When it comes to the recognition of Nickel as the number one metal allergen worldwide, affecting up to 30% of adults and with a particular predilection for women, it seems like Australian health professionals really do come from the ‘land down under’, with many of us still somehow yet to read that memo.
I’ve booked my flights and packed my bags (at least in my mind!) already. The annual Science of Nutrition in Medicine Conference is on 2-3rd May in Melbourne & there’s one name on the bill that alone I would be attending for – Dr Robert Loblay. He’s the head of the Immunology unit at RPAH which specialises in the management & treatment of every possible type of food & chemical reaction (including all the ones the average medico would suggest are impossible/unreal or psychosomatic). By the way he also a strong interest in bioethics so this makes for a great combination in this field. He helped put together the RPAH diet and book ‘Friendly Foods’, which is such a great clinical resource for patients with food intolerances.
The way I approach food reactions in clinic has been heavily influenced by his work and because the RPAH unit is working everyday with some of the most severe, complex and unusual reactions, when he talks I listen! (more…)
In the Byron shire we have a fabulous local comedian called Mandy Nolan who makes a lot of fun of the health and food fads that regularly sweep this area and one of her favourite catch-cries is “I’m gluten intolerant-intolerant, if I meet another person who tells me they’re gluten intolerant I’m going to scream!” Although I take genuine gluten reactions very seriously I do get where she’s coming from and it stems primarily from pervasive misunderstandings & misuse of terms in the community. The problems with this are multiple: firstly those people who are walking around with an exaggerated sense of their problem will unnecessarily limit their diet (and perhaps the diets of their loved ones) at significant financial, nutritional & even psychological cost and then we have people who have the most extreme gluten reactions not receiving the serious attention that they absolutely need in all sorts of settings like restaurants, childcare centres and schools…because seemingly everyone has some sort of ‘gluten issue’ & therefore it has become dangerously ‘normalised’.
So let’s just recap the possibilities and try to clear the confusion. When people walk through our door and tell us they ‘can’t eat bread’ or ‘pasta makes them bloat’ or ‘I don’t think wheat agrees with me’, that’s where our work just begins in terms of needing to clarify what the nature of their reaction is. Putting them immediately on a gluten free diet is a mistake because it doesn’t tell us which one of the below issues is at play and therefore fails to give us clear guidance about what is an appropriate course of treatment & dietary intervention.
My one exception would be in children diagnosed on the spectrum for autism. I think going gluten free where possible is appropriate from the get-go in ASD. For everyone else, a correct diagnosis is the essential first step to effective & proportionate treatment so keep your wits about you my fabulous fellow diet detectives! 