Advice not to feed peanuts to babies may be behind soaring levels of food allergies

Advice to avoid giving peanuts to babies for fear of sparking allergic reactions may in fact be driving the rate of allergy higher, according to a leading expert.

Professor Gideon Lack, a paediatric allergy specialist at Kings College London, believes there is growing evidence to suggest that parents should feed their children peanuts from a young age to protect them from allergies. The same may apply to other potentially-allergenic foods including fish and eggs.
The professor's work, which proposes a new mechanism for what leads children to develop allergies, is contrary to advice from public health officials at the Department of Health and the World Health Organisation, who insist children should avoid eating peanuts until three years old.
The Food Standards Agency has now launched a full review of the evidence to determine if a shift in the advice is needed.
Professor Lack is conducting the first clinical trial into whether eating peanuts in the first year of life can protect children from allergy, but he insisted it was still too early to know if official health advice should be changed.
He said: "Peanut allergy in English-speaking countries has almost trebled in the last 15 years and occurs in almost one in 50 primary school children. In traditional societies in Africa and Asia, however, it doesn't occur in children to the same extent. In these societies babies are allowed to eat peanuts from a very early age.

"The hypothesis is that by eating peanuts in the first year of life, babies become tolerant of those foods.
"The gut is surrounded by a belt of immune tissue which help to recognise friendly proteins such as those from food. Without this you would reject everything you ate.
"The immune system learns early in life, through the repeated introduction of food, that proteins from food are harmless and innocuous substances. So regular exposure in a healthy baby in early life may actually help the immune system to distinguish between friend and foe."
Professor Lack will describe his work at the official opening of new research laboratories in the Medical Research Council's and Asthma UK's Centre in Allergic Mechanisms of Asthma at Kings College London on Monday October 27.

Peanut allergy is now the most common food allergy. Symptoms can vary from rashes and itching to breathing difficulties, narrowing of the airways and leaking of the blood vessels. In severe cases, known as anaphylactic shock, it can lead to death.

Allergies occur due to an over-reaction of the immune system to molecules that are normally harmless, triggering an attack that releases toxic biological chemicals into the blood stream.
These in turn damage the body's own tissues and causes inflammation.
Professor Lack believes that children who have not eaten peanuts may be more prone to suffer an allergic reaction when they come into contact with them through their skin, particularly if they suffer from skin conditions.

He said: "The problem is that food proteins can be found everywhere in a house, so what I believe is happening is that when babies suffer from eczema, the skin barrier is broken down and there is a lot of inflammation as molecules of peanut and other food get through the skin.
"The body sees the food molecules as a threat and responds to it as it would to a parasite, by mounting an antibody response."
Professor Lack is currently two years into a five-year clinical trial to examine whether it is possible to make children more tolerant of a food by feeding it to them earlier in life. Using 650 children who suffer from eczema, which is known increase the risk of developing an allergy, he has asked half the parents to feed their children peanuts while they are weaning between the ages of four and eleven months.



The other half have been asked not to feed their children any peanuts. As the youngsters grow up they are having regular blood samples taken to observe how their immune systems are developing. At the age of five they will be tested for food allergies.
Professor Lack is also planning a second trial to look at other food allergies in 2,500 children. Again, half the parents will be encouraged to feed their children a variety of solid foods from an earlier age than the other half.

A spokesman for the Food Standards Agency said a panel of independent experts on the Committee of Toxicity had been asked to review the current advice, issued in 1998, on early exposure to peanuts and other allergens. In the meantime, he said, parents should continue to follow existing advice.
He said: "The independent experts of the Committee on Toxicity are considering the findings of the review and other relevant evidence, and have been informed about ongoing research in this area, including the King's College study. They are considering whether their previous recommendations are still appropriate."

Confusion about Weight Watchers and overall diet advice

Confused about diets? What else is new?

Here's one comment from the announcement about the Weight Watchers points overhaul.

Daniela: Make up your mind, CNN...you just wrote a story about the professor who proved to us that the Twinkie Diet works the opposite way. I know you are just reporting on this, but can you at least make some type of cross reference to the previous story so we aren't confused.

Earlier this month, CNN.com reported on a crash diet by a nutrition professor at Kansas State University. Mark Haub, the professor basically ate junk food and lost weight by reducing his calories.

This diet was a class experiment with a very, very small sample size – that’s right, one. This happened for only 10 weeks. This diet is not recommended for anyone and it’s not even endorsed by Haub.

It essentially showed that yes, you can lose weight by reducing calories. Technically, you could lose weight through all sorts of things - fasting, starving, cleanses, etc.

So this question was taken to Stephanie Rost, corporate program development director of Weight Watchers.  Why bother trying to eat healthy foods like fruits and veggies when you can lose weight on Twinkies?

“When you lose weight on Twinkies, you’re not looking at long-term effects,” she said. “If you restrict calories, you lose weight, but it’s hard to stick with that for the long term.”

Here's how other readers answered the commenter's question:

Bob: Look, you could conceivably eat anything and reduce weight over a short period. That doesn't mean it's sustainable or healthy. A sustainable lifestyle change is the issue – and that's where fad diets fail.

Lisa: Lowered calorie levels will result in weight loss no matter where the calories come from. What Weight Watchers is aiming for is weight loss with good nutrition which results in a healthier lifestyle and overall better health.

Fruits and vegetables fill people up and give them proper nutrition, Rost said.   After all, a diet higher in fruits and vegetables has been shown to decrease risks of heart disease, cancers, and a variety of chronic diseases,  she said.

Bobbi Brown Explains How To Clean Your Makeup Brushes

In Confessions of a Beauty Editor, we guiltily admitted that even we don't clean our makeup brushes as often as we should. Determined to make a change, we asked makeup artist Bobbi Brown—whose Blush Brush is a Best of Beauty winner—for instruction.

How often should you clean makeup brushes?
For concealer and foundation brushes, at least once a week to prevent a buildup of product. And because these brushes are used on your face, the cleaner, the better. Brushes that are used around the eyes should be cleaned at least twice a month, while all others can be washed once a month.

How do you do it?
The best and most thorough method for cleaning your makeup brushes requires only water and either a gentle soap or brush cleanser. Using plain soap and water can dry out the brush's bristles, especially if they're made of natural hair. [Editor's Note: Try one part baby shampoo to four parts water.] Wet the bristles with lukewarm water, place a drop of cleanser into the palm of your hand, and gently massage the tips of the bristles in your palm. Always remember to keep the base of the brush head away from soap and water. The bristles are glued to the base, and water and detergent can cause the glue to disintegrate and the bristles to come loose and shed.

Rinse the bristles, squeeze out the excess moisture with a clean towel, reshape the brush head, and let the brush dry with its bristles hanging off the edge of a counter. This allows the brush head to dry into a perfect shape. Never let your brushes dry on a towel—the bristles can become mildewed.

How do you know when a brush is just kaput?
When the bristles start to fray, shed, or lose their shape. I can't emphasize enough that the right tools are as important in getting the look you want as the actual makeup itself. If your brushes become too pinched or squashed, then they simply will not be up to the job.

Accutane Not Linked to Depression, Study Says

A small study fails to link the use of the controversial acne drug Accutane to severe depression or suicide. The findings are reported in the May issue of the journal Archives of Dermatology.

For years, critics have said Accutane can cause serious depression and increase suicide in teens. A U.S. congressman blames the drug for his teenage son's suicide five years ago, as does a Florida mother whose 15-year-old son died in 2002 after intentionally flying a small plane into a Tampa, Fla., skyscraper.

But the drug's manufacturer has long contended that Accutane does not increase the risk of depression and suicide, and a newly published study appears to back that up.

Teens in the study who took the drug showed far fewer signs of depression three and four months after beginning treatment than they did before starting Accutane.

"This certainly backs up what we have seen in our practices," pediatric dermatologist Elaine Siegfried, MD, tells WebMD. "Most dermatologists are in agreement that Accutane is a miracle drug for acne. I have treated many thousands of patients with it, and I have never seen clinically significant mood alterations in any of my treated patients."

Known Risks

Accutane was approved in 1982 for the treatment of serious acne that doesn't respond to other treatment. Its safety has been the subject of heated debate ever since. A synthetic derivative of vitamin A, the drug is well known to cause serious birth defects in up to a third of babies born to women who use it during pregnancy.

As a result, women of childbearing years who take Accutane are required to use at least two forms of birth control while on the drug.

But while Accutane has long been suspected of causing depression, there is no direct proof to back up the claim, says psychiatrist Douglas G. Jacobs, who is a consultant to the drug's manufacturer, Roche Labs. Roche is a WebMD sponsor.

"I have spent more time reviewing the studies than anyone and there is just no evidence that Accutane causes depression or increases the risk of suicide," Jacobs tells WebMD.

A statement published earlier this month by the FDA notes that the agency continues to assess reports of suicide or suicidal attempts associated with the use of Accutane. The statement also calls on physicians to be vigilant about following their patients taking the drug closely for signs of depression.

The latest study was conducted by Siegfried and colleagues from St. Louis University Health Sciences Center without financial backing from Roche Pharmaceuticals.

The researchers used standardized tests to evaluate depression levels among teens with moderate to severe acne -- before beginning Accutane and while on the drug. Another group of teens who took antibiotics instead of Accutane for their acne were also evaluated.

Roughly 14 percent of the teens in the Accutane group and 19 percent of those in the antibiotic group had scores suggestive of depression before beginning treatment. Three to four months later about 8 percent of the teens taking Accutane and 15 percent of those taking antibiotics had similar scores.

Siegfried says it just makes sense that teens who feel better about th

Brain Imaging Studies

But Emory University psychiatrist J. Douglas Bremner, MD, who also studies Accutane, says the latest study was too small to answer many questions about whether Accutane causes depression. Of the 132 patients enrolled, 59 were treated with Accutane and 73 were prescribed antibiotics and topical creams.

Bremner says a study of at least 1,000 patients is needed to either prove or disprove the link between Accutane and depression.

The psychiatrist says his own recent imaging research shows that Accutane causes changes in the frontal lobe of the brain, which is associated with emotion. The research was published last month in the American Journal of Psychiatry.

Bremner found significant changes in the area of the brain known as the orbitofrontal cortex in 13 adults taking Accutane. No such changes were seen in a similar number of adults taking antibiotics.

But a Roche spokeswoman tells WebMD there is no consensus in the scientific community that the orbitofrontal cortex of the brain controls depression and mood. She added that there was no difference in depression symptoms between the people in Bremner's study taking Accutane and those taking antibiotics.

All the Evidence They Need

The lack of clinical proof has done nothing to change the views of those who blame Accutane for the suicide of a loved one.

Rep. Bart Stupak (D-Mich.) is among the drug's most outspoken critics. Stupak's 17-year-old son, B.J., shot himself in May of 2000, and Stupak says he believes Accutane is responsible. The legislator has been working to get tighter controls on Accutane ever since.

The mother of a teenager who killed himself by flying a Cessna airplane into a Florida high-rise office building in January 2002 is also convinced that Accutane caused her son's death.

And a grieving father in Ireland has reportedly spent more than $1 million of his own money attempting to prove that Accutane is linked to suicide. Liam Grant's 19-year-old son, also named Liam, took his own life in 1997 while studying engineering at Dublin University.

Fixing Health Care: When Patients Don't Know Best

Few spontaneous injuries are as obvious as a rupture of the Achilles tendon. That ropelike cord in the back of our ankles carries enormous loads. It resists, literally, a thousand pounds of tension when a person, even of normal weight, runs or jumps. When the tendon pops, it's not subtle; many patients report actually hearing a bang. It hurts a lot. And most characteristically, they suddenly lose all "down power" in the ankle, making it impossible to get up on tiptoe.

The X-ray of an ankle with a torn Achilles tendon will generally be normal, but simply examining the patient makes the diagnosis quite easy. Instead of the stout tendon, you feel mush with a hole or divot at the spot where it's torn. It's easy to compare with the other ankle. And there's a great test we do by squeezing the calf and watching the ankle move; on the good side, it wiggles up and down when we squeeze. On the torn side, there's no motion at all. Yes, there is an occasional partial tear that might be harder to diagnose, but in the vast majority of cases, an orthopedist who simply looks, listens and feels will make the diagnosis of Achilles-tendon rupture — with confidence. (Watch TIME's video "Uninsured Again.")

So why is it that the patient I saw today and the one I saw last week both came to me having had MRI scans of their ankles?

Frank is a fit, 59-year-old insurance adjuster who had felt the pop during a kickboxing class 10 days before. He immediately had a pretty good idea of what had happened, so after limping out of the gym, he called an old friend who is a retired orthopedist. "He said he was pretty sure it was my Achilles, but I wanted an MRI to be sure. He just said 'fine' and gave me the prescription." I spoke with Frank and showed him the powerlessness of his ankle — the squeeze test. I even had him put his finger into the divot in his tendon. I tried to be gentle about bringing up the s word — surgery — but when I finally broached it, he shot back with, "But you haven't even looked at the MRI yet. I heard the ads — it's the new stand-up unit. Listen, doc, I know you've treated this before but ..." So I just put up the films and showed him the tear. I could have been showing him a plate of scrambled eggs, but he was happy and we booked his case. (See pictures from an X-Ray studio.)

Paul is a 45-year-old teacher who tore his Achilles in a basketball game two weeks earlier. The first orthopedist he saw went into a long talk about risks and benefits and scared him out of his wits. With a torn Achilles tendon, there are just two things to do: either sew it up (which means doing a small operation) or put a cast on with the foot flexed down. The cast treatment isn't as good — it won't restore normal power — but there are none of the risks of surgery (like scarring and infection). So he demanded an MRI, which he got, then called his internist to ask for another specialist. "You're not playing any more basketball, at least not the kind that requires jumping, if you don't have that tendon repaired" is what I told him after taking him out of the cast and examining the ankle. "Can't we get another MRI to see if it's healing? I've read about them."

"If you're going to trust me to operate on you, you're going to have to trust me on this too — you don't need another MRI. You didn't even need the first one."

There are real savings to be had in cutting down on MRIs — especially unneeded ones. But it's quite hard to keep insured patients who ask for expensive medical tests and treatments from getting them. Blocking a patient who wants something they saw in an advertisement is time-consuming. Teaching the complex truth one on one is a lot harder than convincing large numbers through eye-catching, sound-biting market psychology. It's a money loser too. Most of the time, a patient who has been sold on something you don't want to use will just leave and go to another doctor. (Read about the five big health-care dilemmas.)

We face this issue every day: the pill they saw on TV or in the magazine, the new scan, the diet supplement, even the specific brand of hip or knee prosthesis are difficult, occasionally impossible, to deny to the folks who ask for them. In the American doctors' precarious medico-legal (and fiscal-social) position, career success is increasingly built on cooperation with the corporate and government powers that touch us. Playing along with that sketchy (but expensive) new treatment or being a champion of the wacky new state initiative is more likely to help your career than giving an educated but honest appraisal of actual patients' well being. The only salvation from this might be, strangely, the recession. Traditional medicine, without the consumer marketing or institutional pandering to federal agencies, is cheaper. And if the downturn turns down low enough, we'll need to turn down demand. And stop hawking medicine.

Heart-healthy cooking

No matter how much time you have or don't have for cooking, you can make quick and easy heart-healthy meals by following these simple suggestions.

Heart-healthy cooking focuses on lowering your intake of fat, especially saturated and trans fats. It also includes limiting salt while upping fibre and making sure you eat four to 10 servings of vegetables and fruit a day.

What's on your plate?
Start by changing the proportions of your plate so that protein sources such as meat and fish are no longer the main attractions. Instead, fill about half of the plate with a colourful variety of vegetables, a quarter of the plate with whole grains such as brown rice and 100% whole-grain bread. Fish, poultry, lean meat or legumes (chickpeas, lentils, tofu) should make up the remaining one-quarter of the plate.

Slash the fat
Trim all visible fat from meat and take the skin off poultry and fish to reduce fat and calories. Instead of pan-frying or deep-frying, try baking, broiling, grilling or roasting (on a rack, so fat can drip away). Fish may be poached in water, sodium-reduced tomato juice or lower-fat milk. To sauté, use a non-stick pan or a small amount of heart-healthy olive or canola oil.

Double up
If you're sautéeing, steaming or boiling a vegetable, it's just as easy to cook two or more in the same pot or pan. If you're making brown rice, cook twice the amount you need so you'll have enough for another meal.

Try smart-switching
Substituting healthy ingredients for less healthy ones won't take any more time and may even save you money. Use plain, lower-fat yogurt instead of sour cream, lower-fat cheese instead of the full-fat type, and evaporated skim milk instead of cream. Cook whole-wheat pasta instead of white. Replace some of the white flour in a recipe with 100% whole-wheat flour.

Shake the salt habit
Instead of salt, spice things up with fresh or dried herbs. Try dill with fish, paprika with chicken or ginger with beef. Lightly sautéed garlic, onions and sweet red peppers add flavour as well as assorted nutrients that promote good health.

Great Wedding Food: Tips from a Newly Married Critic

 Gluttony tends to be a solo pursuit, which is one reason food writers tend to have more knowledge than friends. No memorable high school drives down to the lake, no going on tour with the Dead, no trips to the All-Valley Karate Final — just an uninterrupted series of shameful and solitary feedings. That's the youth of a food writer. But sometimes we get delivered from the prison of our preoccupations, and this recently happened to me. I fell in love and got engaged. So of course, the first thing I thought about was what the food at the wedding would be.

Wedding food is universally understood to be bad. The chicken is leaden and the salmon chalky. The vegetables tend to be washed out. You almost never eat well at a wedding. The reason is obvious: it's hard to cook a dinner for 200 people at once. What's more, most caterers aren't really good cooks. Or maybe at home they are. But even in a restaurant, you don't have to serve 200 people all at the same time. Nor do you have to come up with a dish that nobody will object to. Basically, the caterer's job is to not screw up. To put something edible on the table that looks fancy and is warmer than the average body temperature. It's a low bar, but the bride and groom count themselves lucky if nothing goes catastrophically wrong.
(See TIME's photo-essay on food as pop culture.)
Naturally, that's not how I approached my wedding. There are restaurants all around New York City that are objects of my special passion — why wouldn't I want their best stuff at my wedding? Most everything can be done ahead of time in hotel pans and reheated at the reception. In fact, most foods are better when reheated. Think of a pan of lasagna. When it's fresh, it's searingly hot, runny, a torrid mess. The lasagna you really want has had time to cohere, to settle, to cool a little. That's the lasagna you want when you come home, famished, at the end of a long drive and find it sitting on the back burners. That's the lasagna you may even pick at directly from the refrigerator, clad only in your pajama bottoms. Why not experience that lasagna at your wedding? It can only get better the longer it sits in its pan.

(See pictures of what makes you eat more food.)
That was my thought, and I put it into action with immense success. I cherry-picked my favorite dishes from half a dozen restaurants. Orhan Yegen's brilliant mezes and hummus from Sip Sak started out, along with a salad made ahead of time by Ed "Eddie Glasses" Schoenfeld of Red Farm, with his memorable Chinese black-vinegar dressing. Jim Lahey of Sullivan Street Bakery, the city's best, was on bread duty, and we had his crusts to smear the hummus on. Michael White of Alto, Marea and Convivio restaurants, i.e., the Sultan of Spaghetti, made the lasagna — and my god, what a lasagna it was! How I wish I had a pan of it now. (There was one left over too, but the staff got it, damn them!) For the vegetarian contingent at the wedding — from the bride's side, naturally — there was a meatless moussaka from the great Greek chef Michael Psilakis of Kefi, with mushrooms and béchamel subbing in for the ground lamb. Doug and Laura Keiles of Ribs Within, one of our top northeast competition barbecue teams, whipped up some smoked tofu, so that even a stray vegan might have some hint of what flavor is. Every taste was accounted for.

Of course, not everything can be cooked ahead of time. The marquee proteins, prime dry-aged Creekstone beef and day-boat scallops, were both done on-site. Both were cooked by the Empire Hotel's restaurant chef, Ed Brown of Ed's Chowder House (and formerly of Eighty-One). But the truth is that you didn't need a chef of Ed's caliber to cook these bone-on strip loins. You just put salt and pepper on them, put them in an oven, and have some guy cut them up afterward. (Then you could also make a sandwich on the Jim Lahey bread — recombination is the way to go at these feasts.) Ed cooked the scallops himself in a pan on a little burner, and took inordinate pride in doing so. I felt bad for him; everyone else was living it up, and he was stuck cooking scallops. At the very least, someone should have brought him a steak sandwich. But I was too busy dancing with the bride to Elvis' immortal 1974 recording of Don McLean's "And I Love You So," and too happy at the profusion of great dishes on every side.

(See 10 myths about dieting.)
But, you ask, what about the cake?

It will come as no surprise by this point, but we decided against getting a conventional wedding cake that tastes like polyurethane. Instead, we had a big multitiered chocolate cake with chocolate frosting and pink flowers all over the place. The cake came over by car with the lasagna: the Sultan of Spaghetti has a brilliant pastry chef, Heather Bertinetti, who made a cake that everyone wanted to eat, even when they were full and drunk and highly emotional — and that's no easy feat. But Heather only had to make cake, in much the same way that White only had to make lasagna, Lahey bread, and so on. Everybody got to do their best work, nobody was forced to carry the whole load, and since all the contributing chefs were invited to the wedding, they got to feel a well-earned pride at seeing their peers ravenously tear apart the dishes they (or in most cases, their underlings) had so carefully constructed. Out of so much destruction, my bride and I created the happiest possible memory, and all the guests got to eat their fill at the greatest wedding banquet ever thrown.

(See a special report on the science of appetite.)
So here's my advice to anyone who is starting to plan a wedding: Forget the caterer! Plug directly into the source of your hometown's culinary delights, and happiness, enduring and radiant, will immediately follow. I'm still glowing, and my only regret is not getting to take any of the cake or lasagna home.
Josh Ozersky is a James Beard Award–winning food writer and the author of The Hamburger: A History. His food video site, Ozersky.TV, is updated daily. He is currently at work on a biography of Colonel Sanders.

Clarification: Robert Sietsema's open letter to me in the Village Voice today makes me look unethical rather than dumb, and thus requires some clarification on my part. Some of my closest friends are chefs, and when they asked me what I wanted for a wedding present, instead of a crystal decanter that I would never look at, I told them to just cook some lasagna or bake a few loaves of bread that I could share with other friends. I thought, and still think, that wedding food is almost always awful, and that having the responsibility spread out among a few chefs, each doing a specialty in pans ready for reheating, was the way to go. That said, it was dumb of me not to be more explicit about the fact that I did not pay for any of their delicious contributions, and I was wrong not to make this clear to my editor beforehand. I am not an anonymous critic and I don't review restaurants for TIME (or anyone else). I comment and enlarge on trends on gastronomy, which I stay aware of by being close to chefs. I love my chef friends, and wanted to share their food with my other friends. Michael White's daughter was a flower girl in the wedding; Jeffrey Chodorow said one of the seven blessings under the chuppah. It was a mistake, but I was hardly trying to trade column space for goods, as Sietsema is pretending to suppose.