To start off our ingredient series, I wanted to review the basics about fats and why they are an important part of a person’s diet. 

The main purpose of fats is to serve as a storage system. They can also be used as an energy source if the body is depleted of necessary carbohydrates. Fats provide more calories (9 calories/gram) than both carbohydrates and protein (4 calories/gram), but this doesn’t mean they are bad and should be avoided!  As you probably know, there are both good and bad fats.

Bad Fats

Saturated and trans fats are known as the “bad fats,” as they are linked to raising cholesterol levels and are attributed to increased risk for heart disease.  Examples of bad fats include butter, animal fats, fried foods, all those yummy pastries, stick margarines and shortenings.  Although these fats are known as the “bad fats” they are still okay to have in moderation, so it’s not necessary to strike them completely from the diet! 

Good Fats

There are two types of unsaturated fats – polyunsaturated or monounsaturated.  They are known as the “good fats” and aid in lowering cholesterol levels and are beneficial in fighting heart disease. Examples of good fats include vegetable oils, avocados, peanut butter, nuts, seeds and fatty fish like salmon and trout. If you want to learn more about good and bad fats, the American Heart Association has some fun facts.  

Triglycerides

Now that we know the basics of fats, I wanted to briefly discuss triglycerides. Triglycerides are the chemical form in which most fat exists in food as well as in the body.

There are two types of triglycerides — Medium Chain Triglycerides (MCTs) and Long Chain Triglycerides (LCTs). Both refer to the length of the carbon chain of a fatty acid. 

• MCTs are comprised of 6 to 12 carbon chains and are considered saturated fats. They are beneficial in the treatment of constipation or as a natural laxative and are digested more easily than LCTs. 
• LCTs have a carbon chain greater than 12 and can be monounsaturated, polyunsaturated and saturated fats.  LCTs have been studied and shown to repair the gut if it’s been damaged. ¹

Normal fats and oils contain LCTs and MCTs.  Both types of triglycerides are beneficial and should be incorporated into your child’s diet.    

DHA and ARA

Next, I wanted to touch on DHA and ARA which has been a hot topic for some time now.  DHA and ARA are polyunsaturated fatty acids which are naturally found in breast milk.  Studies have shown that they aid in brain and vision development, and are most effective when provided in the diet for up to 6 months of age.  With this, it was also found that formula fed babies were getting less DHA and ARA than breast fed babies, so now most formulas have a formula option with DHA and ARA. ^{2, 3, 4} This means, if your little one needs to be formula fed, now you can ensure that he or she is getting enough DHA and ARA that is needed to meet their needs!  

Now that we know the basics of fats, look out for Christine’s blog next week when she will continue this topic to discuss the fats found in Neocate! 

- Nita

References:
1. Warner BW, Vanderhoof JA, Reyes JD. What’s new in the management of short gut syndrome in children. J Am Coll Surg. 2000 Jun;190(6):725-36. 2. Birch, EE, Hoffman, DR, Uauy, R et al. Visual Acuity and the Essentiality of Docosahexanoic Acid and Arachidonic Acid in the Diets of Term infants. Pediatr Res. 44:201-209, 1998. 3. Birch, EE, Garfield, S, Hoffman, DR et al. A Randomized Controlled Trail of Early Dietary Supply of Long-Chain Polyunsaturated Fatty Acids and Mental Development in Term Infants. Develop Med Child Neurol. 42: 174-181, 2000 4. Hoffman DR, Birch EE, Castañeda YS, Fawcett SL, Wheaton DH, Birch DG, Uauy R.  Visual function in breast-fed term infants weaned to formula with or without long-chain polyunsaturates at 4 to 6 months: a randomized clinical trial.  J Pediatr. 2003 Jun;142(6):669-77.

I often get asked whether our Neocate^® formulas have all the vitamins and minerals a child would need to thrive for all stages throughout their lives. The answer is yes; but I thought I should explain further what the term “nutritionally complete” really means.

If a formula is considered nutritionally complete it can be used as a sole source of nutrition because it will provide all of the important carbohydrates, protein, fat, vitamins and minerals a child needs to grow and thrive.  For a nutritional product to be nutritionally complete and say so on its product label, it should be age-appropriate and provide all the nutrients a child would need for that specific age.  For example, infant formulas are designed specifically to meet the needs of infants.  As the infant grows into a toddler and older child, their nutritional needs differ and age-specific nutritionally complete products are needed to ensure they are meeting all their nutrient needs.

Having complete nutrition is important for children who are on very restrictive diets because of conditions such as food allergies, eosinophilic esophagitis (EoE) and short bowel syndrome (SBS). When children cannot eat a wide variety of foods, it is common for them to have nutrient deficiencies as a consequence. One study¹ found that in children with food allergies, many were not receiving enough vitamin D, calcium, iron, vitamin E and zinc. This is a serious problem because inadequate nutrition in children could have long-lasting implications such as poor growth, delayed development, and failure to thrive.

One way to avoid nutrient deficiencies is by having a registered dietitian involved in your child’s care – they can assess your child’s nutritional status and give recommendations on what options may work for you and your family. Your chosen nutritionist can also help you to properly read food labels and really understand what is being put into your child’s food.  Just as important, finding a nutritional formula that has adequate (and even higher) amounts of important nutrients (such as calcium, iron, vitamin D, phosphorus and zinc) can help you ensure your little one is receiving proper age-specific nutrition to grow and thrive.

As I mentioned, all of the nutrition formulas in the Neocate family are nutritionally complete. If you are also using Neocate Nutra (a semi-solid amino-acid based medical food) don’t forget that it is meant to supplement formula and not replace it. Nutra contains lots of important nutrients like protein, fat, calcium, and vitamin D but just not enough to be the only source of nutrition.

Are there any vitamins and/or minerals you are worried your little one may not be getting enough of due to a restricted diet? Let us hear about it!

Christine

1. Salman et al, Dietary intakes of children with food allergies: comparison of the food guide pyramid and the recommended dietary allowances, J Allergy Clin Immunol 2002.

Back in our vitamin series we often referenced the ingredient list on formula & food labels and helped identify some of those long words as vitamins.  This sparked us to think about ingredients in general and the importance of understanding ingredients when dealing with food allergies.

There is so much more to ingredients then what’s listed on the label.  So, of course, we decided to blog about it!  Understanding fats, carbohydrates and proteins will be the topic of our next series.   Within the next few months we hope to cover some common inquiries such as types of fat, healthy vs. unhealthy fats, types of carbohydrate including corn, identify sugars, and hidden allergens such as dairy, and explain the building blocks of protein.

A few things to keep in mind while reading those labels and looking at ingredient lists: 

• The FDA requires all manufacturers to list all ingredients in the food on the label.
• Based on the Food Allergen Labeling and Consumer Protection Act of 2004, manufacturers are required to list the top eight foods which account for the most food allergies in commonly used terms.  This does not include allergens accidently introduced during manufacturing or packaging through cross-contamination. 
• Ingredients are listed in order of predominance.  The ingredient used in the greatest amount is listed first, followed by those in smaller amounts listed next, in descending order.
• There are several different types of ingredients such as:
  • Preservatives (ascorbic acid, citric acid) to prevent food from spoiling
  • Emulsifiers (soy lecithin, mono-and diglycderides) which allow smooth mixing and prevent separation
  • Sweeteners (saccharin, aspartame, acesulfame potassium) to add sweetness with or without the extra calories
  • Color Additives (citrus red no. 2, beta-carotene) which offsets color loss due to exposure to light, air, temperature extremes or moisture

Don’t forget to check back with us next week as we kick-off our ingredient series with the topic of fats.  Do you have any questions on what’s listed in the ingredients on food labels?

- Sarah

We know how difficult mealtime can be for kids whose food choices are restricted by food allergies. So, we thought it might be helpful to put together a Food Allergy Cookbook. But we need help from families like you who have worked through trial and error to develop yummy recipes that your kids with food allergies can enjoy.

We’re asking you to share with us your favorite “safe food” recipes so we can compile them into a collaborative cookbook and share with food allergy families. We’ll say “thanks” with a $5 gift card to Target!*

We want everyone – from the overwhelmed parent with a newly diagnosed child with food allergies to the veteran allergy-free cook – to learn something from others who have faced similar challenges. This is an excellent opportunity to share your delicious creations, lend a hand to other members of the allergy community and maybe discover something new for your own family. Each selected recipe will be credited to you and printed alongside a photo of the dish and/or your family enjoying it.

Submission requirements:

• Please send recipe submissions to foodallergyliving@shsna.com by April 1, 2010.
• The only requirement is that the recipe must omit at least one of the top eight allergens. But of course we’d love to see the creative ways you’ve found to use the Neocate product range – including Neocate Junior, Neocate Nutra and E028 Splash!
• If possible, please send photos of the dish and/or of your little ones enjoying your recipe.

Once we receive everyone’s submissions, we’ll compile our favorites into an online cookbook that you can download and share with your friends, families and support groups. Of course we can’t pick every entry, but everyone who submits a recipe will receive the $5 gift card to Target.

Here at Nutricia, we’re all really excited about this idea and we can’t wait to see what recipes you all submit. So, thanks in advance!

- Sarah

* Recipes must be your own. A maximum of five $5 gift cards will be sent to each household (one for each recipe submitted).

Our post today is a special guest blog entry from Nicole Smith. Her blog is Allergicchild.com and she is also the author of the books Allie the Allergic Elephant: A Children’s Story of Peanut Allergies, Cody the Allergic Cow: A Children’s Story of Milk Allergies  and Chad the Allergic Chipmunk: A Children’s Story of Nut Allergies. Nicole has also served as Treasurer for the non-profit organization, Kids With Food Allergies, Inc. and is currently serving on the Food Allergy Initiative (FAI) Advocacy Steering Committee. We would like to thank her for guest blogging for us.

Living with food allergies and eczema has become quite normal for our family. Our son, Morgan, is now almost 14 years old and has lived with food allergies his entire life. He is anaphylactic to peanuts, tree nuts, sesame, fish and shellfish. He is severely allergic to dogs, cats and other furry animals. His eczema is our ongoing battle. He is allergic to grasses, weeds and trees. He currently is receiving allergy shots in the hopes that his seasonal allergies will be minimized, and maybe he will be able to pet a dog in the near future!

From his first few months, Morgan had severe, weeping eczema across his body. It was everywhere – behind his knees, on his hands and feet, and even behind his earlobes. His skin was constantly infected, and I coated him with lotions and over the counter steroid creams to not much avail.

Morgan as a baby

Morgan’s eczema was helped by using Eucerin® lotion in the paste form, and by sparingly using Elocon® lotion (a steroid) when he was an infant. The Eucerin® is almost the consistency of lard.  Wal-Mart sells a generic brand of this that costs about 1/2 the amount of Eucerin®, and we’ve found it to be equally as good.  We slathered it on him every night.  When he was a baby, we applied it every time we changed his diaper.  The Elocon® lotion is a steroid cream, so we tried to use it only when his eczema got very severe. 

The eczema moved around his body as he grew older, but it has never entirely disappeared.  For a while, he had one finger that regularly sported an eczema spot if he ate any food with food dyes!

The use of heat in the winter time dries out his skin, as does swimming in chlorinated water in the summertime.  So, there isn’t a season where he gets a break.  If we forget to use the Eucerin® paste, his eczema will crack and fissures will form.  He has been put on antibiotics, which ended up curing the fissures.  However, we try to not allow the eczema to get this out of control.  The Elocon® lotion will sting if put on eczema with fissures.  He would cry in pain which hurt me almost as much as him – and made me more aware of staying ahead of his skin problems.

Morgan’s eczema gets worse when certain foods are added to his diet.  We notice that processed foods with yellow and red dyes made his skin much worse, so we removed these from his diet entirely when he was young.  This helped the eczema to disappear, yet it would amazingly reappear for no apparent reason. When he was a baby he was severely allergic to eggs; when this allergy disappeared, we started feeding him foods containing eggs, only to find that his eczema flared up.

We live in Colorado Springs, which has hot, dry air in the summer.  However, combining the heat with sun lotions is a recipe for disaster.  We use titanium dioxide sun lotions since they seem to be kinder to his skin.  Certain fabrics such as nylon bother his skin, creating eczema-like blotches.  Long ago, I began using laundry soap that is free of all dyes and perfumes.  None of this cures his eczema, but it helps it to not become worse.

Morgan today

Now that he’s a teenager, he’s responsible for taking care of his skin. As with most teenage boys, hygiene is a difficult daily practice! For a while, the prescription medication Singulair® cured his eczema completely. Now it doesn’t work as well. Since he started allergy shots his eczema seems to be worse, yet he is also in the middle of puberty. Our allergist had told us that some patients experience worsening eczema with allergy shots, yet his environmental and pet allergies are much better. It’s a difficult trade off!

When he has a bad eczema breakout, we have begun wet wrapping his skin with CeraVe® moisturizing cream and Betamethasone steroid cream. (He also takes an antihistamine, such as Xyzal or Zyrtec once a day.) We apply the steroid first, then the moisturizing cream and then hot, wet gauze to wrap his skin sealing in the moisture. Adding socks or ace bandages over the top insures the gauze stays in place. Keeping the wet wraps in place overnight helps the worst eczema spots. Twice a day wet wrap treatments can do wonders for his skin!

We feel like detectives on most days, attempting to find the cause of the eczema. It might be food related, contact related (such as grass or clothing articles) or none of the above. We would love to find the magical cure to make his eczema disappear. In the meantime, we’ll keep searching for what works for today to ease the itch!

 Nicole can be reached at:

Allergicchild.com

425 W. Rockrimmon Blvd, Suite 202

Colorado Springs, CO 80919

nicole@allergicchild.com

http://www.linkedin.com/in/nicoleshieldssmith