Nicole Bando | Dietitian & Lactation Consultant

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What should I eat for my immune system?

A well-balanced diet with a variety of plant foods can help to ensure your immune system is functioning properly. If a diet is nutritious, there may be no need for dietary supplements.

The three nutrients important to maintain a healthy immune system is zinc, vitamin C and vitamin D. Zinc can be found in food sources such as lean meat, fish, nuts, seeds, and legumes. Vitamin C is found in oranges, strawberries, tomatoes, broccoli, and kiwi fruit and Vitamin D is gained from the sun, eggs, liver, and oily fish. Other nutrients of importance are selenium, iron, and protein. Check out my latest blog posts on Zinc and Vitamin C for more information.

A hearty, nutritious soup such as chicken soup with large amounts of vegetables or a red lentil soup, or a pumpkin soup may help increase your immunity and help with relieving some of the symptoms of a common cold. The anti-inflammatory properties of whole ingredients, including vegetables, may reduce symptoms associated with upper respiratory tract infections. Please see my latest blog posts, for hearty, nutritious, and tasty soup recipes.

Fermented foods promote the growth of good bugs in our gut, which help with immunity and digestion. Examples of fermented foods to include in your diet are sauerkraut, kombucha (if less than 5g of sugar per 100g), and kefir.

To protect your immune system, it is recommended to reduce those foods that provide a limited amount of nutrients, such as ultra-processed foods high in saturated and trans-fat, high sugar foods, and excess alcohol. Social distancing, mask wearing, hand washing & staying home if you have symptoms are all first line defences against illness.

SM post 1: What do I eat to improve my immunity this flu season?
A well-balanced diet with a variety of plant foods can help to ensure your immune system is functioning properly. If a diet is nutritious, there may be no need for dietary supplements.
The three nutrients important to maintain a healthy immune system is zinc, vitamin C and vitamin D. Try out hearty soups full of vegetables and fermented foods this flu season to improve your immunity!

SM post 2: What foods potentially affect my immunity?
To protect your immune system, it is recommended to reduce those foods that provide a limited amount of nutrients, such as ultra-processed foods high in saturated and trans-fat, high sugar foods, and excess alcohol. Try swapping some of these foods in your diet for foods from the five core food groups, especially vegetables to improve your immunity. Are you eating a rainbow of fresh food? Social distancing, mask wearing, hand washing & staying home if you have symptoms are all first line defences against illness

References:

Nutrition Fact Sheet. Food and your immune system. Baker Heart and Diabetes Institute. Available from: https://baker.edu.au/-/media/documents/fact-sheets/baker-institute_food-your-immune-system.pdf. Accessed on 26 June 2022.

TH. Chan. The Nutrition Source. 2020. Nutrition and Immunity [online]. Harvard, School of Public Health. Available at h https://www.hsph.harvard.edu/nutritionsource/zinc/ [accessed 26 June 2022].

By Emma McShane, Dietitian. Edited by Nicole Bando (APD, IBCLC. July 2022
nurture inside out: pregnancy nutrition

As part of planning for a glowing pregnancy, have you considered your diet? It’s true that supplementation with key nutrients is important, but a nutritionally complete diet during pregnancy and breastfeeding helps to lay the vital foundations for a healthy mother, foetus and eventually, a thriving family. This is important to reduce the risks of chronic disease later in life, in both the mother and child.

New research is emerging that nutrition plays an important role in the pre- conception period and can also affect fertility. Despite having more information at our fingertips than ever before, as a population our diet has never been worse. We are constantly bombarded with myriad information about nutrition and it is little wonder that we are confused about what to eat.

The latest data from the Australian Health Survey shows that less than 7% of Australians are eating enough vegetables and that a significant portion of our daily calories (35%) comes from discretionary items.

These are foods that are not essential to a healthy diet and are high in refined sugar, fat and alcohol. Yet, we have heard the argument that the Australian Dietary Guidelines (ADG’s) don’t work, and this is simply because we are not following them. The ADG’s aren’t designed to be a ‘one-size-fits-all’ approach. They are evidence-based and provide us with a brilliant framework for living a healthy lifestyle without the merry-go-round of fad diets, or the latest buzz in superfoods. Perhaps they just need to sound a little more glamorous.

All foods are fabulous in their own right and there are many ways that the guidelines can be tailored by a dietitian to fit in with a range of lifestyles, cultures, taste preferences and life stages to suit the individual; sounds a little bespoke, doesn’t it?

Boosting vegetable intake by 1-2 serves (half to one cup) per day has many health benefits and can be done relatively easily. For example:

  • Add canned legumes to salads, soups and slow-cooked meals during winter. Legumes are super food powerhouses, replete with fibre, iron and protein. They are low in fat, have a low glycaemic index and on top of these great benefits, are cheap.
  • Try one new recipe a week and add in an extra vegetable that isn’t on the list of ingredients.
  • Snack on cut-up vegetables and dips such as hummus or tzatziki (food safety is an important consideration in pregnancy, avoid dips containing raw egg).
  • Try avocado with tomato on wholegrain toast for breakfast, for a brilliant source of mono- unsaturated fatty acids, lycopene, vitamin C, fibre and beta-carotene. Boost iron and folate with a scattering of basil leaves.
  • Add a handful of spinach or rocket to any meal for a boost of folate, iron, vitamin C and fibre
  • Avoid pre-cut vegetables and ensure all fresh produce is washed to avoid listeriosis

To plan for a healthy pregnancy and make sense of the nutrition information, come and visit me at NEST Elsternwick for personalised advice on how to make the best start for you and your family.

Caffeine can also affect the let-down (the milk ejection reflex) and worsen nipple vasospasm (occurs when blood vessels tighten and spasm, causing nipple pain).

nurture inside out: pregnancy nutrition

As part of planning for a glowing pregnancy, have you considered your diet? It’s true that supplementation with key nutrients is important, but a nutritionally complete diet during pregnancy and breastfeeding helps to lay the vital foundations for a healthy mother, foetus and eventually, a thriving family. This is important to reduce the risks of chronic disease later in life, in both the mother and child.

New research is emerging that nutrition plays an important role in the pre- conception period and can also affect fertility. Despite having more information at our fingertips than ever before, as a population our diet has never been worse. We are constantly bombarded with myriad information about nutrition and it is little wonder that we are confused about what to eat.

The latest data from the Australian Health Survey shows that less than 7% of Australians are eating enough vegetables and that a significant portion of our daily calories (35%) comes from discretionary items.

These are foods that are not essential to a healthy diet and are high in refined sugar, fat and alcohol. Yet, we have heard the argument that the Australian Dietary Guidelines (ADG’s) don’t work, and this is simply because we are not following them. The ADG’s aren’t designed to be a ‘one-size-fits-all’ approach. They are evidence-based and provide us with a brilliant framework for living a healthy lifestyle without the merry-go-round of fad diets, or the latest buzz in superfoods. Perhaps they just need to sound a little more glamorous.

All foods are fabulous in their own right and there are many ways that the guidelines can be tailored by a dietitian to fit in with a range of lifestyles, cultures, taste preferences and life stages to suit the individual; sounds a little bespoke, doesn’t it?

Boosting vegetable intake by 1-2 serves (half to one cup) per day has many health benefits and can be done relatively easily. For example:

  • Add canned legumes to salads, soups and slow-cooked meals during winter. Legumes are super food powerhouses, replete with fibre, iron and protein. They are low in fat, have a low glycaemic index and on top of these great benefits, are cheap.
  • Try one new recipe a week and add in an extra vegetable that isn’t on the list of ingredients.
  • Snack on cut-up vegetables and dips such as hummus or tzatziki (food safety is an important consideration in pregnancy, avoid dips containing raw egg).
  • Try avocado with tomato on wholegrain toast for breakfast, for a brilliant source of mono- unsaturated fatty acids, lycopene, vitamin C, fibre and beta-carotene. Boost iron and folate with a scattering of basil leaves.
  • Add a handful of spinach or rocket to any meal for a boost of folate, iron, vitamin C and fibre
  • Avoid pre-cut vegetables and ensure all fresh produce is washed to avoid listeriosis

To plan for a healthy pregnancy and make sense of the nutrition information, come and visit me at NEST Elsternwick for personalised advice on how to make the best start for you and your family.

Caffeine can also affect the let-down (the milk ejection reflex) and worsen nipple vasospasm (occurs when blood vessels tighten and spasm, causing nipple pain).

ALTERNATIVE CALCIUM SOURCES IF YOU CAN’T HAVE DAIRY

When a mother is breastfeeding a baby with an allergy or intolerance to dairy and/or soy proteins, these foods may need to be eliminated from the mother’s diet for 2-4 weeks, before possible reintroduction (under guidance of a health professional). These conditions include Cow’s Milk Allergy, Food Protein Induced Allergic Proctocolitis (FPIAP) and Food Protein-Induced Enteropathy (FPIES).

  • Both dairy and soy are common food sources of calcium, and many other important nutrients including Vitamin A, Vitamin B12, protein, zinc & magnesium.
  • Calcium is vital to ensure strong bones and teeth and reduce the risk of osteoporosis, therefore it is important to find other sources of this mineral within your diet.
  • A mother who cuts dairy and/or soy out of her diet may be at risk of developing weak bones and osteoporosis if she doesn’t replace these foods with alternatives.
  • Calcium in the breastmilk is constant and comes from the mother’s skeleton. A women’s dietary intake of calcium, or supplements does not affect the amount in breastmilk.
  • The calcium taken from the mother’s bones is restored within a few months of stopping breastfeeding. Studies show that women who breastfeeds are not at higher risk of osteoporosis than a woman who does not breastfeed.

Below is a table of dairy-free (DF) and/or soy-free (SF) food sources of calcium. Check food labels every time you buy a food, medication or supplement, as ingredients may change. Use this guide for label reading: https://www.allergy.org.au/images/pcc/ASCIA_PCC_Dietary_avoidance_cows_milk_soy_2015.pdf

  • So how much calcium do we need? The average women needs 1,000 mg/day. See the sample meal plan below to demonstrate how to meet average calcium needs:

This sample meal plan provides 1319mg of calcium across the day, and meets nutritional requirements from the five core food groups, in line with the Australian Guide to Healthy Eating (AGTHE), for a breastfeeding woman. It is a guide only. 

Sometimes a calcium supplement is needed to ensure that you are getting the amount of calcium you need every day. Your dietitian or GP will help you decide if a supplement is necessary.

References:

  1. UCSF Health (2021). Calcium content of foods. University of California. Accessed June 10th 2021. Available from: https://www.ucsfhealth.org/education/calcium-content-of-foods
  2. Nutrient Reference Values (2014). Calcium. NHMRC. Accessed June 10th 2021. Available from: https://www.nrv.gov.au/nutrients/calcium
  3. Fishbein L. (2004). Multiple source of dietary calcium – some aspects of its essentiality. Regulatory Toxicology and Pharmacology. 39(2);67-80. Accessed June 10th 2021. Available from: https://doi.org/10.1016/j.yrtph.2003.11.002.
  4. Gueguen L., Pointillart A. (2013). The Bioavailability of Dietary Calclium. Journal of the American College of Nutrition. 19;sup2, 119-136. Accessed June 11th 2021. Available from: 10.1080/07315724.2000.10718083
  5. Australasian Society of Clinical Immunology and Allergy. Cow’s Milk (Dairy) Allergy. ASCIA, 2019. (Available from https://www.allergy.org.au/images/pcc/ff/ASCIA_Introducing_Foods_Fast_Facts_2019.pdf, accessed May 31st, 2021).
  6. Australian Guide to Healthy Eating Serve Sizes [Internet]. Eat for Health. Australia; 2015. Accessed June 23rd 2021. Available from: https://www.eatforhealth.gov.au/food-essentials/how-much-do-we-need-each-day/serve-sizes
NUTRITION AND BREASTFEEDING

By Emma McShane & Nicole Bando

Nutrition whilst breastfeeding is vital to optimise the health of both mother and baby. New motherhood is a very busy time, and many women put their own health last. A woman’s remarkable body will produce the live, biodynamic, complete food that is breastmilk that evolves with her baby’s growing needs. Milk production is robust and will only be affected in very extreme circumstances. The average woman produces 750mls of breastmilk per day, from 1-6 months. Fat stores accumulated during pregnancy are used to fuel milk production when baby arrives, though this does not cover all of the energy needed to produce breastmilk. Some elements of breastmilk are impacted by a woman’s diet and those that follow a vegetarian or vegan diet, are at greater risk of vitamin and mineral deficiencies.

DID YOU KNOW?

  • Adequate nutrition can help with coping with a new baby and the adjustment to motherhood, mood, and energy levels. Restrictive eating during breastfeeding can impact mood, milk supply, overall coping, and bone health.
  • Certain nutrients in breastmilk, such as lactose and protein are fairly constant, however the fat content of breastmilk changes according to how empty the breast is. The types of fatty acids and quantities of iodine and Vitamin B12 are also affected by the mother’s diet.
  • A mother’s varied diet exposes baby to different flavours and tastes, which will help baby to accept a wider range of solid foods, including fruit and vegetables.
  • Regular nutritious meals and snacks are important to nourish both mother, and baby. There is no need to aim for dietary perfection.

ENERGY:
An extra 2000kJ per day is needed for a breastfeeding mother, though this can change depending on individual needs. This is equivalent to a serving of spaghetti Bolognese with cheese (1 cup pasta and ½ cup sauce), or a bowl of porridge with apple, yoghurt, and nuts (½ cup uncooked oats, made with 1 cup of milk, 1 apple and a handful of nuts) or a combination of snacks throughout the day, such as yoghurt (¾ cup), popcorn (small packet/1 cup), crumpets, and peanut butter (1 crumpet with 1 tb of nut butter). Studies show that not eating enough can directly impact milk supply and composition, so a wholesome diet is vital to fuel both mother and baby.

FLUID:
Breastmilk production requires fluid, so a breastfeeding woman requires more fluid than usual. The amount depends on various factors such as weather conditions, activity levels, and the food eaten. Be guided by your body, and ensure you’re drinking water consistently throughout the day.

CAFFEINE:
Caffeine transfers directly into breastmilk, so avoid large quantities of caffeinated drinks when breastfeeding. 1% of caffeine enters breastmilk and peaks an hour after consumption. A newborn baby can take up to 160 hours to process caffeine, however by 6 months that drops to 2-3 hours, so an older baby is able to better tolerate caffeine. A morning latte or a few cups of tea across the day might not cause any issue, but observe baby; a mother may consider changing to a decaffeinated tea or coffee if she notices that her baby is very wakeful after her morning coffee. A moderate amount of caffeine a day, such as two cups of coffee (latte or espresso), three cups of instant coffee or four cups of tea is usually fine. Remember that sources of caffeine include: cola, chocolate, tea, guarana, and energy drinks.

Caffeine can also affect the let-down (the milk ejection reflex) and worsen nipple vasospasm (occurs when blood vessels tighten and spasm, causing nipple pain).

ALCOHOL:
The safest option while pregnant and breastfeeding is to avoid alcohol altogether, as it can reduce breastmilk production and impact baby’s growth and development. Alcohol is present in breastmilk in the same levels as the bloodstream and it takes approximately 2-3 hours for the mother’s body to clear the alcohol in one standard drink. This time increases with each drink consumed. So if choosing to consume alcohol, wait around 2 hours before breastfeeding. Any milk expressed before the 2-hour window will need to be discarded, as it is not safe for the baby to consume. If there are times where a mother plans on drinking more than one standard alcoholic drink, plan ahead and express some breast milk beforehand to feed baby during this time. Below are two links to resources for further information:

MIXED FEEDING:
Any amount of breastfeeding increases a woman’s dietary requirements, however given the wide variation in breast milk production when mixed feeding, it can be difficult to estimate. A woman should use her appetite as a guide and may require additional foods from the core groups. A dietitian can help to guide this.

DO CERTAIN FOODS INCREASE BREASTMILK PRODUCTION?
Oats: Many women wonder if oats or lactation cookies help with milk supply, however, there is no clear evidence to support this.
Fenugreek: There is poor quality and limited evidence to suggest that fenugreek increases milk supply.
Breastfeeding with good attachment, flexibly and frequently is the best way to protect milk supply.

Dairy & kids: alternatives & full cream or low fat?

Dairy products contain 10 essential nutrients; calcium, potassium, phosphorus, magnesium, carbohydrate, protein, vitamin A, riboflavin, vitamin B12 and zinc, important for healthy immune and blood systems, eyesight, muscle and nerve function, healthy bones, skin, energy, growth and repair of your body. If your child cannot have dairy, whether it be due to an allergy, intolerance or dislike, it is important to find alternatives that provide these nutrients.

Soy milk has the most similar nutritional profile to cow’s milk and is considered the best choice if your child cannot have dairy, unless they have a soy allergy. Soy milk is also high in protein. Look for soy milks with added calcium, Vitamin A, B1, B2, and B12. When opting for a milk alternative, always look for brands that contain 120mg/100mL of calcium.

f your child cannot have dairy and soy, other options are:

Choose fresh, natural, unprocessed foods, where possible:
–    Oat; contains protein, fibre and is high in carbohydrates. Choose those fortified with calcium.
–    Almond milk; low in protein and carbohydrates. Again choose unsweetened brands with added calcium.
–    Coconut: High in saturated fat, and low in most nutrients e.g. protein, carbohydrates, vitamins and minerals.
–    Check out our article comparing plant vs dairy milks: https://www.nicolebando.com/articles/which-milk-a-review-of-plant-vs-dairy-milks

For dairy-free brands, see our article; https://www.nicolebando.com/articles/dairy-free-andor-soy-free-foods-supermarket-brands-to-look-for.
See here for information on how much dairy kids need.

Full cream or low fat milk?
The latest evidence suggests that full cream milk is recommended from the age of 12 months onwards, even into your adult years, unless you have high cholesterol, and then reduced fat is recommended.

Infants (0-12 months of age) should only be given breastmilk or infant formula. Cow’s milk as a drink is not suitable for infants under 12 months of age. Cow’s milk may be consumed as part of a meal, e.g. in cereal.

By Emma McShane, Dietitian, November 2022 (Edited by Nicole Bando, APD, IBCLC)

Allergy-friendly party food

If you are planning a party for children who have food allergies, it can seem overwhelming to know where to start. Follow these steps for safe and yummy party food. A food allergy is when a person’s immune system reacts to the protein in a food, causing symptoms such as hives, rashes or in more severe cases swelling of the mouth and throat (anaphylaxis). Find out which allergens you need to exclude and take it from there. The key allergens are: peanuts, dairy, wheat, egg & fish.

  1. Have a plan: Find out the symptoms of the child’s food allergy. Who will be supervising them? What is their allergy/anaphylaxis plan? Make sure they have their epi-pen & you or a supervising adult knows how to use it. Call an ambulance if the child demonstrates signs of an allergic reaction.
  2. Know your key allergens and read the ingredients list. It is Australian law that processed foods must be clearly labelled to include allergens using their common names (e.g. egg or milk) so that they can be easily recognised. Allergens are often shown in bold
    in the ingredients list. There is also a ‘contains’ section that has a summary list of the allergens present in that food. Check food labels every time you buy the product, as ingredients and processes can change.
  3. What about ‘may contain traces of?’ This means that there is a potential cross-contamination risk. It may be best to avoid these foods for safety reasons.
  4. Food preparation and cross contamination: When the tiniest amount of an allergen comes into contact with another food (e.g. crumbs from wheat bread are on the bread board used to prepare gluten-free bread) it can be enough to cause an allergic reaction. Set up the food preparation area in a clean environment away from other foods being prepared. Use only clean (using hot, soapy water) equipment when preparing food. Make sure that your hands are cleaned prior to preparing and serving as well and that any products used haven’t been exposed to allergens (e.g. margarine previously used for wheat containing bread).
  5. So what party foods can I serve? Choose fresh over processed foods, it is easier to avoid multiple food allergens this way. Have fun with fruit, e.g. fruit skewers or try our simple allergy-friendly popsicle recipe: Blend 500ml of plant-based milk, 1 tb of maple syrup and your choice of 300g frozen fruit. Pour mixture into moulds, add an icy-pole stick & freeze until solid. Also try gluten-free pizza bases with vegetables (either without cheese or with vegan cheese), tofu and vegetable skewers, mini beef burgers with gluten free rolls, 100% corn chips & avocado dip, popcorn (over 3 years), rice crackers & dried fruit. Consider party bags that are food free and perhaps involve craft, such as colouring.
  6. What about the cake? Check out this allergy free birthday cake recipe! https://www.allergicprincess.com/egg-free-dairy-free-nut-free-cake/ – if looking for a wheat/gluten free option, swap out the plain flour for gluten-free flour.

References:

  1. What is allergy? – Australasian Society of Clinical Immunology and Allergy (ASCIA) [Internet]. Allergy.org.au. 2022 [cited 9 July 2022]. Available from: https://www.allergy.org.au/patients/about-allergy/what-is-allergy
  2. Avoiding Cross-Contact [Internet]. FoodAllergy.org. 2022 [cited 9 July 2022]. Available from: https://www.foodallergy.org/resources/avoiding-cross-contact
  3. [Internet]. Allergy.org.au. 2022 [cited 9 July 2022]. Available from: https://www.allergy.org.au/images/pcc/ASCIA_PCC_Dietary_avoidance_general_info_2019.pdf

By Emma McShane, Dietitian, edited by Nicole Bando, Dietitian & LC, August 2022

Healthier party food

By Emma McShane, Dietitian. Edited by Nicole Bando, Dietitian & IBCLC, August 2022

At a party, a small amount of sugary food is okay, though it is important to ensure the majority of the food includes healthy options for children to ensure they are being nourished for growth & their best health. Children may have many parties over a weekend, which means their opportunity to eat high sugar, processed foods is beyond their needs for growth.

For quick, easy packaged food options to include in your next kids’ party, check out this link:
https://www.nicolebando.com/blog/simple-packaged-snack-swaps

These colourful ideas also promote growth, mood, play & concentration:

–    Vegetable sausage rolls made with filo pastry
–    Assorted sandwiches using multigrain bread
–    Fruit skewers
–    Fruit and yoghurt cups
–    Wholemeal pita bread pizzas loaded with vegetables such as spinach, capsicum, tomato, mushrooms etc.
–    Healthy bliss balls
–    Popcorn for children over 3 years of age
–    Cheese and crackers
–    Rice crackers & dips
–    See our allergy friendly party food list

Lolly bags have an excessive amount of sugar and minimal nutrients, and are generally not recommended. Try swapping out lollies for something else, such as colouring books and utensils, craft ideas or recipe cards for healthy foods to make at home. Or offer 1 small treat instead of a bag.

Catering for Christmas? How to meal plan for the big day

Many people worry that eating too much on Christmas day will ruin their health goals, however some perspective can help. It is one day of the year, and is meant to be enjoyed, so don’t worry about your activity goals or healthy eating habits for this day. One day will not break the healthy habits you have created for yourself. It is only if these habits carry through for days and weeks that our health can be impacted.

Are you catering for Christmas Day and feeling overwhelmed by the task and dietary requirements?
We recommend following our easy structure for the perfect Christmas spread:

1.  2x Protein: Meat e.g. Beef, chicken, ham or turkey. This can be barbequed or roasted depending on what is easiest for you.
A great vegetarian or vegan option is a mushroom wellington, whole roasted cauliflower with tahini sauce or a vegetable lasagne.

2. 2-3x Vegetables (make this the rainbow – use different vegetables with different colours).-
Starch: No Christmas spread is complete without roasted potatoes, pumpkin or sweet potato. Chop roughly, place in a baking tray with garlic, rosemary, salt, pepper and a generous drizzle of olive oil. Roast for about 40 minutes for crispy goodness.
Greens: Steamed green beans with a drizzle of lemon and olive oil and seasoned with salt and pepper are simple & fresh. Or Brussel sprouts pan-fried with some coconut oil.
Steamed carrots with a sprinkle of cinnamon & roasted almonds (if no allergies)
Note that all these vegetable dishes are  gluten, dairy and egg free.

1-2x Salads
Examples include:

  • A fresh garden salad with lots of green leaves, tomatoes, cucumber, carrots, and olives can be delicious. Add a simple dressing made from olive oil, mustard, lemon juice, and vinegar for extra flavour.
  • Pulse salad e.g. lentil salad with baby beetroot and spinach is a hearty protein option for vegans/vegetarians.

3. Bread: good quality sourdough or wholegrain breads are great options. Gluten free brands include Helga’s and GF Precinct.
4. 1-2x Desserts –
Why not try our smoothie popsicles, great for kids, the recipe can be found here:
https://www.nicolebando.com/articles/allergy-friendly-party-food
Pair dessert with a fruit platter using fresh, in-season fruits such as cherries, raspberries, strawberries, pineapple and mango. Why not try our orange yoghurt dip as a fresh accompaniment to the fruit.

We hope that this structure makes catering for Christmas a little easier so you can spend more time enjoying Christmas with the ones you love.

By Emma McShane, Dietitian, December 2022

Eczema and Dairy

Eczema is a disorder of the immune system caused by an abnormal skin barrier, dryness and inflammation.
30% of people with atopic dermatitis (eczema) also have an allergy. A food allergy may trigger eczema, but it is not the cause of the eczema. Some foods such as dairy may exacerbate eczema.

Eczema can be normally well managed by maintaining, protecting and treating the skin by:
–    Applying moisturiser (at least twice/day)
–    Use non-soap based wash or oil in the bath or shower
–    Avoiding soap and washes that produce bubbles or foam (as these may cause the skin to dry out)
–    Using anti-inflammatory creams and ointments, such as topical steroids
–    Treating bacterial skin infections with antibiotics
–    Use immune modulating treatments if prescribed by your doctor or dermatologist.

Food exclusion diets are only recommended to be tried in children with eczema when the above treatments don’t work. Food exclusion diets should be guided by a clinical immunologist or allergy specialist and dietitian. Only short term food exclusion is needed to determine if the food allergy is causing the eczema.

Dairy is often a common trigger for eczema, even if they are not allergic to dairy but to something else. Research has shown that more often than not food exclusion diets can be short-term. This is because eczema is an immune response, and in children, their immune system is not fully developed. It is predicted that as a child’s immune system develops, they are likely less sensitive to dairy causing eczema and can slowly introduce these foods back into their diet. It is important that this is done under close guidance of a paediatric dietitian.

References:

  1. Eczema and food allergy. Fast facts. ASCIA. 2020. Available at: https://www.allergy.org.au/patients/fast-facts/eczema-and-food-allergy
  2. National eczema association. Everything you need to know about eczema and food allergies. 2018. Available at: https://nationaleczema.org/blog/eczema-food-allergies/
  3. Nikolovski A, Rallis S (2020) The Impact of Dairy Elimination on Pediatric Atopic Dermatitis. J Nutri Med Diet Care 6:044. doi.org/10.23937/2572-3278.1510044
SIMPLE PACKAGED SNACK SWAPS

Emma McShane, Dietitian

References:

  1. National Healthy School Canteens: Guidelines for Healthy Foods and Drinks supplied in School Canteens. Breakfast Cereals. Australian Government: Department of Health, 2013. (Available from: https://www1.health.gov.au/internet/publications/publishing.nsf/Content/nhsc-guidelines~food-drink-table~breakfast-cereals, accessed September 3, 2021).
  2. National Healthy School Canteens: Guidelines for Healthy Foods and Drinks supplied in School Canteens. Savoury Snack Foods. Australian Government: Department of Health, 2013. (Available from:https://www1.health.gov.au/internet/publications/publishing.nsf/Content/nhsc-guidelines~food-drink-table~savoury-snack-foods, accessed September 3, 2021).
  3. Queensland Health. Sodium. The State of Queensland (Department of Health), 2021. (Available from: https://www.healthier.qld.gov.au/guide/sodium/, accessed September 3, 2021).
  4. Coles. Food products. Coles Supermarket, 2021. (Available from: https://www.coles.com.au/, accessed August 22 – September 3, 2021).
  5. Woolworths. Food products. Woolworths Supermarket, 2021. (Available from: https://www.woolworths.com.au/, accessed August 22- September 3, 2021).
  6. Tong, T., Rangan, A., & Gemming, L. Evaluating the Nutritional Content of Children’s Breakfast Cereals in Australia. 2018. Children (Basel, Switzerland), 5(7), 84. https://doi.org/10.3390/children5070084