FTAH Workday 4-3

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Royal Melbourne Institute of Technology *

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2135

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Chemistry

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May 3, 2024

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RMIT Classifi cation: Truste d ONPS2135 Food Toxicology, Allergens and Health Food Toxicology & Allergen Specialist Workday, Semester 1 2023 Instructions – PLEASE READ CAREFULLY BEFORE COMMENCING 1. This assessment includes a series of short answer questions equalling 50 marks. This assessment will contribute to 20% of your final grade in this course. 2. You will not be able to see your grade for this assessment until your overall mark for this course is processed and your total marks are released. This is secondary to RMIT final grading policies. 3. In each section, provide your answers to the questions in the space below the question (labelled “[Write your answer here]”). 4. You are permitted to remove the blue text labelled “[Write your answer here]” when attempting to answer the question. 5. You are permitted to remove incorrect answers to any Multiple Choice Questions, leaving only the answer you perceive to be correct remaining. 6. Do not remove or modify the examinable questions or statements (with the exception of any Multiple Choice Questions – see above). If an examinable question or statement has been found to be modified, you will score zero (0) marks that examinable question or statement. 7. Do not liaise with other students in this course about examinable questions or statements related to this online test, throughout the testing period. You can be reported for misconduct if you breach RMIT academic conduct regulations. 8. Do not copy, share or distribute any of the examinable questions or statements related to this online test, during or following the testing period. You can be reported for misconduct if you breach RMIT academic conduct regulations. 9. You are permitted to utilise study notes, course material, and high-quality open-access internet sources (peer-reviewed journal articles, reputable and government websites). However, make sure you rewrite all answers into your own words. You can be reported for misconduct if you breach RMIT academic conduct regulations. 10. There are no marks awarded specifically for referencing. However, it is good practice so if you wish to include references it will only 1) benefit your own skills in this area, and 2) help to ensure your answer is substantiated / more likely to be correct (if using high-quality sources). 11. Complete your answers to this test within 8-hours. This means that you can submit any time between now and 5pm AEST Thursday 8 th June 2023. 12. Submit your word via Turnitin on Canvas: Assignments, Assessment Task 4: Food Toxicology and Allergen Specialist Workday. Turnitin is an online tool in Canvas that checks your assignments to ensure they're your own work and not plagiarised. For more information on Academic Integrity at RMIT, visit this website: https://www.rmit.edu.au/students/student-essentials/assessment-and-exams/academic-integrity WISHING YOU THE BEST OF LUCK  1

RMIT Classifi cation: Truste d Millie’s Story (11 marks) Millie is a 6-month-old infant. Millie has anaphylaxis to cow’s milk infant formula and was exclusively breastfed until the introduction of cow’s milk formula. Millie has been assessed by a skin prick test under the supervision of a clinical immunology/allergy specialist and her test results were: IgE +ve cow’s milk, soy, peanut IgE -ve to wheat, egg, fish, tree nuts Shellfish not measured Millie’s mother, a migrant from Singapore, was allergic to cow’s milk as a child but is now tolerant. 1. Using your lecture notes, explain the difference between food allergies and food intolerances to Millie’s mother. (2 marks) Food allergies involve immune system reactions triggered by specific proteins in food, which the immune system mistakenly recognises as a foreign invader and triggers an IgE-mediated response to destroy the invader. The release of these antibodies leads to the release of histamine and other chemicals, causing allergic reactions, such as anaphylaxis, difficulty breathing etc. On the other hand, food intolerances do not affect the immune system nor IgE-mediated response and cannot cause anaphylaxis. There is no dependable skin or blood test to diagnose food intolerances. Food intolerance symptoms usually show delayed responses, 30 minutes – 48 hours and are dose-dependent and have non-life threatening, acute responses. In contrast, food allergy responses can occur immediately after consumption or within a short time of>60 minutes. The severity of food can range from mild to severe, including life-threatening. 2. Based on the advice of the Australasian Society of Clinical Immunology and Allergy (ASCIA), when should Millie’s mother begin introducing solid foods to Millie and why? (2 marks) ASCIA recommends the introduction of solid foods around the 6 months of age mark, but not before 4 months of age and preferably whilst still breastfeeding. There is some evidence that following this recommendation can help protect against the development of allergic diseases. Thus, Millie’s mother is recommended to introduce solid foods for Millie now. 3. Millie’s mother has just found out that she is pregnant again. She has been advised by a friend to avoid cow’s milk during the pregnancy to avoid having another child with the allergy, due to the evident family history link. Do you agree with this recommendation? Explain your answer. (2 marks) Based on recommendations by ASCIA, maternal dietary exclusion of cow’s milk during pregnancy is not required to prevent cow’s milk allergy as this process has not been proved to prevent allergies. However, as there is known family history of cow’s milk allergy with Millie’s anaphylaxis, it would be advisable for Millie’s mother to consult with a healthcare professional for personalised advice. 4. Millie’s mother has now had her baby, a little boy named Jack. Baby Jack has developed eczema on his elbows and knees. Millie / Jack’s mother has heard from friends that there is a link between eczema and food allergies. Explain this link to Millie / Jack’s mother. (2 marks) Eczema frequently links with food allergy, with 50% of those with early-onset moderately severe eczema developing food allergy by one year of age. Both food allergies and eczema involve the immune system irregulating, with eczema, exhibiting an overreactive immune response and impaired skin barrier function that allows allergens, including food proteins, to penetrate the skin. This can lead to allergic sensitisation, increasing the risk of developing food allergies (Leung et al., 2019). On the other hand, eczema flare-ups can be triggered by certain foods in susceptible individuals. 2

RMIT Classifi cation: Truste d 5. What are the factors associated with migration that could explain why Australian born infants of Asian-born parents have increased allergy risk (use the Allen & Koplin 2015 paper in Canvas Weeks 10)? (3 marks) Food sensitizations, eczema, Peanut and other food allergies are 3x more common in infants with parents born in East Asia compared with parents born in Australia. The increased allergy risk appeared specific to infants of Asian-born parents and was not seen among infants of parents born in Europe or other areas. Factors that may explain the increased allergy risk in infants of Asian parents could be migration. Lifestyle changes, such as humidity and hygiene routine, can impact the skin barrier, increasing the risk of eczema and sensitization of the skin. Eczema has been found to increase the likelihood of developing food allergies. Furthermore, microbial exposure and dietary changes may affect the increased allergy risk. Asia has a diverse microbe exposure with more crowding, more exposure to domestic animals, less clean water and food supplies, and less personal health. For Asian-born parents migrating to Australia, the lifestyle, dietary and hygiene changes, and moving towards a more Westernized lifestyle can affect the immune system. These factors collectively contribute to the increased allergy risk in this specific population, how the allergy risk in Australian-born infants of Asian-born parents allergy risks increased over one generation, and how the immune system can be affected by migration. Jenny’s Story (7 marks) Millie’s neighbour, Jenny, has recently been diagnosed with coeliac disease after receiving a positive result on a gut biopsy examination. She completed the gut biopsy, only after showing symptoms of coeliac disease and being tested as positive for the risky HLA-DQ genes associated with the disease. Jenny’s dad was also tested for the HLA-DQ genes, and found to have the risky variants, however, has not developed coeliac disease. 1. Jenny needs to follow a strict lifelong gluten free diet. Using the relevant workshop notes, describe four potential sources of gluten contamination that can occur outside of the home (i.e., in the food industry) and four potential sources of gluten contamination that can occur inside of the home. (4 marks) Outside of the home: (1.) Cross-contamination during food preparation at restaurants, café, and food manufacturing facilities. This contamination can occur when gluten-containing foods are prepared in the same area or using shared equipment as gluten-free foods. The cross-contamination can occur if there is no proper cleaning or separate spaces and equipment for gluten-free and gluten-containing foods. (2.) Misleading labelling of ingredients can lead to gluten contamination. Gluten can be present in many hidden forms, such as flavourings, additives etc. Thus, with inaccurate or incomplete labelling of ingredients, a gluten-free individual can unknowingly consume gluten. (3.) shared fryers and cooking surfaces for gluten-free and gluten-containing foods in commercial kitchens or fast-food establishments can lead to gluten cross-contamination. The gluten particles can contaminate the gluten-free option when cooked in the same oil or on the same grill. (4.) If food manufacturers or restaurants source ingredients from suppliers that do not guarantee gluten-free food or have inadequate quality control measures, there is a risk of gluten contamination in the ingredients used to prepare food. Inside of the home: (1) When storing gluten-free grains or cereals in bulk containers, there is a risk o cross- contamination. If the containers were previously used to store gluten-containing ingredients or if utensils such as scooping utensils are shared. (2) Crumbs are residue from gluten-containing food that contaminates countertops, kitchen towels etc. If these meet the gluten-free food, cross-contamination can occur. (3) Some products, such as toothpaste, lip balms etc. may contain gluten ingredients, thus if someone with coeliac disease uses these products, accidental contact with gluten can occur 3

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