The Dirty Dozen and Clean 15.

The Dirty Dozen and Clean 15.

The dirty dozen and the clean 15 refer respectively to the fruits and vegetables that are the most and least contaminated by pesticide use, according to the Environmental Working Group.

Why do we care? Pesticides are toxic by design! Different pesticides have been linked to a variety of health problems, including hormone disruption, cancer and brain toxicity.

But for most people, switching to organic produce is a gradual process. Because organic foods tend to be more expensive than their counterparts, making informed choices in the produce aisle helps minimize pesticide consumption while keeping the budget in check!

 

The Dirty Dozen (in order of contamination) Apples Celery Sweet bell peppers Peaches Strawberries Nectarines Grapes Spinach Lettuce Cucumbers Blueberries Potatoes

The Clean 15 (in order of least contamination) Onions Sweet Corn Pineapples Avocado Cabbage Sweet peas Asparagus Mangoes Eggplant Kiwi Cantaloupe Sweet potatoes Grapefruit Watermelon Mushrooms

 

Reference: http://www.davidsuzuki.org.

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Managing Children’s Immunity

 Managing Children’s Immunity

The development the human immune system starts early in foetal life and continues its maturation process throughout infancy and early childhood. Because young children’s immune systems are still developing, they are more prone to catching communicable illnesses than older children and adults.

The common cold, for example, is the most cited reason for absence from school or work, and the most common reason people visit the doctor. While an adult who is not in contact with children can expect to suffer through about two or three episodes throughout the year, children and parents are likely to experience significantly more. In fact, young children may catch six to twelve colds a year.[1]

Whilst infections are a normal part of growing up, it is hard for parents to watch their child suffer. It can also lead to frustration and financial stress due to lost work days while staying at home looking after a sick child.

A Look at Common Childhood Infections

Another reason that young children come down with frequent infections is because the viruses and bacteria that cause them spread easily and rapidly from person to person in crowded, closed spaces such as daycare centres, preschools and schools. Common childhood infections include:[2]

Colds and flu

Colds are caused by a large number of viruses and characterised by a sore throat, stuffy or runny nose, watery eyes, mild fever, headache and cough. The symptom profile of flu is similar to that of a cold, but can be more severe, usually has a rapid onset, and can include symptoms such as chills, higher temperatures, aches and pains, and vomiting. Children sick with the flu are recommended bed rest, adequate hydration and fever management.

Both conditions usually resolve by themselves, but symptoms such as; difficulty in breathing or drinking, fever that lasts for more than 2-3 days or comes back after resolving, blue lips or nails, ear ache, or being lethargic or more irritable than usual may require a visit to a healthcare practitioner.

Croup

Croup is a viral infection that affects the voice box and the airways, making it hard for the child to breathe. It is most common in toddlers, but can also affect older children. Croup may start off with symptoms similar to a cold, but will progress into a cough that sounds like a seal’s bark. Using a humidifier can help the child breathe easier. Steam treatment may also be helpful.

A doctor should be seen straight away if the child is struggling to catch a breath, cannot speak because of lack of breath, makes a harsh rasping or hoarse sound when breathing (stridor), drools or has trouble swallowing.

Sinusitis

Sinusitis is an inflammatory condition affecting the lining of the nose and sinuses. It may be viral or bacterial, or accompany allergies such as hay fever. Children with sinusitis present with nasal discharge, daytime cough, and may complain of symptoms such as pain or tenderness around the eyes, cheekbones or upper teeth and severe headache.

The advice of a healthcare practitioner is required if the child does not feel better after 3-4 days of treatment, has severe pain or develops a sudden high fever.

Strep throat

A common bacterial infection in children and teens, strep throat causes pain in the throat, swollen, tender glands in the neck, headache and fever and may need to be treated with antibiotics.

Pneumonia

Pneumonia is an infection of the lungs that often occurs a few days after the onset of a cold. Symptoms may include a cough with shortness of breath, fever, loss of appetite and low energy levels. In more severe cases shaking chills, chest pain and difficulty breathing may be seen. Antibiotics are prescribed if the infection is of bacterial origin.

Ear infections

Otitis media, or middle ear infection, is a very common infection in young children and is often seen secondary to an upper respiratory tract infection. The symptoms – predominantly pain – are due to fluid build up that causes pressure on the eardrum.

Acute otitis media often clears up on its own, but sometimes the fluid can stay in the ear causing trouble hearing. Fluid build up in the ear can also be as a result of allergies.

Impetigo

Impetigo is a bacterial skin infection that is characterised by small blisters that become oozing, yellow and crusty. The lesions often appear on the face, but can be found anywhere on the body.

Conjunctivitis

Commonly known as pinkeye, conjunctivitis is an infection of the white part of the eye and can be caused by viruses, bacteria or chemicals, or may accompany an allergy. Conjunctivitis caused by a bacteria or viruses spreads easily at school or daycare.

Diarrhoea and vomiting

Also frequently encountered during childhood are gastrointestinal infections, characterised by vomiting and/or diarrhoea. These can be caused by many different pathogens, including viruses and bacteria. Most are self-limiting, but it is very important to ensure that the child stays hydrated.

Enhancing a child’s resistance to infections

The best approach in supporting immune function – in children and adults alike – is following a comprehensive plan involving lifestyle, stress management (if applicable), diet, nutritional supplementation and the use of botanical medicines.

Lifestyle

  • Avoid exposure to cigarette smoke and environmental toxins.
  • Participate in regular exercise.
  • Maintain a healthy body weight.
  • Ensure adequate sleep – sleep deprivation has consistently been shown to impair different components of immune function.
  • Stress management – it was recently reported that 1-2 children in every Australian classroom are too anxious to enjoy life.[3] What is more, these problems often go unnoticed by parents and teachers.
  • Take steps to avoid infections, such as frequent hand washing.

Dietary

The health of the immune system is greatly affected by a person’s nutritional status. Factors that reduce immunity include: nutrient deficiencies, excessive sugar consumption and consumption of allergenic foods.[4]

Dietary factors that enhance immune function include all essential nutrients and antioxidants. Thus, consistent with good health, optimal immune function requires a diet that:

  • is rich in fresh fruits and vegetables, grains, seeds and nuts
  • excludes junk foods, excessive amounts of saturated fats and refined sugars
  • has adequate protein
  • has plenty of pure water.

Supplements and Botanical Medicines

Having access to effective natural remedies in the early stages of illness can be a key determinant of how quickly the illness lingers. Proactive use of specific remedies can shorten the duration and potentially reduce the likelihood of the illness developing into something more sinister.

Sambucus nigra (elder)

The use of elder as a medicine dates back to antiquity. In 400 BC, Hippocrates referred to the elder tree as his “medicine chest”; other classical healers, such as Dioscorides and Galen, regarded elder as one of nature’s greatest healing plants.[5] Traditional uses include fever management, colds and flu, chronic nasal catarrh, sinusitis and to increase resistance to illness.[6]

Modern research supports the traditional uses of elder with studies showing antibacterial, antiviral (including against influenza viruses) and immune stimulating effects.[5,7] In vitro activity against the H1N1 virus (swine flu) has also been reported.[8]

Clinical studies have demonstrated a significant reduction in duration and severity of illness:

Patients with three or more flu-like symptoms who started taking an elderberry extract within 24 hours of onset of symptoms reported a significant reduction in symptoms after 48 hours, with 28% being symptom free. This was in stark contrast to the patients in the placebo group in whom the symptoms were either unchanged or worse.[6]

Within two days, 93.3% of elderberry-treated patients experienced a significant improvement in symptoms, and complete resolution was achieved by 90% of the group within two to three days. The placebo group did not experience similar improvement or resolution until day six.[9]

Where treatment was initiated within 48 hours of symptom onset, flu symptoms decreased significantly in the elder-treated group by the third or fourth day versus seven-to-eight days in the placebo group.[6]

Elderberry is often used together with vitamin C and zinc to support the natural process of recuperation.[5]

Quercetin

Quercetin, a naturally occurring flavonoid in a wide variety of fruits and vegetables, has many applications in natural medicine. In relation to infections, its antioxidant, anti-inflammatory, immune modulating and antiviral properties are of great value.

Research suggests multiple mechanisms for the antiviral effects of quercetin. Cell culture studies have shown that quercetin can reduce the infectivity of target cells and block viral replication at an early stage of multiplication for several respiratory viruses, including adenoviruses, coronaviruses, rhinoviruses, respiratory syncytial virus, parainfluenza virus type 3 and SARS.[10]

Vitamin A

Vitamin A plays a fundamental role in immune health. Together with the skin, the mucosal lining of the airways, digestive and genitourinary tracts form our first line of defence against infection. Vitamin A and its metabolites help to maintain the structural and functional integrity of these cells. Moreover, vitamin A plays a central role in the development and differentiation of lymphocytes involved in the immune response.[11]

Vitamin A deficiency impairs normal regeneration of mucosal barriers and it is these changes, together with diminished function of neutrophils, macrophages and natural killer cells, that are presumed accountable for the increased mortality seen in vitamin A-deficient infants and young children in many areas of the world today.[12]

Vitamin A supplementation has been reported efficacious in ameliorating impaired immune function in well-nourished children suffering from vitamin A deficiency.[13]

Vitamin C

Vitamin C, a potent antioxidant, is highly concentrated in leukocytes and is used up rapidly during infection, presumably to prevent oxidative damage. It is thought that reduction of free radicals will prevent DNA damage to immune cells and thereby maintain their functional and structural integrity.[14]

A large review of studies has found that regular vitamin C consumption reduces the duration of common cold episodes in children.[15]

Vitamin D

Vitamin D is a potent immune system modulator. There is considerable evidence that the active form of vitamin D (1,25-dihydroxyvitamin D) has a variety of effects on immune system function, including enhanced innate immunity and inhibition of the development of autoimmunity.[16]

Many of the effects of 1,25-dihydroxyvitamin D are mediated through the vitamin D receptor (a nuclear transcription factor known as VDR). VDR is expressed in several types of immune cells, including monocytes, macrophages, dendritic cells and activated T cells.[17]

In several observational studies, lower 25(OH)D (a pre-hormone to 1,25-dihydroxyvitamin D) serum levels have been associated with increased risk of respiratory infection in adults, children and infants.[18] 25(OH)D deficiency has also been connected to increased severity of acute lower respiratory infection in children.

Vitamin D deficiency and is emerging as major paediatric health issue in both Australia and New Zealand.[19]

Zinc

Zinc affects multiple aspects of immune function and a clear link has been established between zinc deficiency and an increased susceptibility to infections. Human studies have observed that even a mild zinc deficiency can elicit changes in immune status.[20]

Used prophylactically, supplemental zinc is associated with shorter duration of cold symptoms, decreased severity of symptoms and a reduced incidence of colds in children.[21,22]

Probiotics Approximately 70% of our immune system resides in our gut.[23] Probiotics can be effective as bolstering immunity by boosting the healthy populations of friendly bacteria that regulate important immune defence chemicals, such as secretory IgA.[24]

Taking a broad spectrum probiotic, and/or sacharomyces boulardii can help support immune function and is a simple preventative measure, particularly for children. In fact, one study found that simply taking a probiotic could reduce the number of days off from illness, and a reduction in the spread of respiratory infections in a daycare setting.[25]

IN SUMMARY

Infections account for many days of lost work and school and are one of the leading reasons for visits to the healthcare practitioner. Numerous natural therapeutics exert immune-enhancing and anti-pathogenic properties and therefore support the body’s natural defences against infections. Collectively these therapies are noted to reduce the incidence of infections and shorten duration as well as the severity of symptoms, in children and adults alike.

 

REFERENCES

  1. Cold and flu. Lung Foundation Australia. [Link]
  2. Common childhood infections. American Academy of Paediatrics 2005. [Link]
  3. Anxious kids suffer in silence: professor. Nine News 20 June 2014. [Link]
  4. Murray MT, Pizzorno J. The encyclopaedia of natural medicine, 3rd ed. NY: Simon & Schuster, 2012.
  5. Krawitz C, Mraheil MA, Stein M, et al. Inhibitory activity of a standardized elderberry liquid extract against clinically-relevant human respiratory bacterial pathogens and influenza A and B viruses. BMC Complement Altern Med 2011;11:16. [Full Text]
  6. Engels G, Brinckmann J. European elder. HerbalGram 2013;97:1-7. [Link]
  7. Kinoshita E, Hayashi K, Katayama H, et al. Anti-influenza virus effects of elderberry juice and its fractions. Biosci Biotechnol Biochem 2012;76(9):1633-1638. [Full Text]
  8. Roscheck B Jr, Fink RC, McMichael MD, et al. Elderberry flavonoids bind to and prevent H1N1 infection in vitro. Phytochemistry 2009;70(10):1255-1261. [Abstract]
  9. Zakay-Rones Z, Varsano N, Zlotnik M, et al. Inhibition of several strains of influenza virus in vitro and reduction of symptoms of an elderberry extract (Sambucus nigra L.) during an outbreak of influenza B Panama. J Altern Complement Med 1995;1(4):361-369. [Abstract]
  10. Davis JM, Murphy EA, McClellan JL, et al. Quercetin reduces susceptibility to influenza infection following stressful exercise. Am J Physiol Regul Integr Comp Physiol 2008;295(2):R505-509. [Full Text]
  11. Higdon J. Vitamin A. Micronutrient information center, Linus Pauling Institute 2003. [Link]
  12. Stephensen CB. Vitamin A, infection, and immune function. Annu Rev Nutr 2001;21:167-192. [Abstract]
  13. Lin J, Song F, Yao P, et al. Effect of vitamin A supplementation on immune function of well-nourished children suffering from vitamin A deficiency in China. Eur J Clin Nutr 2008;62(12):1412-1418. [Full Text]
  14. Field CJ, Johnson IR, Schley PD. Nutrients and their role in host resistance to infection. J Leukoc Biol 2002;71(1):16-32. [Full Text]
  15. Hemilä H, Chalker E. Vitamin C for preventing and treating the common cold. Cochrane Database Syst Rev 2013;1:CD000980. [Link]
  16. Higdon J. Vitamin D. Micronutrient information center, Linus Pauling Institute 2004. [Link]
  17. Drake VJ. Nutrition and immunity. Micronutrient information center, Linus Pauling Institute 2010. [Link]
  18. Sundaram ME, Coleman LA. Vitamin D and influenza. Adv Nutr 2012;3(4):517-525. [Full Text]
  19. Munns C, Zacharin MR, Rodda CP, et al. Prevention and treatment of infant and childhood vitamin D deficiency in Australia and New Zealand: a consensus statement. Med J Aust 2006;185(5):268-272. [Abstract]
  20. Roxas M, Jurenk J. Colds and influenza: a review of diagnosis and conventional, botanical, and nutritional considerations. Altern Med Rev 2007;12(1):25-48. [Abstract]
  21. Kurugöl Z, Akilli M, Bayram N, et al. The prophylactic and therapeutic effectiveness of zinc sulphate on common cold in children. Acta Paediatr 2006;95(10):1175-1181. [Full Text]
  22. Das RR, Singh M. Oral zinc for the common cold. JAMA 2014;311(14):1440-1441. [Full Text]
  23. Vighi G, Marcucci F, Sensi L, et al. Allergy and the Gastrointestinal System. Clin Exp Immunol 2008 Sep;153(1):3-6 [Full Text]
  24. Macpherson A, Slack E. The functional interactions of commensal bacteria with intestinal secretory IgA. Curt Opin Gastroenterol 2007 Nov;23(6):673-8 [Abstract]
  25. Hatakka K, Savilahti E, Ponka A, et al. Effect of long term consumption of probiotic milk on infections in children attending day care centres: double blind, randomised trial. BMJ 2001;322:1327 [Full Text]


DISCLAIMER:

The information provided on FX Medicine is for educational and informational purposes only. The information provided on this site is not, nor is it intended to be, a substitute for professional advice or care. Please seek the advice of a qualified health care professional in the event something you have read here raises questions or concerns regarding your health. 

Fighting Flu with Fish Oil

Fish oil is traditionally considered as a treatment option in inflammatory conditions such as pain, arthritis, cardiovascular disease, depression and mood disorders. However, it does have some scope for inclusion in treatment plans for cold and flu season.

“DHA-enriched fish oil can enhance B cell activation and select antibody production.”

A study published in the Journal of Leukocyte Biology suggested that consumption of DHA-rich fish oil may boost immune function by enhancing the function of immune B cells.[1]

Fish oil derived docosahexaenoic acid (DHA) is generally believed to suppress T lymphocyte function, however the effect of fish oil on B cell function had been relatively unexplored. Given the important role of B cells in immunity, researchers tested the hypothesis that DHA is incorporated into the cell membrane to alter lipid microdomain clustering and enhance B cell function.

The discovery was significant as it showed that fish oil does not necessarily reduce the overall immune response to lower inflammation, but may actually have immune enhancing properties that could benefit immunocompromised individuals.[2]

Study details

Investigating their theory, the science team used two groups of mice fed either a control diet or a diet supplemented with DHA-rich fish oil for five weeks. B cells were then harvested from several tissues and stimulated in culture. It was found that DHA-enriched fish oil enhanced B cell activation and select antibody production, which was suggested to aid immune responses associated with pathogen clearance while possibly dampening the totality of the inflammatory response.

“These results support the hypothesis and an emerging concept that fish oil enhances B cell function in vivo,” confirmed the researchers.

Antiviral effects

Meanwhile, Japanese scientists discovered an ability for protectin D1 (PD1), a compound derived from omega-3 polyunsaturated fatty acids, to treat influenza infection in mice.[3] Importantly, PD1 was found to be beneficial even at advanced stages of infection, during which existing antivirals were no longer effective.

“Given the potential for future lethal pandemics, effective drugs are needed for the treatment of severe influenza, such as thosse caused by H5N1 viruses,” said senior study author Yumiko Imai in a press release via EurekAlert.[4] “We’ve identified a novel therapeutic target for the treatment of severe influenza that is effective under conditions where known antiviral drugs fail to protect from death.”

In their study, Imai and collaborators found that PD1 was effective at inhibiting the replication of viruses, and furthermore, low levels of PD1 in the lungs of influenza-affected test animals was associated with severe infection and highly pathogenic viruses such as H5N1. More interestingly treatment with PD1 improved the survival and pathology of severe influenza in the animals.

“Our findings suggest that PD1 could serve as a biomarker as well as a much needed antiviral drug for severe and lethal influenza virus infections,” Imai stated.

These results identify the omega-3 derived lipid mediator PD1 as an innate suppressor of influenza virus replication that may protect against lethal influenza infection.

References

  1. Gurzell EA, Teague H, Harria M, et al. DHA-enriched fish oil targets B cell lipid microdomains and ex vivo and in vivo B cell function. J Leukoc Biol 2013;93(4):463-470. [Full Text]
  2. Science news. Nothing fishy about it: fish oil can boost the immune system. ScienceDaily, 1 Apr 2013. [Link]
  3. Morita M, Kuba K, Ichikawa A, et al. The lipid mediator protectin D1 inhibits influenza virus replication and improves severe influenza. Cell 2013;153(1):112-125. [Full Text]
  4. O’Leary MB. Fatty acids could lead to flu drug. EurekAlert! Public release date, 7 Mar 2013. [Link]

DISCLAIMER:

The information provided on FX Medicine is for educational and informational purposes only. The information provided on this site is not, nor is it intended to be, a substitute for professional advice or care. Please seek the advice of a qualified health care professional in the event something you have read here raises questions or concerns regarding your health.

Common Dietary Allergens

Examples of ingredients which may contain common dietary allergens

Food                                                                                                Ingredients

Milk  :                         Artificial butter flavour, butter, butter fat, buttermilk, casein, caseinates (sodium, calcium, etc.), cheese, cream, cottage cheese, curds, custard, hydrolysates (casein, milk, whey), lactalbumin, lactose, milk (derivatives, protein, solids, malted, condensed, evaporated, dry, whole, low-fat, non-fat, skim), nougat, pudding, rennet casein, sour cream, sour cream solids, sour milk solids, whey (delactosed, demineralized, protein concentrate), yogurt.

MAY contain milk  :           Brown sugar flavouring, natural flavouring, chocolate, caramel flavouring, high protein flour, margarine.

Egg :  egg (white, yolk, dried, powdered, solids), egg substitute, eggnog, globulin, livetin, lysozyme, mayonnaise,meringue, Albumin,ovalbumin, ovomucin, ovomucoid.

Wheat  :                     Bread crumbs, bran, cereal extract, cracker meal, enriched flour, farina, gluten, graham flour, high gluten flour, high protein flour, malt, vital gluten, wheat bran, wheat germ, wheat gluten, wheat starch, wheat heat flour, spelt.

MAY contain wheat  :       Gelatinised starch, hydrolysed vegetable protein, modified food starch, modified starch, natural flavouring, soy sauce, starch, vegetable gum, vegetable starch.

Soy  :                             Hydrolysed vegetable protein, miso, shoyu sauce, soy (flour, grits, nuts, milk, sprouts), soybean (granules, curd), soy protein (concentrate, isolate), soy sauce, textured vegetable protein (TVP), tofu.

MAY contain soy   :          Hydrolysed plant protein, hydrolysed soy protein, hydrolysed vegetable protein, natural flavouring, vegetable broth, vegetable gum, vegetable starch.

Peanut  :                          Cold pressed peanut oil, ground nuts, mixed nuts, artifical nuts, peanut, peanut butter, peanut flour.

May contain peanut         African, Chinese, Thai and other ethnic dishes, baked goods (pastries, cookies, etc.) candy, chilli, chocolate candy, egg rolls, hydrolysed plant protein, hydrolysed vegetable protein, marzipan, nougat.

http://www.metagenics.com.au

Source:

Sicherer SH. Food allergy: when and how to perform oral food challenges. Pediatr Allergy Immunol. 1999 Nov;10(4):226-34.

Low FODMAP Diet

Dr Sue Shepherd developed the low FODMAP diet in 1999. She has proven, through her pioneering PhD research, that limiting dietary FODMAPs is an effective treatment for people with symptoms of IBS. The low FODMAP diet has been published in international medical journals and is now accepted and recommended as one of the most effective dietary therapies for IBS. Abstracts of these articles are available in our GP/Specialist Section.

FODMAPs are found in the foods we eat. FODMAPs is an acronym (abbreviation) referring to Fermentable Oligosaccharides, Disaccharides, Monosaccharides and Polyols*. These are complex names for a collection of molecules found in food, that can be poorly absorbed by some people. When the molecules are poorly absorbed in the small intestine of the digestive tract, these molecules then continue along their journey along the digestive tract, arriving at the large intestine, where they act as a food source to the bacteria that live there normally. The bacteria then digest/ferment these FODMAPs and can cause symptoms of Irritable Bowel Syndrome (IBS). Symptoms of Irritable Bowel Syndrome include abdominal bloating and distension, excess wind (flatulence), abdominal pain, nausea, changes in bowel habits (diarrhoea, constipation, or a combination of both), and other gastro-intestinal symptoms.

What are the FODMAPs?

FODMAPs are found in the foods we eat. FODMAPs is an acronym for

Fermentable
Oligosaccharides (eg. Fructans and Galactans)
Disaccharides (eg. Lactose)Monosaccharides (eg. excess Fructose)
and
Polyols (eg. Sorbitol, Mannitol, Maltitol, Xylitol and Isomalt)

Where are FODMAPs found?

A few examples of food sources for each of the FODMAPs are listed below. The list is not complete. New data has been obtained through Monash University Department of Gastroenterology regarding the FODMAP content of foods. As a result, there have been some changes from previous food lists. Below is a list containing up-to-date information. Excess Fructose: Honey, Apples, Mango, Pear, Watermelon, High Fructose Corn Syrup, Corn Syrup Solids

  • Fructans: Artichokes (Globe), Artichokes(Jerusalem), Asparagus, Beetroot, Chicory, Dandelion leaves, Garlic (in large amounts), Leek, Onion (brown, white, Spanish, onion powder), Raddicio lettuce, Spring Onion (white part), Wheat (in large amounts), Rye (in large amounts), Inulin, Fructo-oligosaccharides.
  • Lactose: Milk, icecream, custard, dairy desserts, condensed and evaporated milk, milk powder, yoghurt, margarine, soft unripened cheeses (eg. ricotta, cottage, cream, marscarpone).
  • Galacto-Oligosaccharides (GOS): Legume beans (eg. baked beans, kidney beans, bortolotti beans), Lentils, Chickpeas
  • Polyols: Apples, Apricots, Avocado, Cherries, Longon, Lychee, Nectarines, Pears , Plums, Prunes, Mushrooms, Sorbitol (420), mannitol (421), xylitol (967), maltitol (965) and Isomalt (953).

Common Dietary Allergans

Examples of ingredients which may contain common dietary allergens

Food                                                                                                Ingredients

Milk  :                         Artificial butter flavour, butter, butter fat, buttermilk, casein, caseinates (sodium, calcium, etc.), cheese, cream, cottage cheese, curds, custard, hydrolysates (casein, milk, whey), lactalbumin, lactose, milk (derivatives, protein, solids, malted, condensed, evaporated, dry, whole, low-fat, non-fat, skim), nougat, pudding, rennet casein, sour cream, sour cream solids, sour milk solids, whey (delactosed, demineralized, protein concentrate), yogurt.

MAY contain milk  :           Brown sugar flavouring, natural flavouring, chocolate, caramel flavouring, high protein flour, margarine.

Egg :  egg (white, yolk, dried, powdered, solids), egg substitute, eggnog, globulin, livetin, lysozyme, mayonnaise,meringue, Albumin,ovalbumin, ovomucin, ovomucoid.

Wheat  :                     Bread crumbs, bran, cereal extract, cracker meal, enriched flour, farina, gluten, graham flour, high gluten flour, high protein flour, malt, vital gluten, wheat bran, wheat germ, wheat gluten, wheat starch, wheat heat flour, spelt.

MAY contain wheat  :       Gelatinised starch, hydrolysed vegetable protein, modified food starch, modified starch, natural flavouring, soy sauce, starch, vegetable gum, vegetable starch.

Soy  :                             Hydrolysed vegetable protein, miso, shoyu sauce, soy (flour, grits, nuts, milk, sprouts), soybean (granules, curd), soy protein (concentrate, isolate), soy sauce, textured vegetable protein (TVP), tofu.

MAY contain soy   :          Hydrolysed plant protein, hydrolysed soy protein, hydrolysed vegetable protein, natural flavouring, vegetable broth, vegetable gum, vegetable starch.

Peanut  :                          Cold pressed peanut oil, ground nuts, mixed nuts, artifical nuts, peanut, peanut butter, peanut flour.

May contain peanut         African, Chinese, Thai and other ethnic dishes, baked goods (pastries, cookies, etc.) candy, chilli, chocolate candy, egg rolls, hydrolysed plant protein, hydrolysed vegetable protein, marzipan, nougat.

http://www.metagenics.com.au

Source:

Sicherer SH. Food allergy: when and how to perform oral food challenges. Pediatr Allergy Immunol. 1999 Nov;10(4):226-34.