO's hit the mainstream food supply, food allergies and chronic diseases have doubled. From what I am reading, there is not adequate testing, our government is leaving it up to big business to determine what's safe and what's not, other countries' governments have long since realized that there is a serious health risk and are imposing regulations while big business is doing everything in it's power to shut down the small farmers who want to avoid the use of genetically modified seeds for their crops.
 
NaturalNews.com has created a good list of ways to avoid GMO foods.  Obviously, eating organic is the easiest.  Using the shopping guide I mentioned above is helpful, but frustrating.  The products tend to be more expensive and many aren't safe for our household because of the risk of cross-contamination with peanuts/tree nuts.  I've done a few things like purchase organic produce, rice and canned goods, switched to Safflower Oil for cooking, purchase Kashi crackers and cereal, and Kettle potato chips.  Trader Joes is another source for non-GMO snacks.  However, I've got a really long way to go!

Here are a few more links if you want to do a little more reading.