Heather MacKenzie

How do teenagers manage their food allergies

Background The peak incidence of deaths from anaphylaxis associated with nut allergy occurs in teenagers and young adults. During adolescence, the management of food allergy shifts from being the responsibility of parents to that of the young person. This is a group who therefore need special attention in the clinic.

Teenagers’ experiences of living with food hypersensitivity: A qualitative study

MacKenzie H, Roberts G, Van Laar D, Dean T. Teenagers’ experiences of living with food hypersensitivity: A qualitative study.
Pediatr Allergy Immunol 2010: 21: 595–602.
© 2009 John Wiley & Sons A/S

A new quality of life scale for teenagers with food hypersensitivity

To cite this article: MacKenzie H, Roberts G, Van Laar D, Dean T. A new quality of life scale for teenagers with food hypersensitivity. Pediatr Allergy Immunol 2012: 23: 404–411.

Quality of life in children and teenagers with food hypersensitivity

Given that food is essential for life and that there is currently no cure for food hypersensitivity (FHS), quality of life is a key outcome measure for those affected. The quality of life of children and teenagers with FHS is particularly important given that they must learn to manage their FHS while also contending with normal developmental challenges. This article will review the current state of quality of life research in this important area, and discusses the impact of FHS on the quality-of-life of children and teenagers, the availability and suitability of disease-specific health-related quality-of-life measures for this population, and the identification of factors that may influence their health-related quality of life. Two previous reviews have been conducted in this area, and this article aims to extend this work by including recent publications and qualitative studies on this topic.

Prevalence Of Fish and Shellfish Allergy- A Systematic Review

BACKGROUND Accurate information on the prevalence of food allergy facilitates a more evidence-based approach to planning of allergy services and can identify important geographic variations. OBJECTIVE To conduct a systematic review to assess the age-specific prevalence of fish and shellfish allergy worldwide. METHODS Searches were conducted using Web of Science and PubMed. Population-based cross-sectional studies and cohort studies that examined the prevalence of fish and shellfish allergy (IgE mediated and non-IgE mediated) at an identifiable point in time were eligible for inclusion in the study. Reviewers extracted general study information and study design, type of food allergy considered, food(s) assessed, method of diagnosis, sampling strategy, and sample characteristics. Raw data were extracted and percentage prevalence and 95% confidence intervals calculated. RESULTS A total of 7,333 articles were identified of which 61 studies met the inclusion criteria and were included in this review. The prevalence of fish allergy ranged from 0% to 7% and the prevalence of shellfish allergy from 0% to 10.3%, depending on the method of diagnosis. Where food challenges were used, the prevalence for fish allergy was found to be 0% to 0.3% and for shellfish allergy was 0% to 0.9%. CONCLUSION Few studies have established the prevalence of fish or shellfish allergy using the gold standard double-blind, placebo-controlled challenge criteria, with most instead relying on self-reported questionnaire-based methods. The limited data available suggest that fish allergy prevalence is similar worldwide; however, shellfish allergy prevalence may be higher in the Southeast Asia region.

Information and support from dietary consultation for mothers of children with food allergies

BACKGROUND Professional dietetic input is essential to ensure that children with diagnosed food allergies have an individualized avoidance plan and nutritionally adequate diet. However, it is not clear what dietary information and support parents require. OBJECTIVE To explore what information and support parents of children with food allergies require from a dietary consultation. METHODS Focus groups were conducted with 17 mothers who attend an allergy center for dietary advice for their food allergic child. A number of issues around food allergy dietary advice needs were explored and analyzed using thematic analysis. RESULTS Six themes were identified. The mothers described how they sought to protect their child from harm, to maintain normality for their child, and to promote child independence. They described needing to become an expert in their childs food allergy and fight their corner when needed. The dietitian supported their needs by ensuring their childs diet was safe and nutritionally adequate and giving information and support to help them provide a normal life for their child. Dietitians also taught mothers about food allergy and provided advocacy and emotional support. CONCLUSION Mothers of children with food allergies want to understand how to provide a nutritionally adequate, allergen-safe diet while maintaining a normal life. Hence, mothers value a range of support from dietitians, including monitoring their childs health and providing information, practical advice and support, and emotional support.

Food allergy competencies of dietitians in the United Kingdom, Australia and United States of America

BackgroundA knowledgeable and competent dietitian is an integral part of the food allergy multidisciplinary team, contributing to effective diagnosis and management of food allergic disorders. Little is currently known about the food allergy training needs and preferences of dietitians. The purpose of this paper is to measure and compare self-reported food allergy competencies of dietitians based in the UK, Australia and USA.MethodsA survey of USA-based paediatric dietitians was developed to measure self-reported proficiency and educational needs in the area of food allergy. The survey was modified slightly and circulated online to paediatric and adult dietitians in the UK and Australia. Descriptive statistics and Pearson correlations are presented.ResultsA total of 797 dietitians completed the questionnaire. Competency in “developing food challenge protocols” and “managing feeding problems” were rated the poorest overall across all three settings. A higher level of competency was significantly positively associated with length of practice as a dietitian, percentage of caseload composed of patients with food allergy and training in food allergy. The most popular topics for further training were food additives, pharmacological reactions and oral allergy syndrome.ConclusionsThere is a need amongst dietitians to increase their knowledge in different aspects of food allergy diagnosis and management, specifically the areas of developing food challenge protocols and management of feeding problems. This study provides valuable information for designing targeted food allergy education for dietitians.

Factors influencing food choices of food-allergic consumers: findings from focus groups

Up to 35% of the population modify their diet for adverse reactions to food. This study described the food choice behaviour of diagnosed food‐allergic (DFA), self‐reported food‐allergic or intolerant (SFA) and nonfood‐allergic (NFA) consumers, and explored differences between them.

An exploratory investigation of food choice behavior of teenagers with and without food allergies

BACKGROUND Understanding food choice behavior in adolescence is important because many core eating habits may be tracked into adulthood. The food choices of at least 2.3% of teenagers living in the United Kingdom are determined by food allergies. However, the effect of food allergies on eating habits in teenagers has not yet been studied. OBJECTIVE To provide an understanding of how teenagers with food allergies make food choice decisions and how these differ from those of non-food-allergic teenagers. METHODS One focus group discussion with non-food-allergic teenagers (n = 11) and 14 semistructured interviewers (7 with food-allergic and 7 with non-food-allergic teenagers) were performed (age range, 12-18 years). The focus group discussion and interviews were audiorecorded, transcribed verbatim, and analyzed using thematic content analysis. RESULTS Teenagers from both groups (food-allergic and non-food-allergic) named sensory characteristics of foods as the main reason for choosing them. Some food-allergic teenagers downplayed their allergy and frequently engaged in risk-taking behavior in terms of their food choices. However, they reported difficulties in trying new foods, especially when away from home. Parental control was experienced as protective by those with food allergies, whereas non-food-allergic teenagers felt the opposite. Most teenagers, including food-allergic ones, expressed the wish to eat similar foods to their friends. Other themes did not vary between the 2 groups. CONCLUSION Food-allergic teenagers strive to be able to make similar food choices to their friends, although differences to non-food-allergic teenagers exist. It is important to address these differences to improve their dietary management.

Relationship between maternal and child behaviors in pediatric food allergy: an exploratory study

In children with food allergies, the development of food habits and preferences takes place in the context of their continuing condition. Mothers often have primary responsibility for the dietary management of their childs allergies in early childhood. Although few studies have addressed mother–child interactions in the food allergy literature, research in the pediatric chronic illness literature and in the literature with healthy children indicate that, in early childhood in particular, developmentally typical feeding difficulties include transient food preferences, picky or fussy eating, and food refusal, which are stressful for parents and a potential cause of interaction difficulties. Collectively these findings point to the importance of redressing the neglect of mother–child interactions in early childhood in the context of food allergies.