LIVING WITH ALLERGIES 9

AllergiesAUTUMN 2016

LIVING WITH

eczema tips + eye allergies + nutrition advice

magazine

COSY winter living

EATING YOUR WAY TO A HEALTHY IMMUNE SYSTEM

FOR KIDS

Party treats

FREE WITH COMPLIMENTS FROM YOUR PHARMACIST OR HEALTH PROFESSIONAL

GIVEAWAYSFIVE GREAT

competitions see inside

ASTHMA & EXERCISE

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eyes or skin, sneezing or runny nose, allergies could be the culprit talk to your

pharmacist about which Arrowcare product is right for you.

Allergies can be an issue all year round

Pets

PlantsInsect Bites

Dust

Pollen

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Recommendations should be consistent with the datasheet, label or pack insert of each medicine, which should be consulted. Arrowcare Zetop, Fexofast and Lorafix: always read the label and use as directed. People with kidney problems, and pregnant or breast-feeding women should seek medical advice before taking these medications. If symptoms persist see your Doctor or health professional. TAPS CH4464. *IMS, 2014. Total tablets including those on prescription.

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0393 Actavis Arrowcare Allergy LWA advert.indd 1 26/08/15 4:44 pm

ContentsLIVING WITH ALLERGIES AUTUMN 2016

ALLERGY AWARE2 News and Views

NUTRITION KNOW-HOW4 Gluten free and healthy

EYE ALLERGIES9 What kind of conjunctivitis?

HEALTHY HOMES11 Banishing mould

ASTHMA14 Keeping fit

NATURAL HEALTH16 Sick of being sick?

LIVING WITH ALLERGIESPUBLISHERPublished by Hawkhurst Media Services LtdPO Box 25679, St Heliers, Auckland 1740Director: Kerry McKenzie09 528 7103 or 0275 969 979

ADVERTISING Advertising Sales: Debbie Bishop021 340 [email protected]

BUY A MAGAZINE Visit our website www.livingwithallergies.co.nz 09 528 [email protected] www.facebook.com/livingwithallergiesmagazine

PRODUCTIONEditor: Sara [email protected]: Rose Miller at Kraftwork [email protected]: Stella Clark

PRINTERMcCollams Print

ISSN: 2324-2213

Disclaimer: Every effort is made to ensure accuracy but Living with Allergies accepts no liability for errors of fact or opinion. Information in this publication is not intended to replace advice by your health professional. If in doubt check with your allergy specialist, GP, nurse, dietitian or other health care professional. Editorial and advertising material does not necessarily reflect the views of the Editor or publisher. Advertising in Living with Allergies does not constitute endorsement of any product.Living with Allergies is an independent publication and is in no way affiliated with or endorsed by the charity Allergy New Zealand. All rights reserved. No article in whole or part should be reprinted without permission of the Editor.

ECZEMA19 Tips for successful treatment

FOOD & RECIPES25 Gluten free birthday treats

ENDPOINT32 Useful snippets

GIVEAWAYS!Look out for 5 great reader competitions throughout the magazine.

See inside for how to enter or go to www.livingwithallergies.co.nz

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allergy aware

DITCH SECOND HAND SMOKE Children with asthma who are exposed to second hand smoke at home are twice as likely to be hospitalised, according to an article in the Annals of Allergy, Asthma and Immunology, which reviewed 25 studies investigating smoking exposure at home. Children are perhaps more likely to be negatively affected by cigarette exposure than adults due to the immaturity of their lungs and immune systems, the article concluded. As well as that, toxins such as second hand smoke reduce lung growth rates, even though details of how this occurs arent entirely known.

Food Journal AppsIf youre looking for a food allergy journal app but dont know which one to choose, check out Scratch Me Nots recommendations at http://blog.scratchmenot.com/the-best-food-allergy-journal-apps/

An Evolutionary Basis for Allergy?Using computational techniques, a new study out of the London School of Hygiene & Tropical Medicine supports the theory that allergies have an evolutionary basis. It is thought that the part of our immune system that has evolved to provide immunity against infection by parasitic worms can become hyper-responsive if there isnt any parasitic infection to combat. The result? It mistakenly targets allergenic proteins in food or the environment instead.

2 LIVING WITH ALLERGIES Autumn 2016

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Call 09 361 3295 or 021 88207135 Jervois Rd, Herne Bay, Auckland

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Natural Remedies Safest for ColdsDont be surprised if your pharmacist recommends a natural remedy for your child this winter. Pharmacy Today reports that pharmacies are recommending natural remedies for young children suffering colds, flus and chesty coughs, after Medsafe increased age restrictions on popular treatments last year.

Children under six can no longer be given bromhexine, a medicine used to break up excessive or thick phlegm associated with a chesty cough, and the pain reliever codeine is now restricted to those aged 12 and over.

Why? There is not enough evidence for the use of bromhexine for productive coughs, and there have been reports of rare but life-threatening adverse effects,

Medsafe said in its release. In relation to codeine (which is metabolised to morphine in the body), Medsafe said there is limited evidence supporting its use to treat acute coughs in either adults or children, and they have concerns about the risk of toxicity.

Medsafe recommends that children with coughs and colds should be allowed to rest, be made comfortable and be given plenty of fluids. Honey drinks can help to soothe a cough in children over the age of one. (Babies younger than 12 months shouldnt be given honey because it can sometimes contain a bacterium that causes serious illness infant botulism in babies under one.) Also, dont give lozenges to young children theyre a choking hazard.

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LIVING WITH ALLERGIES Autumn 2016 3

nutrition know-how

GLUTEN FREE AND HEALTHY

Q: Does following a gluten free diet leave us vulnerable to nutritional deficiencies? Yes it does. I liken it to becoming vegetarian. You cant just take meat out of your diet without knowing what to replace the missing nutrients with. Those following a gluten free diet need to know which foods they need to be including in their diet.

Q: What nutrients are people following a gluten free diet most at risk of being deficient in? Fibre would be top of the list as wholegrain bread, cereal and crackers are common and easy sources of fibre. Unfortunately many gluten free products are made from low fibre alternatives such as potato starch, maize starch and white rice flour. Iron is another important nutrient to be aware of as approximately 40% of our iron comes from wholegrains. Wholegrains also provide B vitamins such as thiamine (vitamin B1) and folate.

Gluten free, and worried you might be missing out on vital nutrients? Nutrition Consultant Sarah Elliott has advice on optimising your diet.

Q: Fibre, iron and B vitamins why do we need them?You may have heard of the gut microbiome, the good bacteria which live in our digestive tracts.

Fibre is a valuable food source for these bacteria and helps to keep them (and therefore us!) healthy. Fibre also helps lower cholesterol and keeps us regular.

Iron is essential because it binds to oxygen and transports it throughout the body. (In New Zealand, approximately 20% of women are iron deficient.)

B vitamins perform a wide range of functions such as helping the body utilise fats and protein. B vitamins are needed for healthy skin, hair, eyes, and liver, and they also help the nervous system function properly.

Q: If were following a gluten free diet, how do we ensure were getting all the nutrients we need?Learn to replace gluten-containing grains with good alternatives such as quinoa or buckwheat. Choose wholegrain options where possible, such as brown rice


and grainy gluten free bread. If you dont have to follow a strict lifelong gluten free diet (such as with coeliac disease), then experiment to find your personal tolerance level. Also learn to love legumes and lentils as they are full of fibre, B vitamins and iron.

Q: Anything special parents need to be aware of?This advice is for everyone, but its especially important for children. Go and see a registered dietitian to get a proper diagnosis if you suspect gluten is an issue for your child. Professionals can support you with individualised advice that will

meet the growing needs of your child. If you dont feel removing gluten has made any improvement, then look at reintroducing gluten back into your childs diet. If your childs symptoms are gut related, it is more likely to be a FODMAP intolerance (see www.foodsavvy.co.nz/fodmap.aspx).

Q: You were diagnosed with Crohns disease 20 years ago do you have any tips from your personal experience youd like to share?Experiment with different grains to find ones you enjoy. I personally dislike millet but enjoy quinoa

Sarah Elliott is a Nutrition Consultant & Registered Dietitian with FoodSavvy, specialising in the dietary management of digestive issues such as irritable bowel syndrome and inflammatory bowel disease. Having previously worked as the Immunology Dietitian at Wellington Regional Hospital, she is also skilled in the management of food allergies and intolerances. See www.foodsavvy.co.nz for more info.

mixed into salads or soups. Even my kids will eat it!

Play around with home baking. You can use brown rice flour, mashed banana, nut flours and ground flaxseed to boost the fibre and nutrients. Keep some in the freezer as quick on-the-go snacks.

Learn to replace gluten-containing grains with good alternatives such

as quinoa or buckwheat.


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Conjunctivitis an easy way to stop the spread

Over-the-counter conjunctivitis treatments need to be applied up to five times a day. Applying eye drops can be fiddly at any age so the fewer times a day you need to do it, the better.

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CONJUNCTIVITIS A COMMON PROBLEMYou may know conjunctivitis as pink eye or red eye. Common symptoms include redness, itching, swelling of the eyelids and a discharge that may cause the lids and lashes to be matted together in the mornings.

There can be a scratchy feeling, pain with bright light, or tearing.

Conjunctivitis affects approximately 12% of New Zealands population and peaks from winter through to springtime.

The three most common ways you can get it are through an allergic reaction, from bacteria, or from a virus.

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Fucithalmic (Fusidic Acid 1% ) is a Prescription Medicine for the treatment of bacterial infections of the eye like conjunctivitis. Medicines have risks and benefits. Do not use if you wear contact lenses. Do not drive or operate machinery if vision is blurred after application. Possible side effects: mild stinging and burning in the eye, tearing & blurring of the eyes. Use only as directed. If symptoms persist see your doctor. For further details refer to Consumer Medicine Information on www.medsafe.govt.nz, Seqirus (NZ) Ltd, Auckland. Fucithalmic is a registered trademark of Amdipharm Limited. TAPS NA6382 FUCI-018-10/15

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Easy to catchMost bacteria that cause conjunctivitis are spread through direct hand-to-eye contact from contaminated hands. The disease can be caught just by touching something that was handled by an infected person. For this reason, people who are diagnosed with conjunctivitis, particularly children, should stay home until treatment has started, to avoid infecting others.


eye allergies

Itchy eyes and wondering whether your conjunctivitis is due to an allergy or an infection? Dr Malcolm McKellar separates out the symptoms and offers some advice.

CONJUNCTIVITIS is the medical term for inflammation of the conjunctiva, a thin layer of transparent tissue that covers the white of the eye and lines the inside of the eyelids. The most common types of conjunctivitis are infectious conjunctivitis and allergic conjunctivitis. But how do you tell the difference?

If your conjunctivitis is recurrent or chronic; develops during the day; you have itchy, watery eyes and other allergies, such as asthma, hayfever or eczema; and your lymph nodes are normal, chances are you have allergic conjunctivitis.

If, on the other hand, your conjunctivitis is one-off and accompanies another infection, for example a cold or flu; is worse in the morning, and you have gritty, sticky eyes and swollen lymph nodes, you very likely have infectious conjunctivitis.

TELL-TALE SIGNS


Allergic Conjunctivitis But Which Type?There are three common types of allergic conjunctivitis acute allergic conjunctivitis, chronic allergic conjunctivitis and giant papillary conjunctivitis.

1. Acute allergic conjunctivitisThis quite spectacular reaction typically occurs in children playing in long grass or with pets. The eyes are very itchy and watery, and eyelid swelling is common. Most cases resolve spontaneously within a few hours, and the best treatment is cool compresses (see sidebar).

2. Chronic allergic conjunctivitisThere are three types of chronic conjunctivitis:Hayfever conjunctivitis is the most common type. The main symptoms are itchiness and watering, which begin abruptly after exposure and resolve soon after the allergen is removed. Symptoms may be seasonal or occur year round. The eyelids may swell and darken, an appearance known as allergic shiners.

Most sufferers are only too familiar with what causes their conjunctivitis. Common triggers include grass and tree pollens (seasonal allergic conjunctivitis) and animals, house dusts and mould (perennial

allergic conjunctivitis).Drug induced conjunctivitis:

Every eyedrop and ointment can cause an allergic response, from a reaction either to the drug itself or to the preservative solution used to keep the bottle sterile. The reaction may occur within a few days of use or after many months of treatment. Patients typically complain of non-specific irritation and low-grade itch.

Vernal keratoconjunctivitis is a severe allergic conjunctivitis that usually occurs in patients with other allergies. In adults the disease is called atopic conjunctivitis. Symptoms typically begin in spring and are often severe. The eyes are extremely itchy, watery, burning and very sensitive to light. In severe cases vision is reduced.

3. Giant papillary conjunctivitisThis much less common disease affects contact lens wearers and patients with artificial eyes. Large, cobblestone-like papillae (rounded protuberances) form on the inner surface of the upper eyelid.

TreatmentNo matter what type of allergic conjunctivitis youre suffering from, treatment will involve one or more of the following: simple home remedies (see sidebar),

over-the-counter medicines, prescription medicines, specialist-only medicines and, perhaps most importantly, avoiding known causes.

Simple measures of avoidance include: Changing play areas Hand washing after work or play Staying indoors when pollen or dust levels are high Closing windows Delegating lawn mowing Removing plants youre allergic to Air-conditioning/filtering Wearing goggles and wrap-round sunglasses Wet-dusting Putting dust covers on pillows and mattresses Exposing furniture to sunlight to kill dust mites Removing carpet Selling or giving away pets Moving house (a not-quite-so-simple measure!)

Try This At HomeCool compresses can provide excellent relief, particularly in children with acute allergic conjunctivitis. The simplest way to do this is to keep a wet facecloth in a plastic bag in the fridge. Instant relief! Also try washing the eyes with artificial tears or a solution such as Optrex.

With thanks to Dr Malcolm McKellar, an optometrist and ophthalmologist based in Christchurch. www.drmalcolmmckellar.co.nz.

eye allergies


OUT, DAMNED MOULD!

healthy homes

MOULD LOVES damp, cool, still air. Therefore preventing mould in your home involves three main strategies. 1. Eliminating or minimising

sources of moisture2. Insulating and

heating your home3. Preventing air from

getting trapped

The main sources of moisture in New Zealand homes are cooking, showering, airing washing indoors, using un-flued gas heaters, and for homes with raised timber floors rising damp.

So what can you do to minimise mould?

As we head into winter, its time to think about minimising or ideally banishing mould from our homes. Nelson Lebo, Eco Design Advisor with Palmerston North City Council, tells us how.

Fan-tastic: Properly installing extractor fans in your kitchen and bathroom can remove most of the moisture generated by cooking and showering. Unfortunately, many bathroom extractor fans arent up to the task. If you have a below-par fan, try installing a 10-minute delay timer on the fan and/or installing a Steam Stopper or Shower Dome.

Out with gas: Avoid using un-flued gas heaters; any heater is better than an un-flued gas heater (particularly LPG portable gas heaters).

Banish the (clothes) horse: Avoid drying clothes inside and instead find an alternative that works for your family. Do you have a covered outdoor area you could use? A vented dryer? Could you hang clothes in your garage or shed with the windows open? Or how about going to the local laundry and using a dryer there?

On the rise: Rising damp can be a major source of moisture for houses built on piles. Addressing this issue effectively will involve installing heavy-duty polythene on the ground beneath your home and, where appropriate, improving drainage around the perimeter.


Extraction: Use an extractor fan and pot lids while cooking. The best range hoods are larger than the cooking area, are vented outside, and have quiet motors.Green isnt always good: Limit indoor pot plants and cover fish tanks.Gutted: Check gutters and downpipes for signs of leaks.Wipe it: Wipe condensation from windows as soon as you see it.Call for back up: Run a dehumidifier if and when needed.Flush: Finally, flush your home with fresh air for 10 to 20 minutes, once or twice a day. Simply open doors and windows at opposite ends of the house to ensure cross-ventilation. During winter months the best time to do this is around mid-day when outdoor temperatures are highest.

Banish the clothes horse from inside your home try using a covered outdoor area instead.

Insulate: In terms of heating, the best way to heat your home is to thoroughly insulate it. After that, the World Health Organisation recommends heating living spaces to a minimum of 18 degrees and bedrooms to 16 degrees. The most cost effective heaters are wood burners, flued mains gas heaters, pellet stoves and heat pumps.

Move air: Mould often appears in bedrooms at the south end of a home in two main areas: behind furniture against external walls and in closets. In both cases the reasons are the same: the cold, damp air gets trapped there. During winter months, pulling furniture away from external walls (at least a hand-width away) and leaving closet doors ajar will help encourage air movement and discourage mould from growing.


Protect your kitchen, bathroom, laundry and other indoor wet areas with the Resene Kitchen & Bathroom range, formulated with anti-bacterial silver and MoulDefender to minimise mould and bacteria growth.

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Now thats fresh thinking!

RECIPE FOR REMOVING MOULD

If mould finds its way into your home, spray the surface with a mixture of 70% white vinegar and 30% water, leave for 15-60 minutes, and then scrub. Be sure to rinse off the vinegar afterwards with a sponge. This is extremely important as mould will grow back on the vinegar residue if its not rinsed properly.

For more information, check out the factsheets (under Resources) at www.ecodesignadvisor.org.nz.


EXERCISE IS VITAL for our total body health and wellbeing. Having exercise induced asthma just means you need to find a form of exercise that doesnt affect you as much. Be prepared and monitor the way you breathe while exercising.

First up, some things to remember: Your fitness level will play

a part in how breathless you are while exercising.

To improve your fitness it is important to actually get a bit breathless. A good rule of thumb is the walk and talk test. When exercising you should be moderately short of breath but still able to speak.

Do you really have exercise induced asthma? Exercise induced hyperventilation (or disordered breathing) can mimic exercise induced asthma and also cause shortness of breath, chest tightness and feelings of air hunger. In a study

asthma

Managing Exercise Induced Asthma

of 52 school children in Canada, who had been told they had exercise induced asthma, 40.4% were found to have a form of disordered breathing and 23.1% were merely unfit. Only 15.4% had exercise induced asthma based on diagnostic criteria.

Because of the prevalence of asthma in New Zealand, and the similarity of symptoms, it is easy to see how exercise induced asthma is often the first diagnosis people think of.

What can you do if you have exercise induced asthma?Firstly make sure you get your asthma under control. Talk to your GP and get

an asthma action plan Use your inhalers regularly

and correctly. If you use a puffer inhaler make sure you use a spacer.

Take the asthma control test at www.asthmacontrol.co.nz

You can also: Consider when and where

you exercise. Check the weather if there is a cold, dry wind, use a scarf or bandana over your mouth to warm up the air. This trick can also be used if you are exercising around dust or fumes. Exercise inside if you find cold wind, pollen or fumes to be big triggers. This could mean joining a gym, finding an exercise group to join or walking around your local mall.

Warm up before exercising. Consider the type of

exercise that you do. Some people prefer exercise which stops and starts for rests such as tennis or team sports; others prefer exercise where they can pace themselves, like running, walking, tramping or swimming.

Be prepared have your inhaler with you. This can help take the worry out of exercise.

Exercise can be a trigger for some people with asthma but thats not an excuse to sit on the couch! Physiotherapist Brigitte Eastwood shares her tips for managing exercise induced asthma.


Think about the way you are breathing it is important to start out breathing through your nose as much as possible and keep your breathing pattern calm. For more help with this contact your local respiratory physiotherapist (www.physiotherapy.org.nz is a great place to look) or ask your doctor to refer you to your local district health board respiratory physiotherapy department.

What to do if you get asthma symptoms during exercise1. Firstly, dont panic.2. Take your reliever

medication calmly.3. Stop, sit down and lean

forward, supporting your arms on your legs. If you are unable to sit down then place your hands above your knees and lean forward while standing.

4. Focus on breathing out, slowing and controlling your breathing until your reliever works.

Formerly a Senior Physiotherapist in the cardiorespiratory team at Counties Manukau Health in Auckland, Brigitte Eastwood now works as Senior Physiotherapist Special Interest Paediatrics, at Bay of Plenty District Health Board.

Be prepared have your inhaler with you. This can help take the worry out of exercise.


If youre living with allergies, identified or not, youll very likely have a compromised immune system. This is simply because having allergies puts pressure on your general immunity as it stays in a more inflammatory or reactive state.

Supporting the immune system to help reduce allergic tendency and severity of response is well accepted as part of the allergy treatment protocol; it will also help to strengthen immunity to ward off the risk of recurrent virus and infection such as the common cold.

As the seasons change, there are a number of well researched and effective natural supplements you can add to your daily regime to help achieve good health and immunity throughout the long winter months.

natural health

SICK OF BEING SICK?

With the change from summer to autumn, its useful to start supporting your immune system, particularly if youre living with ongoing allergies, says Naturopath Rebekah Paddy.


Probiotics: See Living with Allergies Summer 2015 to read how probiotics can support immunity and reduce allergic tendency. Taken daily in the appropriate strains this is a great way to increase important microbes in the gut.

Slippery Elm Powder: This is one of my favourite pre-biotics. A pre-biotic helps to set the scene by creating the perfect environment and feeding our good gut flora which are at the very heart of a healthy immune system. Slippery Elm has the added benefit of healing the gut mucosa lining, which has often been compromised due to the inflammatory response, especially when food allergies have been present. This can lead to a condition called leaky gut syndrome which can increase the likelihood of ongoing allergic response and compromised immunity. Slippery elm powder can be added to any food or put it in a smoothie. Just make sure you increase your fluid intake. Omega 3s: It is well known that Omega 3s increase immunity and reduce inflammation associated with allergies. They are a first choice supplement especially for atopic conditions such as eczema and hives.

Vitamin D: Humans get this vitamin from sunshine. In New Zealand we have almost epidemic levels of Vitamin D deficiency in summer we need to be covered from our harsh sun and in winter we see little sun. Low vitamin D levels are associated not only with recurrent illness, but increased allergy risk and the winter blues. Sometimes Vitamin D needs to be prescribed by a GP if levels are too low. For maintenance, I suggest cod liver oil (there are good tasting supplements these days!). This has high levels of natural vitamin D and A as well as Omega 3, so is a good all-round option. Other foods high in Vitamin D include saltwater fish, eggs, dairy and green leafy vegetables.

Zinc: Deficiency in this mineral is associated with recurrent infection, slow wound healing, increased colds, fatigue, and growth retardation. Zinc needs to be part of a daily supplementation regime in winter if you have lowered immunity. Foods that can help maintain good levels of zinc are eggs, seaweed, mushrooms and lamb. Zinc can displace other needed minerals such as iron, so zinc supplements should be taken separately, at night.

Vitamin C: This is a well-known immune booster. I suggest taking a supplement in an easily absorbable form once a day and increasing frequency throughout the day if youre getting sick or when youre ill.

For appropriate dosing and peace of mind that you are taking good quality supplements, speak to your pharmacist, naturopath or local health shop.

Finally, a few things to be conscious of if you or your kids keep getting sick or take a long time to shake illnesses off: Check for further allergies or intolerances that may be compromising your immunity. Get your iron tested. If this is low, your immunity will be low too. When youre sick, honour your appetite and only eat when you need to. Drink plenty of fluids, preferably warm, such as herbal teas and honey and lemon drinks, and get lots of rest. This will allow your body to heal and let you get back into the fast lane more quickly.

Rebekah Paddy is a Naturopath, Medical Herbalist and Director at Mother-Well Holistic Health in Auckland www.mother-well.co.nz.


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Clinically studied Essential support for expectant mothers and babies Protects and supports against skin flare-ups

0024GH LWA_March 2015 AP.indd 1 26/02/15 12:56

Successful treatment of childhood eczema often comes down to the details, says immunologist and allergy specialist Dr Andrew Baker.

eczema

ATTENTION TO DETAIL

See Dr Bakers Top 5 Tips for Parents on the next page.

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DR BAKER encourages parents to seek out expert advice on how to effectively use moisturisers and steroid creams. Often, the benefits are in the details of how these are used, he says. Regular, more preventative use of these creams, when guided by an expert, is often best, rather than reactionary use just when the eczema is bad.


Consult with an expert who can supervise treatment with regular follow-ups.

Successful treatment is often in the details. For example, do you wait until your childs eczema gets bad before you start treatment or do you start early? Do you put cream just on the spots or over the whole area? How much steroid cream should you put on? The Australasian Society of Clinical Immunology and Allergy website (www.allergy.org.au) has a good page on Eczema which includes information on fingertip units (or FTUs), which can help guide treatment.

Discuss any worries you might have about using steroid based creams with your doctor or specialist. These creams vary a lot, and while some are strong, others such as 1% hydrocortisone, are actually very weak and almost certainly do not cause skin thinning. (They can be used on the face as well.) All of these treatments are approached on a case by case basis though, so regular follow-ups with your GP or a specialist are necessary.

Avoid all soaps and other cleansers. Stick to a simple soap substitute such as Sorbolene 10% glycerine.

Have a plan in place: When a flare of eczema improves, a plan for preventative treatment should be put in place to stop recurrent flares. This might be as simple as avoiding all soaps and using moisturiser twice a day, but another more preventative approach sometimes used is the application of steroid cream twice weekly, also known as steroid cream weekends. This can be a good option for children with moderate recurrent eczema and some studies have shown less steroid cream is needed in total because exacerbations are prevented. Once again, this needs to be decided on a case by case basis, so talk to your childs GP or specialist.

DR BAKERS TOP 5 TIPS FOR PARENTS

eczema

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DR BAKERS TOP 5 TIPS FOR PARENTS

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eczema

Should I stop certain foods for eczema?There is a lot of misinformation about this. Advice to avoid large numbers of foods can be very harmful both nutritionally, psychologically and socially, both for adults and children. Almost all eczema in adults is not food related. In only a very small proportion of eczema cases in children should foods be avoided just because of eczema. In most cases, it is better managed by other means. Also, new evidence shows that avoiding some foods in early infancy may actually increase the chances of the child developing more severe allergy to those foods. The evidence for this is particularly clear for peanuts.

DR BAKER ANSWERS THREE COMMON QUESTIONS ABOUT ECZEMA:

As a result, the Australasian Society for Clinical Immunology and Allergy (ASCIA) recommends introducing all typical allergenic foods to a childs diet at age 4-6 months.

Do bleach baths work?In one study, patients were randomised to normal baths, and the others to a bath with half a cup of Janola in it. This makes the bath basically about the same chlorine concentration as a swimming pool. Those having the bleach baths twice weekly for 15 minutes each time had a 3040% improvement in their eczema. Bleach baths work by killing a bacteria on your skin called Staph Aureus, which drives eczema in some patients.

What about dustmite desensitisation?In those patients with a positive dustmite skin test, or IgE RAST blood test to dustmite, a study has shown that eczema improves on average by about a third if they have dustmite desensitisation. For people with only mild eczema, this may not be worth it, but for those with more severe eczema, this may be valuable. Correct use of moisturisers and steroid creams always comes first and 9/10 times it is better advice on the specifics of HOW these are used that will do the job.

Dr Andrew Baker is an Immunologist and Allergy Specialist at Waitemata Allergy Clinic on Aucklands North Shore. See www.allergyspecialistdoctor.co.nz.


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food and recipes

STRESS-FREE GLUTEN FREE FOR KIDS

CATERING for gluten free children can be challenging, particularly when it comes to filling lunchboxes and special events like birthday parties, says Sally Holland, Tauranga author of the newly released Goodbye Gluten cookbook.

Especially when you think that the school lunchbox staple is sandwiches, and common kids

party foods include cheerio sausages, flavoured chippies and fairy bread, all of which are likely to contain gluten. It is this conundrum that prompted Sally to include a dedicated childrens section in her book, which was launched in December.

I think its very important that we teach our children how to cook, and even more so when they have special dietary needs, says Sally.

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Sally Holland shares recipes that gluten free kids and their friends will love.


Many of my recipes are simple and straightforward, so that children can try them for themselves.

If you are hosting a birthday party and you have a gluten free child on the guest list, its easier for everyone concerned to make the whole party gluten free, she advises.

There are many party foods that are gluten free anyway, so dont forget about them. Popcorn, some marshmallows, meringues, jellies, ice creams and even smoothies are all good.

You can also make nachos with gluten free corn chips or homemade potato wedges

with child-friendly dips.When it comes to school

lunchboxes (a chore even for parents of non-gluten free kids!), Sally says the challenge is to fill it with foods that will travel well and not fall to pieces.

There are some good commercially made gluten free breads on the market now that are very springy and suitable for sandwiches. Keep them in the freezer and semi-thaw in the microwave in the morning and the sandwiches will be great by lunchtime.

Gluten free wraps are another good option.

Find out more about Sally Holland and Goodbye Gluten at www.goodbyegluten.co.nz

CHECK OUT RECIPES FROM SALLYS BOOK ON PAGES 27 & 28

Bobs Red Mill Natural Foods is a miller of stone-ground whole grains and a leader in organic and gluten free foods.

With more than 40 gluten free products, theres no shortage of choice for breakfast, morning tea or lunch.

Check out wheat free oats, nutritious gluten free cereals, baking and bread mixes at your local organic store, or visit www.organix.co.nz


BIRTHDAY CAKEServes 10

This simple and delicious vanilla cake, paired with chocolate or orange cream cheese icing, is perfect for your next birthday party, or any special occasion. The recipes for gluten free flour mix and the icing can be found on page 28.

125 g butter1 cup sugar3 large eggs2 tsp vanilla extract cup sour cream1 cups gluten free flour mix (see page 28)2 tsp baking powder, gluten free1 tsp baking sodapinch of salt1 x quantity chocolate icing (see p 28)or1 x quantity orange cream cheese icing (see p 28)gluten free cake decorations as desired

Preheat oven to 170 C. Line the base of a 23 cm round cake tin with baking paper.Beat the butter and sugar until pale.Add the eggs, one at a time, beating well after each addition.Add the vanilla extract and the sour cream. Beat to combine.Fold in the sifted flour mix, baking powder, baking soda and salt.Pour into the prepared tin and level the top.Bake for 3540 minutes until a skewer comes out clean.After 10 minutes, turn out on to a wire rack to cool.Ice with chocolate icing or orange cream cheese icing and decorate as desired.

THE BIRTHDAY CAKE is the pice de rsistance of the party. I have used a vanilla cake which is perfect with either a chocolate or cream cheese icing.

The chocolate numbers were made using a silicon mould from a kitchenware shop. Simply melt some chocolate and fill the mould, level off, and place in the refrigerator. When hard, gently peel away from the mould. White chocolate looks good on chocolate icing and dark chocolate is best on the lighter coloured icing.


GLUTEN FREE FLOUR MIXMakes 4 cups

This is easy to mix up and is best stored in an airtight container in the pantry. I have used white rice flour and cornflour from maize not wheat. Xanthan gum is made from corn sugar and is used as a gluten substitute to give elasticity in gluten free baking. Tapioca flour is also known as arrowroot.

2 cups rice flour1 cup tapioca flour1 cup cornflour2 tbsp xanthan gum

Sift all ingredients into a large mixing bowl.Using a wire whisk, slowly stir until well blended. Transfer to an airtight container.

CHOCOLATE ICING50 g butter, melted1 cup icing sugar, gluten free3 tbsp cocoa

Place all ingredients in a bowl. Beat in enough hot water to make a smooth creamy icing.

ORANGE CREAM CHEESE ICING125 g cream cheese, softened50 g butter, softenedFinely grated rind of 1 orange2 cups icing sugar, gluten free

Beat the cream cheese and butter together until creamy. Add orange rind and icing sugar and beat until smooth.

YUMMY STICKY CHICKEN STICKS These are a great savoury item for a birthday party.

Makes 24

3 tbsp tomato paste cup tomato sauce, gluten free2 tbsp white wine vinegar1 tbsp tamari, gluten free100 ml maple syrup8 skinless, boneless chicken thighs

Mix the tomato paste, tomato sauce, white wine vinegar, tamari and maple syrup together in a bowl.

Cut each chicken thigh into nine pieces and add to the marinade. Cover and refrigerate for several hours.

Soak 24 bamboo satay sticks in cold water. This prevents them burning during cooking.

When ready to serve, thread three pieces of chicken on each skewer.

Either barbecue or grill, turning once or twice during cooking, until the chicken is done. This will take about 20 minutes.

While cooking the chicken, place the leftover marinade in a small saucepan and bring to the boil. Simmer for five minutes.

Drizzle over the cooked chicken sticks.


Dexem more than just relief from eczemaDexem Repair helps eczema in 3 ways:

Soothes: Moisturises and conditions the skin to help relieve itching and aid healing.

Restores: Skin friendly pH provides an optimal environment for skin healing and normalisation of skin health. Protects: Containing the natural bacteria blocker 2QR, Dexem Repair helps prevent bacterial infection on and around the eczema site. Always read the label and follow the instructions. Do not use if you are sensitive to one or more of the ingredients. For external use only. If symptoms persist, please see a healthcare professional. Distributed by Air Flow Products Limited, Wellington. 0800 247 356 www.air-flow.co.nz. TAPS CH4745

RRP from $14.99. Dexem Repair cream and scalp are only available from Pharmacies. For more information visit dexem.co.nz

Allergy Guide ADVICE, BENEFITS & CHOICES

Clear Eyes -A relief for itchy eyesClear Eyes -A is a triple action formula that relieves itching associated with exposure to airborne allergens, removes, redness and moisturises irritated eyes.

Always read the label use only as directed. If symptoms persist consult your healthcare professional. TAPSCH4095

Available in pharmacies www.cleareyes.co.nz

Dairy free yoghurt no bull!NoMoo proudly produce their new range of Dairy Free Yoghurts in their modern dedicated facility in rural Nelson. Containing the goodness of non-GMO whole bean soy milk, coconut cream, real fruit and live probiotic cultures, they dont contain preservatives, artificial flavouring or colouring. NoMoo dont make products containing cows milk, nuts, eggs or gluten either, so you can be sure their yoghurt is free of these common allergens too. Available at selected supermarkets and retailers or email: [email protected]

DIY carpet cleaning for a clean and healthy homeRug Doctors DIY equipment covers it all. From whole floor cleans, to spills, mattress cleaning, stairs and upholstery (chairs, couches and vehicles). Cleaning your carpet regularly not only maximises the life of your carpet, it is also very important for the health of your family, eliminating fleas, cockroach eggs and dust mites, giving you a clean and healthy home. To find out more, visit www.rugdoctor.co.nz or call 0800 800 245

Dermalab natural care for winter skinWinter means less humidity in the air which can lead to dry, cracked skin and eczema flare ups. Keep skin soft and healthy with DermaLab, packed with skin-loving natural ingredients such as oats, honey, almond oil, shea butter, calendula and chamomile. Natural goodness made right here in New Zealand. Skin Friendly pH Fragrance Free Colour Free Paraben Free Lanolin Free SLS Free PEG Free www.dermalab.co.nz


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endpoint

That about 40% of the iron in our diet comes from wholegrains. PAGE 4

That pulling furniture away from external walls and leaving wardrobe doors ajar will help encourage air movement and discourage mould from growing in bedrooms during the winter months. (And that this is particularly important in bedrooms on the south side of the house.) PAGE 11


USEFUL SNIPPETSWeve enjoyed putting together this issue of Living with Allergies and have learnt some interesting things along the way. Here are some of them

That the pain reliever codeine is metabolised to morphine in the body. PAGE 3

That itchy, watery eyes are associated with allergic conjunctivitis; whereas gritty, sticky eyes are a symptom of infectious conjunctivitis. PAGE 9

That to improve your fitness its

important to get a bit breathless. A good rule of

thumb is the walk and talk test. When

exercising you should be moderately short

of breath but still able to speak. PAGE 14

That as well as being a pre-biotic

that helps maintain gut flora, slippery elm has the added

benefit of healing the gut mucosa lining

which often becomes compromised in people with allergies. PAGE 17

That the Australasian Society of Clinical Immunology and Allergy website,

www.allergy.org.au, has an informative page on Eczema which includes information on fingertip units

(or FTUs), which can help guide

treatment. PAGE 20

ACU_ING_11391

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Talk to your healthcare professional today

Oralair is an unfunded prescription medicine. Always use strictly as directed. Ask your doctor if Oralair is right for you. Oralair has risk and benefits. If symptoms continue or you have side eects, see your healthcare professional. Normal doctors fees will apply For futher information on Oralair contact your doctor or healthcare professional or view the Consumer Medicine Information (CMI) go to www.medsafe.govt.nz/consumers/cmi/cmiform.asp Stallergenes Australia Pty Ltd Suite 2408 4 Daydream Street Warriewood NSW 2102 Distributed in New Zealand by EBOS Group Ltd 108 Wrights Rd Addington Christchurch Ph: +64 (0) 9 4153 267 Fax: 0800 262 262 Stallergenes & Oralair are registered trademarks of Stallergenes SA STG12115 TAPSPP5855

REFERENCES: 1. AUST R 167565 - ORALAIR Initiation Treatment & AUST R 167566 - ORALAIR Continuation treatment. 2. Approved Oralair product information. 3. (VO34.04 study): Didier A. optimal dose, ecacy and safety of once-daily sublingual immunotherapy with a 5-grass pollen tablet for seasonal allergic rhinitis. J Allergy Clin Immunol 2007;120:1338-45. 4. (VO52.06 study): Whan U.et al. Ecacy and safety of 5-grass pollen sublingual immunotherapy tablets in paediatric allergic rhinoconjuntivitis.J Allergy Cin Immunol 2009;123:160-6.

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