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Introduction: The thyroid gland undergoes metabolic changes that can cause benign or malignant diseases, one of which is thyroid cancer, which is increasing worldwide, and women are most prone to develop this disease. Objective: To present scientific evidences based on a systematic review of the literature (PRISMA) verifying the effectiveness of food in preventing thyroid cancer. Method: For the selection of studies, the combination based in the Medical Subject Heading Terms (MeSH) was used. The MEDLINE (PubMed), LILACS, SciELO, BIREME and Scopus databases were utilized. The search period for the articles ranged from January 2010 to March 2020, with no language or localization restrictions. Results: 32 articles with potential for inclusion were retrieved, and three articles responded to the guiding question that consisted in analyzing the effectiveness of food in preventing thyroid cancer. Conclusion: Studies have reported a possible association between food intake and the prevention of thyroid cancer. It is suggested that food rich in calcium may play a protective role against thyroid cancer, but excessive levels of iodine in the diet may also affect thyroid function negatively due to changes in hormone levels. The researches also demonstrate that women have significantly higher incidence of thyroid cancer than men. Introducción: La glándula tiroides sufre cambios metabólicos que pueden causar enfermedades benignas o malignas, una de las cuales es el cáncer de tiroides. Lo cáncer de tiroides está creciendo cada vez más en todo el mundo, siendo las mujeres las más propensas a desarrollar esta enfermedad. Objetivo: Presentar evidencia científica basada en una revisión sistemática de la literatura (PRISMA) que verifique la efectividad de los alimentos en la prevención del cáncer de tiroides. Método: Para la selección de los estudios, se utilizó la combinación basada en los términos de encabezado de temas médicos (MeSH). Se utilizaron las bases de datos MEDLINE (PubMed), LILACS, SciELO, BIREME y Scopus. El periodo de búsqueda de los artículos vario desde enero de 2010 hasta marzo de 2020, sin restricciones de idioma y localización. Resultados: Se recuperaron 32 artículos con potencial de inclusión, y tres artículos respondieron a la pregunta guía que consistió en analizar la efectividad de los alimentos para prevenir lo cáncer de tiroides. Conclusión: Los estudios han reportado una posible asociación entre la ingesta de alimentos y la prevención de cáncer de tiroides. Se sugiere que los alimentos ricos en calcio pueden proporcionar un papel protector contra lo cáncer de tiroides, pero los niveles excesivos de yodo en la dieta también pueden afectar negativamente la función tiroidea debido a los cambios en los niveles hormonales. La investigación también muestra que las mujeres tienen una incidencia significativamente mayor de cáncer de tiroides en comparación con los hombres. Introdução: A glândula tireoide sofre alterações metabólicas que podem ocasionar doenças benignas ou malignas, sendo uma delas o câncer de tireoide, o qual esta crescendo cada vez mais ao redor do mundo, sendo as mulheres mais propensas a desenvolver essa doença. Objetivo: Apresentar evidencia cientificas com base em revisão sistemática da literatura (PRISMA), verificando a efetividade da alimentação na prevenção do câncer de tireoide. Método: Para a seleção dos estudos, utilizou-se a combinação baseada no Medical Subject Heading Terms (MeSH). Foram utilizadas as bases de dados MEDLINE (PubMed), LILACS, SciELO, BIREME e Scopus. O período de busca dos artigos compreendeu entre janeiro de 2010 ate marco de 2020, sem restrição de idioma e localização. Resultados: Foram recuperados 32 artigos com potencial de inclusão, sendo que três responderam a pergunta norteadora que consistiu em analisar qual a efetividade da alimentação na prevenção do câncer de tireoide. Conclusão: Os estudos relataram uma possível associação entre a ingestão de alimentos e a prevenção do câncer de tireoide. Sugere-se que os alimentos ricos em cálcio possam fornecer um papel protetor contra esse tipo de câncer, porem níveis excessivos de iodo na dieta também podem, de forma negativa, afetar a sua função da tireoide em razão das alterações nos seus níveis de hormônio. As pesquisas demonstram também que as mulheres apresentam significativamente maior incidência de câncer de tireoide em relação aos homens.

Food allergy has increased in recent decades and has a major impact on patients' quality of life. There is currently no treatment in routine clinical practice, and patients are often faced with accidental reactions. Precautionary allergen labelling (PAL) has been used by the food industry to attempt to minimize this risk, although not standardized and often ambiguous. Estimating the risk of reacting to traces in foods is complicated by heterogeneous amounts of allergens in foods with precautionary labelling and individual variability in reaction thresholds. In recent years, oral food challenge studies have shown that low individual reaction thresholds do not necessarily correlate with severe reactions, and current understanding of thresholds is evolving with novel low-dose challenge protocols better adapted to estimate them. Future tools to provide a better estimation of minimal eliciting doses, including basophil activation tests, may improve our management of food-allergic patients.

BACKGROUND:The European Academy of Allergy and Clinical Immunology (EAACI) is developing Guidelines for Allergen Immunotherapy (AIT) for IgE-mediated Food Allergy. To inform the development of clinical recommendations, we sought to critically assess evidence on the effectiveness, safety and cost-effectiveness of AIT in the management of food allergy.METHODS:We undertook a systematic review and meta-analysis that involved searching nine international electronic databases for randomized controlled trials (RCTs) and nonrandomized studies (NRS). Eligible studies were independently assessed by two reviewers against predefined eligibility criteria. The quality of studies was assessed using the Cochrane Risk of Bias tool for RCTs and the Cochrane ACROBAT-NRS tool for quasi-RCTs. Random-effects meta-analyses were undertaken, with planned subgroup and sensitivity analyses.RESULTS:We identified 1814 potentially relevant papers from which we selected 31 eligible studies, comprising of 25 RCTs and six NRS, studying a total of 1259 patients. Twenty-five trials evaluated oral immunotherapy (OIT), five studies investigated sublingual immunotherapy, and one study evaluated epicutaneous immunotherapy. The majority of these studies were in children. Twenty-seven studies assessed desensitization, and eight studies investigated sustained unresponsiveness postdiscontinuation of AIT. Meta-analyses demonstrated a substantial benefit in terms of desensitization (risk ratio (RR) = 0.16, 95% CI 0.10, 0.26) and suggested, but did not confirm sustained unresponsiveness (RR = 0.29, 95% CI 0.08, 1.13). Only one study reported on disease-specific quality of life (QoL), which reported no comparative results between OIT and control group. Meta-analyses revealed that the risk of experiencing a systemic adverse reaction was higher in those receiving AIT, with a more marked increase in the risk of local adverse reactions. Sensitivity analysis excluding those studies judged to be at high risk of bias demonstrated the robustness of summary estimates of effectiveness and safety of AIT for food allergy. None of the studies reported data on health economic analyses.CONCLUSIONS:AIT may be effective in raising the threshold of reactivity to a range of foods in children with IgE-mediated food allergy whilst receiving (i.e. desensitization) and post-discontinuation of AIT. It is, however, associated with a modest increased risk in serious systemic adverse reactions and a substantial increase in minor local adverse reactions. More data are needed in relation to adults, long term effects, the impact on QoL and the cost-effectiveness of AIT.

Despite careful avoidance measures, food allergic patients have a significant risk of anaphylactic episodes. Risk situations need to be identified for more efficient preventive measures.Responders to an internet-based survey on the awareness of food anaphylaxis were invited to relate the circumstances of their most severe reaction following the diagnosis of IgE-mediated food allergy. Items of the questionnaire included the circumstances of the reaction and the treatment, as well as questions related to reactions occurring at specific categories of sites (i.e. home, schools, or restaurants).Fifty-one of the returned questionnaires (34.1%) corresponded to the study criteria. The median age of the subjects was 7 years (range 0.5-61), with 33/51 (64.7%) being less than 16 years of age. Reactions were reported to peanuts (24/51; 47.1%), milk (12/51; 23.5%), tree nuts (6/51; 11.8%), fish and shellfish (5/51; 9.8%), and others (3/51; 5.8%). Reactions occurred at home (13/51; 25.5%), in restaurants (9/51; 17.6%), at school or daycare or kindergarten (8/51; 15.7%), at a relative or friend's home (7/51; 13.7%), at sites of leisure activities (6/51; 11.8%), at work (3/51; 5.9%), in church or a hospital ward (2/51; 3.9% each), or in a food store (1/51; 2.0%). In severe reactions (37/51; 72.5%) epinephrine was administered in 28/37 (75.7%) of the responders. Finally, while most reactions happened after ingestion of the food (40/51; 78.4%), others were reported after skin contact exclusively (8/51; 16%), or after inhalation (3/51; 5.9%).Food induced-anaphylaxis in patients aware of their allergy happens most often at sites considered as safe (i.e. home, schools, workplace, hospitals). Better strategies to avoid accidental reactions include clear labelling of forbidden foods and increased information at all levels. These might dramatically reduce the risk of food-induced anaphylaxis in food allergy sufferers.

Background: The debate about whether energy consumed in liquid form is more obesogenic than energy consumed in solid form remains equivocal. We aimed to evaluate the effects of liquid versus solid energy intake and different beverage types on changes in childhood adiposity. Methods: Our analyses included 8-year-old Australian children (n = 158) participating in the Childhood Asthma Prevention Study. Dietary information was collected using three 24-h recalls at age 9 years. Multivariate linear regression was used to evaluate the effects of liquid versus solid energy intake and different beverage types on changes in body mass index (BMI) Z-score from ages 8 to 11.5 years (▵BMIz 8-11.5y) and percentage body fat (%BF) at age 11.5 years (%BF 11.5y). Substitution models were used to evaluate the effects of substituting other beverage types for sugar-sweetened beverages (SSB). Results: Liquid energy intake (1 MJ day -1) was more closely associated with both ▵BMIz 8-11.5y (β = 0.23, P = 0.02) and %BF 11.5y (β = 2.31%, P = 0.01) than solid energy intake (▵BMIz 8-11.5y: β = 0.12, P = 0.01 and %BF 11.5y: β = 0.80%, P = 0.07). SSB consumption (100 g day -1) was directly associated with ▵BMIz 8-11.5y (β = 0.08, P = 0.02) and %BF 11.5y (β = 0.92%, P = 0.004),whereas diet drinks (100 g day -1) were inversely associated with ▵BMIz 8-11.5y (β = 0.18, P = 0.02). Substitution of 100 g of SSB by 100 g of water or diet drink, but not other beverages, was inversely associated with both ▵BMIz 8-11.5y and %BF 11.5y (P < 0.01). Conclusions: Our findings indicate that liquid energy is more obesogenic than solid energy. In particular, SSB, but not other beverage types, are a significant predictor of childhood adiposity and replacing SSB with water can have long-term beneficial effects on childhood adiposity.

Hugh A. Sampson, MD, Roy Gerth van Wijk, MD, Carsten Bindslev-Jensen, MD, PhD, Scott Sicherer, MD, Suzanne S. Teuber, MD, A. Wesley Burks, MD, Anthony E. J. Dubois, MD, Kirsten Beyer, MD, Philippe A. Eigenmann, MD, Jonathan M. Spergel, MD, PhD, Thomas Werfel, MD, and Vernon M. Chinchilli, PhD New York, NY, Rotterdam and Groningen, The Netherlands, Odense, Denmark, Davis, Calif, Chapel Hill, NC, Berlin and Hannover, Germany, Geneva, Switzerland, and Philadelphia and Hershey, Pa

A favorable outcome of anaphylaxis depends on the rapidity of adequate initial management and epinephrine injection. However, few data on the management of anaphylactic reactions are available. The aim of this study was to investigate the management and awareness of anaphylaxis to foods by mean of an Internet-based survey.Visitors to a website with information on food allergy were invited to join the survey. Items in the survey included the management of anaphylactic reactions, investigations done by the diagnosing physician, and information given to the responder in anticipation of a new anaphylactic reaction.Almost all of the 264 responders were from North America, Europe, Australia, or New Zealand (263/264). The most recent reaction was treated by epinephrine injection in 68.7% (180/262) of cases, or by antihistamines in 14.1% (37/262). Epinephrine was the first treatment for the most severe reaction in only 43.9% (101/230), while antihistamines were given first in 43.5% (100/230). One-third (62/210 = 29.5%) of the responders diagnosed by a physician received neither a diagnostic blood test nor a skin test. Responders diagnosed by an allergist were more often investigated (91/105 = 86.7%) than those diagnosed by a pediatrician or an internist (29/44 = 65.9%), a general practitioner (22/45 = 48.9%), or another physician (6/16 = 37.5%) (P0.001). Most responders had received instructions on how to deal with a new episode of anaphylaxis (244/263 = 92.8%). Responders instructed by an allergist were most frequently satisfied with the instructions (115/131 = 87.8%).A large number of responders did not receive epinephrine for treatment of their most severe, or most recent anaphylactic reaction, and did not undergo allergy tests. The conventional management of anaphylaxis might still be improved.

Objective. There is a growing body of clinical and laboratory evidence to support the notion that food allergy plays a role in the pathogenesis of atopic dermatitis (AD). However, the incidence of IgE-mediated food allergy in children with AD is not well established.Design. A prospective study to determine the prevalence of IgE-mediated food hypersensitivity among patients referred to a university-based dermatologist for evaluation of AD.Setting. University hospital pediatric dermatology clinic.Patients. A total of 63 patients with AD were recruited (35 male; 32 white, 24 African-American, 7 Asian).Methods. Patients were assigned an AD symptom score (SCORAD) and were screened for food-specific serum IgE antibodies to six foods (milk, egg, wheat, soy, peanut, fish) known to be the most allergenic in children. The levels of food-specific serum IgE were determined by the CAP System fluoroscein-enzyme immunoassay (CAP); patients with a value ≥0.7 kIUa/L were invited for an additional allergy evaluation. Those with CAP values below the cutoff were considered not food allergic. Patients were considered to be allergic if they met one of the following criteria for at least one food: 1) reaction on food challenge; 2) CAP value more than the 95% confidence interval predictive for a reaction; 3) convincing history of an acute significant (hives, respiratory symptoms) reaction after the isolated ingestion of a food to which there was a positive CAP or prick skin test.Results. A total of 63 patients (median age, 2.8 years; median SCORAD, 41.1) were recruited; 22 had negative CAP values (without a significant difference in age or SCORAD score, compared with the 41 with positive specific IgE values). Further allergy evaluation was offered to the 41 remaining patients; 10 were lost to follow-up and 31 were evaluated further. Of these, 19 underwent a total of 50 food challenges (36 double-blind, placebo-controlled, and 14 open), with 11 patients experiencing 18 positive challenges (94% with skin reactions). Additionally, 6 patients had a convincing history with a predictive level of IgE; 5 had a convincing history with positive, indeterminate levels of IgE; and 1 had predictive levels of IgE (to egg and peanut) without a history of an acute reaction. Overall, 23/63 (37%; 95% confidence interval, 25% to 50%) had clinically significant IgE-mediated food hypersensitivity without a significant difference in age or symptom score between those with or without food allergy.Conclusions. Approximately one third of children with refractory, moderate–severe AD have IgE-mediated clinical reactivity to food proteins. The prevalence of food allergy in this population is significantly higher than that in the general population, and an evaluation for food allergy should be considered in these patients.