Ruchi Gupta (1m 44s):

Come so far. This whole medicalization of early feeding is not ideal. Enjoy eating with your babies and enjoy feeding them new foods. And it should be fun and pleasurable and not so medicalized as we have it right now.

Katie Ferraro (1m 58s):

Hey, there I'm Katie Ferraro Registered Dietitian college nutrition professor and mom of seven specializing in baby led weaning here on the baby led weaning made easy podcast. I help you strip out all of the noise and nonsense about feeding, leading you with the competence and knowledge you need to give your baby a safe start to solid foods using baby led, weaning All. Alright, tell me the truth. Do Food Allergies freak you out when it comes to feeding your baby? I know we hear the guidance to introduce allergenic foods early and often, but when it comes down to it and you're there at the high chair with the baby, and you're about to offer the shrimp in a safe form for your baby.

Katie Ferraro (2m 42s):

Like, are you freaking out? As I know, a lot of parents are, and I don't want you to feel alone. My guest today is here to answer your most frequently asked questions and hopefully take some of the fear out of feeding these foods to your baby. My guest today is Dr. Ruchi Gupta. Dr. Gupta is a pediatrician and a researcher at Northwestern university where she is the founding director of their center for food allergy and asthma research CFR. So Dr. Gupta's team is internationally recognized for research in food allergy. They publish the prevalence data, for example, a pediatric allergy in the U S so when you hear okay, one in 13 kids or one in 10 children, five and under have food allergy, it's her team that did those publications.

Katie Ferraro (3m 27s):

They also work on research that helps to characterize the economic impact of Food Allergies, and then also to identify disparities in access to care and outcomes among food allergy and asthma patients. Dr. Gupta is internationally renowned in the food allergy research community. She sits on numerous committees that establish international guidelines. She's published over 140 research papers on food allergy, and she's also a book author. So Dr. Gupta recently published a labor book called food without fear, identify, prevent, and treat food allergies, intolerances, and sensitivities. So today she's joining us to answer some of your most frequently asked questions about food allergies for babies.

Katie Ferraro (4m 7s):

So with no further ado here is Dr. Gupta

Ruchi Gupta (4m 14s):

Thank you so much for having me,

Katie Ferraro (4m 15s):

Katie. All right, before we get started talking about food allergies and infancy, could you share a little bit about your background and how you came to specialize in food allergies in this really unique area of medicine?

Ruchi Gupta (4m 26s):

I am a pediatrician and researcher. I've been at Northwestern and Chicago and Lurie children's for 17 years. I came to Northwestern 17 years ago and met a family who had two young kids with food allergies. And they were so passionate about this. And they realized so little was known about food allergies. We didn't even know how many people have food allergies or what types. So I got my master's in public health, right before this did outcomes, research and thought maybe I can help in this space. So I started working in it. We started learning about 8% of kids. One in 13, have food allergies. I get deeper, deeper involved. And then one day, my four year old son was playing with my one-year-old daughter and eating a peanut butter and jelly sandwich touched her.

Ruchi Gupta (5m 11s):

She broke out in hives, threw up and I became a parent of a child with food allergies. So now it's my 24 7. I have a child with food allergies. I do research on it and I see patients with it.

Katie Ferraro (5m 23s):

Oh, that's so fascinating. You are really like living the entire food allergy dream, but certainly the right person to be talking about. And before we get to these frequently asked questions about Food Allergies, I wanted to ask about your new book, that's called food without fear, how to identify, prevent, and treat food allergies, intolerances, and sensitivities. Why did you call it food without fear?

Ruchi Gupta (5m 44s):

People who live with food conditions, a lot of times fear that food, right? Like, so you are eating every food and you're fearing that food may be in it. And it's very stressful and anxiety provoking on an every day, every meal basis. And so the goal of this book, and a lot of times, a lot of those reactions, people have not gotten up fully diagnosed or know what kind of treatments are out there. So the point of making it food without fears, we want to empower people to be able to live their best life with whatever they have and really understand what food condition they have, how to best manage it, take control of it and potentially treat it. So just want people to live without fear, you know, every single day possible

Katie Ferraro (6m 27s):

A lot about the importance for introducing allergenic foods early and often to help prevent food allergy. And we've done tons of education here on the podcast about how to do that safely using Baby Led Weaning. Could you speak a little bit to prevalence? You mentioned that one in 13 kids have food allergy, but how common are food allergies in babies under 12 months of age?

Ruchi Gupta (6m 47s):

Great question under 12 months. So that early periods, zero to five, they're very common. That's most prevalent age, but under 12 months, it's challenging. You know, our data found the top allergens under that age are typically milk and egg, right? Because those are the foods they're eating or drinking, you know, at that young age. And that's what you identify because they don't come in contact with a lot of the other foods. You know, the peanuts, Trina shellfish, and fish later, we see them happening later. So they may have them under 12 months, but they haven't been identified yet. So I like to think of more around that zero to five age group when they're starting to try these foods for the first time. And then you realize, oh my gosh, you know, they, haven't a food allergy to a specific, you know, shellfish, for example, we see it later because most babies don't eat shellfish.

Ruchi Gupta (7m 36s):

And so, so I can't give you an exact under 12 months, but I can tell you in that early time, that zero to five, it's about 10%.

Katie Ferraro (7m 45s):

So experts say that an allergic reaction to a food will usually occur on the second or the subsequent exposure, but not the first time the baby is exposed to the potentially allergenic food protein. Could you explain why that is?

Ruchi Gupta (7m 57s):

Yeah. That is confusing for so many families. So your child may have had it for the first time and have an allergic reaction. They may also have been exposed to it through another way. So we talked a lot about being exposed to the protein through your skin, and that could be the first time and that your, your baby is exposed to that food protein. And that actually launches a different immune pathway, a more allergenic food immune pathway. So the first time you orally give it to them, they may have a reaction, but sometimes, and this is what I really want to really push is sometimes people introduce peanut products like peanut butter to their baby once and say, oh great. They didn't react.

Ruchi Gupta (8m 37s):

And then they forget about it and then they don't introduce it. And then three months later, they have a peanut butter and jelly or something, and then they have a full-blown reaction. So it's also still important that if you introduce it once no reaction, you got to keep it in their diet two or three times a week, two teaspoons, each meal.

Katie Ferraro (8m 57s):

Can I ask about the two teaspoons per meal? Like, what is that based

Ruchi Gupta (9m 1s):

On? So the two teaspoons of peanut butter. So we typically say two teaspoons of peanut butter mixed with about the same amount of water or breast milk or formula or whatever, apple sauce. So it's not so sticky. And then that is about the amount they need per meal. And it doesn't have to be exact, but that's based on the leap study. And the leap study found that two grams, it's about two grams, two grams, three times a week is what they use. So we say two grams, at least two to three times a week,

Katie Ferraro (9m 28s):

But that's one particular study. There's nothing to say that doing any more or any less grams of peanut protein would be more or less protected. Like we really don't know that. Right?

Ruchi Gupta (9m 37s):

You don't know that. And that's such a good point, but because we know that amount is that's all we have to base it on. We're doing a large study in Chicago. So hopefully we'll have better answers in a couple of years.

Katie Ferraro (9m 48s):

It is confusing for parents when they hear early and often they want to be like, all right, how often, how much tell me the exact number of grams. They're like, I hate to tell you that research just isn't out there, but we do know that one and done does not cut it. And so we do need to be re-introducing that as you point out now, we know that the guidance, when we're talking about peanut allergy suggests that babies who are at high risk for peanut allergy or those with established egg allergy and or severe eczema. And so as soon as parents hear eczema and then not the severe qualifier there, they tend to overestimate their baby's risk for peanut allergy because every baby has some degree of eczema. Right. So could you speak a little bit about the relationship between eczema and food allergy risk and then what is severe eczema?

Katie Ferraro (10m 28s):

Yes,

Ruchi Gupta (10m 28s):

This is so important. Okay. So the reason we found that eczema is a risk factor. The number one risk factor for babies is what we talked about just now. So if you have broken skin, if your baby has broken skin, then they're somewhat compromised, right? So food proteins could get in through their skin. And then as I said, the immune pathway takes a different route. So one thing is if your child has eczema, mild, moderate, severe protect their skin, get to your pediatrician or your dermatologist or whoever, and get that skin protected. You know, there are great things we can do for eczema. Now, what is severe eczema? And when do you know your infants at risk?

Ruchi Gupta (11m 8s):

So if your baby has asthma as significant amount, like on their arms, legs, trunk back, you know, you see it patches everywhere, not just a small patch on their hand or something that's important. Now I would actually say if your baby has any eczema taken to their doctor and get it diagnosed, because what we found is severe eczema is a risk factor, the biggest risk factor, but even moderate eczema is a little bit more of a risk factor. And mild is a smaller, but like all eczema needs to be treated and evaluated, but severe eczema, you know, more body surface area, deeper, darker red excoriate, or, you know, like red itchy, irritable. If you just see them red around their body, that is severe eczema.

Katie Ferraro (11m 53s):

Yeah. I always encourage parents also look at pictures of severe eczema. Cause sometimes you'll see a baby with like a tiny little patch and the mom's like, does he see this? I'm like, no, I don't even see that. Like, I can't even see that like severe eczema, like it is severe. It is painful. The child is usually already being treated for it as far as management goes. But what I want parents to know is that not all cases of eczema are severe eczema and you made a very important point that while it elevates risk, it does not automatically put your baby in the high risk category. So yes, having eczema increases risk, but I don't want parents to be like, well, my baby's high risk for peanut. And so now I have to follow the different protocols for high risk for peanut because they don't, it's only a small percentage of the population is actually in the high risk for peanut allergy category.

Ruchi Gupta (12m 32s):

Yeah. Less than 5% probably. You know, so the majority of families can feed their babies, peanut products early and not worry about it. But for that small percentage, they're the most, most at risk. We need to get them help right away. So if you think your baby has severe asthma, get in early four months, get to an allergist, get tested because the earlier we start in those high-risk babies, what we're finding is the better we can prevent.

Katie Ferraro (12m 57s):

You have done some work about racial inequalities in food allergy. And one of the newer publications of yours that I was looking at ahead of this interview is titled African-American children are more likely to be allergic to shellfish and finfish. And I was curious what you guys found out. Why is that

Ruchi Gupta (13m 16s):

So different groups, right? Racial, ethnic groups will have different top allergens, a lot of different things. But what I want to really point out with that is we have been looking very closely at racial and ethnic differences. And what we are finding is food allergy prevalence is actually higher in black infants and Latinex. And so we need to really be aware of that as families, you know, it can occur and the allergens we're seeing are different. So we are seeing more shellfish finfish in black children. And we are seeing like say more tree nuts and Asian children. And a lot of times we think this may be because of dietary habits, you know, are you catching these things because that is prominent in the diet versus are you higher in terms of your allergenicity?

Ruchi Gupta (14m 6s):

So, and do you think it's important? I also think it's important to point out when we talk about eczema, it looks different in different populations, right? So you have to make sure you understand what it looks like. So I really liked that you encourage people to go and look at pictures and we have pictures that we can share in different skin colors to really show what eczema looks like. And then the third thing with racial disparities is we need to make sure that the new guidelines, things like this are getting to everyone, you know, and making sure that all families can access, you know, the care that they need.

Katie Ferraro (14m 38s):

And I think that's a huge problem. We know so many of our parents are like, listen, my doctor's not even talking about this. And I know there's a lot of things that pediatricians need to do, especially at the six month appointment. But even before that, you know, the three month, four month appointment talking about, listen, when you do start solid foods, your baby turns six months of age and is sitting relatively unassisted and showing the other reliable signs of readiness to eat early introduction of allergenic foods does help prevent food allergy. And I know there's some really staggering data out there about how many pediatricians are not even broaching this topic. And I think a lot of it has to do with their own sometimes challenges interpreting the data. So I really appreciate the work that you and your team do, which is to help kind of simplify for practitioners, how important this is and how we can talk to parents about it in ways that they can understand and actually implement, because we need babies, eating these foods at home, we don't need to over medicalize it.

Katie Ferraro (15m 24s):

We don't need to be at the ER. We don't need to be doing stick packs and supplements and expensive subscription programs. Babies can eat food and they need to eat food based versions of these allergenic foods.

Ruchi Gupta (15m 34s):

That's right. Oh my goodness. You know, we just did a study of, and I am a pediatrician. I understand this every day. It's so many things you have to go over at that point in six months visits. So how do you incorporate this into your discussion? So we have a large NIH study going right now to figure that out. And so we're incorporating it into their electronic medical record. We have handouts, really great handouts. You know, that pediatricians can just give their families. But what we found is also that caregivers, parents reported 70% reported. They haven't heard of us. And this was just in the beginning of 2021. You know, we did this study of 4,000 caregivers and 70% said, they'd never heard of early introduction and the value of it.

Ruchi Gupta (16m 18s):

So the information is not getting out to the families. You know, either the pediatrician is talking about it, but you know, we talk about a hundred things and you can't remember all of them at those very, very short visits or the caregiver just never got the information. So having things like this are so critical to get it straight to the people who need it.

Katie Ferraro (16m 36s):

And if I may, for your NIH study, if you're adding another layer of it is turning to pediatric dieticians, this is what pediatric dieticians do. They're already existed in your health care systems where all of these pediatricians are giving out information to lean on them and their expertise to teach parents safe ways to introduce food based versions of these foods. That is something that the dietician has time to do, that they are trained to do and should be doing to fill in the gap here, where to be honest, the pediatricians don't have time. And you and I both know that, you know, more than 90% of physicians in this country have never taken a dedicated nutrition class. And so when parents go to their pediatrician and ask questions about nutrition, to be honest, most of the time the doctor has no formal training in that we just did a huge Baby Led Weaning summit and with 17 different leading feeding experts from around the world.

Katie Ferraro (17m 19s):

And there was a lot of pediatricians who wrote and said, that's the most nutrition education I've ever had is that, of course it is because it's not required in graduate medical education. And so we end up with a lot of pediatricians who might be interested in nutrition, but certainly not qualified to teach about it, but that's what dieticians can do. And they are an important resource that pediatricians should be leaning on.

Ruchi Gupta (17m 38s):

Absolutely. Oh, I, a hundred percent agree. We have three dieticians on our team and I learn every single day. So such a critical resource, we need more of them and we need more access to them.

Katie Ferraro (17m 47s):

Is there anything that a mom can do during pregnancy to protect against food allergy in her unborn baby?

Ruchi Gupta (17m 52s):

This is so important. I have this comic and one of our books where, when mom says, you know, I ate this during pregnancy. That's why my kid has food allergies. The other one says, I didn't eat this during pregnancy. That's why my kid has food allergies. So it goes back to the guilt. We always feel of what we're doing and what can we do? What I can tell you is there is no data saying you should avoid foods during pregnancy to protect your child from having a food allergy. So actually the only data limited data, we have, a lot of people are doing research on this, but the limited data we have says it could benefit, but it's not really strong data. So I encourage pregnant moms to eat whatever they are fading and not worry about it impacting food allergy.

Ruchi Gupta (18m 32s):

We really don't know if it helps to eat it, but it's leading in that direction, but it definitely doesn't hurt.

Katie Ferraro (18m 39s):

And also for parents, it's so important to know that there's nothing that you did that caused this child's food allergy. So much of food allergy risk is out of our hands. However, the one thing that we can control is the timeline for the introduction of allergenic foods. So if you are hearing this would between the time your baby is six and 11 months of age, it's so important that you be introducing those allergenic foods.

Ruchi Gupta (18m 60s):

Absolutely. Yes, yes, yes. Can't stress that enough. That is the one piece of data we have for prevention. So introduce peanut products early, kind of went over how to get it into their diet. You know, not their first food, of course, but early in that six month period. And if your baby is high risk, get them to an allergist at four months, even introducing earlier, getting it in their diet may truly prevent their allergy. And as far as the other foods go, you know, there is no data on it. Like I said, we're doing a large study to look at the other foods, but we do encourage a diverse diet. I think it's so important. So if you're comfortable introducing some of the other allergenic foods, do it early in life,

Katie Ferraro (19m 37s):

Our mutual friend and colleague Carina Venter is doing such important work on helping to define diet diversity because we hear this term and I teach a hundred first foods approach where we teach parents how to introduce their babies to a hundred different foods before the time they turn one, you'll say, well, what's the deal with a hundred? Is it a magical number? No, certainly not. But we know that the greater, the variety of foods and flavors and tastes and textures that babies are exposed to early and often the more likely it is to prevent picky eating, to prevent food allergies, to help you raise an independent eater, all these things that we want. And so Corrina's group is really looking at the numbers, you know, for every new allergenic food that you introduce, what percent reduction in food allergy risk do we see, like we need to have these quantifiable numbers and all the data points to more is better. So the greater, the number of foods you can do, including the allergenic foods, it does so much for your child throughout the course of their lifetime.

Katie Ferraro (20m 23s):

Yes.

Ruchi Gupta (20m 23s):

Corrina is one of my closest colleagues ever, and she's working on this large study with us. So anything she says I a hundred percent agree with, but I will say that the guidelines right now, this whole introduced three to five days, that's something I've been really pushing. It sounds like you have two against, because there's no data showing waiting five days between introducing a new food is beneficial in any way. And so when we did a survey of pediatricians, pediatricians even told us they don't really recommend that they've been recommending at least a day or two. So again, what you're doing is so critical, like the a hundred foods and diversifying the diet and getting new foods into your babies. I mean, if you think about how we started, right? You just, whatever you're eating, you kind of smushed in your mouth, get the microbiome, give it to your baby, you know?

Ruchi Gupta (21m 7s):

And so we've come so far. And like you mentioned earlier, this whole medicalization of early feeding is not ideal. Enjoy eating with your babies and enjoy feeding them new foods. And it should be fun and pleasurable and not so medicalized as we have it right now.

Katie Ferraro (21m 23s):

So regarding the three to five day, wait, I mean, this is a huge pain point because still in American academy of pediatric publications coming out this year, it says, wait a few days between new foods. And I think it's so important that the leaders in feeding and food allergy are out there saying, listen, there is absolutely no data to support waiting three to five days between new foods. And I was curious just to your thoughts, or to hear your thoughts, because if we know the vast majority of allergic reactions to food occur within minutes and up to no more than two hours following the ingestion of food, where in the world is this three to five day weight thing coming from like Babies can not achieve diet diversity that they need. If we're waiting five days between introducing new foods and how can we get rid of it is my bigger question.

Ruchi Gupta (22m 3s):

Well, if you figure that out, I'm ready to serve on that committee with you right beside you, because we do need to get rid of it. And there is no data. You know, when we did this study with pediatricians, we searched the literature, we went to books, we were trying to find anything to show the value of waiting such a long period of time. And we couldn't find anything. I don't know if it was from industry when we started bottling foods and, and, you know, it took a couple of days to finish a bottle. I don't know where it came from or who started it, but no data that we can find so totally with you, allergenic reactions happen really quickly. So waiting is not to prevent an allergic reaction. And the common allergens are not like sweet potatoes and avocado and bananas and applesauce.

Ruchi Gupta (22m 45s):

You know, that's just not what kids tend to react to. So feel comfortable introducing new foods more frequently, at least daily, you know, if not every other day, if you're nervous, but again, no medicalization. I mean, we used to introduce foods with multiple spices and ingredients in it to babies, whatever you were eating, we didn't have the opportunity to introduce single food items in the past. And so yes. Get back to basics.

Katie Ferraro (23m 9s):

So when I get my forgetting three to five days between food, like entire movement up and supported by the AAP, and we're educating pediatricians about not saying that, and I've actually done work even at UCF with the medical students being like, who is whispering in your guys' ear this whole like way three to five days. Like, I don't know, we just learn it in medical school. It's like, yeah, but it's not actually based in any research. And we know like a lot of problems stem from that, this passing down kind of these old wives tales for feeding. And there are still parents out there who come to me and say, you know, my pediatrician told me to wait until one defeat, egg white. I'm like, are you serious? That is 20 year old guidance that you are getting from your pediatrician. We want to be doing egg white, where the protein is at six months of age. And by waiting that long, you're actually increasing your baby's risk of Food Allergies.

Katie Ferraro (23m 52s):

So sometimes these things that might sound harmless or just, we say them and throw them out there, especially as practitioners, parents take them to heart. And if they actually put them in practice, we could be getting the opposite of the intended effect. We want you to introduce more foods more quickly, and we want you to do those allergenic ones earlier as well.

Ruchi Gupta (24m 8s):

Yes. And you're exactly right. I mean, we, we asked pediatricians, we said, why do you do this? That's what I was taught. Right. It's just passed down. That's exactly where it came from. And so we do need to break that cycle I'm with you and switch it back to faster. You know, the only other thing I can think of is that maybe it came out of fear, you know, as we saw this food allergy, prevalence crime, maybe people got scared and they're like, slow it down. You know, we don't know what's going on, but just like with peanut introduction, I mean, that's what we did. We said, don't introduce peanuts till age three. And then the data came back around and say, actually, that wasn't the right thing to do. You know? And so maybe the same with us. So, and then for your movement, I'm right there.

Katie Ferraro (24m 46s):

I know you've also done research on clinician's perception and understanding of Food Allergies in different parts of the world, including India. So I'm curious, how do prevalent rates differ in other regions outside of the United States? And you think that's due to reporting differences in different cultures in different countries, or is it differences in the diversity of infant diets and their tendency to introduce or not introduce allergenic foods early?

Ruchi Gupta (25m 8s):

This is very interesting because if you look around the world, you do see higher rates of food allergy and develop countries, right? Is that because we have the data there, we know, you know, in Australia and Europe, they're aware and they're looking at these numbers versus more rural areas, right? We don't have great data. So one thing everyone always asks us is this because we are more aware, like, are we now getting access to care? And we have a term for Food Allergies. You know, we call it something. And a lot of parts of the world, you know, if you eat something and have a negative reaction and you just take it out of your diet and even in the US, we're finding a lot of people may eat a food and have a reaction, and then they just take it out of their diet, but they never go to see a doctor, right.

Ruchi Gupta (25m 51s):

They never get to the doctor, they just remove it. So the other thing we're seeing is yes, to your point, even in places like India, if you look at rural India versus urban centers, urban centers are really similar, right? Their babies are eating one food. Every couple of days, they're getting more antibiotics. They're exposed to a much larger variety. Whereas in rural areas, it's kind of back to the basics. And so we see less of it in rural areas than urban areas. And a lot of those factors may play a role. When we talk about why Food Allergies are happening, we talk so much about the microbiome now, right? So like what changes your microbiome again, C-sections antibiotics, all these new things that happened over time to impact our microbiome and that good bacteria along with the bad bacteria.

Katie Ferraro (26m 38s):

Okay. My last question is kind of a doozy sensitized versus desensitized. So when you, the baby to a protein, are you sensitizing the body of the protein or desensitizing, which one's good. What do we want? Can you break it down for us?

Ruchi Gupta (26m 52s):

So these words are very confusing. So couple really important points to Food Allergies. So if your baby eats the food has a negative reaction, you go to the doctor, what happens? They test them, right. Either do a blood test or they do a skin prick test. Now, if they don't know what the food is, they'll do an oral food challenge, right? Where you eat the food that you think they reacted to. And if they react again, then they have that allergy. So two things when you have a positive test, but you're eating the food, right? So you have a positive skin prick test to add. Yet you can eat just fine. We call that sensitized. Okay. So you're sensitized, but not allergic.

Ruchi Gupta (27m 33s):

What that means is your body somehow is building and making antibodies that IgE to that specific food, but you're not having a reaction. So it is so important than that. You keep it in your diet. Now desensitization is an important word. And so when now we have treatments for Food Allergies, or we have one FDA approved treatment for peanut allergy. So when you go on treatment, you're desensitizing your body to that food. So you have a little bit of peanut powder more and more and more. And as you increase the amount you are becoming desensitized. So they are weird words. They're not direct opposites necessarily, but if you have a positive test and a negative, like actual reaction, we call you sensitized.

Ruchi Gupta (28m 21s):

But when we're trying to treat you, we call that desensitized.

Katie Ferraro (28m 24s):

But I think also you make a really good point. It's like, there's a lot of gray area in testing. And then we had Dr. David Stukas Honda. Talk about why there's such a high percentage of false positives in food allergy testing. And like parents roll back like angry. Like, I don't understand why anything would get approved of a test if there's a 50% chance that it's a false positive. We said, yes, but there's like a 99% chance that when it's negative, it's believable. So that if it does come back negative, what we don't want to see is parents unnecessarily restricting or removing entire groups of foods from a baby's diet unnecessarily, but there is no black and white test for food allergy. And so obviously kind of job security for you. Dr. Gupta, there is a lot for it to be done in this area

Ruchi Gupta (29m 2s):

And knock on wood. I mean, there are new tests that are more accurate on the way. So I am hoping like in the next five to 10 years, we're going to have a better diagnostic tests and more treatments.

Katie Ferraro (29m 13s):

So we need better education for pediatricians on how to use these because widespread blanket testing is a massive problem in just general medicine right now, pediatricians, you know, if your baby has never reacted to a food and your doctor suggests you get tested for it, you should get a new pediatrician. And it's a travesty. There's a lot of money to be made in food allergy testing. And yet parents will do whatever their doctor recommends might not be that the doctor has unscrupulous recommendations. He just might not realize the vast amount of false positives and that testing is not black or white. And it does give, I think on many cases, parents so much more anxiety than it needs to. So again, a lot of areas for improvement, you did mention the FDA treatment for peanut allergy. And I was wondering if you could shed light on that.

Katie Ferraro (29m 53s):

Who's it approved for? Is it something you've tried with your own child? Who's peanut allergic, just curious

Ruchi Gupta (29m 59s):

Treatments are coming up, right? So there's so many in clinical trials. There's one, that's FDA approved oral immunotherapy for peanut. It's called California. It's peanut powder. You do it with your allergist, you start low dose, and then you increase with your allergist. And that's what we call desensitized. Cause we don't call it a cure. So it is you're desensitizing. You still have to take the peanut on a regular basis to make your body's immune system aware of it. So that is one thing. And then that same company along with other companies are developing similar oral immunotherapy for other foods. So it's all coming down the pike. The other two that are really exciting is sublingual. So it's under your tongue sublingual, immunotherapy, same thing exposing you to the protein, but under your tongue, there's a patch one.

Ruchi Gupta (30m 43s):

That's hopefully going to be approved soon. Same thing at the cutaneous. So a little bits of protein through your skin. So those are three. Then there's the biologics, which kind of block a certain part of your immune pathway. That would cause the cascade, right? So those are being tested in clinical trials right now and on their way, then there's companies out there making vaccines for Food Allergies. So I really am excited that there's one out there and there's many, many more in progress.

Katie Ferraro (31m 12s):

Curiosity, you don't have to answer if you don't want to, but have you tried any of these with your own child?

Ruchi Gupta (31m 16s):

So my daughter is now 15. She had no interest in trying any of these. And now she does. So you have to, it's a discussion you have to have with your own child. Right? She was pretty comfortable. She's a peanut tree nut allergy, and she was living with it just fine and did not want to eat the food that has caused her so many terrible reactions. Right. Cause that's a little scary cause you're actually, that's exactly what you're doing now that she's 15 and she's in high school and she wants to socialize and she wants to go out with her friends. Now she is coming towards, okay, let's try this. Let's get rid of these allergies. So I have not done it yet, but we are close to ready to get started with it. So it's good timing.

Ruchi Gupta (31m 57s):

I would encourage everyone who is considering it to really have that discussion with your child. It depends on their stage of development and when they're ready and then, you know, when they are do it together because it can be scary and anxiety provoking for both the child and the parent.

Katie Ferraro (32m 11s):

Well, Dr. Gupta, thank you so much for sharing all of this valuable information about Food Allergies with us. Can you tell our audience where we can go to learn more about your work and particularly about your book as well?

Ruchi Gupta (32m 21s):

Yes, of course. So the book is food without fear book.com and the website it'll have like a food spectrum that you can take a look at to really better understand your food conditions. There's a survey on the website for better understanding what's going on in your body. And then to learn more about our research or give some of our free resources. It's CFaar.northwestern.edu. And that's our website where you learn a lot about our research, but we do have a lot of great resources, even for children in daycare or early childcare. We have great materials for you, for your providers and you know, just to help educate and increase awareness.

Ruchi Gupta (33m 2s):

Well, thank

Katie Ferraro (33m 2s):

You so much for joining us. It was great chatting with

Ruchi Gupta (33m 5s):

You. You too. Thank you so much, Katie.

Katie Ferraro (33m 8s):

Well, I hope you guys enjoyed that episode with Dr. Ruchi Gupta. I swear when you find a researcher who can explain complex processes and a lot of data in simple terms that parents can understand. I'm like, come on the podcast a million more times, we brainstormed like five other episodes that we're going to try to do together. So if you guys want to check out Dr. Gupta's research, her work, her publications, including some of the publications that were mentioned in today's episode and to find out where you can get her book food without fear, head to the show notes page for this episode, which is at blwpodcast.com/180. Thanks so much for listening and I'll see you next time.