Posted in allergies, food, Health, news

Death By Cookie: How Common are Food Allergies?

A 15 year-old girl with known peanut allergies has died after eating a Chips Ahoy cookie that she mistakenly thought was peanut-free.

Alexi Ryann Stafford, of Weston, Florida, was at a friend’s house when she reached for a cookie in the red Chips Ahoy packaging, famous for being the “Chewy” type. However, she did not read the package delineating it was the “Chewy Reeses Peanut Butter cups/chips” brand.

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Both packages are similar in color, and Alexi immediately began to feel symptoms. She went home, was given two Epi-Pens while waiting for paramedics, but unfortunately went into anaphylactic shock and died within 90 minutes of consuming the cookie.

Her mother, Kellie Travers-Stafford, is now calling for more warning labels on the packaging.

If one is allergic to an insect or food, a severe allergic reaction may ensue upon exposure, in which the immune system releases a flood of chemicals that can cause throat tightness, hives, lip and facial swelling, difficulty breathing, nausea, vomiting, low blood pressure, rapid heart rate, cardiac arrest and possibly death.  This anaphylaxis needs to be treated immediately while maintaining airway support and minimizing the allergic response.

The EpiPen® auto-injector contains epinephrine, a drug of choice in these situations.

Epinephrine stimulates the heart to increase cardiac muscle contractility, cardiac output, subsequently raising the blood pressure. Additionally it relaxes the muscles surrounding the airways, allowing one to breathe easier and take in more oxygen. Moreover it helps to stop the release of additional immune chemicals.

The EpiPen® is manufactured by Mylan.  Its cost made headlines when the EpiPen two-pack recently stickered for close to $600. Now generic forms are available costing anywhere from $109-$300 for a dual pack.

The disposable auto-injector, for an adult, delivers 0.3 mg of epinephrine, while the EpiPen Jr., used in pediatric populations, delivers 0.15mg of the medication.  It can be self-administered, through clothing if necessary, into the thigh muscle in one smooth movement once the safety release is removed.

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What Foods Cause Anaphylaxis?

Any food could theoretically cause an allergic reaction, mild or severe, but the most common culprits include:

  • Nuts (peanut, tree nuts, pistachio, etc.)
  • Milk
  • Shellfish
  • Fish
  • Soy
  • Wheat
  • Fruits

 

Food Allergies are Rising

According to FARE – Food Allergy Research and Education, 15 million adults have food allergies, including approx. 6 million children, or 1 in 13 kids.

On their website they report:

  • The Centers for Disease Control & Prevention reports that the prevalence of food allergy in children increased by 50 percent between 1997 and 2011.
  • Between 1997 and 2008, the prevalence of peanut or tree nut allergy appears to have more than tripled in U.S. children.

Why are food allergies rising?

Multiple theories have been suggested.  Some include:

  1. The hormones in our food alter our immune system, making it more sensitive
  2. The preservatives in our food may have the same effect, sensitizing our immune system
  3. We may be “too clean”…over sanitizing or not exposing our children to the outdoors as we did as children, thus preventing their immune system to mature
  4. Our gut microbiome may be changing as we eat more of a fatty, junk food diet, having some effect on our ability to manage food allergens.
  5. Vitamin D deficiency, caused by lack of sunlight and playing outdoors, might be a risk factor for severe allergies
  6. Obesity has been linked to allergies and asthma, and the average weight of an American has risen over the past few decades

Researchers are desperately working on desensitization treatments for those with severe food allergies.  In the meantime, however,  those who are vulnerable need to be extremely cautious about what they eat, stock EpiPens®, have a plan for alerting the Emergency Medical System, and wear medical alert bracelets for others to be aware in time of an emergency.

 

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Daliah Wachs, MD, FAAFP is a nationally syndicated radio personality on GCN Network, KDWN, and iHeart Radio.

She is also a Board Certified Family Physician and Assistant Professor at Touro University Nevada

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Posted in food, Health, news

McDonald’s Salads Recalled in Two States Over Parasite Fears

Over 100 people have been sickened in what is believed to have been an exposure to a parasite while eating salad at McDonald’s.  Currently the departments of health in Iowa and Illinois are investigating the cause.

The parasite involved is called Cyclospora cayetanensis, causing an intestinal infection called cyclosporiasis.

The Illinois Department of Health has seen 90 cases of cyclosporiasis recently, 25% of whom admitted to consuming a salad at McDonald’s.

Iowa has identified 15 people who have become ill, having eating a salad at the highly popular fast food franchise.

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Cyclosporiasis may occur when one consumes contaminated food and water and symptoms include abdominal pain, bloating, nausea, vomiting, fever, loss of appetite, weight loss, headache, and watery diarrhea.

Explosive diarrhea has been reported in severe cases and occurs when the loose stools are passed very quickly and abruptly and may even make loud sounds.

Treatment of cyclosporiasis includes fluids, rest and antibiotics such as trimethoprim-sulfamethoxazole, Bactrim.

PEOPLE MAGAZINE reports:

“Anyone who ate these salads since the middle of June and who developed diarrhea, especially watery diarrhea and fatigue, should see their health care provider and get tested for Cyclospora to ensure an accurate diagnosis and appropriate treatment,” Dr. Patricia Quinlisk said in the statement on the IDPH website.

Out of an abundance of caution, we decided to voluntarily stop selling salads at impacted restaurants until we can switch to another lettuce blend supplier,” McDonald’s told PEOPLE in a statement. “We are in the process of removing existing salad blend from identified restaurants and distribution centers – which includes approximately 3,000 of our U.S. restaurants primarily located in the Midwest.”

McDonald’s has tried to re-brand itself, offering healthier options, however this past year we’ve witnessed multiple food-related illnesses involving fresh vegetables.

This week Del Monte Fresh Produce has had to initiate a vegetable tray recall when over 200 people fell ill to an intestinal parasite.  According to the CDC, as of July 5, 2018, 212 cases of Cyclospora occurred in individuals who consumed broccoli, cauliflower, carrots and dill dip in their Del Monte Fresh Produce Vegetable Tray.  Thus far the states involved include Wisconsin, Michigan, Iowa and Minnesota.  Indiana and Illinois consumers are also being warned of the recall.

 

 

Daliah Wachs, MD, FAAFP is a nationally syndicated radio personality on GCN Network, KDWN, and iHeart Radio.

She is also a Board Certified Family Physician and Assistant Professor at Touro University Nevada

 

Posted in food, Health, news

Parasite Outbreak Linked to Veggie Trays Causing “Explosive Diarrhea”

Del Monte Fresh Produce has had to initiate a vegetable tray recall when over 200 people fell ill to an intestinal parasite.  According to the CDC, as of July 5, 2018, 212 cases of Cyclospora occurred in individuals who consumed broccoli, cauliflower, carrots and dill dip in their Del Monte Fresh Produce Vegetable Tray.  Thus far the states involved include Wisconsin, Michigan, Iowa and Minnesota.  Indiana and Illinois consumers are also being warned of the recall.

The parasite involved is called Cyclospora cayetanensis, causing an intestinal infection called cyclosporiasis.

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Cyclosporiasis may occur when one consumes contaminated food and water and symptoms include abdominal pain, bloating, nausea, vomiting, fever, loss of appetite, weight loss, headache, and watery diarrhea.

Explosive diarrhea has been reported in severe cases and occurs when the loose stools are passed very quickly and abruptly and may even make loud sounds.

Treatment of cyclosporiasis includes fluids, rest and antibiotics such as trimethoprim-sulfamethoxazole, Bactrim.

The CDC posted the following on the recent outbreak:

    • On June 15, 2018, Del Monte Fresh Produce recalled 6 oz., 12 oz., and 28 oz. vegetable trays containing fresh broccoli, cauliflower, celery sticks, carrots, and dill dip. Recalled products were sold in clear, plastic clamshell containers.
        • Recalled products were distributed to the following stores: Kwik Trip, Kwik Star, Demond’s, Sentry, Potash, Meehan’s, Country Market, FoodMax Supermarket, and Peapod.
        • Recalled products have a “Best If Enjoyed By” date of June 17, 2018.
        • The recalled 6 oz. Del Monte Fresh Produce vegetable tray has a UPC code of 7 1752472715 2 found on the package label.
      • The recalled 12 oz. Del Monte Fresh Produce vegetable tray has a UPC code of 7 1752472518 9 found on the package label.
      • The recalled 28 oz. Del Monte Fresh Produce small vegetable tray has a UPC code of 7 1752478604 3 found on the package label.
    • Do not eat or sell recalled vegetable trays. Throw them away.

 

Daliah Wachs, MD, FAAFP is a nationally syndicated radio personality on GCN Network, KDWN, and iHeart Radio.

She is also a Board Certified Family Physician and Assistant Professor at Touro University Nevada

 

Posted in food, Health, news

Banana Survival Threatened by Deadly Fungus

Scientists are going bananas over the possibility of the fruit becoming extinct due to a widely spreading fungal disease.  Panama disease is an infection that has already ravaged banana farms in Africa, Australia, Central America, the Middle East and Asia.  If it spreads to South America, the most widely consumed banana, the Cavendish banana, may fall victim.

For those of us who tire of constantly throwing away the easily bruised and mushy fruit, we may not care and reach for an apple instead.

 

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But scientists are concerned that the fall of the Cavendish banana may be the end of the fruit’s species.

Panama disease (Fusarium Wilt) is caused by the fungus Fusarium oxysporum and is resistant to most fungicides.  Back in the 1950’s, the tropical disease nearly wiped out banana farms in South America but today’s strain appears more resilient and deadly.

 

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Image from ResearchGate

Scientists may have one recourse to save the species.  There are 5 rare trees in Madagascar that grow a wild banana and are resistant to the fungus.  Researchers are hoping they could hybrid the resistant properties of the rare Madagascar trees to the current bananas the world seems to enjoy in their banana splits.

 

Daliah Wachs, MD, FAAFP is a nationally syndicated radio personality on GCN Network, KDWN, and iHeart Radio.

She is also a Board Certified Family Physician and Assistant Professor at Touro University Nevada

 

Posted in food, Health, news

Working Overtime Increases Diabetes Risk in Women

Photo above by Getty Images

 

Canadian researchers report women who work 45 hours or more a week are at higher risk of developing diabetes.  Those who work 30-40 hours weekly, however, are not at increased risk.

In this study, published in the British Medical Journal Diabetes Research and Care, study authors looked at 7000 men and women, aged 35-74, who were working a variety of hours per week.  They found men more likely to develop diabetes, especially if they were obese, but women who worked greater than 45 hours/week were 62% more likely to acquire the disease than women who worked “normal working hours.”

This may shock many of us whose normal work week plus housework clocks in at 80-100 hours.  However, extra hours of work increases stress inducing hormones that may contribute to poor sugar metabolism.

Another theory is longer work days may induce more carbohydrate eating for energy.

Study author Peter Smith of the Institute of Work and Health in Toronto said, “If you look at time spent outside of work, women do more care of household members and more routine housework. The only thing women don’t do more of is watching TV and exercising.”

According to the CDC, 23.4 million people in the US have diabetes, and in total 100 million Americans suffer from pre-diabetes or diabetes.

Previously the 7th leading killer of Americans, diabetes affects so many people that it has now become third leading cause of death in the US.  A study in 2017 found 12% of deaths in the US is caused by diabetes, trailing behind heart disease and cancer, ranked at #1 and #2.

What is Diabetes?

Diabetes is a disease in which the body doesn’t utilize and metabolize sugar properly.  When we consume food, its broken down into proteins, nutrients, fats, water, and sugar. These components are necessary for cell growth and function.  They get absorbed in the small intestine and make it to the blood stream.   In order for a cell to utilize sugar, it needs the hormone insulin to help guide it in.  It’s similar to a key that fits in the keyhole of the “door” of the cell, opening it up so sugar can enter.  Insulin is produced in the pancreas, an organ that receives signals when one eats to release insulin in preparation of the sugar load coming down the pike.

Diabetes Explained

So I imagine our mouth like a waiting room, the blood stream like a hallway, and the cells of the body the rooms along the hallway.  Insulin is the key to open the cells’ “doors” allowing sugar to enter.  If the sugar does not get in, it stays in the bloodstream “hallway” and doesn’t feed the cell.  Weight loss occurs, and individuals may become more thirsty as the sugar in the blood makes it fairly osmotic, something the body wants to neutralize, reduce.  The kidneys are going to want dump the excess sugar, so to do so, one would urinate more, again causing thirst.  So when a diabetic loses weight, urinates more frequently and becomes thirsty, you now understand why.

Complications of Diabetes

Cardiovascular disease – Sugar is sticky, so it can easily add to atherosclerotic plaques.

Blindness – high sugar content draws in water to neutralize and small blood vessels in the eye can only take so much fluid before they burst.  Moreover, high blood sugar weakens blood vessels.

Kidney disease – the kidneys work overtime to eliminate the excess sugar. Moreover, sugar laden blood isn’t the healthiest when they themselves need nourishment.

Infections – pathogens love sugar. Its food for them.  Moreover blood laden with sugar doesn’t allow immune cells to work in the most opportune environment.

Neuropathy – nerves don’t receive adequate blood supply due to the diabetes-damaged blood flow and vessels, hence they become dull or hypersensitive causing diabetics to have numbness or pain.

Dementia – as with the heart and other organs, the brain needs healthy blood and flow.  Diabetes has been found to increase risk of Alzheimer’s as well.

Type I vs. Type II Diabetes

Type I Diabetes, previously called insulin dependent or Juvenile diabetes, occurs when the pancreas doesn’t produce insulin, possibly from the immune system destroying the cells that produce the hormone. When this occurs there is rapid weight loss and death could occur if the cells don’t get the sugar they need.  Insulin has to be administered regularly.

Type II Diabetes, previously called non-insulin dependent or adult-onset diabetes,  occurs in those who began with a fully functioning pancreas but as they age the pancreas produces less insulin, called insulin deficiency, or the insulin produced meets resistance.  This is the fastest growing type of diabetes in both children and adults.

What is insulin resistance?

Insulin resistance, if using our hallway and door analogy, is as if someone is pushing against the door the insulin is trying to unlock. As we know, those with obesity are at higher risk for diabetes, hence fat can increase insulin resistance.  It’s also been associated with an increase in heart disease.

Blood sugar numbers

If your fasting blood sugar (glucose) is greater than 126 mg/dl, or your non fasting blood sugar is greater than 200 mg/dl, you may be considered diabetic.  Pre-diabetes occurs when the fasting blood sugar is between 100 and 125 mg/dl.  If ignored, and the sugar rises, pre-diabetics may go on to develop diabetes.

 

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SOURCE DIABETESMEALPLANS.COM

Preventing/Controlling Diabetes

1/3 of American adults are currently pre-diabetic.  Experts predict 1/3 of US Adults will be diabetic by the year 2050.  Although genetics plays a big role, decreasing ones sugar intake and maintaining an active lifestyle can help ward of diabetes.

Foods high in sugar and carbohydrates increase one’s risk, so a diet rich in vegetables and lean meats is preferred.

For more information, visit http://www.diabetes.org/.

 

Daliah Wachs, MD, FAAFP is a nationally syndicated radio personality on GCN Network, KDWN, and iHeart Radio.

She is also a Board Certified Family Physician and Assistant Professor at Touro University Nevada

Posted in food, Health, news

Superbug’s Found on Nearly 80% of Our Grocery Meat

A study from the Environmental Working Group (EWG) found that most of our meat purchased at the supermarket contains antibiotic resistant bacteria.

The National Antimicrobial Resistance Monitoring System tested bacteria on meat in 2015 and found them to be resistant to one of fourteen antibiotics.  These “superbugs” were detected on:

  • 79% of Ground Turkey
  • 71% Pork Chops
  • 62% Ground Beef
  • 36% Chicken Breasts, Wings and Thighs tested.

Dr. Gail Hansen, a public health expert and veterinarian states, “Bacteria transfer their antibiotic resistance genes to other bacteria they come in contact with in the environment and in the gastrointestinal tract of people and animals, making it very difficult to effectively treat infections.”

The EWG provides a tip sheet on how to avoid superbugs in meat here.

 

What is a Superbug?

A superbug is a pathogen, most commonly bacteria, that can survive antibiotics that most species would buckle under.  It’s resistance could be caused by a variety of factors.  Maybe it has a mutation that makes it stronger.  Maybe its genetic material shields it from the toxic medicine.  Maybe it’s luck.  So shortly after it celebrates surviving the antibiotic assault, it divides to reproduce, making more bacteria.  If this progeny bacteria maintain the same genetic material as its parent, or if included, mutation, they can be now be resistant to the antibiotics as well.

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DRUG RESISTANT E. COLI – IMAGE FROM BBC

According to the CDC: Each year in the United States, at least 2 million people become infected with bacteria that are resistant to antibiotics and at least 23,000 people die each year as a direct result of these infections.

Why are superbugs growing on our food?

One theory is we give antibiotics to farm animals to keep them healthy, avoid disease and improve their growth.  These antibiotics may be used and consumed so frequently that bacteria learn how to overcome and create new, resilient progeny.

How do we avoid getting sick?

The following is a guide on temperature goals for various meats:

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Daliah Wachs, MD, FAAFP is a nationally syndicated radio personality on GCN Network, iHeart Radio.

She is also a Board Certified Family Physician and Assistant Professor at Touro University Nevada

Posted in food, Health, news

Could Your Hangover Actually be an Allergy to Alcohol?

Drinking too much can make one feel pretty sick the next day.  But a small population will claim their “hangover” to be a little too exaggerated for the small amount of alcohol they actually consumed.

Holly Shaw, Nurse Advisor at Allergy UK, reports to Cosmopolitan that some may actually have an “allergy” to alcohol.

Not all hangovers are equal. Some complain of headache, some nausea, some feel achy.  According to Shaw, those with an allergy to alcohol, “may also be accompanied by a red rash, swelling to the eyes, lips, face, breathing difficulties, stomach upset, feeling dizzy or faint due to low blood pressure.”

She also cites sulphites and their effects on those with asthma or sensitive lungs.  “The amount of sulphites contained in alcohol will vary between products, but sulphur dioxide is one of the fourteen major food allergens that are required by law to be included on labels.” So some may have an exacerbation of their asthma or lung disease when they drink.

Does alcohol contain allergens?

Sure, it can.  If one is allergic to grapes, yeast, rye, hops, wheat, barley, etc., they may  have a reaction when they drink alcohol.

WebMD lists the following potential allergens in alcoholic beverages:

  • Barley
  • Egg protein (usually in wine)
  • Gluten
  • Grapes
  • Histamines
  • Hops
  • Rye
  • Seafood proteins
  • Sodium metabisulphite
  • Sulphites
  • Wheat
  • Yeast

What is alcohol intolerance?

Alcohol intolerance is not an allergy.  It occurs in those who lack the enzymes needed to break down alcohol.  Alcohol dehydrogenase (ADH), for example, converts alcohol to acetaldehyde, and this becomes converted to acetic acid by an enzyme, acetaldehyde dehydrogenase (ALDH).  Some populations, including East Asians, may lack ALDH, becoming flushed when drinking alcohol as they have difficulty converting acetaldehyde, the latter building up, causing hangover-type symptoms.

 

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Image from oxfordpresents.com

 

So what is a hangover?

It’s a constellation of symptoms that occur post-partying…..and include headache, muscle ache, nausea, anxiety, moodiness, wanting to avoid light and loud sounds, eye redness, thirst and dizziness, though some hangovers may have many more symptoms.

They could be caused by a variety of factors:

  • Dehydration – alcohol isn’t the best choice to replace lost fluids during a night of dancing, plus it causes increase in urination
  • Low blood sugar – caused by lack of good nutrition over the last 12 hours and enhanced by drinking alcohol
  • Poor sleep – let me guess, you didn’t get a good nice, cuddly, deep sleep for 9 hours once you came home
  • Irritated stomach lining – alcohol tends to do that and ticks off the pancreas as well
  • Acetaldehyde – a chemical converted from alcohol that has been postulated to make you feel nauseous and achy, either during its breakdown in the liver or after its metabolism
    • acetald
  • Cytokine production and release – seen in inflammatory states and can make you achy

Other theories suggesting lactic acid build up, withdrawal from drinking the night before, and congeners that are compounds that vary in alcohol types (red wine vs vodka).

 

How you can you treat a hangover?

The following  are the most popular ways to treat hangover.

 

Water

Hydrate people, hydrate.  Alcohol is a diuretic, which means it makes you urinate more and lose valuable fluid and salts. Water is the easiest, most tolerable, cheapest way to hydrate. Take it slow so you don’t vomit.  And not scotch and water.  Just water….

 

Eat something

An empty stomach is an irritable one.  While most sources say eat a “greasy breakfast”, I would recommend balanced breakfast with protein. Give the stomach acid something to chew on but make it easily digestible.  Remember the alcohol irritated your gut so you need to go easy on it. Baby steps, but healthy baby steps.

 

Exercise

Take a short, brisk walk.  The adrenaline gets the blood pumping and can help with the headache.  The cool air outside will feel good when you inhale and some endorphins will release. This may help with your headache.

 

Drink some Sprite/Sports Drinks

Chinese researchers back in 2013 found Sprite to be the best hangover cure and even though we don’t have many other studies to back it up, the sweet and bubbly it provides makes your head and tummy feel better.

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Sport’s Drinks add the salts you lost from alcohol’s diuretic features. Though many of us don’t like the taste, those who do find it a nice way to hydrate.

What is “hair of the dog”?

Originally it was a treatment to ward off rabies.  One would, after being bit by a dog, put a piece of dog hair on the wound.  A treating fire-with-fire strategy. It later was used for hangovers.  Treating a hangover with a chaser of alcohol was supposed to elevate moods and lessen the withdrawal.  To date there is not enough scientific support to recommend hair of the dog.

 

For next time, how do you avoid the dreaded hangover?

Want to avoid a hangover?  Here’s how:

Firstly, try to avoid getting drunk.  Set your limits and stick to it.

Secondly, drink plenty of water throughout the night and once you get home.

Finally, don’t drink on an empty stomach to “speed up the buzz”. Your empty gut will absorb alcohol quicker so eat a good nutritious meal prior to partying.

Avoid popping antiinflammatories or Tylenol once you get home because your stomach and liver are already irritated from the alcohol and this may make matters worse.  But if any of the above “cures” don’t help, you may need to use these as a last resort.

Daliah Wachs, MD, FAAFP is a nationally syndicated radio personality on GCN Network, iHeart Radio, KDWN…..

She is also a Board Certified Family Physician and Assistant Professor at Touro University Nevada