Posts Tagged ‘tuna’

Acupuncture
Acupuncture shot to fame in the West in 1972, when James Reston, a correspondent for the New York Times, fell ill with appendicitis while covering President Nixon’s historic

trip to China. Following the removal of his appendix, he received acupuncture treatment for pain, and was highly impressed with its effects.
His Chinese doctor invited Reston to witness the use of acupuncture in anaesthesia, and he reported the remarkable fact that patients undergoing surgery could be free from pain

with just a few tiny needles inserted into carefully chosen points on the body. They remained alert and talkative throughout the operation.
Traditional Chinese medicine has enjoyed a good reputation in the West ever since, but what few people realise is that acupuncture anaesthesia is a very new invention. Surgery

was not traditionally practised in China and it was only in the 1950s, after Chairman Mao had urged Chinese doctors to unify Western and Chinese medicine, that the anaesthetic

potential of acupuncture was discovered.
The remarkable effects of acupuncture anaesthesia made a huge impression on doctors in the West – a high-profile success that has had both good and bad results. On the positive

side, conventional medicine has been prepared to take acupuncture seriously, and to undertake some research into its effects. On the negative side, most
of that research has concerned pain control – the effects of acupuncture on the endorphins. These are natural painkilling compounds produced by the body (their effects are

mimicked by opiate drugs such as morphine and heroin).
Western researchers have paid little attention to how acupuncture affects most other aspects of health, including the immune system and allergic diseases. One exception to this

is asthma, where certain nerves do play a large part in producing the symptoms (see box on p. 235).
Treating the person
Diagnosis and treatment are far more orientated towards the individual patient-, in traditional Chinese medicine, and diagnostic labels such as ‘allergy’ or `hayfever’ are less

important than the particular character of a person’s Qi (see box on p. 215), as detected by the acupuncturist. A traditional Chinese acupuncturist pays great attention to the

quality of the different pulses and takes them at the start of every appointment, and at intervals during treatment, to check how the Qi flow has changed. Each treatment session

is unique and tailored to the individual’s condition at that particular moment.
This makes it very difficult to carry out conventional scientific research into traditional acupuncture.
In an effort to make acupuncture accessible to research, a more Westernised and formulaic approach has been developed, using orthodox medical diagnosis and needling a set of

acupuncture points that are prescribed for that medical condition. Experts in traditional acupuncture feel that this approach – first name the disease, then apply a standard

remedy – will often fail, and is missing the whole point of acupuncture.
That is not the only problem with Westernised acupuncture, as Dr David Eisenberg of Harvard University, a leading expert on acupuncture, points out. He describes a typical

acupuncture session in China: ‘Each time the acupuncturist inserts a needle, he or she asks the patient, “Do you have it or not?” referring to the patient’s “obtaining the Qi”

(de Qi). The question asks whether the patient has felt a sensation of fullness, distension, pins and needles, or the like, from the insertion of the needle in the spot being

used… Most Chinese have experienced acupuncture and they understand the phenomenon of de Qi… By contrast, most Western patients seeking acupuncture therapy know nothing of

the phenomenon of de Qi. Not knowing what sensations they should anticipate, they cannot tell the acupuncturist whether a needle is in the right place. When both therapist and

patient know little about de Qi, as frequently occurs in Western acupuncture clinics, the result is bound to be disappointing.’ Fortunately it is possible to find acupuncturists

who have been properly trained, and the sensation of ‘obtaining the Qi’ is perfectly detectable, even to a sceptical Westerner, so look for someone who pays attention to this.
There can be emotional and psychological reactions to acupuncture, so make sure that you also feel relaxed with your acupuncturist and that there is a certain empathy between

you.
Does acupuncture work for allergies?
According to Chinese theories, acupuncture can have some benefits in any illness – if you are ill, your flow of Qi must be disturbed, and it will help to put that right. Indeed,

most people do feel a sense of well-being after an acupuncture session.
To look at this from a Western scientific perspective, acupuncture can stimulate your body to increase its production of endorphins (see p. 214). This gives you a mild high,

similar to that you’d get from running for a couple of hours. Feeling relaxed and confident helps most people to cope better, and gives them a new perspective on life’s

problems. Since the mind plays some part in almost all illness (if only to aggravate the effects of an underlying physical problem), inducing a more positive state of mind can

be of benefit.
As regards more specific effects, several studies show that acupuncture can have a small, short-term effect in opening up the airways of asthmatics. This is not surprising

because acupuncture affects the autonomic nervous system, the ‘auto-pilot’ section of the nervous system (see box on p. 235) which can tighten or relax the muscles around the

airways. A short-term effect is just that – it doesn’t treat the real problem. What matters more in asthma is the long-term impact of any treatment on the underlying

inflammation of the airways (see p. 36). Although some studies of acupuncture treatment have found a reduction in inflammation, other studies have not. However, only one study

to date used an individualised approach to acupuncture, as opposed to a same-for-everyone formula. It is interesting that this study did find good long-term effects on airway

inflammation.
The larger picture
Acupuncture is just one element of Chinese medicine, which has several other techniques available. In China (and in some Chinese clinics in the West) these techniques are used

together, as different ways of tackling the same problem. No traditional Chinese doctor would dream of trying to treat every patient with acupuncture alone and, in the case of a

patient with allergies, herbal remedies would usually be a central part of the treatment.
A recent and very careful scientific study from Germany took this combined approach with hayfever, and showed some benefit. The patients were treated with both acupuncture and

herbal treatment, using a standardised regime but with additional acupuncture points and herbs chosen to suit the individual. Those treated reported a substantial improvement in

how they felt generally –but not in the specific symptoms of hayfever.
The flow of energy
Acupuncture is rooted in ancient Chinese ideas of the human body. which are radically different from those of Western medicine:
•    Vital energy. called Oi or Chi (and always pronounced ‘thee’). is what distinguishes living bodies from dead ones. It should flow easily and harmoniously thrOLIC11011i

the body nourishing and protecting the organs. When the flow of Qi is blocked, or becomes unbalanced. then illness develops. - Channels called meridians are the conduits for Qi

in the body. They mostly run vertically (i.e. from head to toe) and the points where acupuncture needles are inserted all lie on these meridians.
•    The flow of Qi can be measured by carefully taking pulses — not just one pulse as in Western medicine, but several different kinds of pulse.
•    By detecting disturbances in the flow of Qi, and correcting them, existing illness can be cured, and incipient illness prevented, before there are any obvious symptoms.
The nature of the meridians and the acupuncture points remains a mystery to Western doctors. Some parts of the meridians run roughly along the lines of certain nerves or blood

vessels, but they do not follow them exactly. The acupuncture points have no anatomical reality — there is nothing to see either on the surface or under the skin. However, many

are located near major nerve endings or over deep pressure receptors.

Pollen

Do you ever wake up in the middle of the night with an attack of hayfever or pollen asthma? And do you ever wonder why this should happen? The explanation is that warm air, rising up from ground level on a summer’s day, takes pollen with it high into the Earth’s atmosphere. When the air cools down after sunset, this pollen slowly descends again — an invisible ‘pollen shower’.
This pollen shower falls quite quickly in the countryside, reaching ground level between 8 p.m. and 10 p.m., but hot city pavements and buildings keep upward air currents going, and pollen stays aloft for longer. Most pollen lands on the city between about midnight and 2 a.m. That’s why you wake up sneezing or wheezing – especially if you sleep with the windows open.
Understanding facts like these about pollen can help you to reduce exposure substantially. Pollen is by far the most difficult allergen to avoid, but don’t believe the defeatists who tell you ‘You can’t do anything about pollen.’
Pollen counts and forecasts
Pollen counts are based on the amounts of pollen collected at specific sites earlier in the day, or on the previous day.
Forecasts for the coming day are really just informed guesswork, based on the present pollen count, the time of year, the temperature and rainfall over the last few days, and the weather forecast for the next day. At best, pollen forecasts are only as good as the weather forecast.
Forecasts of pollen can be useful in deciding when to start taking antihistamines for hayfever or when to Increase your asthma preventer drugs (steroid or cromoglycate inhalers). The start of the grass-pollen season is now predicted quite accurately.
Avoiding pollen outdoors
One thing that really can help here is an air-conditioned car. In an ordinary car, closing the windows (and perhaps fitting a filter to the air intake) helps a lot, but the heat is terrible.
The size of the allergen particles
The pollen grains that cause allergies are between 10 and 40 microns in size, with the majority between 20 and 35 microns. An ordinary dust mask takes out particles larger than 5 microns, so it will be adequate for most pollens. However, a few plants — including rye grass — produce tiny allergenic fragments, some no bigger than half a micron. These are about the same size as cat allergen and will therefore need much better masks. For these fragments, it is worth using a HEPA air filter, and getting a high-quality vacuum cleaner.
A cycle mask, or special nose filters sold for hayfever, will keep out pollen at peak pollen times. Just wearing a scarf over the mouth and nose will also give some protection. Another option is to smear a little Vaseline just inside each nostril and breathe through your nose only. Much of the pollen coming into your nose will stick to the Vaseline. If you ’suffer symptoms in the eyes, sun- glasses will keep some pollen out. Even better are wrap-around shades, or safety goggles with side panels sold in DIY stores.
Pollen release occurs at different times of day for different plants. Grasses release pollen from about 7.30 a.m, onwards, but if the ground is damp the release will be delayed until the moisture has evaporated. Unfortunately, a few grass species wait until the afternoon, so there will be some pollen entering the air all day. If you get up at 6 a.m. for a walk or run, you can be safely home by 7.30 a.m. Alternatively, go out In the early evening, after grasses have finished releasing pollen, and before the ‘pollen shower’.
Birch is an afternoon pollen: release peaks between noon and 6 p.m. Unfortunately, there is no information at present for other types of plants.
All types of plants favour warm sunny days for releasing pollen, and they all avoid rainy weather. On cloudy days there is a build-up of pollen in the flowers, so a massive release of pollen occurs on the next day of good weather.
Avoiding pollen indoors
Pollen grains have one huge point in their favour: compared to other allergenic particles, they are big and heavy. This means that they settle more quickly from the air. In a room with 3m- (1 Oft-) high ceilings, all the pollen will settle within four minutes, as long as the air is completely still. In other words, if you close all the doors and windows, block off any draughts, and sit fairly still, within four minutes you will be breathing pollen-free air.
This does not mean that all your symptoms will instantly vanish, because the ‘Late Phase Reaction’ (see p. 13) can go on for up to 24 hours. But you should feel better and, by not starting a new cycle of allergic reaction, you are improving the prospects for the next day. Escaping from pollen for a few hours every day should produce a general improvement in the long run, with your nose and airways becoming less inflamed.
The bad news is that some plants produce allergenic fragments much smaller than the pollen grains themselves. Various grasses do this, as do birch trees and certain plants not generally found in Britain, such as ragweed. These tiny particles take much longer – up to six hours – to settle from the air.
Some plants even produce ‘volatiles’ – airborne chemicals that provoke symptoms. Birch trees release volatiles from their buds in early spring, weeks before the pollen itself is released, and they affect a great many people, including some who are not allergic to birch pollen. Volatiles can only be removed by masks or air filters if they contain an activated carbon filter (see p. 109).
The notorious effects of oil-seed rape on the nose are also due to volatiles, not pollen. These volatiles are simply irritants and there is no allergic reaction.
To cut down on the amount of pollen you inhale at home:
• Dry all your laundry indoors during the pollen season, to stop it collecting pollen.
• Pets bring in pollen on their fur, so keep them outdoors during the pollen season, and avoid stroking them or getting too close. Brushing them thoroughly before they come in is another option, but the allergic individual should not do this.
• Close the windows when your offending pollen is being released, and during the evening ‘pollen shower’ (see p. 126).
• Change your clothes when you arrive home, since they will be coated with pollen, and wash or rinse your hair. Keep some clothes for indoor use only.
• Aim for still air (no draughts, no fans and no vigorous movement) in the rooms where the allergic individual studies, sits or sleeps. Air currents stir up pollen from the floor and furnishings. (No draughts means poor ventilation, of course, which is acceptable during the pollen season – but ventilate again afterwards, to discourage moulds and dust mites.)
• If tranquil air is an impossibility, consider getting a high quality air cleaner, or air conditioning. Alternatively, wet-dust and vacuum every day (using a vacuum cleaner that keeps allergen particles in – see pp. 116-17) to reduce the amount of pollen residue. Those who are very sensitive may need to do this as well as having an air cleaner.
• Cover your armchair and bed with a dust sheet during the day. In the evening, fold this up very gently and wash it. This removes the layer of pollen that accumulates on furniture during the day, before it is disturbed and inhaled. If you are studying, cover your desk and books when not working.
Places to go, places to avoid
• For the grass-sensitive, mown grass is usually fine (it won’t flower) although some people react to skin contact with grass (see p. 43). Unmown grass does flower, and will cause symptoms. Wheat, barley and oats, although they are grasses, release little pollen and rarely cause problems. Rye and sugarcane do release pollen, and may affect some people, but maize (corn) has heavy pollen that does not travel far, so it rarely causes much trouble.
• The levels of most pollens do not differ much between town and country. In fact, high up in a tower-block may be one of the worst places, because of pollen rising on warm air.
• The seaside is often pollen-free thanks to onshore breezes. Mountain peaks and ridges are also good, but deep mountain valleys can be pollen traps.
Roses are not the problem
The pollens that cause allergic reactions almost all come from plants with inconspicuous greenish flowers. These plants are pollinated by the wind, which is why there is so much of their pollen wafting about in the air. Colourful and scented flowers are pollinated by insects and have big sticky pollen grains that don’t float about and rarely cause allergies. However, strong scents can irritate the nose of those who already have hayfever, and make their symptoms worse.

Allergens in Food
Anyone with true food allergy or coeliac disease needs to be very careful about avoiding certain foods. The information given here is aimed mainly at such people, rather than those with food intolerance (see p. 74), who can usually tolerate small amounts of their offending foods. However, some of the basic information given here is relevant to those with food intolerance as well.
There are different levels of sensitivity even among those with true food allergy. The ‘exquisitely sensitive’ can react to unbelievably minute traces of the food, and for them life is especially difficult. The same is true of some coelicacs, who can be affected by the tiniest quantity of gluten.
These people are a small minority. The level of vigilance required of such people will not be necessary for most people reading this book, so don’t get things out of proportion. While it is vital to be sensible about avoiding your problem food, it is also important not to become over-anxious.
Buying basic ingredients
Cooking for yourself is the safest way to eat for those with true food allergy and coeliac disease. There are relatively few hazards, but do beware of well-meaning assistants in health-food shops who try to sell you some exotic package of grain or flour – spelt or kamut or triticale, for example – reassuring
you that it is ‘definitely not wheat’. Be well informed about the different forms of your problem food and the names under which it is sold (see pp. 172-5).
Oils made from foods such as corn or peanut sometimes cause concern. Ordinary refined oils have been so thoroughly processed that they actually contain no allergenic proteins, so you can safely use these. Bottles of gourmet walnut oil and almond oil are a different story however, and should be avoided if you have nut allergies. Sesame oil is not purified either and can provoke serious reactions. With any oil, if you are unsure how safe it might be, go by the smell. Oils that smell or taste like the food from which they are made could well contain allergens.
Those with allergy to tuna can usually eat tinned tuna because the processing makes it safe. The allergens in fresh fruit and vegetables are generally inactivated by cooking too, so jams and tinned fruits tend to be safe – but test very cautiously. Cooking does not have much effect on other food allergens, apart from eggs. In rare cases, cooking can create allergens (see box on p. 186).
If you share your kitchen with others, and are highly sensitive, check that all cooking utensils are truly clean before use. Coeliac should watch out for breadcrumbs in the butter dish, jam or toaster. Where small children are allergic to a food, it may be best to keep the culprit out of the house entirely.
Genetic engineering and food allergy
Many people with food allergies are very concerned about the possibility that genetic engineering could introduce allergens from one plant species into another. This concern seems to be shared by government officials and those in the food industry, who are being extremely vigilant and cautious at present. As long as this attitude continues, there should be little danger to food allergy sufferers.
Finding food in funny places
If you are suffering some inexplicable reactions to non-food items, it might, just possibly, be a food reaction. Some latex gloves contain the milk protein casein, for example, added as a manufacturing aid.
Buying packaged foods
There are several different issues here:
• the need to read labels carefully for allergenic ingredients described by unfamiliar names (see p. 172)
• errors in the packaging used (see pp. 174-5)
• contamination by minute traces of a food substance due to processing machinery not being cleaned adequately. Cartons of fruit drink have occasionally been contaminated with traces of milk because the same production lines were used for packaging milk drinks. Tofu desserts made in ice-cream factories can also become contaminated with milk. These tiny traces of a food will only affect the most highly sensitive individuals, but contamination by nuts can involve large pieces and affect anyone with nut allergy (see p. 174).
• foodstuffs which are used as part of the production process
and leave a tiny residue in the finished item (see p. 174).
Be very cautious indeed about ready-made food that is unlabelled, such as that from bakeries and home-made stalls. Egg is frequently used as a glaze on baked products, nuts may lurk within, and milk or wheat can turn up in the most unlikely places.
Restaurants, cafes and takeaways
The majority of fatal and near-fatal incidents involving people with true food allergy are due to restaurants, cafeterias and canteens. Takeaways can also be a problem except in the case of the large chains such as McDonald’s, where ingredients are standardised. It is alarming that highly allergenic foods (e.g. peanut) are sometimes used – yet far from obvious – in recipes and sandwich fillings where they would simply not be expected. Anyone with peanut or shellfish allergy should be ultra-cautious about Chinese, Thai or Malaysian cooking – but those with milk allergy should find a haven here, because milk is not part of these culinary traditions.
The simplest solution is to eat very plainly when you go out –steak and salad, for example. Steer clear of casseroles and thick soups, where you can’t see what’s in it (the occasional chef throws in peanut butter to thicken the mix…). Food wrapped in pastry is best avoided for the same reason. Desserts and cakes are risky for anyone with nut, egg or milk allergy.
You must insist on accurate information about the food before you taste it. If the counter staff, the waiter or the waitress
is unsure of the ingredients, ask them to check with the chef, or with the label on pre-packaged food. Be persistent and never eat anything unless you are sure. Make eye contact with the person concerned, and learn to be a good judge of character. Your life could depend on telling the difference between the waiter who knows the facts about the food and the waiter who is being blandly reassuring for the sake of a quiet life.
It is a great mistake to pick out the pieces of offending food – kiwi fruit from a fruit salad for example – and eat the rest. There is often enough allergen left behind to cause anaphylaxis in the highly allergic individual.
Those who are extremely sensitive to the offending food must also consider the problem of contamination in the kitchen. Grills and fryers in restaurants and canteens can become contaminated with fish allergens or nut allergens (e.g. from nut cutlets) and these can be transferred to fried potatoes or other foods, provoking anaphylaxis in the highly allergic individual. One person with fish allergy died in this way. Sesame seeds can also contaminate equipment, work-surfaces or bakery counters.
Parties and buffets
Milk, egg, shellfish or nut allergies can make it especially hazardous to eat buffet or party food. Regard everything with suspicion. Cocktail snacks with nuts or peanut paste hidden inside are a particular problem.
When fish allergy isn’t fish allergy
Anisakis is a parasitic worm that infests fish and can sometimes survive the
cooking process to infect humans. The worms are easily thrown off by the human immune system, but the body is primed to make IgE antibodies should
it ever encounter Anisakis again. Another meal of parasitised fish – even if the Anisakis worms are all dead this time, and only the allergens remain
will provoke a massive IgE-mediated reaction, leading to anaphylactic shock. This problem is usually misdiagnosed as allergy to fish itself.
Other inconsistent reactions to food can be due to contaminants such as antibiotics, preservatives, other food additives or (especially in the case of shellfish) naturally occuring toxins.