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Sanjay Gupta MD
How To Protect Your Family From Food Allergies; Gastric Bypass Surgery May Be Riskier Than Previously Thought; College Freshman Gaining More Weight
Aired October 22, 2005 - 08:30 ET
THIS IS A RUSH TRANSCRIPT. THIS COPY MAY NOT BE IN ITS FINAL FORM AND MAY BE UPDATED.
TONY HARRIS, CNN ANCHOR: Now in the news, Hurricane Wilma is a Category 3 storm right now, but it is steadily weakening. The latest advisory puts winds at 120 miles an hour. The storm pounded Mexico's Yucatan Peninsula early this morning.
The 400 mile wide storm is now drifting to the north near Cancun. The storm could hit Florida's southwest coast late Sunday or early Monday.
Meanwhile, Hurricane Wilma drenched resort areas of Cozumel and Cancun. Reported wind gusts of up to 150 miles per hour, combined with heavy rain reduced visibility to near zero. More than 20,000 tourists were ordered out of the area. Forecasters say the wind and rain may not let up for another day.
HOUSECALL is up next, taking a closer look at ways you can protect yourself and your family from food allergies. Betty and I will be back at the top of the hour with much more on Hurricane Wilma. HOUSECALL begins right now.
SANJAY GUPTA, CNN SENIOR MEDICAL CORRESPONDENT: Hello and welcome to HOUSECALL. An estimated 11 million Americans suffer from food allergies. Today on HOUSECALL, we're going to be taking a closer look at the prevalence of food allergies and how you can protect yourself and your children.
Let's begin with the story of a young Canadian girl and her tragic odyssey with food allergies. Here's Sabrina's story.
GUPTA (voice-over): For the first 13 years of her childhood, Sabrina Shannon never did what most school kids take for granted, eat cafeteria food.
MIKE SHANNON, SABRINA'S FATHER: It was very rare, very, very rare that we'd actually stop in a restaurant and eat.
GUPTA: Sabrina was allergic to milk, soy, and peanuts. Even a small amount could cause a dangerous reaction called anaphylaxis or anaphylactic shock.
When she had reactions, epinephrine injected quickly in the thigh with an Epipen was key. It bought her time to get through the hospital. What's going through your time each time one of these anaphylactic reactions occur?
SARA SHANNON, SABRINA'S MOTHER: What's going through my mind is the need for fast action, that I have to give the Epipen right away.
GUPTA (on camera): In elementary school, Sabrina would make a short walk home every day for a safe lunch guaranteed. But on September of 2003, she and her friends graduated to high school a bus ride away. Being a teenager meant more autonomy and more danger.
(voice-over): Her fourth week of high school, Sabrina surprised her mother, who made her a safe lunch every day.
S. SHANNON: And she said I'm not eating another sandwich, mom. I can eat the french fries, I've checked. And I have already eaten them. It's something I ate just this Friday and they're fine, mom. I checked. There's no peanut or soy or dairy in these french fries. It's fine.
GUPTA: Sabrina ate the cafeteria fries, but shortly after complained she wasn't feeling well and went to the principal's office.
UNIDENTIFIED MALE: Sir, it's my asthma, it's my asthma. I can't breathe. I can't breathe.
GUPTA: Sabrina thought she was having an asthma attack and used her inhaler, but she was really having an allergic reaction.
UNIDENTIFIED MALE: She became unconscious right there and was taken down to the floor by one of the staff members. CPR was quickly started.
GUPTA: Sabrina's friend went with her teacher to get Sabrina's Epipen from unlocked locker.
UNIDENTIFIED MALE: I administered the Epipen in her thigh, but the unfortunate part was too late. She was already unconscious.
GUPTA: Too much time had apparently gone by for the Epipen to work. The coroner's investigation found that the cafeteria fries Sabrina ate most likely had residue of dairy from tongs that had also served cheese.
Sabrina's story became a rally rallying cry for improved school safety and allergy awareness.
S. SHANNON: Just being conscientious on how you're preparing the foods and being careful to avoid, you know, reduce the risk of contamination and cross contamination. And also, if there was proper training with the school in how to use the Epipen and how to recognize the signs and symptoms and better communication with the school community. Perhaps Sabrina would still be living today.
PETER ADAM, PRINCIPAL, BISHOP SMITH HIGH SCHOOL: We thought we were prepared. We thought we were prepared for everything. We had a policy in place. We had an anaphylaxis policy for years here. And we knew Sabrina. And we knew her condition. It's just that a number of circumstances took place that just did not seem to get us to where we wanted to be.
GUPTA: With food allergies on the rise, Ontario-proposed legislation requiring schools to reduce the risks for those students. Sara Shannon testified at a hearing.
S. SHANNON: I promised Sabrina while she was dying on her deathbed, I'd do everything possible to prevent this tragedy from happening again to another family or another child.
GUPTA: When the measure passed it was named Sabrina's Law.
UNIDENTIFIED MALE: The ayes are 10 to 5. The nays are zero. I declare the motion carried.
GUPTA: Do you think that you and Sabrina together have saved lives?
S. SHANNON: We'll never know how many lives we'll save, but these - with Sabrina's Law in place, I know that everything's being done to prevent this tragedy from happening to another child.
GUPTA: More than 150 Americans die each year from severe allergic reactions to foods just like Sabrina did. Ninety percent of those reactions are caused by eight main foods: milk, eggs, peanuts, tree nuts such as walnuts or cashews, fish, shellfish, soy, and wheat.
Joining us to talk more about food allergies is Dr. Hugh Sampson. He's director of the Jaffey Food Allergy Institute at Mount Sinai School of Medicine.
Welcome, doctor, first of all. I know you're very busy, so I appreciate your time.
HUGH SAMPSON, DR., MOUNT SINAI SCHOOL OF MEDICINE: Well, thank you.
GUPTA: Listen, there's a perception out there that food allergies are on the rise in the United States and other developed countries. Is that true? And why is that happening?
SAMPSON: There certainly does appear to be an increase in the U.S. We had just finished a survey on the prevalence of peanuts and tree nuts in the U.S. separated by a five year time period, 1997 to 2002.
And during that period, in the children less than five years of age, we saw a doubling of peanut allergy. This has also been seen in other countries as well. The U.K., as well as Canada. Why it's happening, we're not exactly sure. We think it has something to do with the way we prepare our foods. For example, with peanut, we tend to dry roast it in our country as opposed to many other countries where they're frequently boiled. And we think something related to our preparations, the early exposure in health foods may be part of the cause.
GUPTA: OK. Well, we're going to drill down on this a little bit because I think it's important for people to understand not only that they're going up, but also how to maybe prevent them.
Let's get to an e-mail question now from Linda in Missouri. She asks this, "What is the difference between a milk allergy and lactose intolerance?" Specific question, doctor, the difference between allergy and intolerance?
SAMPSON: An allergy is where your immune system reacts against a food in an abnormal way, such as having this allergic reaction or potentially anaphylaxis
An intolerance is not involving the immune system. It's in this case where you lack a certain enzyme, lactase to break down the lactose that's present in milk, which will give you the sensation of bloating, stomach cramps, and possibly diarrhea.
GUPTA: OK, let's keep on topic here. Let's move on to another e-mail. This one specifically about outgrowing egg allergies. Shane in Eldridge, Iowa, asked this. "I found out I was allergic to eggs when I was four years old. I'm now 24 years old and I've heard most people outgrow egg allergies." Is there a good way to test whether he's still allergic? Doctor, what do you tell him?
SAMPSON: Right. About 80 percent of individuals will outgrow egg allergy. And typically, we see them outgrow it in the first decade of life.
The simplest thing to do would be to see an allergist who might perform skin testing, see whether or not there's a presence of the allergic antibody still there. We also will sometimes do a blood test, which will actually quantitate the amount of allergic antibody to egg.
If these are very low, the allergist would then go on to do a challenge, where you would actually feed the patient egg to see whether or not they'd actually outgrown it.
GUPTA: But important point. He shouldn't go ahead and eat eggs without going through those tests first, is that right?
SAMPSON: Absolutely right. This is not something you want to do on your own.
GUPTA: OK, don't test this at home without talking to the doctor first. Another e-mail on egg allergy. Specifically Siobhan from Woodbridge, Virginia asks, "My son has a severe egg allergy. Can he get a flu shot?" A lot of people asking about flu shots now. Doctor, what is the relationship here?
SAMPSON: Right. The flu vaccine is actually grown in egg protein. So there is some residual egg protein in the vaccine. There is a difference from lot to lot. Some lots have very low levels.
Typically, you can go to your allergist and they will test a particular lot and see whether or not it can activate the allergic reaction. If there's very little egg it can be given, otherwise we can actually do a desensitization routine, so that even a highly egg allergic patient could still receive the flu vaccine.
GUPTA: OK, that's good to know. So there's still options available even for people who do have egg allergies. Lots of good information. We're talking with Dr. Hugh Sampson.
Coming up, can kids inherit your food allergies? That answer and more coming up on HOUSECALL.
UNIDENTIFIED FEMALE: Kids and common foods, from peanuts to shellfish, when is the right time to have kids give them a try? That's after the break.
First, take today's quiz. What is the most common cause of deadly food allergies? A, milk; B, peanuts; C, shellfish; or D, eggs? Stay tuned for the answer.
UNIDENTIFIED FEMALE: Before the break we asked, what is the most common cause of deadly food allergies? A, milk; B, peanuts; C, shellfish; or D, eggs? The answer is b, peanuts.
GUPTA: Welcome back to HOUSECALL. As we just learned in the quiz, peanut allergies are the most common and the most deadly food allergy as well.
And we're joined again by Dr. Hugh Sampson to help answer your e- mail questions. And let me say as well, doctor, you've just received a $17 million grant to come up with a vaccine for peanut and other food allergies. Is a vaccine something that's on the horizon, doctor?
SAMPSON: We think so. We're now - we've studied it fairly extensively in animal models. And we're now getting the vaccine prepared in special facilities, so that we will hopefully start the clinical trials some time next year.
GUPTA: And so how would it work, then? Would everybody get this vaccine or would it just be somebody who has a known food allergy or how that would work exactly?
SAMPSON: Initially the vaccine is directed specifically for peanut. So we would be starting in an adult population with peanut allergy, first looking at the safety and how well it does reverse peanut allergy. Then we would be moving on to study some children. If this works, we can then do similar vaccines with other foods as well. GUPTA: Fascinating. I wish you the best of luck with that vaccine trial. We've got lots of viewer e-mails lined up.
Here's one from Yvonne in Florida. "I have heard that if a pregnant woman eats a lot of peanuts, the baby will be born with food allergies." Is this true, doctor?
SAMPSON: Not necessarily food allergy in general, but there is some concern that if you come from a family that has a lot of allergy, and the mother eats peanuts during pregnancy, that the child may become sensitized.
The evidence on this is not very clear. What does appear more clear is that if the mother is ingesting peanuts while breast-feeding, that some of the peanut protein will be transmitted in her breast milk to the baby. And the baby may become sensitized from this.
GUPTA: And just - because I want to clarify this for our viewers, some people say that if you're eating more of the thing that you might be allergic too, peanuts, in this case, that you might become sort of desensitized in the sense that you'd be developing an immunity towards peanut allergies.
But you're saying it really sort of goes the other way. So if the pregnant mom or the breast-feeding mom eats peanuts, then it might cause more of a likely to have an allergy.
SAMPSON: Right now that is the going opinion. There is a lot of discussion about what is the better way to go. There is something called high dose tolerance with the idea that if you feed somebody enough of a protein, you might in fact desensitize them.
But right now, the evidence on that is not clear. There are studies that are going to be underway very soon to look at that question.
So right now the American Academy of Pediatrics, for example, is recommending avoidance of peanut in families where there is a high risk of developing allergy.
GUPTA: OK, so that's the best advice for right now, avoidance.
We've got time for one more question before the break. Scott in Illinois asked this. "At what age should a child be able to eat peanuts?" And doctor, you yourself, I understand, had a child with severe foot allergies. So what's your advice on that?
SAMPSON: If you come from a high risk family, meaning that somebody in the family has asthma, eczema, or allergic rhinitis, or there is another child or individual with food allergy, we would recommend delaying the introduction of some of these foods such as peanut.
If you have no high risk factors, then we're not recommending any prolonged period of time of avoidance and would just recommend introducing foods as you normally would. GUPTA: Specific age? And you say delay it, what does that mean?
SAMPSON: Oh, I'm sorry. We would ask that they hold off until about three years of age.
GUPTA: Three years of age. OK, we're talking with Hugh Sampson. Lots of good information here. And more of your e-mails about food allergies still to come up on HOUSECALL.
UNIDENTIFIED FEMALE: Going out to eat isn't such a treat when you have food allergies. Some tips to stay healthy and stay safe when you don't eat at home. That's coming up next.
But first, this week's medical headlines in "The Pulse."
ELIZABETH COHEN, CNN CORRESPONDENT (voice-over): New studies in the "Journal of the American Medical Association" say gastric bypass surgery may carry more risks than previously thought. One study showed that for every 100 people who had gastric bypass surgery, two died in the first month after surgery and nearly five died in the first year. Researchers say these numbers were higher than expected.
In the procedure, surgeons stapled the stomach, making it smaller, forcing patients to eat less. Researchers also found patients were twice as likely to end up in the hospital in the year after surgery, compared to the year before.
Doctors say the surgery really is the only option for some, but surgeons need to work harder to make the procedure safer for the patient.
Elizabeth Cohen, CNN.
GUPTA: We're back with HOUSECALL. Going out to a restaurant could be dangerous if you have food allergies. So here are some tips to keep you safe when eating out.
First, tell your server about the allergies. They're going to be your first line of defense. Ask the server lots of questions as well. Choose your restaurant wisely. Buffets, bakeries, and restaurants that didn't cook from scratch are recipes for food allergy disasters. Too many unknowns in the kitchen. And order simple dishes. A plain baked potato or steamed broccoli are some safe, maybe boring, but still safe examples.
Finally, get your sauce on the side. Gravy and other toppings can be full of hidden allergens.
We're joined again by Dr. Hugh Sampson. He's a food allergy expert at the Mount Sinai Medical Center.
And doctor, lots of good information there. As you know, MSG is being used by some restaurants to flavor foods. And that led to an e- mail question from Carol in New York who things she might be allergic.
"Every time I make a mistake and eat something with MSG in it, I get a headache and feel terrible. It usually lasts at least 24 hours. No over-the-counter medication seems to help. Is there anything else I could do to feel better?"
So, you know, going back doctor, is this an allergy or an intolerance?
SAMPSON: This is really an intolerance. And the exact mechanism is not fully understood, but it does not appear to involve the immune system. And basically right now, the only thing we can recommend is that people be very careful and to try to avoid exposure.
GUPTA: Yes, and I think having those discussions with your wait staff and choosing your restaurants wisely may help with that.
Let's keep going here. Let's move on to another e-mail. This one comes from Joe in New Jersey who wants to know this. "I seem to be allergic to many fruits. Could this be due to the pesticides? Should I see an allergist?" What would you tell Joe, doctor?
SAMPSON: I would suggest he see an allergist. I think it's more likely that he has an - something called Oral Allergy Syndrome. And this is where we see cross reactivity between protein and birch pollen, which is fairly common in the Northeast area and several proteins in several of the fruits.
So for example if he were to eat a raw apple, he would get itchiness in his mouth, his throat, may get a feeling of some swelling in his lips and his tongue.
Typically, this doesn't go on to a severe anaphylactic reaction. If the fruit is cooked, it destroys the protein that cross react, and they'll do very well.
GUPTA: OK. Hope that helps you, Joe.
Coming up, Web sites you're not going to want to miss if you've got food allergies. Plus, we're headed to college cafeterias as well after the break.
UNIDENTIFIED FEMALE: Is the freshman 15 becoming the freshman 20? We're checking in on campus co-eds after the break.
GUPTA: Welcome back. Here at HOUSECALL, we're committed to the growing problem of childhood obesity. In this week's "Get Going" segment, we look at the problem of weight gain in college. Has the freshman 15 turned into the freshman 20? .
SANJAY GUPTA, HOST (voice-over): Researchers at Cornell University found that a group of 60 freshmen gained an average of six pounds over 12 weeks.
If you kept gaining at that rate throughout the school year, you'd end up 20 pounds heavier. The main reasons for putting on the pounds, the all you can eat mentality and being influenced by your environment. We asked Georgetown University students about their campus' challenges.
MIRA DEWJI, STUDENT, GEORGETOWN UNIVERSITY: I gained about 7 to 10 pounds my freshman year. And that was basically because I had access to french fries, to hamburgers, to pizza rather than home cooked meals.
UNIDENTIFIED FEMALE: In socializing and meeting new people it's always around food. I remember every event was around free food. Ice cream social, free food.
UNIDENTIFIED FEMALE: I did quite a losing battle with the freshman 15. And I think a lot of it for me was stress related. It was just a comfort, you know, way to deal with the stress.
GUPTA: Research nutritionist Rose Collins says it all boils down to awareness.
ROSE COLLINS, RESEARCH NUTRITIONIST: Your clothes start to get tight, you know, that you're putting on a few pounds. And it's time to take a look and see where you're getting those extra calories from.
GUPTA: Good old-fashioned balance.
COLLINS: You do want to try to eat within about an hour of waking up and then about every three to five hours have some kind of a meal or a snack. And to try keep balanced, watch your portions. Still, you know, keep up with fruits and vegetables. Try to eat some for every lunch or every dinner.
GUPTA: Collins advises to eat before parties to avoid filling up on alcohol or sugary drinks, but there's always temptation.
DEWJI: The cafeteria has like unlimited options. And you're always tempted to have dessert. You're always tempted to order pizza late at night.
GUPTA: Being at college also means learning discipline and good exercise habits to avoid gaining too much weight or developing an eating disorder.
GUPTA: Hopefully that discipline will last later into life as well. After the break, more information on today's HOUSECALL topic. Food allergies.
First, a tip though for the Feeling Fit in this edition of the "Bod Squad."
(BEGIN VIDEOTAPE) UNIDENTIFIED FEMALE (voice-over): An essential part of any exercise routine or diet is staying properly hydrated. So how much fluid is enough? Registered dietitian and author Ellie Krieger says that amount is a very individual thing.
ELLIE KRIEGER, REGISTERED DIETICIAN: The amount of fluid that you need throughout the day depends on your size, your body weight, the temperature in which you're living and also your activity. The National Academy of Science recommends for the average woman the adequate intake is nine 8-ounce glasses a day and the average man, 13- ounce glasses a day. Now that's total fluid, not just water.
UNIDENTIFIED FEMALE: Juice, smoothies, milk, and even coffee count, too,
KRIEGER: The latest studies indicate that caffeinated beverages actually do contribute to your hydration. You don't have to have a water bottle strapped to your hip all day long
It is a good idea to get most of your fluid intake from water. It has no calories it's all natural. And also, studies show that it does have an extra preventative effect in terms of a number of diseases.
UNIDENTIFIED FEMALE: Thanks, Ellie. For the "Bod Squad," Kelly Callahan (ph), CNN.
GUPTA: For more on food allergies, click on the food allergy and aphylaxis network Web site. That's at www.foodallergyorg. You're going to find allergy alerts and lists of which foods to watch out for.
And speaking of foods to watch out for, sometimes it is difficult when you go to the grocery store to figure out all those labels. There's so many different names on there that can be challenging with someone with food allergies.
And Dr. Hugh Sampson, who's been our guest today, what do you say about that? Is that about to change?
SAMPSON: Yes. On January 2006, the new food labeling law is going to come into effect. Initially, it may be a little bit difficult, but it - what it's going to do is put the names of foods in common language, so milk will be milk, not caseinate, sodium caseinate. So it should be much easier.
GUPTA: Yes, that does sound a lot easier, the milk versus the caseinate. Unfortunately, that's all the time we have for today. Dr. Sampson, I want to thank you. I know you're very busy.
SAMPSON: GUPTA: Very valuable advice and great e-mails to all of our viewers at home as well. Make sure to tune in next weekend for another edition or HOUSECALL. I'm Dr. Sanjay Gupta. Stay tuned now for more news on CNN.
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