Friday, February 27, 2015

Peanut Free Pinecone Bird Feeders!

Back during Christmas break, I decided to do a bird feeder craft with the kids.  We all know that the traditional pinecone birdfeeder has peanut butter, but considering that birdseed often contains sunflower seeds, I figured birds (and squirrels, darn them) would be perfectly fine with Sunbutter.  So that's what we did!



It was superhero pajama day, in case you couldn't tell.

Zax caught licking the knife!  (The knife that had been spreading Sunbutter on dirty pinecones.  Pinecones that still had some dead bugs on them.  Boys!)

For some reason, I was unprepared for how much of a mess this would make.  Kids with peanut allergies definitely cannot be anywhere near where this has been going on (if they were made the traditional way), not even the next day.  Are the teacher and custodian really going to clean up all that residue?  If either of my sons's teachers ever tells me they want to do this craft, I will firmly state "you're doing it with Sunbutter, or you aren't doing it at all."
The picture doesn't really do the mess justice.  Sunbutter was
smeared all over the table.

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Getting ready to roll them in birdseed.  Make sure the birdseed is free of your allergens!  I would also recommend washing hands after finishing, not only to get the mess off, but because I'll bet birdseed doesn't label for cross contamination.



Aren't they pretty?  See, you can do this craft just as easily and nicely without the peanuts!




The squirrels decimated most of these, but we did see birds eating from those few that were in places birds couldn't reach.  What fun!

How have you modified "traditional" allergen-containing crafts to be safe?

Linking up at Allergy Free Wednesdays, Gluten Free Fridays, and Corn-free Everyday
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Wednesday, February 25, 2015

What the new Peanut Findings Mean

The food allergy community was rocked Monday when researchers at the AAAAI Annual Meeting revealed the results of a study stating that early introduction of peanut dramatically reduced the incidence of peanut allergy in children.

You can read (one of many) accounts of the study and announcement here.

The team identified 640 babies considered to be at a higher risk for developing a peanut allergy because they had eczema or egg allergies, things which are often tied together. For half of the babies, the parents were asked to avoid peanuts (I don't know for how long, at least for the first year.) For the other half of the babies, the parents were asked to feed their babies peanut products in some form before their 1st birthday (they were introduced between 4 and 11 months.)  The study followed the participants until their 5th birthday.

It's hard not to wonder, "what if we'd
opened those Reese's cups?
17% of the babies who avoided peanuts went on to develop peanut allergies.  If the 640 participants were divided exactly in half, that means that 54 of those children developed peanut allergies.

On the other hand, only 3.2% of the babies who ate peanut products earlier developed peanut allergies.  That means only 10 out of roughly 320 babies.  Much better numbers!

This study has lit many sparks among the food allergy community.  I'd like to say a few things based on my experiences and on the comments I've seen on the various posts and articles.

First of all, parents, don't blame yourselves.  Food allergies are complex, and as I stress in each and every "science of food allergies" post I write, I believe that there are many variables that must come together in order for a child (or adult, for that matter) to develop food allergies.  Based on these numbers, age of introduction sounds like it's definitely a factor, but it's not the only one.  And in addition, we can't blame ourselves for things we didn't know.  Nor can we blame our allergists for things they didn't know.  With food allergies on the rise for the past few decades, all sorts of hypotheses have been formed about what's causing them and what we can do to prevent them, but if we knew for sure how to prevent allergies, most parents would be doing it.  We don't know, we can only muddle along and hope for the best.  So feel better, mom!

We also don't need to refute the study because our child doesn't fit within it.  I've seen a ton of comments from parents saying variations of "my child was diagnosed at under 6 months when s/he was exclusively breastfed" or "my child would have died if I'd done this, s/he had an ANA reaction at 9 months when s/he touched my peanut butter sandwich."  This isn't going to be One Size Fits All.  Remember, 10 babies in the eat-peanut half of the study still developed allergies.  Specifics weren't given, but some of those may have been to the first, very young, exposure.  Those of us with children who didn't fit the mould of this study don't need to feel angry or insulted by it.  Researchers have found a way to possibly prevent a lot of peanut allergies, but they aren't going to prevent all of them.  This is also only referring to peanut, and there's no word on other highly allergenic foods.  As with our children's original diagnosis, we must make peace and move on.

This is good news.  It is more akin to a vaccination than a cure, because this knowledge will do nothing for those already allergic to peanut, but careful implementation of recommendations stemming from this study could prevent allergies in many children. Maybe we'll even see numbers drop from here on out, instead of continuing to rise.  For those still having kids, it may mean that your younger kiddos get through with no allergies.

We need to exercise caution, or at least be vigilant.  I don't know for sure, but I would bet that the parents in the study were armed with epinephrine and trained on what symptoms to look for before feeding peanut to their infants.  Heck, the articles I read didn't specify so baby's first taste might even have been done in a doctor's office.

We need to stay tuned for recommendations on feeding our babies.  Hundreds if not thousands of allergists and other doctors will be discussing and analyzing these study results, and the AAP may even release new infant feeding guidelines.  However, I would bet that "official" guidelines will take a while to develop, and in the mean time our doctors will not all be in agreement with one another.  There may be difficult times ahead, as parents who have babies now will have a hard time getting feeding recommendations.


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Personally, I think this is good.  I have heard many things filter through the pipeline over the last few years regarding the upswing in food allergies, and peanut allergies in particular.  Considering that I have allergies myself, I was almost expecting Zax to get allergies.  His reaction to egg was worrisome (but not severe) and just confirmed my feeling that he'd inherited my genes.  I was surprised by his positive test results to peanut at 10.5 months considering that he'd never eaten any.  I guess that puts us in the camp of "it wouldn't have worked for us anyway," however I don't know that for sure.  For one, if we'd exposed him much earlier, it's possible he may not have developed the allergy.  In addition, we didn't challenge him on peanut until 3.5 years old, so we don't know for sure if he might have had a false positive at his first visit, and only developed a genuine allergy later, contributed to by lack of exposure.  I'll never know, and I'm not going to waste time brooding over it.

By the time Kal came around, I had heard the statistic stating that rates of peanut allergies rose after the AAP recommended waiting until after age 1 or even 2 before introducing peanuts.  Some doctors were beginning to suggest that waiting was only increasing allergies and that we should feed our children allergenic foods earlier.  I asked our allergist about that, looking for advice on feeding Kal.  I was informed that such research was preliminary, that nobody knew for sure, and that with family history of severe allergies she recommended delaying peanut and tree nut for Kal as well.We followed that advice, but I've learned even more since then and wish I hadn't.

For instance, I had heard that in other parts of the world (don't remember which country, sorry, maybe India?) peanut broth is one of the first foods fed to babies, and rates of peanut allergies there are very low.  I had also heard that in Israel, puffed peanut snacks were a common toddler food, and rates of peanut allergies were very low there as well. This is, in fact, one of the things that led Dr. Gideon Lack to perform this study:  he noticed that Israeli children in the US and the UK had lower rates of peanut allergies, possibly because their parents often fed them "Bamba," a puffed snack food made of corn and peanut butter.

I can't help but wonder if this technique would have worked on Kal.  We avoided peanut with him, but he wasn't tested for food allergies until shortly after his 2nd birthday.  He had a very minor reaction to peanut.  We debated giving him peanut then to see if he could tolerate it, but couldn't agree and let it fall by the wayside.  Once we finally got around to it, right after he turned 3, his skin reaction was off the charts.  We challenged anyway, and his reaction was minor (although it was only to a small amount brushed on his lips, and it was his very first exposure.)  I often felt that if I'd fed him peanut at 2, or if I'd ignored our allergist's advice and given it even sooner, he might have been allergy free.  Kal's diagnosis stuck with me longer than Zax's, but eventually I had to let that go, too.  I can't change what I did, I can only direct what I will do next.

Because of all of these findings, correlations, and studies (including many I have not mentioned) I had already decided that if hubby and I have a third child, we will feed that child very differently than we fed the boys.  This week's study findings only reinforced this conviction.  I figure that we've got nothing to lose.  We followed old AAP guidelines of avoidance with both of our sons, and both wound up with food allergies.  If we try something new (for example, wheat, fish, and even peanut within the first few months of solids) the child may avoid allergies, or may still get them.  But I see no harm in trying, especially since we know what to look for and have all necessary medications in the house already.

And being prepared is probably just as important as these new findings.  Perhaps all new parents should be advised to invest in a bottle of children's Benadryl, and if at all concerned about food allergies, they ought to borrow a friend's Epi Pen, or visit the house of a friend with allergic children, or even park themselves in an ER parking lot before feeding those all-important first bites.  I don't want anyone to put their child in danger because of this study, but we also need to remember that most of the world doesn't consider peanut to be a danger.  Most of today's allergy parents didn't consider peanut to be dangerous either, until their child suffered an allergic reaction to peanut or another food.  So if we advise "Don't just run out and do this, you could be placing your child in danger!" well, the danger may not be as great as we perceive it to be.

Those are my thoughts.  What do you think of this groundbreaking study?

Monday, February 23, 2015

Baked Donuts

There are two of us behind most of our Allergy Superheroes accounts, although my husband is the one who is generally behind Pinterest.  The other day, he was telling me about all the eggless baked donut recipes he was finding, and that we needed to get a donut pan so we could try them.  My mom overheard this conversation, and gave us a donut pan for Valentine's Day!

For our inaugural donuts, we decided to tweak the recipe that came with the pan so it was egg free.


Egg Free Baked Donuts

Ingredients:

  • 2 cups all-purpose flour
  • 3/4 cup granulated sugar
  • 2 tsp baking powder
  • 1/4 tsp ground nutmeg
  • 1 tsp salt
  • 3/4 cup buttermilk
  • 1 Tbsp Ener-G egg replacer mixed with 4 Tbsp water
  • 2 Tbsp butter, melted


Directions:

Preheat oven to 425 degrees.  Spray donut pan with nonstick cooking spray.

In large mixing bowl, whisk together cake flour, sugar, baking powder, nutmeg, and salt.  Add buttermilk, Ener-G, and butter.  Beat until just combined.


Fill each donut cup approximately 2/3 full.


Bake 7-9 minutes or until the top of the donuts spring back when touched.  Let cool in pan for 4-5 minutes before removing.


Then move to a wire rack.  Aren't they puuurty?


Put 2/3 cup of powdered sugar in a resealable plastic bag.  Add a donut, close the bag, and shake to coat.  Repeat with remaining donuts.


Makes 12 donuts.

And the taste testers say?



They're a hit!

Linking up at Allergy Free Wednesdays
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And don't forget that we have our Peanut Allergy Slap Bracelet available now!  The first in our new line of allergy awareness products for kids!  Click here!

Friday, February 20, 2015

The Infamous Australian Study

A study out of Australia was all over the internet a few weeks ago.  Headlines were often exaggerated in the extreme, and many in the food allergy community felt the backlash from well-meaning friends and family.

"Check it out!  Probiotics will cure your allergy!  Go get some yogurt now!!!!!"


I think this study was great, and opens new doors for further studies and possible treatment down the line--but it's far from a miracle cure.  Allergic Living recently interviewed the study's lead researcher, Dr. Mimi Tang, and delved deeper into how the study worked and what it means.  You can read the interview here.

If you don't know already, the gist of the study was this:

Researchers in Australia took 60 children with peanut allergies and broke them into two groups, test and control (placebo.)  The test group was given a daily dose of a probiotic, lactobacillus rhamnosus, along with increasing doses of peanut protein (just like more traditional OIT therapy.)  At the end of the 18 month study, 80% of the children in the test group were able to tolerate peanut, even after a 2-5 week break after stopping treatment.

Those are good numbers.  I don't know specifics, but I do know that the relapse rate is high after stopping OIT treatments.  There are some few doctors who perform OIT in private practice, and the general rule is that the patient must take a daily maintenance dose every day for the rest of their lives (at least, so far as we know) in order to maintain their desensitization.  Failing to do so could mean a return of reactions, and people who have completed OIT are still advised to carry epinephrine just in case symptoms return unexpectedly.

Peanut Allergy Slap Bands from Allergy Superheroes
are available now!!  A great allergy awareness product
for your little ones!
Click here!
Dr. Tang reported "I think this is the highest rate where the treatment was stopped for a time before challenging to test for tolerance."  That's a good sign.  What it means is that most patients become desensitized during treatment, but when asked to stop treatment for a time and then tested later (2-5 weeks, in this case), the rate of relapse is usually much higher.  And that's good news for the possibility of gaining a lifelong tolerance to the problem food.

In my mind, this is one of the scariest/hardest parts of participating in food allergy studies.  We're currently looking at a nearby egg allergy desensitization study for Zax, and the part that worries me the most about the idea of it is that if he goes through the study, he will have to stop treatment (and not eat any egg products) for two months at the conclusion to find out whether he has a lasting tolerance.  We know that OIT therapy has a pretty good success rate (although it can be fraught with dangerous reactions), but the thought of not having him keep up with a maintenance dose is a little harrowing.  If he relapses, that would mean we would have invested two years of our lives into a study which, while it would provide good data for further study, would have sort of wasted our time.  I'd hate to go back to square one after all that time and stress.

It sounds like Dr. Tang intends to follow up with her subjects, asking them to refrain from eating peanuts for increasing lengths of time and then come in for challenges in order to see if their tolerance lasts even longer.  And if Dr. Tang's study is improving long-term tolerance, that will be wonderful for everyone.

We can't just go out to the store and buy yogurt, though.  I laughed when I read how much probiotic the study subjects received:  5 grams, roughly equivalent to 44 pounds of yogurt.  Every day.  And it has to be combined with OIT too.  Subjects with multiple allergies saw no changes in their other allergies during the course of the study.

When I first heard about this study, it reminded me of another study I blogged about a few months ago.  In that one, the absence of a certain gut bacteria in mice led to increased allergies, whereas the reintroduction of that bacteria, Clostridia, lessened (or even removed) symptoms.  It seems that the health of our gut is connected to food allergies.  At least in some people.  As always, I think there are multiple factors contributing to the higher rates of allergies we're seeing these days, and that many pieces of the puzzle will have to come together before we find a long-term cure.

And we may never find a cure that works for everyone.  But I'm thrilled to be living in a time where progress is being made!

Wednesday, February 18, 2015

FABlogCon Sponsors!

Allergy Superheroes has exciting news:

We are going to be Sponsors for FABlogCon 2015!!!

That's right!  Our big launch will be in the spring, and we decided what better way to cap off our inaugural year than by connecting with and helping other allergy bloggers and parents?


It also works out great that FABlogCon will be here in Denver.  We'll be able to use our networks to help advertise, answer questions only locals know, and help others through social media before they even get here.  We're excited!

In case you'd forgotten, our Peanut Allergy Slap Bracelets are available now over at our website.  Here they are again.  This is just the first of many exciting allergy awareness products that will help empower and protect allergic kids!



And here, modeled by our snowman.
Didn't you know he had a peanut allergy?


The sponsor button above is now proudly on the Allergy Superheroes website:


And on the right sidebar of this blog.  Here it is, in case you missed it:


Allergy Superheroes is really taking shape.  We've got exciting things planned, coming up in just a few short months.  We hope you'll stay tuned!

FABlogCon 2015!  Are you going?


Monday, February 16, 2015

The Great Cupcake Experiment

I've been baking without egg for more than five years now, but it's still often an experiment.  A while ago, I decided to try to figure out the best egg substitute to use.

Of course, the best egg substitute always depends on the type of baked good.  So for this experiment my medium was cupcakes.

My inner scientist was not completely satisfied with this experiment, because I used two different types of cake (where I should have been using two identical mixes so the only variable would be the egg substitute.)  But I used what I had on hand.

Experiment

Each of these boxes of cake mix required three eggs, so I divided each mix in exact thirds, by weight, in order to have correct proportions.

The first box of cake was Fudge Marble.  I pre-mixed the chocolate packet in, because I wasn't going to get fancy with this experiment, so it wound up being a very light chocolate cake (did I mention that I used the only two boxes of cake available in my pantry?)

Labeling the mixes was, of course, essential to making sure that nothing got mixed up.  For the Fudge Marble, I decided to use two different varieties of store-bought egg replacer.  As a control, the third bowl of cake mix would contain an actual egg.

Figuring out the amount of other add-ins to put in each bowl required figuring down to the teaspoon.

Pictured in the corner of this photo is another reason my my experiment was not perfectly scientific.  I have found previously that substituting applesauce for the oil helps cakes made with store-bought egg replacers by making the cakes a little more moist (and less prone to crumbling) so I used it here.  However, I used regular oil in cake box #2, so all things were even less equal.  Bad scientist.  Bad.

Here are the cakes ready for their egg substitutes.  As another point of reference, I also made a from-scratch chocolate cake I found years ago and have used many times.  I'll post that recipe eventually, but if you're curious, a google search for "depression era chocolate cake" ought to find it for you.

Egg replacer for bowl A:  Ener-G

Mixed with a beater.  We get better results when it gets more thoroughly mixed this way.

Egg replacer for bowl B:  Bob's Red Mill

(Aso mixed with a beater.)
Ready to go in the oven, and labelled with the color of cupcake liner, so they can't get mixed up.

After baking.

And now for box #2, Spice Cake.  Again, I had to carefully calculate and measure the other additives (and sort of approximate the water.  7.1 Tbsp?  Who can do that?)

For this cake, I tried making a flax egg.  I had heard of two different ground-flax-to-water ratios, and I wanted to find out which worked better, and which (if either) most successfully replicated an egg.

My mom found this first flax seed substitute:  1 Tbsp of ground flax mixed with 3 Tbsp of water equals one egg.

For both flax ratios, make sure you measure the flax seed AFTER you grind it, and allow it to sit for ~5 minutes or more, until it gets thick and goopy (and clings to itself when a spoonful is lifted out.)

I got this second flax egg recipe from a local gluten free bakery.  (They've gotten better results in some of their baked goods when they also eliminate egg.)

1 Tbsp of ground flax mixed with 1/3 cup of water equals one egg.

See above notes on measuring and allowing to sit.

Before adding their "eggs."  The third bowl, once again, got a real egg for a control.

Ready for baking.

Post baking.

Conclusions

So here are all the cupcakes lined up next to each other.

And again from a lower angle, so you can see how much they rose.

From left to right:

Spice cake with Egg

Fudge Marble with Egg

Fudge Marble with Ener-G egg replacer

Fudge Marble with Bob's Red Mill egg replacer

From-scratch depression-era chocolate cake

Spice cake with flax egg at a ratio of 1 Tbsp ground flax to 1/3 cup water

Spice cake with flax egg at a ratio of 1 Tbsp ground flax to 3 Tbsp water

Out of their liners.  We could already see the cupcakes made with store-bought egg replacers weren't holding together well, as they were already shedding crumbs.

And now cut in half and compared.  Here are the egg cupcakes, behaving the way boxed cupcakes are supposed to behave (at least a high altitude.)  They did shed some crumbs.

The store-bought egg replacer cupcakes.  Ener-G seems to work better than Bob's Red Mill in terms of rising, but both were pretty flat and both fell apart when cut into.

Here, please draw your attention to the brown cupcake, which was the from-scratch cake.  I love this cake recipe.  It rose as well as the egg cupcakes, although you can see the air pockets are smaller.  This is a very dense and heavy cake, so if you want it to be light this isn't the way to go, but otherwise it's a great option.  (It's also dairy free and soy free (provided you don't use soybean oil) so it's a great recipe for many food allergies.  I've even made it with gluten free flour with decent results.)

Lastly, the flax egg cupcakes.  Both held together pretty well.  The one with more water was pretty dense, however, and probably needed more oven time because it was still a bit damp.  It didn't rise as well, either.  The one with less water (1T to 3T) performed very close to the way real eggs performed.  It rose, and was light and airy.

The Winner

Our taste testers.  Kal, with only a peanut allergy, tried all seven varieties.

Zax, with both peanut and egg allergies, tried safe pieces from the egg-free cupcakes.

They both liked the chocolate cake best.  While the from-scratch cake is very good, it served mainly as a control/means of comparison.  The boys didn't seem to understand that we were asking for what they thought had the best texture and not just the best taste, so hubby and I were the judges.  And by our estimation, the best egg substitute when it comes to cupcakes is:

The Flax Egg
1 Tbsp ground flax mixed with 3 Tbsp water for each egg.  Mix well and allow to sit until goopy.

Hooray for side-by-side comparisons!


I wish I could say the experiment ended here, but it didn't.  A short time after performing this experiment, I made some sheet cakes for my family.  I made the Chocolate From-Scratch cake, and a boxed cake with flax eggs.  I was expecting both to rise well, but they didn't.  Flax may have the right properties to replace eggs in cupcakes, but the cake failed to rise.  Apparently, leavening power changes depending on the surface area of the baked goods in question.  I don't know whether it simply failed to rise (probably), or if it rose too much and then fell (something that happens often at higher altitudes.)  Clearly, more study is needed.  But as far as cupcakes go, flax eggs are clear winners for getting properly-cake-like results.

What experiments have you done to determine the best substitutions?

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