This document discusses food allergies in children. It notes that the most common food allergens in children are milk, eggs, peanuts, tree nuts, soy, and wheat. Symptoms of food allergies can include anaphylaxis, skin issues like urticaria and atopic dermatitis, gastrointestinal problems, and respiratory symptoms. Diagnosis involves elimination diets and food challenges. Treatment is elimination of the offending foods from the diet.
Autoimmune hepatitis (AIH) is an immune-mediated inflammatory liver disease characterized by elevated liver enzymes, positive autoantibodies, and interface hepatitis on liver biopsy. It can present in various ways, including asymptomatically, with acute hepatitis, or with cirrhosis. Genetic susceptibility and environmental triggers like viruses are thought to play a role in breaking immune tolerance against liver antigens. This leads to an immune response involving autoantibodies, cytotoxic T cells, and inflammatory cytokines that damage liver cells. Treatment involves immunosuppression with corticosteroids and azathioprine to induce and maintain remission.
This document provides an overview of food allergies for dietitians, including distinguishing allergies from intolerances, common food allergens, symptoms of allergic reactions, diagnosis, and management. It discusses the immune system response to allergens and introduces concepts such as oral tolerance. Statistics on the prevalence of food allergies in children and adults are presented. The roles of dietitians in supporting diagnosis and managing allergies through dietary avoidance and ensuring nutrition are also summarized.
This document discusses the relationship between HIV/AIDS and nutrition. It notes that HIV contributes to and is affected by nutritional status, and that malnutrition increases the severity of HIV/AIDS. Poor nutrition can accelerate the progression of the disease and reduce the effectiveness of medications. The document recommends that people with HIV/AIDS consume a diet that is higher in calories, protein, and micronutrients in order to support the immune system and increase quality of life. Regular nutritional assessments and customized diets are important for managing the disease.
This document provides an overview of nutrition labeling and health claims regulations in several Asian countries including Brunei, Indonesia, Malaysia, Philippines, Singapore, Thailand, Vietnam, China and Japan. It finds that while most countries allow nutrition and nutrient function claims according to Codex guidelines, standards for nutrition labeling formats, criteria for claims and disease risk reduction claims vary significantly across countries in the region. National authorities are working to strengthen regulatory control of label information to ensure it is factual and appropriately presented to consumers.
La dieta mediterannea - di Michele ZonnoMedOliveOil
La dieta mediterannea - di Michele Zonno. 4 giugno 2012. Corso di formazione "valore nutrizionale e salutistico di prodotti agroalimentari” - Università degli studi di Bari.
This document discusses food allergies in children. It notes that the most common food allergens in children are milk, eggs, peanuts, tree nuts, soy, and wheat. Symptoms of food allergies can include anaphylaxis, skin issues like urticaria and atopic dermatitis, gastrointestinal problems, and respiratory symptoms. Diagnosis involves elimination diets and food challenges. Treatment is elimination of the offending foods from the diet.
Autoimmune hepatitis (AIH) is an immune-mediated inflammatory liver disease characterized by elevated liver enzymes, positive autoantibodies, and interface hepatitis on liver biopsy. It can present in various ways, including asymptomatically, with acute hepatitis, or with cirrhosis. Genetic susceptibility and environmental triggers like viruses are thought to play a role in breaking immune tolerance against liver antigens. This leads to an immune response involving autoantibodies, cytotoxic T cells, and inflammatory cytokines that damage liver cells. Treatment involves immunosuppression with corticosteroids and azathioprine to induce and maintain remission.
This document provides an overview of food allergies for dietitians, including distinguishing allergies from intolerances, common food allergens, symptoms of allergic reactions, diagnosis, and management. It discusses the immune system response to allergens and introduces concepts such as oral tolerance. Statistics on the prevalence of food allergies in children and adults are presented. The roles of dietitians in supporting diagnosis and managing allergies through dietary avoidance and ensuring nutrition are also summarized.
This document discusses the relationship between HIV/AIDS and nutrition. It notes that HIV contributes to and is affected by nutritional status, and that malnutrition increases the severity of HIV/AIDS. Poor nutrition can accelerate the progression of the disease and reduce the effectiveness of medications. The document recommends that people with HIV/AIDS consume a diet that is higher in calories, protein, and micronutrients in order to support the immune system and increase quality of life. Regular nutritional assessments and customized diets are important for managing the disease.
This document provides an overview of nutrition labeling and health claims regulations in several Asian countries including Brunei, Indonesia, Malaysia, Philippines, Singapore, Thailand, Vietnam, China and Japan. It finds that while most countries allow nutrition and nutrient function claims according to Codex guidelines, standards for nutrition labeling formats, criteria for claims and disease risk reduction claims vary significantly across countries in the region. National authorities are working to strengthen regulatory control of label information to ensure it is factual and appropriately presented to consumers.
La dieta mediterannea - di Michele ZonnoMedOliveOil
La dieta mediterannea - di Michele Zonno. 4 giugno 2012. Corso di formazione "valore nutrizionale e salutistico di prodotti agroalimentari” - Università degli studi di Bari.
Celiac disease is a multifactorial autoimmune disorder triggered by gluten exposure that affects the small intestine. It can present with gastrointestinal symptoms like diarrhea or weight loss, or with extra-intestinal manifestations involving the skin, bones, or neurology. Diagnosis involves serologic testing for antibodies against tissue transglutaminase followed by small intestinal biopsy demonstrating mucosal damage that improves with a gluten-free diet.
- Nut allergy is commonly caused by peanuts and tree nuts and can cause anaphylaxis. Peanut allergy prevalence is 0.5-2.5% in children in the UK and tree nut allergy prevalence is 0.2-2.2%.
- Diagnosis involves taking a history, skin prick tests, nut-specific IgE levels, and oral food challenges. Skin prick tests ≥3mm or nut-specific IgE levels ≥15kU/L suggest allergy.
- Cross-reactivity between peanuts and tree nuts is common, so testing for multiple nuts is often recommended for those allergic to one type of nut. Component resolved testing for Ara h 2
Updates on Nutrition Labeling and Claims Regulations in the Philippines by Helena S. Alcaraz, RND, Msc, Food & Drug Administration, Philippines.
Presented at the 9th Seminar on Nutrition Labeling, Claims and Communication Strategies, August 4 ~ 5 August, Manila, Philippines.
The presentation may give you an idea abouth the disease, its pathophysiology, signs, symptoms, diagnosis, treatment....Thanks toall the websites which helped me to make this presentation.
FDA Philippines has adopted the Codex Guidelines on use of Health and Nutrition Claims since January 2007. The guidelines specify the allowed nutrient content claims and conditions for comparative and health claims on food labels. Nutrient profiling and sign posting are relatively new concepts being considered to help consumers identify healthier options, but more research is needed before imposing any mandatory rules.
Food additives are substances added to food to preserve or enhance qualities like flavor, appearance, and texture. They are used for preservation, nutrition, convenience foods, appealing foods, and to aid processing. Common direct food additives include preservatives, colors, emulsifiers, stabilizers, and sweeteners. Additives are regulated and assigned E numbers in Europe. The Joint FAO/WHO Expert Committee on Food Additives evaluates the safety of additives.
The document provides information about gastroesophageal reflux disease (GERD), including what it is, common symptoms, causes, potential dangers if left untreated, diagnostic methods, and treatment options. GERD is a chronic condition where stomach acid rises into the esophagus, commonly causing heartburn and regurgitation. Left untreated, it can damage the esophagus and increase the risk of esophageal cancer. Doctors may diagnose it based on symptoms or perform tests like endoscopy. Treatment includes lifestyle changes and medications like H2 blockers or proton pump inhibitors.
This document discusses food additives, including definitions, common types, and functions. It defines food additives according to WHO/FAO and Codex Alimentarius as non-nutritive substances intentionally added to foods in small amounts to improve properties like appearance, flavor, texture and storage. Common types of additives are vitamins, minerals, flavorings, colorings, and preservatives. Additives can be natural, manmade versions of natural substances, or artificial substances not found in nature. The document also lists some specific additives and their typical functions and products, such as sodium nitrate as a preservative, colorant and flavoring in meat processing.
This document provides an overview of healthy eating and nutrition. It discusses the importance of a balanced diet for growth and development. The main food groups are described, including carbohydrates, fruits and vegetables, grains and pulses, dairy, and meat, fish and eggs. It also touches on vitamins and minerals, reading food labels, and common myths about nutrition.
This document provides an overview of food additives and preservatives. It discusses how food preservation began with salting and smoking meats and how ancient civilizations used natural colorings and flavorings. The definition of a food additive is provided as any substance added to food during processing that affects the food's characteristics. Various types of additives are described, including colors, flavors, preservatives, thickeners, nutrients, and more. Their functions and examples are explained. Food additives are also classified as either intentional or unintentional.
This document presents information on food additives and their effects on human health. It discusses the objectives and types of learning, introduces different types and classifications of food additives, and outlines some of their advantages and potential side effects. It also provides examples of specific additives like caffeine, tartrazine, and saccharin and recommends acceptable intake levels. The document aims to educate about food additives and their impacts on our health.
This document discusses carbohydrate counting for managing diabetes. Carb counting involves following a meal plan that specifies grams of carbs per meal and snack, and using an insulin-to-carb ratio to determine insulin dosage. For those with type 1 diabetes, carb counting helps control blood sugar levels. Those with type 2 diabetes also need to count carbs to control portions and support weight loss through a balanced, limited sugar diet with regular physical activity. Common carb foods are listed along with serving size guidelines to estimate grams of carbohydrates from labels.
The document discusses various topics related to food and nutrition including:
- Nutrition is the study of nutrients found in foods and how the body uses them for health, growth, and repair.
- Food provides nutrients and is culturally defined. Common nutrients include carbohydrates, proteins, fats, vitamins, minerals, and water.
- Nutrients in food are broken down and absorbed to be used for energy, growth, maintenance, and repair through the process of digestion.
This document discusses food additives, which are substances added to food during production, processing, packaging, transportation or storage. It defines food additives and explains their need in foods for purposes like preservation, nutrition and appearance. It describes direct/intentional additives that are purposefully added and indirect/unintentional additives that become part of food unintentionally. It also provides examples of different types of direct food additives like preservatives, flavors, colors, thickeners and sweeteners; and discusses labeling, permissible limits and toxicity of food additives.
The document summarizes the key changes brought about by the Food Safety and Standards Act of 2006 in India. It established a single regulatory authority called the Food Safety and Standards Authority of India (FSSAI), replacing multiple existing regulatory bodies. This consolidated and strengthened the food safety standards and regulations in India. It also improved regulatory structures, monitoring systems, and justice dispensation related to food safety. However, challenges remain in fully implementing the new law such as setting science-based standards, developing surveillance and tracing systems, and building capacity through training and education.
as 60 % woman are Anemic and 50 % plus kids are anemic in Pakistan, This situation is alarming so we have taken the initiative for betterment of our Nation and service to humanity as 81 countries in the World have mandatory fortification. this is my presentation as consultant to Global Alliance to Improved Nutrition at Pakistan Flour Mills Association Head Quarters in Lahore.
A vegetarian diet excludes meat but can vary in the consumption of other animal products. The main types of vegetarians are vegans, who eat only plant foods, lacto-vegetarians who consume dairy but not eggs, and lacto-ovo vegetarians, the most common, who eat dairy and eggs. Less common are fruitarians, pescetarians, and pollo-vegetarians, who respectively focus on fruits, include fish, or eat poultry but not red meat.
Food additives are substances added to food to preserve flavor or enhance properties. They include colors, sweeteners, emulsifiers, antioxidants, and enzymes. Colors can be artificial like coal-derived Reds or natural from plant and animal sources. Sweeteners include natural sorbitol and stevia or artificial aspartame and saccharin. Emulsifiers like mono/diglycerides are used in products like margarine and ice cream. Antioxidants like vitamin C and E prevent oxidation. Enzymes aid processes like starch breakdown. Additives are regulated and assigned E numbers in the European Union.
Il mio intervento di apertura al convegno "Il futuro della panificazione artigianale: allergie e intolleranze alimentari", tenutosi il 31-05-14 alla "XI Sagra del pane tipico Gonnose" dal titolo "Allergie e Intolleranze: tra percezione e realtà."
Celiac disease is a multifactorial autoimmune disorder triggered by gluten exposure that affects the small intestine. It can present with gastrointestinal symptoms like diarrhea or weight loss, or with extra-intestinal manifestations involving the skin, bones, or neurology. Diagnosis involves serologic testing for antibodies against tissue transglutaminase followed by small intestinal biopsy demonstrating mucosal damage that improves with a gluten-free diet.
- Nut allergy is commonly caused by peanuts and tree nuts and can cause anaphylaxis. Peanut allergy prevalence is 0.5-2.5% in children in the UK and tree nut allergy prevalence is 0.2-2.2%.
- Diagnosis involves taking a history, skin prick tests, nut-specific IgE levels, and oral food challenges. Skin prick tests ≥3mm or nut-specific IgE levels ≥15kU/L suggest allergy.
- Cross-reactivity between peanuts and tree nuts is common, so testing for multiple nuts is often recommended for those allergic to one type of nut. Component resolved testing for Ara h 2
Updates on Nutrition Labeling and Claims Regulations in the Philippines by Helena S. Alcaraz, RND, Msc, Food & Drug Administration, Philippines.
Presented at the 9th Seminar on Nutrition Labeling, Claims and Communication Strategies, August 4 ~ 5 August, Manila, Philippines.
The presentation may give you an idea abouth the disease, its pathophysiology, signs, symptoms, diagnosis, treatment....Thanks toall the websites which helped me to make this presentation.
FDA Philippines has adopted the Codex Guidelines on use of Health and Nutrition Claims since January 2007. The guidelines specify the allowed nutrient content claims and conditions for comparative and health claims on food labels. Nutrient profiling and sign posting are relatively new concepts being considered to help consumers identify healthier options, but more research is needed before imposing any mandatory rules.
Food additives are substances added to food to preserve or enhance qualities like flavor, appearance, and texture. They are used for preservation, nutrition, convenience foods, appealing foods, and to aid processing. Common direct food additives include preservatives, colors, emulsifiers, stabilizers, and sweeteners. Additives are regulated and assigned E numbers in Europe. The Joint FAO/WHO Expert Committee on Food Additives evaluates the safety of additives.
The document provides information about gastroesophageal reflux disease (GERD), including what it is, common symptoms, causes, potential dangers if left untreated, diagnostic methods, and treatment options. GERD is a chronic condition where stomach acid rises into the esophagus, commonly causing heartburn and regurgitation. Left untreated, it can damage the esophagus and increase the risk of esophageal cancer. Doctors may diagnose it based on symptoms or perform tests like endoscopy. Treatment includes lifestyle changes and medications like H2 blockers or proton pump inhibitors.
This document discusses food additives, including definitions, common types, and functions. It defines food additives according to WHO/FAO and Codex Alimentarius as non-nutritive substances intentionally added to foods in small amounts to improve properties like appearance, flavor, texture and storage. Common types of additives are vitamins, minerals, flavorings, colorings, and preservatives. Additives can be natural, manmade versions of natural substances, or artificial substances not found in nature. The document also lists some specific additives and their typical functions and products, such as sodium nitrate as a preservative, colorant and flavoring in meat processing.
This document provides an overview of healthy eating and nutrition. It discusses the importance of a balanced diet for growth and development. The main food groups are described, including carbohydrates, fruits and vegetables, grains and pulses, dairy, and meat, fish and eggs. It also touches on vitamins and minerals, reading food labels, and common myths about nutrition.
This document provides an overview of food additives and preservatives. It discusses how food preservation began with salting and smoking meats and how ancient civilizations used natural colorings and flavorings. The definition of a food additive is provided as any substance added to food during processing that affects the food's characteristics. Various types of additives are described, including colors, flavors, preservatives, thickeners, nutrients, and more. Their functions and examples are explained. Food additives are also classified as either intentional or unintentional.
This document presents information on food additives and their effects on human health. It discusses the objectives and types of learning, introduces different types and classifications of food additives, and outlines some of their advantages and potential side effects. It also provides examples of specific additives like caffeine, tartrazine, and saccharin and recommends acceptable intake levels. The document aims to educate about food additives and their impacts on our health.
This document discusses carbohydrate counting for managing diabetes. Carb counting involves following a meal plan that specifies grams of carbs per meal and snack, and using an insulin-to-carb ratio to determine insulin dosage. For those with type 1 diabetes, carb counting helps control blood sugar levels. Those with type 2 diabetes also need to count carbs to control portions and support weight loss through a balanced, limited sugar diet with regular physical activity. Common carb foods are listed along with serving size guidelines to estimate grams of carbohydrates from labels.
The document discusses various topics related to food and nutrition including:
- Nutrition is the study of nutrients found in foods and how the body uses them for health, growth, and repair.
- Food provides nutrients and is culturally defined. Common nutrients include carbohydrates, proteins, fats, vitamins, minerals, and water.
- Nutrients in food are broken down and absorbed to be used for energy, growth, maintenance, and repair through the process of digestion.
This document discusses food additives, which are substances added to food during production, processing, packaging, transportation or storage. It defines food additives and explains their need in foods for purposes like preservation, nutrition and appearance. It describes direct/intentional additives that are purposefully added and indirect/unintentional additives that become part of food unintentionally. It also provides examples of different types of direct food additives like preservatives, flavors, colors, thickeners and sweeteners; and discusses labeling, permissible limits and toxicity of food additives.
The document summarizes the key changes brought about by the Food Safety and Standards Act of 2006 in India. It established a single regulatory authority called the Food Safety and Standards Authority of India (FSSAI), replacing multiple existing regulatory bodies. This consolidated and strengthened the food safety standards and regulations in India. It also improved regulatory structures, monitoring systems, and justice dispensation related to food safety. However, challenges remain in fully implementing the new law such as setting science-based standards, developing surveillance and tracing systems, and building capacity through training and education.
as 60 % woman are Anemic and 50 % plus kids are anemic in Pakistan, This situation is alarming so we have taken the initiative for betterment of our Nation and service to humanity as 81 countries in the World have mandatory fortification. this is my presentation as consultant to Global Alliance to Improved Nutrition at Pakistan Flour Mills Association Head Quarters in Lahore.
A vegetarian diet excludes meat but can vary in the consumption of other animal products. The main types of vegetarians are vegans, who eat only plant foods, lacto-vegetarians who consume dairy but not eggs, and lacto-ovo vegetarians, the most common, who eat dairy and eggs. Less common are fruitarians, pescetarians, and pollo-vegetarians, who respectively focus on fruits, include fish, or eat poultry but not red meat.
Food additives are substances added to food to preserve flavor or enhance properties. They include colors, sweeteners, emulsifiers, antioxidants, and enzymes. Colors can be artificial like coal-derived Reds or natural from plant and animal sources. Sweeteners include natural sorbitol and stevia or artificial aspartame and saccharin. Emulsifiers like mono/diglycerides are used in products like margarine and ice cream. Antioxidants like vitamin C and E prevent oxidation. Enzymes aid processes like starch breakdown. Additives are regulated and assigned E numbers in the European Union.
Il mio intervento di apertura al convegno "Il futuro della panificazione artigianale: allergie e intolleranze alimentari", tenutosi il 31-05-14 alla "XI Sagra del pane tipico Gonnose" dal titolo "Allergie e Intolleranze: tra percezione e realtà."
Allergie e Intolleranze Alimentari Documenti Condivisicercalanotizia
Allergie e Intolleranze Alimentari, documento condiviso. Intervento Dott.ssa Pinucca Omodeo (Asl Alessandria) e Dott. Stefano Pizzimenti (Asl di Pinerolo) a #etiche2015, 26 novembre, Camera di Commercio di Alessandria.
Alcat Workshop - Applicazione del test d’intolleranze - Milano, 26 gennaio 2013
Intervento del DR. Alessandro Scorba - Medico Chirurgo, Esperto in Intolleranze Alimentari.
Perchè le allergie sono in continuo aumento? L’allergia è una malattia ereditaria? Che cos’è un’allergia? Come possiamo contenere questa “epidemia” in continua crescita? Quali sono le cause di questa crescita allarmante? Quali sono le differenze tra allergia e intolleranza? Le risposte a queste e a molte altre domande ancora in questo approfondito articolo.
Perchè sono in continuo aumento soprattutto tra i bambini? Che cos’è realmente una intolleranza alimentare e quali disturbi provoca? Quali sono i sintomi? Quali le cause? Esistono soluzioni olistiche efficaci nel tempo? In questo articolo trovi le risposte a queste e a molte altre domande ancora.
Mari A. - Zennaro D. Allergologia nel III° Millennio: cosa è cambiato e cosa ...Gianfranco Tammaro
DOTT. MARI ADRIANO - DOTT.SSA ZENNARO DANILA (Sessione del 01/10/2015) - Convegno "Lunch Meeting al Pasteur: What's New In..." - dal 01/10/2015 al 10/12/2015 - Studio Pasteur - Viale Pasteur, 66 - Roma
Sito: www.asmad.net
Canale Youtube: https://www.youtube.com/channel/UCIggSJlnC77uDHuX5TUoFHg
slow medicine, choosing wisely, fare di più non significa fare meglio, medicina difensiva, disease mongering, Disturi, APEL, ferrando, www.ferrandoalberto.blogspot.it, www.apel-pediatri.it,
Come identificare le patologie legate agli
alimenti e quali opportunità di cura esistono?
Attraverso gli esami del sangue, il test ALCAT e nuove discipline come la nutraceutica
XXVII Congresso Nazionale dell'Associazione Nazionale Specialisti in Medicina dello Sport - Chieti 27-29 maggio 2011:
Le Intolleranze Alimentari e la Pratica Sportiva - a cura del Dr. Francesco Lampugnani
Applicazione del Test di Nutrigenomica come strumento di ausilio Clinico e Diagnostico:
Sindrome Metabolica
Predisposizione al Diabete di Tipo 2
Intolleranza al Lattosio e Glutine
Gluten Sensitivity
La salute Gastrointestinale II° Parte - Prof. VIncent CastronovoMetagenics Academy
Seconda parte della presentazione sulla salute gastrointestinale del Prof. Vincent Castronovo al Corso di Medicina Metabolica e Funzionale di Bologna - 3-4 Luglio 2015
Sorghum:an ancient, nutritious and healthly old world cerealLetizia Saturni
Sorghum is an ancient cereal that has been cultivated for over 5000 years. It is nutritious, providing carbohydrates, proteins, fibers, vitamins, minerals, and phytochemicals. It is considered a healthy cereal as it is gluten-free and may help manage conditions like celiac disease and gluten sensitivity. Sorghum is drought-tolerant and an important crop for food security, especially in Africa and Asia where over 500 million people rely on it as a dietary staple.
This document discusses the interaction between nutrients and genes in Celiac Disease from a nutrigenomic perspective. It describes how Celiac Disease has transitioned from a rare childhood disorder to a common autoimmune disease triggered by gluten in genetically susceptible individuals. It discusses how omics sciences can help elucidate relationships between bioactive molecules like gluten, genetic polymorphisms, and the human gut and immune system. Specifically, it focuses on how recent proteomic developments have furthered understanding of gluten toxicity and the roles of genes and the microbiome in disease risk.
This document appears to be a comic or graphic novel with no discernible text. In 3 sentences or less, I am unable to provide a meaningful summary as there is no clear language, context or narrative to summarize from the given document.
2. ALLERGIE L’ allergia è una reazione avversa a molecole estranee all’organismo mediata dal sistema immunitario. Dr.ssa Letizia Saturni I virus, batteri, funghi o proteine estranee sono definiti allergeni .
3. Dr.ssa Letizia Saturni ALLERGIE La forma allergica più descritta e conosciuta nei suoi meccanismi biochimici è quella mediata dalle Immunoglobuline di tipo E . Y Y Y Le IgE in genere difendono l’organismo da virus e batteri e sono in grado di legarsi alla superficie dei mastociti, cellule ricche di istamina e eparina.
5. ALLERGIE Dr.ssa Letizia Saturni 2. Le IgE prodotte vanno a legarsi ad un recettore specifico sulla membrana dei mastociti 3. Quando ci sarà un secondo contatto con l’allergene si verificherà la vera reazione clinica mediata dal riconoscimento antigene-anticorpo e dalla degranulazione dei mastociti. Quest’ultima scatena una cascata di eventi associata alla liberazione di mediatori chimici – istamina - 1. Sensibilizzazione: produzione di IgE specifiche verso l’allergene
6. Al secondo contatto si avrà la vera reazione allergica con manifestazione clinica. riconoscimento antigene-anticorpo degranulazione dei mastociti e conseguente rilascio di mediatori chimici IgE Allergene Granuli di istamina Degranulazione Mediatori chimici Sintomi
7.
8.
9. ALLERGIE Le allergie agli alimenti sono dovute a molecole che vengono riconosciute come “estranee” dal sistema immunitario. Dr.ssa Letizia Saturni Gli allergeni possono essere molecole intrinseche all’alimento o estranee ad esso. Componenti dell’alimento Contaminanti Chimici o biologici Additivi che migliorano la palatabilità e la conservazione
10. LE CAUSE Uso indiscriminato di insetticidi, diserbanti, fitofarmaci Minor frequenza di allattamento al seno Sostituire precocemente il latte materno con alimenti di origine vegetale o animale può indurre sensibilizzazione nei confronti di componenti alimentari poiché l’apparato gastroenterico non ha ancora raggiunto una maturità funzionale Uso eccessivo di additivi alimentari Dr.ssa Letizia Saturni
11.
12. FATTORI di rischio Allergia alimentare Ereditarietà L’atopia (tendenza a sviluppare reazioni IgE-mediate) ha una incidenza superiore nelle famiglie con soggetti allergici Esposizione ripetuta all’antigene Permebilità gastro-intestinale Fattori ambientali La co-esposizione potenzia la manifestazione e alcuni soggetti allergici hanno sintomi più evidenti in alcune stagioni. Altri fattori possono essere FUMO – SMOG – STRESS – ESERCIZIO FISICO Dr.ssa Letizia Saturni
13. In condizioni fisiologiche…….. Gli alimenti contengono un numero elevato di molecole con potere di antigene (oltre 6000) ma solo in alcuni individui queste inducono sensibilizzazione Dr.ssa Letizia Saturni Sistema immunitario mucose acidità del succo gastrico enzimi del pancreas e dell’intestino motilità intestinale flora batterica enterica X
14. Esposizione ripetuta all’antigene E’ necessario il contatto con l’allergene contro cui produrre IgE. Nel caso degli alimenti tutte le proteine possono essere potenziali allergeni in quanto il SI le riconosce come un non sé Dr.ssa Letizia Saturni E’ pertanto indispensabile che si instauri un meccanismo in base al quale ciascun antigene alimentare viene identificato come “sostanza estranea inoffensiva” TOLLERANZA GALT (Tessuto Linfoide Associato all’Intestino)
15. ALIMENTO TOLLERANZA Tratto GI Normale attività proteolitica Dr.ssa Letizia Saturni Se frammenti proteici a PM medio-alto raggiungono la mucosa intestinale esiste un sistema di monitoraggio GALT IgAs in grado di legare e trattenere gli antigeni a livello mucosale - Immunità neonatale - Immunosoppressione - Patologie virali - Malassorbimento - Immunità neonatale - Patologie che compromettono la funzionalità enzimatica SENSIBILIZZAZIONE
17. La cross-reattività Cross-reattività reattività crociata è il fenomeno per cui un soggetto sensibilizzato ad un certo alimento risulta reattivo anche agli altri a cui non è mai stato esposto. La reazione si basa sul fatto che specie animali filologicamente vicine o vegetali della stessa famiglia botanica, hanno proteine con sequenze aminoacidiche simili, soprattutto nella zona del determinate antigenico. Esempi: soggetto allergico al latte vaccino, allergico alla carne di manzo Dr.ssa Letizia Saturni
19. Additivi alimentari o contaminanti Dr.ssa Letizia Saturni Salicilati Frutta secca, olive, arance, albicocche, uva, erbe aromache, vini Giallo tartrazina (E102) Bevande, salse confezionate, budini Anidride solforosa (E220) Marmellate, succhi, macedonie e insalate trattate con spray Nitrati Insaccati, carni. Tiramina componente naturtale di formaggi, cioccolato, banane Glutammati (da E620 a E623) Patatine, ketchup, insaccati, dadi Solfiti, metabisolfiti e bisolfiti (da E221 a E227) Cibi preconfezionati
20. SAGGI DIAGNOSTICI Tipo di test descrizione Dr.ssa Letizia Saturni In vivo In vitro Skin prick test E’ il più utilizzato soprattutto come primo test. Gli allergeni sono disponibili sotto forma di estratti fluidi o in sospensione colloidale. Es. Prick by prick Oral challenge Non fornisce spiegazioni sul tipo di meccanismo immunologico ma di certo è il più utile. Richiede ospedalizzazione ed un attento monitoraggio del pz. per 24-48 ore. Double-blind placebo controlled food challenge - DBPCFC Potenzialmente molto pericoloso, difficili da interpretare ed eseguire. Richiede opsedalizzazione e né il medico né il pz sanno se si sta somministrando alimento o placebo. PRIST, RAST Test che dosano le IgE sieriche specifiche per i vari alimenti Test di citotossicità Test eseguito su sangue intero o con leucociti isolati del pz. allergico
21. SAGGI DIAGNOSTICI Tipo di test descrizione Dr.ssa Letizia Saturni Non convenzionali Test DRIA Si basa sullo studio delle variazioni del tono muscolare del quadricipite femorale in rapporto all'assunzione di cibi intolleranti. Test Kinesiologico Gli esperti di osteopatia, chiropratica e posturologia affermano che è possibile anche una valutazione diretta e manuale del tono muscolare, senza l'impiego di strumenti di rivelazione Test EAV: Vega test, Sarm test, Bio Strengt Test Sviluppatosi a partire dalle osservazioni dell'elettroagopuntura secondo Voll, si basa sulle variazioni del potenziale elettrico cutaneo in relazione al contatto con alimenti intolleranti. York Foodscan Test che determina, attraverso un semplice prelievo di sangue, la presenza di particolari anticorpi, le immunoglobuline G (IgG), prodotte nei confronti di più di 100 alimenti.
23. INTOLLERANZE L’ intoleranza o ipersensibilità alimentare è in relazione ad un difetto enzimatico o all'azione, in individui predisposti, di alcune sostanze farmacologicamente attive presenti negli alimenti. Dr.ssa Letizia Saturni intolleranze enzimatiche intolleranze farmacologiche
24. Dr.ssa Letizia Saturni Le intolleranze farmacologiche vengono definite anche come reazioni pseudoallergiche (PAR), perché esistono molte somiglianze a livello clinico con le allergie mediate dagli anticorpi specifici (IgE). Le intolleranze alimentari e la manifestazione sintomatologica conseguente sono sempre dose correlate e questo aiuta nella distinzione dalle allergie vere nelle quali i sintomi sono scatenati già dall'assunzione di piccole quantità di alimento responsabile.
25. INTOLLERANZA o ALLERGIA? ? Tempi di manifestazione dei sintomi Dal momento del contatto con l’allergene i tempi di comparsa dei sintomi sono brevi nel caso dell’allergia mentre sono lunghi, anche alcuni giorni, nel caso dell’intolleranza Dr.ssa Letizia Saturni Produzione di anticorpi Nell’allergia si ha produzione di IgE Nell’intolleranza si ha un deficit enzimatico
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29. INTOLLERANZA AL GLUTINE L’ intolleranza al glutine o morbo celiaco o celiachia è una enteropatia immuno-mediata causata da una permanente intolleranza al glutine , che è responsabile della reazione tossica nell’intestino. Questa comporta una profonda alterazione delle pareti dello stesso e una conseguente compromissione dell’assorbimento intestinale. Ne risulta quindi alterato lo stato nutrizionale del soggetto. Dr.ssa Letizia Saturni
30. FATTORI AMBIENTALI (glutine) SANO STILE DI VITA CORRETTA ALIMENTAZIONE Fattori biochimici ( anti-endomisio, anti-gliadina, anti-trasglutaminasi ) Patologie associate diabete, alterazioni della tiroide, dermatite erpetiforme, artrite reumatoide, osteoporosi Il “puzzle” della celiachia Dr.ssa Letizia Saturni Celiachia Intolleranza intestinale permanente FATTORI GENETICI (HLA-DQ2 e HLA-DQ8) HLA ? ?
34. Che cos’è il glutine? Il glutine rappresenta la frazione proteica principale nel frumento ed in altri cereali (orzo, segale, spelta, seitan, kamut, farro e avena). Dr.ssa Letizia Saturni FATTORE AMBIENTALE
35. Il frumento è il cereale più utilizzato in Italia e le specie più coltivate sono IL GLUTINE GRANO TENERO pane GRANO DURO pasta
36. Sul piano nutrizionale i cereali rappresentano ottime fonti di carboidrati complessi e in misura inferiore di proteine. Il frumento contiene circa il 12% di proteine di cui l’85% è GLUTINE . IL GLUTINE È una massa proteica di consistenza elastica che rimane dopo aver rimosso l’amido dall’impasto della farina.
38. Dr.ssa Letizia Saturni IL GLUTINE GLUTINE GLUTENINE PROLAMINE - gliadine nel frumento – ordeine nell’orzo – secaline nella segale = +
39. In soluzione acquosa si formano legami intramolecolari tra le gliadine e le gluteine che portano alla formazione di un reticolo proteico tridimensionale. Catassi C. , Il glutine questo sconosciuto – Celiachia notizie 2: 18 -2004 Questo conferisce coesività , elasticità e resistenza . Nella rete rimangono intrappolati i granuli di amido e i gas della fermentazione. IL GLUTINE
40. Dr.ssa Letizia Saturni IL GLUTINE Il glutine non ha un valore biologico elevato poichè è povero in aminoacidi essenziali - lisina e metionina - mentre è ricco in prolina e acido glutammico.
41. Le GLIADINE (frazione proteica dei cereali estratta in soluzione acquosa di etanolo) possono essere classificate in , , e -gliadina con pesi molecolari variabili (20 – 75KDalton) La loro comune caratteristica è la presenza di sequenze peptidiche ad elevato contenuto di prolina e gluammina . Dr.ssa Letizia Saturni LE PROLAMINE
43. Ai fini della tossicità per il celiaco è importante l’acido glutammico, dato il suo effetto lesivo . Tale effetto, è stato oggi accertato, che non è solo a carico delle gliadine ma anche della glutenina è dunque preferibile riferire la tossicità al glutine “in toto”. TOSSICITA’
44. Il glutine ha un ruolo primario IL RUOLO DEL GLUTINE Nella produzione di sfarinati di varia natura ma soprattutto nel pane Nell’industria alimentare che lo utilizza quale additivo proteico in vari alimenti confezionati