The development of two-week menu cycles for households with children allergic to wheat, soy, cow's milk and egg respectively

[摘要] ENGLISH ABSTRACT: Food allergies in children are a growing problem and have various effects on these children, theirhouseholds, the community and the economy. No medication or cure is currently available to consumerssuffering from food-allergies. Medical teams are aware of the patients' need for support, but information islacking and understanding of their basic needs and problems neglected.Two qualitative research methods, namely the focus group technique and case studies were used toinvestigate the emotional and physical environment of children allergic to wheat, soy, cow's milk and eggrespectively. Five focus group meetings were conducted with the caregivers of food-allergic children. Twoduring the pilot study and three in the main study. A total of twenty three participants attended the threemeetings of the main study. A meeting schedule was developed and the meetings carefully moderated.After the data had been obtained from the focus group meetings, there was a need for more in-depthinformation and understanding.Seven of the participants of the focus groups were identified, through developed criteria, to be furtherinvestigated as case studies. Five units of investigation were identified for the case studies. It was the (i)caregiver, (ii) allergic child, (iii) other children, (iv) non-caregiver parent and (v) household.Some of the matters that were investigated in both the focus groups and case studies were healthconsciousness, menu planning, recipe needs and use, reading of food labels, hidden allergens and thesocial and emotional effects of having and being a food-allergic child. A great need for better support andeducational programs to assist these households were identified. Very few of the households were healthconscious, while they all experienced problems with menu planning, identifying hidden allergens andsuffered from social and or emotional problems. Very few participants made use of recipes or identified aneed for allergen-free recipes.After having gained insight in the daily lives of these households, four - virtually identical, two-week menucycles were developed to suit the life style requirements and restrictions of these children. The same recipeswere used, but allergens omitted, replacements made and the recipes adapted as necessary. Productscouting was done for hidden allergens in selected popular convenience foods, especially those from thelowest level of the USDA Food Guide Pyramid. Hidden allergens appeared to be a problem when food is prepared and bought for the food allergic child. It should be taken into account that despite the informationstated on the food label undeclared allergens might still be present in food.The two-week menu cycle for the child allergic to cow's milk was then quantitatively evaluated for nutritionaladequacy by FoodFinder ™ 2 - a software program, for children aged between seven and ten years. All themacronutrients and micronutrients identified by the National Survey in 1999 as insufficient «67% of theRDA) among South African children aged between one and nine years, were evaluated as well as thosementioned in the WHO Dietary and Health Goals. All the nutrients were sufficient, except for calcium andVitamin D. Supplementation is advised. The sensory acceptability of the menu-items in the two-week menucycles were not evaluated.A vast number of issues pertaining to the food-allergic child require further research. A great need exists forthe development of educational programs to support the households with food-allergic children. Theidentification of hidden allergens and the development of reliable sensory testing models for food-allergicchildren are all areas that should urgently be researched further.

[发布机构] Stellenbosch University