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Introduction
1996-2000 Clinic for Dermatology and Allergology, Charité, Berlin
since 2001 Nutrition counselling Allergology, Munic
Current institution
private practice
Publications
Publications (235)
Background
Consumption of ultra‐processed foods [UPFs] may be associated with negative health outcomes. Limited data exist regarding the potential role of UPFs in the occurrence of allergic diseases. The underlying mechanisms underpinning any such associations are also poorly elucidated.
Methods
We performed a systematic review and narrative evide...
Since the EAT-Lancet Commission’s call for a change in diet towards more plant-based foods, especially protein sources, this so called “Planetary Health Diet (PHD)” has been widely discussed. While for some the reduction in animal foods is not enough and vegan diets are advocated to save the climate, others are sounding the alarm that the reduction...
The term “feeding difficulties” refers to a spectrum of phenotypes characterized by suboptimal intake of food and/or lack of age‐appropriate eating habits. While it is evident that feeding difficulties are prevalent within healthy children, no consensus has been reached for those with food allergies. The aim of this study was to systematically revi...
Following a diagnosis of IgE‐mediated food allergy, to secure the best outcome, the patient should receive individualized advice tailored to their specific needs, which considers the type and presentation of the food involved, level of exclusion required, risk of cross‐contamination and any variance required for age, ethnicity, financial issues, an...
Background
Cow's milk allergy (CMA) is one of the most common food allergies world‐wide. The emergence of online CMA symptom questionnaires, aimed at parents and/or healthcare professionals (HCP), may raise awareness about the possible diagnosis of CMA, but also increases the risk for overdiagnosis leading to unnecessary dietary restriction impacti...
Vegan diets are currently attracting a great deal of attention. However, avoiding animal-based foods restricts the diet and is associated with risks, the extent and medical implications of which are at present not sufficiently understood. Elimination diets represent the usual therapeutic long-term management in the presence of food allergy. In orde...
The prevalence of non-immunoglobulin E (IgE) mediated food allergy is poorly established outside of cow's milk allergy, with a challenge-proven adjusted incidence ranging between 0.13 and 0.72%. The presence and presentation of non-IgE mediated allergy in exclusively breastfed infants is highly debated. The dilemma this poses for healthcare profess...
Microbial metabolism of specific dietary components, such as fiber, contribute to the sophisticated inter‐kingdom dialogue in the gut that maintains a stable environment with important beneficial physiological, metabolic, and immunological effects on the host. Historical changes in fiber intake may be contributing to the increase of allergic and hy...
Background:
The persistently high prevalence of allergic diseases in Western industrial nations and the limited possibilities of causal therapy make evidence-based recommendations for primary prevention necessary.
Methods:
The recommendations of the S3 guideline Allergy Prevention, published in its last version in 2014, were revised and consulte...
Background
Peanuts are a member of the legume family (botanical family Leguminosae) and peanut allergies are the most common cause of food anaphylaxis in many countries. The prevalence of peanut allergy is increasing.
Methods
Experts from Germany and Austria performed a standardized literature search and published their consensus recommendations i...
Background
Food protein-induced enterocolitis syndrome (FPIES) is a non-IgE mediated gastrointestinal food allergy mainly affecting infants and young children. Allergic FPIES reactions differ from IgE-mediated food allergies, e.g. regarding elicitors and clinical course.
Objective
The aim of our study was to describe causative agents and developme...
Microbial metabolism of specific dietary components, such as fiber, contribute to the sophisticated inter-kingdom dialogue in the gut that maintains a stable environment with important beneficial physiological, metabolic, and immunological effects on the host. Historical changes in fiber intake may be contributing to the increase of allergic and hy...
Adverse reactions to food or food ingredients are more often perceived than objectively verifiable. However, reliable laboratory tests are often lacking. As a result, people with perceived adverse reactions to food often follow extensive elimination diets for years and unnecessarily restrict their diet, as in the case of the frequently suspected hi...
The diagnosis “peanut allergy” is often frightening for affected persons and their families because it is perceived as life-threatening much more often than allergies to other foods. In order to be able to realistically assess risks, alleviate or dispel emerging concerns, and effectively counteract the feeling of being powerless over this diagnosis...
Patients with urticaria and angioedema often have triggers that cause an outbreak or a swelling episode or worsen their chronic condition. Exploring these factors with each patient may result in better understanding and control of their disease. Patients should be advised to avoid known triggers, if feasible, or prepare to prevent or control an exa...
Background
Parents of school-age children with food allergies and potential anaphylactic reactions want their children to have an unburdened and risk-free everyday school life. Thus, particularly in the case of peanut allergy, demands for peanut-free schools are put forward.
Results and discussion
The position paper of the food allergy working gro...
Background
Acetylsalicylic acid (ASA) may cause difficult-to-treat symptoms of the airways, skin, or gastrointestinal tract in hypersensitive patients. Due to the chemical relationship between salicylic acid and ASA, a role of a low-salicylate diet has been discussed.
Methods
This review evaluates whether low salicylate diets are meaningful from a...
To fully understand the role of diet diversity on allergy outcomes and to set standards for conducting research in this field, the European Academy of Allergy and Clinical Immunology Task Force on Diet and Immunomodulation has systematically explored the association between diet diversity and allergy outcomes. In addition, a detailed narrative revi...
Sind Eliminationsdiäten bei Kindern mit atopischer Dermatitis noch gerechtfertigt?
The prevalence of allergic diseases such as allergic rhinitis, asthma, food allergy, and atopic dermatitis has increased dramatically during the last decades, which is associated with altered environmental exposures and lifestyle practices. The purpose of this review was to highlight the potential role for dietary fatty acids, in the prevention and...
Die Beobachtung, dass der Konsum von (Hof-)Milch der Entwicklung von Asthma und Atemwegsinfektionen vorbeugen kann, ist nicht neu. Diskutiert werden für diese Schutzwirkung mikrobielle Faktoren unbehandelter Milch, das Vorhandensein intakter Molkenproteine sowie das Milchfett, insbesondere die enthaltenen Omega-3-Fettsäuren. Eine aktuelle Auswertun...
Diese evidenz- und konsensbasierte Leitlinie wurde entsprechend den Methoden der Cochrane und der Grading of Recommendations Assessment, Development and Evaluation (GRADE)-Arbeitsgruppen entwickelt. Die Leitlinien-Konferenz fand am 1. Dezember 2016 statt. Sie ist eine gemeinsame Initiative der European Academy of Allergology and Clinical Immunology...
Zusammenfassung
In den letzten Jahren häuft sich die Nennung der Nicht-Zöliakie-Gluten-/Weizen-Sensitivität (NCGS, „non celiac gluten sensitivity“) sowohl in den Medien, aber auch in Fachkreisen. Die Existenz und die möglichen verantwortlichen Trigger werden kontrovers diskutiert. Drei internationale Expertentreffen mit Empfehlungen zur NCGS waren...
Umweltfaktoren, frühkindliche Sensibilisierung oder genetische Disposition — die Theorien zur Entstehung von Allergien sind vielfältig. Auch deswegen sollte Allergieprävention nicht bloß auf Vermeidungsansätzen basieren.
Ist das noch Therapie oder schon Trend? Die Frage ist bei vielen, häufig selbst verordneten Ernährungsumstellungen angebracht. Oftmals fehlt für die positive Wirkung des Verzichts nämlich jede Evidenz — bisweilen schadet er sogar eher als er nützt. Spätestens dann ist es Zeit für eine funktionierende Kooperation zwischen Arzt und allergologisch ver...
Adverse reactions to food are suspected in one third of the German population, but only 10% of these assumed hypersensitivity reactions can be clinically confirmed. While diagnosis of food allergies is fairly easy due to objective laboratory parameters, non-allergic hypersensitivity reactions are difficult to diagnose because these objective marker...
In den letzten Jahren häuft sich die Nennung der Nicht-Zöliakie-Gluten-/Weizen-Sensitivität (NCGS, „non celiac gluten sensitivity“) sowohl in den Medien, aber auch in Fachkreisen. Die Existenz und die möglichen verantwortlichen Trigger werden kontrovers diskutiert. Drei internationale Expertentreffen mit Empfehlungen zur NCGS waren nicht unabhängig...
Fermentable Oligo-, Di- and Monosaccharides And Polyols (FODMAP) has become a hot topic in the field of gastroenterology and nutritional sciences. In the first place, the low FODMAP diet was introduced as a diagnostic tool in patients with irritable bowel syndrome (IBS). However, the practical implementation of low-FODMAP elimination diets often is...
The so-called histamine intolerance is a popular disorder which is most often selfdiagnosed. As the diagnosis mainly depends on self-reporting of clinical symptoms it is mandatory to make sure that reproducibility, a prerequisite for an adverse reaction, is present. A dietetic approach is only reasonable if ingested histamine does indeed elicit obj...
Within the last decade, non-celiac gluten/wheat sensitivity (NCGS) has been increasingly discussed not only in the media but also among medical specialties. The existence and the possible triggers of NCGS are controversial. Three international expert meetings which proposed recommendations for NCGS were not independently organized and only partiall...
Das fünfte pädiatrische Allergie- und Asthma-Meeting (PAAM), das vom 26. bis 28. Oktober 2017 in London stattgefunden hat, zeichnete sich durch einen hohen Grad an Interdisziplinarität aus. Es war von einer bunten Vielfalt an Kinderärzten, Allergologen, Gastroenterologen, Ernährungsfachkräften, Krankenschwestern/-pflegern und Psychologen aus versch...
Das fünfte pädiatrische Allergie- und Asthma-Meeting (PAAM), das vom 26. bis 28. Oktober 2017 in London stattgefunden hat, zeichnete sich durch einen hohen Grad an Interdisziplinarität aus. Es war von einer bunten Vielfalt an Kinderärzten, Allergologen, Gastroenterologen, Ernährungsfachkräften, Krankenschwestern/-pflegern und Psychologen aus versch...
Transition bei Nahrungsmittelallergien
Die Transition von Kindern mit primären Nahrungsmittelallergien von der Betreuung beim Kinderarzt in die Erwachsenenmedizin stellt eine besondere Herausforderung dar. Ein zentraler Unterschied ist, dass Kinderärzte
in der Regel alle von der Allergie betroffenen Organsysteme behandeln, während in der Erwachsene...
Patienten mit Erdnussallergie erhalten oftmals die Empfehlung, auch auf Schalenfrüchte und andere Leguminosen zu verzichten. Tatsächlich leidet aber nur ein Teil der Erdnussallergiker unter solchen Kreuzallergien. Eine französische Arbeitsgruppe hat sich zur Aufgabe gemacht, in einer Kohorte von erdnussallergischen Kindern Phänotypen zu identifizie...
Adverse food reactions are far more often perceived than objectively verified. In our scientific knowledge on non-allergic adverse reactions including the so-called histamine intolerance, there are large deficits. Due to the fact that this disorder is increasingly discussed in the media and the internet, more and more people suspect it to be the tr...
Eine retrospektive Analyse aus den USA unterstreicht, wie häufig Meidungsempfehlungen bei bestehender Schalenfruchtallergie zu Unrecht ausgesprochen werden.
Cow’s milk and hen’s egg are among the most common triggers of IgE-mediated allergic reactions in childhood. Since not all IgE sensitizations are clinically relevant, it is important to confirm or exclude manifest allergy. Thus, the burden of an elimination diet will be restricted to only those cases where such a measure is essential. A number of p...
Nahrungsmittelunverträglichkeiten sind objektiv nachweisbar deutlich seltener als subjektiv empfunden. Insbesondere zum wissenschaftlichen Kenntnisstand nicht allergischer Überempfindlichkeitsreaktionen bestehen große Defizite. Ein Beispiel ist die Histaminunverträglichkeit, die aufgrund der starken Thematisierung in den Medien und im Internet von...
Adverse food reactions are far more often perceived than objectively verified. In our scientific knowledge on non-allergic adverse reactions including the so called histamine intolerance, there are large deficits. Due to the fact that this disorder is increasingly discussed in the media and the internet, more and more people suspect it to be the tr...
Langkettige, mehrfach ungesättigte Fettsäuren sind Ausgangssubstrate für Prostaglandine, Leukotriene und neu identifizierte Lipidmediatoren. Aufgrund ihrer antiinflammatorischen Wirkung wird die Anwendung langkettiger Omega-3-Fettsäuren bei diversen Erkrankungen diskutiert, die mit einem entzündlichen Geschehen oder einer subklinischen Entzündung v...
Background:
Atopic dermatitis (AD) is a chronic relapsing skin disease prevalent in 1-3% of adults in Western industrialized countries.
Objective:
To investigate the effectiveness of educational training in an outpatient setting on coping with the disease, quality of life (QoL), symptoms and severity in adults with AD.
Methods:
In this German...
Bislang fehlen geeignete objektive Marker zur Diagnostik einer Nicht-Zöliakie-Gluten-Sensitivität (NCGS) (siehe dazu auch Allergo Journal 5/2016). Doch daran könnte sich womöglich bald etwas ändern.
Langkettige, mehrfach ungesättigte Fettsäuren sind Ausgangssubstrate für Prostaglandine, Leukotriene und neu identifizierte Lipidmediatoren. Aufgrund ihrer antiinflammatorischen Wirkung wird die Anwendung langkettiger Omega-3-Fettsäuren für diverse Erkrankungen diskutiert, die mit einem entzündlichen Geschehen oder einer subklinischen Entzündung ve...
Hintergrund
Die Anaphylaxie ist eine akut auftretende, systemische, lebensbedrohliche Überempfindlichkeitsreaktion. Die akute Reaktion tritt aufgrund einer dauerhaft immunologisch veränderten Reaktionslage auf, die bei Allergenkontakt zu leichten bis schweren und in Einzelfällen tödlichen Reaktionen führen kann. Die lebenslang erforderlichen Vermei...
Background:
Chronic spontaneous urticaria (CsU) is a frequent dermatological disease that might last for months or years with high impact on quality of life. Known causes are autoreactive phenomena, infections or intolerances, rarely IgE-mediated allergies. One third of CsU patients benefit from a low-pseudoallergen diet. Additionally, it is often...
EU Regulation 1160/2011 on Food Information for Consumers (FIR) has to be followed since December 13, 2014. This implies changes regarding allergen labelling for prepacked food as well as the newly implemented mandatory allergen information for non-prepacked food. With more transparent labelling and information consumers with food allergies should...
Anaphylaxis is an acute-onset, life-threatening, systemic hypersensitivity reaction. The acute reaction occurs due to a permanently immunologically altered response, which can result in mild to severe reactions and, in isolated cases, to fatal reactions upon allergen contact. The avoidance strategies required lifelong in affected individuals signif...
Wer verträgt heute noch Gluten? In den Medien wird das Krankheitsbild der Nicht-Zöliakie-Gluten-Sensitivität nur selten angezweifelt. In der Fachwelt spielt es dagegen nur eine untergeordnete Rolle [1, 2]. Eine italienische Studie soll jetzt den Beweis für die Existenz der Erkrankung erbracht haben, doch Zweifel sind angebracht.
A therapeutic diet is only indicated if the diagnosis of food allergy is certain. In the case of an unproven suspicion everything should be done to confirm or disprove the diagnosis by diagnostic measures (patient history, diet history, food and symptom protocol etc.). In the case of proven food allergy there are different aims of nutritional thera...
Searching the internet for an explaination of recurring symptoms, many people come across the so-called histamine intolerance disorder. Also many practitioners like to diagnose this disorder without making sure that reproducibility, a prerequisite for an adverse reaction, is present. Consequently, presumably affected persons are often advised to fo...
Auf einem Bauernhof aufzuwachsen ist mit einem geringeren Risiko verbunden, allergische Atemwegserkrankungen und Sensibilisierungen zu entwickeln, als eine Kindheit in der Stadt. Ein Teil des Schutzes ist auf den Verzehr der hofeigenen Milch und Butter zurückzuführen. Doch über die Wirkmechanismen wird noch spekuliert. Eine aktuelle Veröffentlichun...
Background: Anaphylaxis is an acute-onset, life-threatening, systemic hypersensitivity reaction. e acute reaction occurs due to a permanently immu-nologically altered response, which can result in mild to severe reactions and, in isolated cases, to fatal reactions upon allergen contact. e avoidance strategies required lifelong in aected individuals...
Kuhmilch und Hühnerei gehören im frühen Kindesalter zu den häufigsten Auslösern IgE-vermittelter allergischer Reaktionen. Da nicht jede IgE-Sensibilisierung klinisch relevant ist, sollte eine manifeste Allergie zweifelsfrei nachgewiesen oder ausgeschlossen werden. Nur auf diese Weise kann der erhöhte Leidensdruck, der durch eine Eliminationsdiät en...
Das vierte pädiatrische Allergie- und Asthma-Meeting (PAAM) der EAACI, das vom 15. bis 17. Oktober in Berlin stattgefunden hat, stand ganz im Zeichen des galoppierenden Wissenszuwachses auf dem Gebiet der allergischen Erkrankungen. An drei prall gefüllten Tagen hatten die Teilnehmer die Möglichkeit, sich zum aktuellen Kenntnisstand auf den Gebieten...
Cow’s milk and hen’s egg are among the most common triggers of IgE-mediated allergic reactions in childhood. Since not all IgE sensitizations are clinically relevant, it is important to confirm or exclude manifest allergy. Thereby the burden of an elimination diet will be restricted to only those cases where such a measure is essential. A number of...
S2k-Guidelines of the German Society for Allergology and Clinical Immunology (DGAKI) in collaboration with the German Medical Association of Allergologists (AeDA), the German Professional Association of Pediatricians (BVKJ), the German Allergy and Asthma Association (DAAB), German Dermatological Society (DDG), the German Society for Nutrition (DGE)...
Betroffene mit IgE-vermittelten Nahrungsmittel-allergien müssen ihr Allergen konsequent aus dem Speiseplan streichen. Damit Allergiker eine in diesem Sinne informierte und sichere Kaufentscheidung treffen können, gilt gemäß der Lebensmittelinformationsverordnung (LMIV) eine Kennzeichnungspflicht für die 13 häufigsten allergenen Nahrungsmittel(-grup...