Flashcards
allergies // fibre
Cards in this deck (27)
- 1what is an allergy and what are the types?Allergy is the abnormal response to food from the immune system
> IgE mediated
> non IgE mediated
> mixed
<*> non immune mediated hypersensitivity - 2what is it that sets the immune system off?> Epitope = part of food allergen that initiates immune response
> epitopes are a short linear sequence of amino acids OR folded conformational
*linear – resistant to heat
*conformational - may unfold when exposed to heat/digestion
can “grow out’ of conformational allergens, linear allergens continue to be problematic - 3IgE mediated symptoms **Can be caused by trace amounts (eg .001g of egg or peanut enough to illicit anaphylaxis)> symptoms within 30 minutes of ingestion/exposure
> respiratory, GIT, skin and systemic reactions
> includes 1 or more symptoms of:
Anaphylaxis
Angio-oedema
N&V
Abdo pain
Hypotension
Throat tightness
Tachycardia - 4how can you reduce the risk of anaphylaxis?Avoid cross contamination
Don’t share food at school
Read food labels
Call restaurants ahead of time - 5Dx IgE mediated allergyTest and assessment by immunologist / allergy specialist
Skin prick test
Serum allergen IgE test
Food challenge test (under medical supervision)
Does not indicate whether symptoms are due to food allergen nor provide an indication of how severe a reaction may be - 6issues regarding dietary management of allergy> can be complex
> depending on the allergy may be at risk of nutritional risk - 7non IgE mediated allergy responseSkin and GIT, delayed or soon after ingestion, dysphagia and food impaction
- 8non IgE mediated allergy DxSkin prick tests not useful, so detailed clinical hx essential limited diets and food challenges often used
Often nutritionally deficient during this time - 9Non allergic food hypersensitivityMast cells activate and release histamine and other mediators, rashes, hypotension.
Symptoms are dose dependent (unlike IgE – where small amounts can lead to severe responses)
Can occur fast or delayed
Can be, for example, deficiency of enzyme such as lactase, and hence, react to lactose
Salicylates, theobromines, glutamates, benzoates, amines - avoid foods containing these substances :( - 10Common allergen foodsPeanuts, tree nuts
Fish, shellfish
Milk, eggs, wheat and soy (in children)
Fruit (eg strawberries) - 11Mandatory Allergen Labelling:Peanuts
Tree nuts
Fish
Shellfish
Eggs
Sesame
Cow’s milk (dairy)
Soy
Gluten (+ grain source) - 12Coeliac DiseaseSystemic autoimmune disorder, influencing multiple organ systems including GIT, endocrine, bone, reproductive
Immune system reacts to gluten (found in grains)
Can be Dx from children to adults
During Dx individual must continue to consume gluten – and then avoid forever - 13symptoms associated with coeliac diseaseGIT – abdo pain, bloating, diarrhoea, constipation
Malabsorption issues lead to nutritional deficiency such as anaemia
Weight loss
Tiredness
Mouth ulcers
Osteoporosis - 14What is gluten?Protein pair – glutelin and prolamin
The Prolamin activates the bowel the most
Structure varies slightly between different grains - 15managing with coeliac diseaseMust avoid all gluten
Wheat free not necessarily gluten free
Label checking is essential - 16FODMAPS + IBSLow FODMAP diet may help IBS (studies show helps up to 76% of people)
Limit intake of short chain fermentable carbohydrates
IBS – distended abdomen, bloating, pain, gas - 17what are fodmaps?FODMAPs are Fermentable Oligo-saccharides, Di- saccharides, Mono-saccharides And Polyols
They include: Lactose- in milk products Fructose- found in fruit and honey
Sugar polyols- mannitol and sorbitol
Fructans- fructo-oligosaccharides( FOS)
Galacto-oligosaccharides (GOS) - 18Diagnostic criteria for IBS3 months + symptoms
IBS – C/D/M (constipation, diarrhoea, mixed) - 19IBS treatment:Diet
Psychology
Pharmacological
Nutritional management:
Full assessment, Including clinical history
Exclude other disorders
Food / symptom diary useful, Weight changes, trigger foods (often gas producing foods) - 20issues relating to fructoseSlow absorption may lead to IBS symptoms;
Occurs when fructose>glucose
Absorption of fructose in the small bowel is slow so there is more in the large bowel than should be
This has an osmotic effect leading to bloating, discomfort, pain, fermentation, in large bowel by microflora and release of H2 - 21issues relating to lactoseDisaccharide (galactose and lactose)
Requires lactase for digestion
Lactase deficiency common (up to 75% of adults)
Can still manage up to 15g lactose, any more = symptoms
FODMAPS have additive effect hence multiple sources consumed at meal = symptoms - 22issues relating to ogliosaccharidesNot digested
Fermented in the large bowel
Flatulence, diarrhoea, discomfort, bloating
Sources GOS include legumes, soy, nuts
Fructans: Onions, wheat, rye - 23issues relating to polyolsSorbitol: (sources include pear/apples)
Mannitol: (sources include mushrooms, cauliflower)
Slow rate of absorption, increase luminal water – leads to abdominal discomfort, bloating, and large bowel symptoms related to fermentation - 24FODMAP diet trialClose monitoring of symptoms; if unchanged and diet followed strictly, foods eliminated are not the cause.
Reintroduction of foods: challenges one group at a time in order to identify causes, reintroduced in specific amounts, recorded and symptoms monitored and recorded
Foods not causing problems are reintroduced
Trigger foods remain excluded but can be trialled again later - 25soluble fibreSoluble fibre forms gums or gels when water is added and can slow down passage of food through the GIT and help with constipation and diarrhoea
➢ found in some vegetables, fruit, grains ( oats) , legumes ( eg dried beans) - 26insoluble fibreInsoluble fibre not digested and is insoluble in water. Promotes transit of food through the GIT and may be fermented in the colon. Foods include skins of fruit & Vegetables, bran.
- 27resistant starchResistant starch resists digestion and is fermented by microbes in the colon/ large bowel
Found in lentils, starches that are cooked then cooled (potato, pasta)
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- Nutrition Flashcards on allergies // fibre, created by Amelia Claire on 06/11/2018.
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- Amelia Claire
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