Article

The Milk-Mucus Belief: Sensory Analysis Comparing Cow's Milk and a Soy Placebo

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Abstract

A questionnaire designed to measure the "milk mucus effect" was based on sensations and symptoms after drinking milk reported in interviews with 169 individuals, 70 of whom held the belief that milk produces mucus. This was used to measure responses in a randomized, double-blind trial of a flavoured UHT cow's milk drink, compared with a similarly flavoured and constituted UHT soy milk drink. The soy placebo was indistinguishable from cow's milk in a pretest of 185 individuals. Of 14 milk-mucus effect indicator variables, three showed significant increases after consumption of 300 ml of the test drink. These were "coating/lining over the mouth, throat or tongue" (39% increase), "need to swallow a lot" (31% increase) and "saliva thicker, harder to swallow than before" (42% increase). However, these increases occurred in both milk and placebo groups. It is concluded that the effect measured is not specific to cow's milk, but can be duplicated by a non-cow's milk drink with similar sensory characteristics.

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... En la misma línea, se ha descrito una mayor incidencia de síntomas respiratorios, principalmente los relacionados con bronquitis y asma, en personas con una menor ingesta de leche [11][12] . En cuanto a la producción de mucosidad, no se han encontrado diferencias entre el placebo a base de soja y la leche de vaca 13 . ...
... La falta de resultados que sugieran una asociación entre el consumo de lácteos en general y las infecciones estudiadas son consistentes con otras investigaciones 2,12,13,17 . En el análisis de cada uno de los derivados lácteos por separado encontramos estimaciones puntuales de OR que sugerían una posible asociación inversa para los yogures y los quesos. ...
... Group B (dairy) subjects were given a daily dietary supplement, in the form of a milkshake, of 350 mL disguised (see Supporting Information, Appendix B, in the online version of this article) cow's milk for 4 days (study days 4, 5, 6, and 7). (The flavor disguise was based upon the validated technique in the study methodology described by Pinnock and Arney 9 . ...
... Their study demonstrated an overall increase in mucus sensation in both groups and no statistical difference between the reported sensory responses between the groups. 9 Wijga et al. demonstrated reduced risk of asthma symptoms with frequent consumption of products containing milk fat in a cohort study of 2,978 preschool children. 14 Haas et al. found no bronchoconstrictive effects when subjects were exposed to 300 mL of ultra-high temperature processed milk compared to rice milk. ...
Article
Objectives/Hypothesis To examine the effects of dairy versus nondairy diets on self‐reported levels of nasopharyngeal mucus secretion. Study Design Prospective, randomized, double‐blinded controlled study. Methods Twenty‐six men and 82 consecutive women over the age of 15 years attending the otolaryngology department at East and North Hertfordshire NHS Trust who reported experiencing increased levels of nasopharyngeal mucus secretions were selected for a double‐blinded trial of dairy versus dairy‐free dietary supplementation for the last 4 days of a 6‐day dairy‐free diet. Main outcome measures were comparisons of mean daily reporting of subjective levels of nasopharyngeal secretions by linear scoring (1–100) and by an ordinal scale of 1 to 4. On each day, t tests were used to compare differences. Results There was a significant reduction in the reported linear secretion score seen from day 1 to 4 in nondairy (t[53] = 4.39, P < .01) and in dairy (t[53] = 3.94, P < .01) arms. There was a significant increase in secretion score days 4 to 7 in the dairy arm (t[53] = −2.56, P = .01), and a continued but nonsignificant reduction in the nondiary arm (t[53] = 1.54, P = .13, with an overall significant reduction between day 1 and 7 in the nondairy arm (t[53] = 4.79, P < .00). In the ordinal secretion scale, both dairy arm (t[53] = 2.754, P < .01) and nondiary arm (t[53] = 5.52, P < .01) scores decreased significantly from days 1 to 4. There was a significant decrease in scores from days 1 to 7 in the nondairy group (t[53] = 5.12, P < .01). Conclusions In this blinded trial, a dairy‐free diet was associated with a significant reduction in self‐reported levels of nasopharyngeal secretions in adults who previously complained of persistent nasopharyngeal mucus hypersecretion. Level of Evidence 1b Laryngoscope, 2018
... 56,57 By contrast, findings from other studies suggest that dairy has no impact on the symptoms of mucus production and ARTI. 58,59 Given these conflicting findings, more research is required to investigate what, if any, impact dairy has on children with ARTI. ...
Article
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Background: Acute respiratory tract infection (ARTI) is one of the most prevalent types of infection among children and a common reason for hospital admission. Although parents frequently consult complementary and alternative medicine (CAM) practitioners to assist with the management of childhood ARTI, little is known about the treatments that CAM practitioners recommend and why. The aim of this research was to understand what CAM practitioners typically prescribe for the management of childhood ARTI and how practitioners formulate decisions regarding the management of this condition. Method: The research was guided by a qualitative descriptive framework. CAM practitioners across Greater Melbourne (Victoria, Australia) who had treated children aged 0-12 years with ARTI in the past 12 months were eligible to participate. Data were captured using semi-structured interviews, which were audio-recorded and transcribed verbatim. Multiple strategies to improve trustworthiness were implemented (e.g., triangulation of data). Data were analysed using inductive content analysis. Results: Twenty-four CAM practitioners from ten different disciplines participated in the interviews. Most participants were female (75%), and more than half (54%) were practicing naturopaths. The treatments most commonly recommended were lifestyle modification (95%), nutrition/diet-based treatments (91%), and vitamin/mineral supplementation (87%). Practitioners' decision-making process was underpinned by four key concepts namely: the approach to management, individualisation, do no harm, and collaborative practice. Individualisation and the safety of the child are cornerstones of treatment in the practitioner's decision-making process. Conclusion: This research sheds light on commonly used CAM interventions, many of which build on easily accessible and readily available treatments (such as soups) and are aligned with mainstream recommendations (such as rest). Practitioners' decision-making process too aligns well with mainstream health care where the focus is on safety and informed by a biopsychosocial-cultural approach.
... De los 169, 130 accedieron a participar en un ensayo clínico controlado, aleatorizado, doble ciego, a recibir leche o un placebo (fórmula de soya) sobre síntomas que se presentaran de forma aguda (primeras 24 horas) tras la ingesta. No hubo diferencia en la frecuencia de síntomas entre ambos grupos 116 . En algunos estudios se ha descrito la asociación entre producción de moco y la CMF-7, la cual estimula la producción de glicoproteína secretora mucina-5AC (MUC5AC) que se expresa en el epitelio foveolar del estómago y que también está presente en el tracto respiratorio 117 . ...
Article
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Milk is a liquid food that possesses an important quantity of highly bioavailable macronutrients. In addition, it is readily accessible, as well as relatively inexpensive. Given that the knowledge of physicians about nutrition and food composition is deficient, in general, many of the dietary interventions recommended in diverse clinical settings lack a scientific basis. The aim of the present review was to produce a technical opinion that serves as a frame of reference to best sustain recommendations for consuming milk and dairy products as daily nutrition in the adult and older adult. The effects of milk and dairy products during the pediatric stage are not addressed in the present work. The Asociación Mexicana de Gastroenterología and the Asociación Mexicana de Gerontología y Geriatría jointly discussed and analyzed topics dealing with the legal designation of milk, the classification and nutritional profile of cow's milk, its nutritional characteristics, its consumption in the adult, intolerance to cow's milk, and associations of milk consumption with digestive tract alterations and other conditions. Finally, certain aspects of milk consumption in the older adult and its relation to overall health are briefly discussed. Resumen: La leche es un alimento que tiene una importante cantidad de macronutrimentos de gran biodisponibilidad, accesible y de relativo bajo costo. El conocimiento de los médicos en general sobre nutrición y composición de los alimentos es deficiente por lo que muchas de las intervenciones dietéticas que tradicionalmente recomendamos en diversos escenarios clínicos carecen de sustento científico. El objetivo de esta revisión fue generar una opinión técnica que sirva como marco de referencia para sustentar de mejor forma la recomendación sobre el consumo de leche y productos lácteos en la nutrición diaria de adultos y adultos mayores. Los efectos de la leche y productos lácteos durante la etapa pediátrica salen del contexto del presente trabajo. La Asociación Mexicana de Gastroenterología y la Asociación Mexicana de Gerontología y Geriatría comentaron y analizaron de forma conjunta temas acerca de la denominación legal de la leche, clasificación y perfil nutrimental de la leche de vaca, sus características nutrimentales, su consumo en el adulto, intolerancia a la leche de vaca, asociaciones entre el consumo de leche y alteraciones del aparato digestivo y otras condiciones; finalmente, se mencionan de forma breve algunos aspectos sobre el consumo de leche en el adulto mayor y su relación con la salud. Keywords: Dairy products, Cow's milk, Diet, Adult, Older adult, Palabras clave: Lácteos, Leche de vaca, Alimentación, Adulto, Adulto mayor
... De los 169, 130 accedieron a participar en un ensayo clínico controlado, aleatorizado, doble ciego, a recibir leche o un placebo (fórmula de soya) sobre síntomas que se presentaran de forma aguda (primeras 24 horas) tras la ingesta. No hubo diferencia en la frecuencia de síntomas entre ambos grupos 116 . En algunos estudios se ha descrito la asociación entre producción de moco y la CMF-7, la cual estimula la producción de glicoproteína secretora mucina-5AC (MUC5AC) que se expresa en el epitelio foveolar del estómago y que también está presente en el tracto respiratorio 117 . ...
Article
Full-text available
Resumen: La leche es un alimento que tiene una importante cantidad de macronutrimentos de gran biodisponibilidad, accesible y de relativo bajo costo. El conocimiento de los médicos en general sobre nutrición y composición de los alimentos es deficiente por lo que muchas de las intervenciones dietéticas que tradicionalmente recomendamos en diversos escenarios clínicos carecen de sustento científico. El objetivo de esta revisión fue generar una opinión técnica que sirva como marco de referencia para sustentar de mejor forma la recomendación sobre el consumo de leche y productos lácteos en la nutrición diaria de adultos y adultos mayores. Los efectos de la leche y productos lácteos durante la etapa pediátrica salen del contexto del presente trabajo. La Asociación Mexicana de Gastroenterología y la Asociación Mexicana de Gerontología y Geriatría comentaron y analizaron de forma conjunta temas acerca de la denominación legal de la leche, clasificación y perfil nutrimental de la leche de vaca, sus características nutrimentales, su consumo en el adulto, intolerancia a la leche de vaca, asociaciones entre el consumo de leche y alteraciones del aparato digestivo y otras condiciones; finalmente, se mencionan de forma breve algunos aspectos sobre el consumo de leche en el adulto mayor y su relación con la salud. Abstract: Milk is a liquid food that possesses an important quantity of highly bioavailable macronutrients. In addition, it is readily accessible, as well as relatively inexpensive. Given that the knowledge of physicians about nutrition and food composition is deficient, in general, many of the dietary interventions recommended in diverse clinical settings lack a scientific basis. The aim of the present review was to produce a technical opinion that serves as a frame of reference to best sustain recommendations for consuming milk and dairy products as daily nutrition in the adult and older adult. The effects of milk and dairy products during the pediatric stage are not addressed in the present work. The Asociación Mexicana de Gastroenterología and the Asociación Mexicana de Gerontología y Geriatría jointly discussed and analyzed topics dealing with the legal designation of milk, the classification and nutritional profile of cow's milk, its nutritional characteristics, its consumption in the adult, intolerance to cow's milk, and associations of milk consumption with digestive tract alterations and other conditions. Finally, certain aspects of milk consumption in the older adult and its relation to overall health are briefly discussed. Palabras clave: Lácteos, Leche de vaca, Alimentación, Adulto, Adulto mayor, Keywords: Dairy products, Cow's milk, Diet, Adult, Older adult
... The subjects were then given either a flavoured ultra heat treated (UHT) cow's milk drink or a constituted UHT soy milk drink, which was indistinguishable. 15 Immediately after drinking 300 mL, three variables were significantly increased: 'coating/ lining over the mouth, throat or tongue' (in 39%); 'need to swallow a lot' (in 31%) and saliva thicker and harder to swallow than before (in 42%). However, there was no difference between those having cow's milk versus the soy product suggesting it is not a physiological effect of milk but the sensory characteristics (flavour and mouth feel) that account for the effect. ...
... Compte tenu des connaissances actuelles, voire de l'absence d'études sérieuses, il est donc faux d'affirmer que les produits laitiers sont source de baisse de la fertilité masculine, ou qu'il faille les supprimer en cas d'autisme, de polyarthrite rhumatoïde, d'otites et de rhinites. L'AFSSA a d'ailleurs attiré l'attention sur l'inutilité et les risques potentiels (nutritionnels et renforcement de l'isolement) des régimes sans caséine et sans gluten chez l'enfant autiste (27). Par ailleurs, pour invalider la rumeur ORL, il a fallu que des chercheurs publient dans une excellente revue internationale des résultats de pesées de mouchoirs (constatant que les écoulements ne sont pas en relation avec la consommation de lait ni de produits laitiers), et réalisent une étude d'intervention, avec du jus de soja ou du lait, tous deux parfumés identiquement afin que le consommateur ne fasse pas de différence (28). ...
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Aucune classe d’aliment ne doit être négligée, car chacune offre des spécificités nutritionnelles, en termes de vitamines, oligo-éléments, minéraux, acides aminés indispensables, acides gras oméga-3 et 6. Le lait et les produits laitiers ont donc leur place. Dans le cadre d’une alimentation diversifiée, leur présence assure une meilleure santé, ne serait-ce que par la réduction du risque de certaines pathologies.Le lait subit, depuis de très nombreuses années, des attaques qui sont le plus souvent injustifiées, intuitives ou pseudo-scientifiques. Ainsi, les détracteurs du lait et des produits laitiers utilisent, globalement, deux séries d’arguments. L’une relève de l’utilisation erronée ou abusive de données scientifiques et médicales, épidémiologiques et statistiques : elle foisonne de propos pseudo-scientifiques. L’autre série d’assertions présente quelques allégations (parmi de nombreuses) qui ne reposent sur aucun support scientifique : on peut les qualifier de fantaisistes. Toutefois elles bénéficient malheureusement d’une certaine influence auprès des consommateurs.
... The TPB-based interview guide allowed us to identify people or groups with a strong influence on participants' milk and cheese consumption (i.e., normative beliefs), including family and friends, health professionals and advisors (e.g., doctors, physical trainers, dietitians/nutritionists) and influences in the communications domain (e.g., advertisements, internet, celebrities, TV shows). In parallel, we noted the persistence of several beliefs in relation to milk and cheese consumption which run counter to evidence found in the nutrition science literature (e.g., milk as mucus producing) [37][38][39] but that were propagated for years by some health professionals [40]. Perhaps in reaction to loss of confidence in agri-food industry and almost unlimited access to unregulated information sources, some participants in our study seem to feel that the verification of food sources and its quality are their own personal responsibility. ...
Article
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Background In spite of multiple efforts by public health authorities to promote consumption of milk and alternatives in the Canadian adult population, consumption of these healthy foods is still suboptimal. This study aimed to explore salient beliefs underlying the consumption of fluid milk and cheese among adults. Methods The qualitative descriptive research design was based on the Theory of Planned Behaviour framework, using 20 focus groups. A total of 161 men and women (19 to 50 years old) from Quebec City, Montreal and Toronto (Canada) were recruited to participate in focus groups. A hybrid approach (deductive and inductive) to qualitative methods of thematic analysis was used during coding of focus group transcripts to draw out participant’s salient beliefs regarding milk and cheese consumption. ResultsFor both milk and cheese, most groups cited advantages or disadvantages with regards to health effects, nutritional value, taste, socio-affective aspects and practicality. Family and friends, health professionals and advisors, and communications domain (e.g. advertisements, TV programs, well-known personalities) were cited as major influences affecting consumption. Price reduction, product improvements, supply increase and variation, favourable food/drink combinations and access were among the most commonly cited facilitators for milk and cheese consumption. Major barriers included high price, reduced confidence in the product (reasons/contexts that reduce perceived safety of the product), health status, problems linked to supply (varieties/formats which are not available), and habits and cultural values. Gender and level of milk and cheese consumption differences were observed between groups: men referred more often to industry and politics as factors influencing their milk consumption, while women expressed more animal and environmental concerns. Differences were also noted between high and low consumer’s groups in relation to the themes of taste, pleasure and emotions for milk and cheese consumption. Lastly, low consumers expressed more distrust and disgust relating to milk consumption than high consumers. Conclusions The majority of beliefs observed are consistent with earlier studies on milk or dairy product consumption. Consumers’ concerns about origins of milk, however, have never been reported. These findings will help optimize approaches for promoting consumption of these foods among different segments of Canadian adults.
... Dissemination of such myths goes hand in hand with significant reduction of milk consumption. It should be stressed that so far there has not been a single competent study confirming the afore-mentioned myths (Pinnock et al. 1990; Pinnock and Arney 1993; Wijga et al. 2003; Wuthrich et al. 2005). In contrast, milk and other milk products that are the main source of calcium and other essential nutrients help to reduce the risk of majority of chronic diseases and so contribute to a healthier lifestyle (Van der Meer et al. 1998). ...
Article
Milk is a complex physiological liquid that simultaneously provides nutrients and bioactive components that facilitate the successful postnatal adaptation of the newborn infant by stimulating cellular growth and digestive maturation, the establishment of symbiotic microflora, and the development of gut-associated lymphoid tissues. The number, the potency, and the importance of bioactive compounds in milk and especially in fermented milk products are probably greater than previously thought. They include certain vitamins, specific proteins, bioactive peptides, oligosaccharides, organic (including fatty) acids. Some of them are normal milk components, others emerge during digestive or fermentation processes. Fermented dairy products and probiotic bacteria decrease the absorption of cholesterol. Whey proteins, medium-chain fatty acids and in particular calcium and other minerals may contribute to the beneficial effect of dairy food on body fat and body mass. There has been growing evidence of the role that dairy proteins play in the regulation of satiety, food intake and obesity-related metabolic disorders. Milk proteins, peptides, probiotic lactic acid bacteria, calcium and other minerals can significantly reduce blood pressure. Milk fat contains a number of components having functional properties. Sphingolipids and their active metabolites may exert antimicrobial effects either directly or upon digestion.
... Pinnock and Arney [15] conducted a randomised, doubleblind trial to investigate the relationship between cow's milk consumption and mucus formation, the so called " milk mucus effect " . They divided 125 subjects into a milk (n 60) or placebo group (n 65), of which 43 and 29, respectively, believed that cow's milk consumption produces mucus. ...
Article
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There is a belief among some members of the public that the consumption of milk and dairy products increases the production of mucus in the respiratory system. Therefore, some who believe in this effect renounce drinking milk. According to Australian studies, subjects perceived some parameters of mucus production to change after consumption of milk and soy-based beverages, but these effects were not specific to cows' milk because the soy-based milk drink with similar sensory characteristics produced the same changes. In individuals inoculated with the common cold virus, milk intake was not associated with increased nasal secretions, symptoms of cough, nose symptoms or congestion. Nevertheless, individuals who believe in the mucus and milk theory report more respiratory symptoms after drinking milk. In some types of alternative medicine, people with bronchial asthma, a chronic inflammatory disease of the lower respiratory tract, are advised not to eat so-called mucus-forming foods, especially all kinds of dairy products. According to different investigations the consumption of milk does not seem to exacerbate the symptoms of asthma and a relationship between milk consumption and the occurrence of asthma cannot be established. However, there are a few cases documented in which people with a cow's milk allergy presented with asthma-like symptoms.
Article
Milk is a complex physiological liquid that simultaneously provides nutrients and bioactive components that facilitate the successful postnatal adaptation of the newborn infant by stimulating cellular growth and digestive maturation, the establishment of symbiotic microflora, and the development of gut-associated lymphoid tissues. The number, the potency, and the importance of bioactive compounds in milk and especially in fermented milk products are probably greater than previously thought. They include certain vitamins, specific proteins, bioactive peptides, oligosaccharides, organic (including fatty) acids. Some of them are normal milk components, others emerge during digestive or fermentation processes. Fermented dairy products and probiotic bacteria decrease the absorption of cholesterol. Whey proteins, medium-chain fatty acids and in particular calcium and other minerals may contribute to the beneficial effect of dairy food on body fat and body mass. There has been growing evidence of the role that dairy proteins play in the regulation of satiety, food intake and obesity-related metabolic disorders. Milk proteins, peptides, probiotic lactic acid bacteria, calcium and other minerals can significantly reduce blood pressure. Milk fat contains a number of components having functional properties. Sphingolipids and their active metabolites may exert antimicrobial effects either directly or upon digestion.
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The relationship between diet and asthma aetiology, control and management is an area of continued controversy that has never been fully evaluated. Anecdotally, diet does seem to play a role in asthma, but the exact extent remains unclear. The use of dietary manipulation and nutritional supplementation therapies for asthma is common. This article discusses the role of diet in asthma, focusing on the role of cow milk.
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Milk and other dairy products are an important part of the human diet, but some people believe that they are harmful. This article explores some of these beliefs, examines the scientific evidence, and gives suggestions so that nutritionists can help consumers make informed decisions. The topics include lactose intolerance, raw milk, pasteurization, milk and mucus, milk and asthma, milk and allergies, and recombinant bovine growth hormone. Many people believe that lactose-intolerant individuals should not consume milk or dairy products, but in fact lactose tolerance varies, and drastic dietary restrictions may not be needed. Others believe that if someone has once suffered from lactose intolerance, that person always will. The fact is that a person’s tolerance can change over time. In addition, self-diagnosis of lactose intolerance is often incorrect. Some people drink raw milk rather than pasteurized milk because they believe it is healthier and safer and that pasteurization destroys beneficial things in milk. These beliefs are all false, and in fact, raw milk poses a significant health risk. There are other beliefs that exist surround milk and its effect on the respiratory tract and allergies. The facts are that milk does not cause increased mucus production, nor does it cause or worsen allergies or asthma. Some members of the public fear that the hormones in milk can affect the humans who drink it, but this is false. Belief in many of the mistaken notions outlined in this article is widespread and pervasive in the United States at present. Even health professionals often accept such fallacies as truth. Health professionals can play an important role in dispelling these nutrition myths through nutrition education and counseling.
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There is a perception by some asthmatic patients that stimulation of respiratory mucous production by cow milk may worsen airway obstruction. To determine whether cow milk ingestion reduces bronchial airflow in asthmatic patients as measured by standard spirometry. Twenty-five atopic adults with mild asthma but no history of cow milk allergy or lactose intolerance participated in a prospective, randomized, double-blind, placebo-controlled crossover study. Subjects were randomly assigned to ingest either a solution containing cow milk powder or a placebo solution, received neither during a 14-day washout period, then ingested the alternate solution. Forced vital capacity (FVC), forced expiratory volume in 1 second (s) (FEV1), and FEV1/FVC were measured at 30 minutes, 1 hour (h), and 7 hours after challenge. A > or = 20% decrease in FEV1 or FEV1/FVC was considered clinically significant. FEV1 was slightly lower at 30 minutes than the baseline value (mean change, .6% to 3.3%) for both challenges. None of the subjects experienced any adverse symptoms, acute or delayed, after cow milk or placebo challenges. Statistically significant changes in FEV1 were reached 30 minutes after cow milk challenge (P = .0007) and at one hour after placebo (P = .0027). These changes are not clinically significant. Although this study disclosed no acute or delayed asthmatic symptoms or deterioration of pulmonary function detected by using conventional spirometry, methacholine inhalation before and after cow milk challenge may be more sensitive for evaluation of cow milk-induced bronchial hyperreactivity.
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The belief has persisted for centuries that ingestion of milk causes excessive mucus, although the few studies on the topic have failed to demonstrate any effects of milk on mucus production.1- 3 The objectives of this study were to ascertain the prevalence and sources of this belief in parents; whether parents were more likely to believe that milk causes mucus if their children had allergies, asthma, or cystic fibrosis; and whether this belief altered their children's diets.
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Exposure to food allergens can cause a varied pattern of respiratory symptoms, with allergic responses ranging from asthma symptoms to occupational asthma. Food allergy in a patient presenting as asthma tends to indicate a more severe disease constellation. Patients with underlying asthma experience more severe and life-threatening allergic food reactions. When a food reaction involves respiratory symptoms, it is almost always a more severe reaction compared with reactions that do not involve the respiratory tract. Susceptible patients may even react to a causative food on inhalation without ingestion. However, isolated asthma or rhinitis symptoms without concomitant cutaneous or gastrointestinal symptoms are rare events.
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Nutrition plays a major role in the development and maintenance of bone structures resistant to usual mechanical loadings. In addition to calcium in the presence of an adequate vitamin D supply, proteins represent a key nutrient for bone health, and thereby in the prevention of osteoporosis. In sharp opposition to experimental and clinical evidence, it has been alleged that proteins, particularly those from animal sources, might be deleterious for bone health by inducing chronic metabolic acidosis which in turn would be responsible for increased calciuria and accelerated mineral dissolution. This claim is based on an hypothesis that artificially assembles various notions, including in vitro observations on the physical-chemical property of apatite crystal, short term human studies on the calciuric response to increased protein intakes, as well as retrospective inter-ethnic comparisons on the prevalence of hip fractures. The main purpose of this review is to analyze the evidence that refutes a relation of causality between the elements of this putative patho-physiological "cascade" that purports that animal proteins are causally associated with an increased incidence of osteoporotic fractures. In contrast, many experimental and clinical published data concur to indicate that low protein intake negatively affects bone health. Thus, selective deficiency in dietary proteins causes marked deterioration in bone mass, micro architecture and strength, the hallmark of osteoporosis. In the elderly, low protein intakes are often observed in patients with hip fracture. In these patients intervention study after orthopedic management demonstrates that protein supplementation as given in the form of casein, attenuates post-fracture bone loss, increases muscles strength, reduces medical complications and hospital stay. In agreement with both experimental and clinical intervention studies, large prospective epidemiologic observations indicate that relatively high protein intakes, including those from animal sources are associated with increased bone mineral mass and reduced incidence of osteoporotic fractures. As to the increased calciuria that can be observed in response to an augmentation in either animal or vegetal proteins it can be explained by a stimulation of the intestinal calcium absorption. Dietary proteins also enhance IGF-1, a factor that exerts positive activity on skeletal development and bone formation. Consequently, dietary proteins are as essential as calcium and vitamin D for bone health and osteoporosis prevention. Furthermore, there is no consistent evidence for superiority of vegetal over animal proteins on calcium metabolism, bone loss prevention and risk reduction of fragility fractures.
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