The All Party Group for Allergy meeting 16th October 2013

Yesterday I attended a Meeting to discuss Allergy at the Houses of Parliament. It was a collaboration between the All Party Parliamentary Group for Allergy and the Parliamentary Office of Science and Technology  supported by Allergy UK. The meeting was to discuss progress in Allergy in the UK since the Lords' report of 2007. (More details here.)

Dr Adam Fox (Joint Clinical Lead for Allergy, Consultant & Reader in Paediatric Allergy Guy's & St Thomas' Hospitals ) explained how whilst Allergy is not new, its incidence amongst the population is increasing exponentially. Whilst it was a rare phenomenon when described in the early Nineteenth Century this is sadly no longer the case -with the incidence of allergic disease higher in the UK than any other country in the world. There has been considerable progress in joining up care improving transition from paediatric to adult services, and in beginning to address equality of availability and access to services across the country but there is still a long way to go. GPs are not trained to support allergic patients and too often symptoms are partitioned and dealt with singly rather than a holistic approach with specialist allergy care at the centre. There are only 20 specialist Paediatric Allergists in the UK at present, and only 28 Adult Allergy Specialists. Many US cities boast far more.

Recent NICE guidelines have been issued (Feb 2011) to advise on diagnosis and assessment of food allergy in children and young people which, if taken up would greatly improve the situation of many, many children and young people across the country. However, as GP Dr Matthew Doyle reminded everyone, GPs receive many new guidance documents on a weekly basis

Unfortunately there was little time for meaningful questions and I was unable to publicly ask the burning question I had nurtured all afternoon-

"What is being done to address the relative lack of progress in both awareness and understanding of delayed non IgE allergic reactions amongst the medical professionals?"

Because all too often I encounter ignorance about delayed reactions - the assumption that if it isn't an IgE response, cannot be tested for it isn't an allergy. There is considerable research into cell mediated responses and they are detailed extremely clearly in the NICE guidelines - yet they are unread, ignored or rubbished.

It's a great document. I recommend anyone dealing with delayed gut reactions in particular - which include EGID, Ulcerative colitis, Chrohn's, Coeliac disease, allergic gut disease, multiple food intolerances to read it.

I was also lucky enough to hear Ruth Holroyd speak, from What Allergy? What Allergy? was voted in the Top 5 UK allergy blogs by Cision UK and regularly gets 2000+ unique visits a day with some blog posts getting hundreds of comments each.

Healthy Eating?

This was published as a Blog post here and on my personal Blog, but it's such a hot topic I have made it a permanent page - at least for now!

Today K and A's school included in their weekly "newspaper" an editorial on "Healthy Eating", asking parents to support the school's two week drive to improve on an already ongoing campaign.

But just what IS Healthy Eating? The school in question have twice termly cake sales, and hands out sweets in birthday assembly, which hardly fits the "Healthy Eating" criteria that the school is so keen to promote? But actually I have more support for cake sales than you might think. The key to good health is usually a balance in all things, cakes have their place in our children's diets as much as fruit, more so if you speak to a dentist - many of whom deplore the plethora of dried fruit snacks which are the biggest culprits for causing cavities in young children today. On the subject of fruit generally the message is the same, balance is key:-

"It might seem counter intuitive to think that a food with lots of sugar is good for your teeth, but fresh fruit is good for your teeth when consumed as part of a balanced diet."

However frequency also matters, and the modern craze for snacking does no one's teeth, blood sugar or appetite any favours.

Given that my younger two are on such restricted diets their school's two snacks a day (which has to be fruit or cheese) means we probably hit 5-a-day by lunch time, so I am not going to lose any sleep about the odd free-from cake which their school very thoughtfully provides for those unable to buy the regular cakes at their charity sales.  My bigger concern is the drive for low fat-high sugar foods, the demonising of animal fats and the rising importance of carbohydrates in society- and initiative endorsed by successive governments over the past couple of decades. The NHS' "Eatwell Plate" demonstrates clearly this change in focus, and the obesity surge and diabetes time bomb are evidence of how badly wrong politicians and health experts have been. The comments at the bottom of this NHS page do a far, far better job than I could of explaining how skewed our thinking has become about fats and carbohydrates. The processed food industry has been key in promoting grains and sugars, particularly fructose and sucrose with government support but many people are cottoning on slowly, with a surge in online writings trying to expose the myth that vegetable oils are good and animal fats are bad. Even schools are caught up in the effort to increase carbs and fruit and this frustrates me considerably.

My biggest issue with the "Healthy Eating" campaign though, be it at their school or elsewhere, is that I would really prefer my kids to eat for fuel and pleasure - social, sensory, satiety pleasures - and not think too much about it. I resent having to read every label, cook everything from scratch all the time and stress over their daily intake as it is, I try hard (and it IS hard) to ensure their lives are as normal as possible, that they don't feel too different and they don't miss out. But most of all, I would like for food and eating to be necessity not a focus, to take a back seat in life and just be something I as their mother need to consider. If we get through a day where the children have eaten when hungry, had their fill and run off back to more interesting activities then I have succeeded. A day spent thinking about every bite, each ingredient, its impact and value is a day wasted for a child, it is the responsibility of adults to feed their children appropriately and make it as mundane a process most of the time as filling the car with petrol. Of course food is to be enjoyed, but to make it a major or even the sole focus of a child's life for even a short period of time is as bad as ignoring natural appetite.

I have to say, I write none of this whilst wearing an imaginary halo, I fail miserably at this ideal many days and the children's extremely restricted diet makes it very, very difficult to achieve even our own version of normality. But my heart sank reading that newsletter column tonight, because all my efforts made on a daily basis will be shot down in flames in a misguided fortnight of demonising fats, pushing carbs, vegetable oils and fruit - but most of all in drawing attention to something which I would prefer my children not to have to think about. Add to that the fact that they will most likely be discrediting foods my twins rely on to keep them well and it's not going to be a positive experience I fear. I hope I'm wrong.