Cybermedlife - Therapeutic Actions Dietary Modification - Elimination Diet

Elimination Diet Effectively Treats Eosinophilic Esophagitis in Adults; Food Reintroduction Identifies Causative Factors.

Abstract Title: Elimination Diet Effectively Treats Eosinophilic Esophagitis in Adults; Food Reintroduction Identifies Causative Factors. Abstract Source: Gastroenterology. 2012 Mar 3. Epub 2012 Mar 3. PMID: 22391333 Abstract Author(s): Nirmala Gonsalves, Guang-Yu Yang, Bethany Doerfler, Sally Ritz, Anne M Ditto, Ikuo Hirano Article Affiliation: Division of Gastroenterology and Hepatology, Northwestern University Feinberg School of Medicine, Chicago, Illinois. Abstract: BACKGROUND & AIMS: Adults with eosinophilic esophagitis (EoE) typically present with dysphagia and food impaction. A 6-food elimination diet (SFED) is effective in children with EoE. We assessed the effects of the SFED followed by food reintroduction on the histologic response, symptoms, and quality of life in adults with EoE. METHODS: At the start of the study, 50 adults with EoE underwent esophagogastroduodenoscopies (EGDs), biopsies, and skin-prick tests for food and aeroallergens. After 6 weeks of SFED, patients underwent repeat EGD and biopsies. Histologic responders, defined by≤5 eosinophils/high-power field (eos/hpf) (n = 32), underwent systematic reintroduction of foods followed by EGD and biopsies (n = 20). Symptom and quality of life scores were determined before and after SFED. RESULTS: Common symptoms of EoE included dysphagia (96%), food impaction (74%), and heartburn (94%). The mean peak eosinophil counts in the proximal esophagus were 34 eos/hpf and 8 eos/hpf, before and after the SFED, and 44 eos/hpf and 13 eos/hpf in the distal esophagus, respectively (P<.0001). After the SFED, 64% of patients had peak counts≤5 eos/hpf and 70% had peak counts of ≤10 eos/hpf. Symptom scores decreased in 94% (P<.0001). After food reintroduction, esophageal eosinophil counts returned to pretreatment values (P<.0001). Based on reintroduction, the foods most frequently associated with EoE were wheat (60% of cases) and milk (50% of cases). Skin-prick testing predicted only 13% of foods associated with EoE. CONCLUSIONS: An elimination diet significantly improves symptoms and reduces endoscopic and histopathologic features of EoE in adults. Food reintroduction re-initiated features of EoE in patients, indicating a role for food allergens in its pathogenesis. Foods that activated EoE were identified by systematic reintroduction analysis but not by skin-prick tests. Article Published Date : Mar 02, 2012

Reversal of premature ovarian failure in a patient with Sjögren syndrome using an elimination diet protocol.

Abstract Title: Reversal of premature ovarian failure in a patient with Sjögren syndrome using an elimination diet protocol. Abstract Source: J Altern Complement Med. 2010 Jul;16(7):807-9. PMID: 20618099 Abstract Author(s): Joe Feuerstein Article Affiliation: Department of Integrative Medicine, Stamford Hospital, Stamford, CT 06902, USA. This email address is being protected from spambots. You need JavaScript enabled to view it. Abstract: BACKGROUND: Premature ovarian failure is diagnosed with a picture of amenorrhea, elevated follicle-stimulating hormone (FSH), and age under 40 years. Twenty percent (20%) of patients with premature ovarian failure have a concomitant autoimmune disease. Cases of premature ovarian failure associated with Sjögren syndrome have been reported in the literature. PATIENT AND METHOD: We report a case of a 42-year-old white woman with Sjögren syndrome and premature ovarian failure who underwent a reversal of her premature ovarian failure and restoration of normal menses using an elimination diet protocol. The patient was diagnosed with her rheumatological condition in 2005 and started on disease-modifying antirheumatoid drugs, which were taken intermittently due to a concern over medication side-effects. Her menses became irregular at the time of initial diagnosis and finally ceased in 2006, with a dramatic elevation in her FSH, indicative of autoimmune-induced premature ovarian failure. In March 2009, she commenced an elimination diet protocol, eliminating gluten, beef, eggs, dairy products, nightshade vegetables, refined sugars, and citrus fruit for 4 months. RESULTS: Her repeat laboratory tests after 4 months showed a drop in FSH from 88 to 6.5 and a drop in erythrocyte sedimentation rate from 40 to 16. Her menses also resumed and her rheumatological symptoms significantly improved. CONCLUSIONS: It is hypothesized that the restoration of normal menses was caused by reduced inflammation in the ovarian tissue and supports the hypothesis that the gut immune system can influence autoimmune disease and inflammation. Article Published Date : Jul 01, 2010

Dietary exclusions for improving established atopic eczema in adults and children: systematic review. 📎

Abstract Title: Dietary exclusions for improving established atopic eczema in adults and children: systematic review. Abstract Source: Allergy. 2009 Feb;64(2):258-64. PMID: 19178405 Abstract Author(s): F Bath-Hextall, F M Delamere, H C Williams Article Affiliation: Faculty of Medicine and Health Sciences, University of Nottingham, Nottingham, UK. Abstract: Atopic eczema is the most common inflammatory skin disease of childhood in developed countries. We performed a systematic review of randomized controlled trials to assess the effects of dietary exclusions for the treatment of established atopic eczema. Nine trials (421 participants) were included, most of which were poorly reported. Six were studies of egg and milk exclusion (n = 288), one was a study of few foods (n = 85) and two were studies of an elemental diet (n = 48). There appears to be no benefit of an egg- and milk-free diet in unselected participants with atopic eczema. There is also no evidence of benefit in the use of an elemental or few-foods diet in unselected cases of atopic eczema. There may be some benefit in using an egg-free diet in infants with suspected egg allergy who have positive specific IgE to eggs - one study found 51% of the children had a significant improvement in body surface area with the exclusion diet as compared with normal diet (95% CI 1.07-2.11) and change in surface area and severity score was significantly improved in the exclusion diet as compared with the normal diet at the end of 6 weeks (MD 5.50, 95% CI 0.19-10.81) and end of treatment (MD 6.10, 95% CI 0.06-12.14). Despite their frequent use, we find little good quality evidence to support the use of exclusion diets in atopic eczema. Article Published Date : Feb 01, 2009

Wheat is a primary food trigger for migraines

Abstract Title: Wheat is a primary food trigger for migraines Abstract Source: Lancet. 1979 May 5 ;1(8123):966-9. PMID: 87628 Abstract Author(s): Grant EC. Abstract: 60 migraine patients completed elimination diets after a 5-day period of withdrawal from their normal diet. 52 (87%) of these patients had been using oral contraceptive steroids, tobacco, and/or ergotamine for an average of 3 years, 22 years, and 7.4 years respectively. The commonest foods causing reactions were wheat (78%), orange (65%), eggs (45%), tea and coffee (40% each), chocolate and milk (37%) each), beef (35%), and corn, cane sugar, and yeast (33% each). When an average of ten common foods were avoided there was a dramatic fall in the number of headaches per month, 85% of patients becoming headache-free. The 25% of patients with hypertension became normotensive. Chemicals in the home environment can make this testing difficult for outpatients. Both immunological and non-immunological mechanisms may play a part in the pathogenesis of migraine caused by food intolerance.
Therapeutic Actions DIETARY MODIFICATION Elimination Diet

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An In-Depth Characterization of a Large Cohort of Adults Patients with Eosinophilic Esophagitis.

Related Articles An In-Depth Characterization of a Large Cohort of Adults Patients with Eosinophilic Esophagitis. Ann Allergy Asthma Immunol. 2018 Sep 14;: Authors: Leigh LY, Spergel JM Abstract BACKGROUND: Eosinophilic esophagitis (EoE) is a chronic allergic, immune-mediated disease associated with increased risk of comorbid atopic conditions. OBJECTIVE: We aim to perform an in-depth characterization of a large cohort of manually verified adult EoE patients including evaluation of less studied associations such as pollen food allergy syndrome, anaphylaxis, autoimmunity and psychiatric comorbidities. METHODS: We performed manual retrospective electronic medical record review of 1,218 patients with EoE identified by ICD-9 and 10 codes from the University of Pennsylvania Health Systems (UPHS). Through manual chart review, we evaluated patient demographics; family and smoking history; laboratory and endoscopic findings; treatment; and comorbid atopic, autoimmune, and psychiatric conditions. RESULTS: 950 out of 1,218 patients had biopsy-proven EoE. This cohort was predominantly male, Caucasian, never-smokers who presented most commonly with dysphagia with an initial biopsy showing 49 Eos/HPF, serum absolute eosinophilic count of 446, and average total IgE of 243. 55% had impaction (of which 38% required endoscopic removal), 56% had strictures/fibrosis (of which 56% underwent dilatation). Therapy used was predominantly (77%) medical only. Comorbid atopy, pollen food allergy syndrome, drug allergy, anaphylaxis, autoimmunity, and psychiatric illnesses were higher in the EoE cohort compared with the general UPHS population. CONCLUSION: Our adult cohort of manually verified, biopsy-proven EoE showed increased risk of pollen food allergy syndrome, anaphylaxis, and comorbid autoimmune and psychiatric conditions compared with the UPHS population. There was also an increased prevalence of impaction and stricture/fibrosis requiring endoscopic intervention compared with the pediatric population. PMID: 30223114 [PubMed - as supplied by publisher]

Immune-mediated cerebellar ataxias: Practical guidelines and therapeutic challenges.

Related Articles Immune-mediated cerebellar ataxias: Practical guidelines and therapeutic challenges. Curr Neuropharmacol. 2018 Sep 16;: Authors: Mitoma H, Manto M, Hampe CS Abstract Immune-mediated cerebellar ataxias (IMCAs), a clinical entity reported for the first time in the 1980s, include gluten ataxia (GA), paraneoplastic cerebellar degenerations (PCDs), anti-glutamate decarboxylase 65 (GAD) antibody-associated cerebellar ataxia, post-infectious cerebellitis, and opsoclonus myoclonus syndrome (OMS). These IMCAs share common features with regard to therapeutic approaches. When certain factors trigger immune processes, elimination of the antigen(s) becomes a priority: e.g., gluten-free diet in GA and surgical excision of the primary tumor in PCDs. Furthermore, various immunotherapeutic modalities (e.g., steroids, immunoglobulins, plasmapheresis, immunosuppressants, rituximab) should be considered alone or in combination to prevent the progression of the IMCAs. There is no evidence of significant differences in terms of response and prognosis among the various types of immunotherapies. Treatment introduced at an early stage, when CAs or cerebellar atrophy is mild, is associated with better prognosis. Preservation of the "cerebellar reserve" is necessary for improvement of CAs and resilience of the cerebellar networks. In this regard, we emphasize the therapeutic principle of "Time is Cerebellum" in IMCAs. PMID: 30221603 [PubMed - as supplied by publisher]

Benefit of Oleuropein Aglycone for Alzheimer's Disease by Promoting Autophagy.

Related Articles Benefit of Oleuropein Aglycone for Alzheimer's Disease by Promoting Autophagy. Oxid Med Cell Longev. 2018;2018:5010741 Authors: Cordero JG, García-Escudero R, Avila J, Gargini R, García-Escudero V Abstract Alzheimer's disease is a proteinopathy characterized by accumulation of hyperphosphorylated Tau and β-amyloid. Autophagy is a physiological process by which aggregated proteins and damaged organelles are eliminated through lysosomal digestion. Autophagy deficiency has been demonstrated in Alzheimer's patients impairing effective elimination of aggregates and damaged mitochondria, leading to their accumulation, increasing their toxicity and oxidative stress. In the present study, we demonstrated by microarray analysis the downregulation of fundamental autophagy and mitophagy pathways in Alzheimer's patients. The benefits of the Mediterranean diet on Alzheimer's disease and cognitive impairment are well known, attributing this effect to several polyphenols, such as oleuropein aglycone (OLE), present in extra virgin olive oil. OLE is able to induce autophagy, achieving a decrease of aggregated proteins and a reduction of cognitive impairment in vivo. This effect is caused by the modulation of several pathways including the AMPK/mTOR axis and the activation of autophagy gene expression mediated by sirtuins and histone acetylation or EB transcription factor. We propose that supplementation of diet with extra virgin olive oil might have potential benefits for Alzheimer's patients by the induction of autophagy by OLE. PMID: 29675133 [PubMed - indexed for MEDLINE]

Resolution of Allergic Rhinitis and Reactive Bronchospasm With Supplements and Food-specific Immunoglobulin G Elimination: A Case Report.

Related Articles Resolution of Allergic Rhinitis and Reactive Bronchospasm With Supplements and Food-specific Immunoglobulin G Elimination: A Case Report. Altern Ther Health Med. 2016 10;22(S3):24-28 Authors: Kwiatkowski L, Mitchell J, Langland J Abstract Context • Allergies are a common affliction, whether they are respiratory, food related, or dermatological. People often resort to continuous use of over-the-counter medications, such as antihistamines, to manage their symptoms. Controversy still remains over testing serum immunoglobulin (Ig) G to diagnose food allergies. Objective • This study intended to examine the benefits of treatment of a pediatric patient with natural supplements and an elimination diet for IgG food allergies. Design • The research team reported a case study. Setting • The study was conducted at Southwest Naturopathic Medical Center (Tempe, AZ, USA). Participant • The participant was a 10-y-old Caucasian female who had diagnoses of allergic rhinitis and reactive bronchospasm, the second of which was exacerbated by allergens such as wheat, perfumes, and seasonal flora. Intervention • Following testing for IgE- and IgG-reactive foods, the patient was treated with natural supplements to reduce her allergic responses and was instructed to make dietary changes to eliminate the IgG-reactive foods. Outcome Measures • The patient's symptom severity was tracked starting 1 mo after her initial visit to Southwest Naturopathic Medical Center. The severity was based on the patient's subjective reports about her congestion to her mother and on her mother's observations of the effect of symptoms on her attention and school performance. The bronchospasm severity was based on the frequency of a sensation of wheezing and chest tightness, the frequency of inhaler use, and the occurrence of any exacerbation of symptoms with acute respiratory illness Results • After 1 mo, in which the patient used the natural supplements, she experienced a 90% improvement in coughing; a 70% improvement in nasal congestion; less chest tightness; and no need for use of loratadine, diphenhydramine, or albuterol. At the 8-mo follow-up visit, her nasal congestion was reported to be entirely gone. Conclusions • The case demonstrates the effectiveness of natural supplements and a diet eliminating IgG-reactive foods in the treatment and management of pediatric allergic rhinitis and reactive bronchospasm. PMID: 27866183 [PubMed - indexed for MEDLINE]