Systematic review and meta-analyses on the accuracy of diagnostic tests for IgE-mediated food allergy
The European Academy of Allergy and Clinical Immunology (EAACI) is updating the Guidelines on Food Allergy Diagnosis. We aimed to undertake a systematic review of the literature with meta-analyses to assess the accuracy of diagnostic tests for IgE-mediated food allergy. We searched three databases (Cochrane CENTRAL (Trials), MEDLINE (OVID) and Embase (OVID)) for diagnostic test accuracy studies published between 1 October 2012 and 30 June 2021 according to a previously published protocol (CRD42021259186). We independently screened abstracts, extracted data from full texts and assessed risk of bias with QUADRAS 2 tool in duplicate. Meta-analyses were undertaken for food-test combinations for which three or more studies were available. A total of 149 studies comprising 24,489 patients met the inclusion criteria and they were generally heterogeneous. 60.4% of studies were in children ≤12 years of age, 54.3% were undertaken in Europe, ≥95% were conducted in a specialized paediatric or allergy clinical setting and all included oral food challenge in at least a percentage of enrolled patients, in 21.5% double-blind placebo-controlled food challenges. Skin prick test (SPT) with fresh cow's milk and raw egg had high sensitivity (90% and 94%) for milk and cooked egg allergies. Specific IgE (sIgE) to individual components had high specificity: Ara h 2-sIgE had 92%, Cor a 14-sIgE 95%, Ana o 3-sIgE 94%, casein-sIgE 93%, ovomucoid-sIgE 92/91% for the diagnosis of peanut, hazelnut, cashew, cow's milk and raw/cooked egg allergies, respectively. The basophil activation test (BAT) was highly specific for the diagnosis of peanut (90%) and sesame (93%) allergies. In conclusion, SPT and specific IgE to extracts had high sensitivity whereas specific IgE to components and BAT had high specificity to support the diagnosis of individual food allergies.
https://doi.org/10.1111/all.15939
CD23+IgG1+ memory B cells are poised to switch to pathogenic IgE production in food allergy
Food allergy is caused by allergen-specific immunoglobulin E (IgE) antibodies, but little is known about the B cell memory of persistent IgE responses. Here, we describe, in human pediatric peanut allergy, a population of CD23+IgG1+ memory B cells arising in type 2 immune responses that contain high-affinity peanut-specific clones and generate IgE-producing cells upon activation. The frequency of CD23+IgG1+ memory B cells correlated with circulating concentrations of IgE in children with peanut allergy. A corresponding population of "type 2-marked" IgG1+ memory B cells was identified in single-cell RNA sequencing experiments. These cells differentially expressed interleukin-4 (IL-4)- and IL-13-regulated genes, such as FCER2/CD23+, IL4R, and germline IGHE, and carried highly mutated B cell receptors (BCRs). In children with high concentrations of serum peanut-specific IgE, high-affinity B cells that bind the main peanut allergen Ara h 2 mapped to the population of "type 2-marked" IgG1+ memory B cells and included clones with convergent BCRs across different individuals. Our findings indicate that CD23+IgG1+ memory B cells transcribing germline IGHE are a unique memory population containing precursors of high-affinity pathogenic IgE-producing cells that are likely to be involved in the long-term persistence of peanut allergy.
https://doi.org/10.1126/scitranslmed.adi0673
Supplementation of the maternal diet with Brazil nut (Bertholletia excelsa HBK) prevents cognitive impairment in the offspring of obese mothers
Maternal obesity may trigger long-term neurodevelopmental disorders in offspring. Considering the benefits of the Brazil nut (Bertholletia excelsa H.B.K.), a rich source of nutrients such as selenium, this study aimed to evaluate its effect on the behavior of obese rat offspring and its relationship with oxidative stress. From 60 days of age until weaning, female Wistar rats were fed a high-fat diet (mHF) or an HF diet supplemented with 5% Brazil nut (mHF/BN), while control mothers (mCTL) were fed a standard diet or a standard diet supplemented with 5% Brazil nut (mBN). Male pups received a standard diet throughout life and, at 30 and 90 days old, were subjected to behavioral tasks to evaluate anxiety and cognition. Biochemical evaluations were performed at 90 days of age. No alterations were observed in the anxiety behavior of the offspring. However, the offspring of the mHF group (oHF) exhibited impaired short-term memory at 30 and 90 days of age and impaired long-term memory at 30 days. Short-term memory impairment was prevented by Brazil nuts in young rats (30 days). While the serum selenium concentration was reduced in the oHF group, the serum catalase concentration was reduced in all groups, without changes in lipid peroxidation or protein carbonylation. Brazil nut maternal diet supplementation prevented short- and long-term cognitive impairment in the offspring, which may be related to the selenium levels.
https://doi.org/10.1017/S2040174424000023
The Effect of Raisin (Currant) Intake on Anthropometric Indices and Blood Pressure: Systematic Review and Meta-analysis of Randomised Controlled Trials
Introduction: Raisins are a relatively healthy snack, particularly when compared to snacks with a high glycemic index, and can have beneficial effects on human health against chronic disorders. However, contradictory information has been reported on the effect of raisin consumption on anthropometric indices and blood pressure. This systematic review and meta-analysis sought to evaluate the effect of raisin consumption on body weight, body mass index, waist circumference, systolic blood pressure (SBP), and diastolic blood pressure in adults. Methods: We comprehensively searched electronic databases, including PubMed, Scopus, Google Scholar, ISI Web of Science, and Embase, from inception to February 2021. Overall, eight randomised clinical trials with 352 participants were included in the present study. Results: There was a significant effect between raisin consumption and SBP (weighted mean difference [WMD]: 3.45 mmHg, 95% CI: −6.30, −0.59, P = 0.01), but no significant effect was found between raisin consumption with diastolic blood pressure (WMD: −0.51 mmHg, 95% CI: −2.67, 1.65, P = 0.64), body weight (WMD: 0.08 kg, 95% CI: −0.41, 0.57, P = 0.74), body mass index (WMD: 0.02 kg/m2, 95% CI: −0.54, 0.59, P = 0.93), and waist circumference (WMD: −0.38 cm, 95% CI: −1.24, 0.48, P = 0.38). Consumption of raisins can reduce SBP, with greater effects found in unhealthy individuals, in the dosages of ≤84 g/d, and intervention durations >6 weeks. Conclusions: It appears that raisins could be advocated as an SBP-reducing snack in the management of hypertension in adults.
https://doi.org/10.1016/j.hermed.2023.100830
Metabolisable energy from nuts and patterns of nut consumption in the Australian population: a secondary analysis of the 2011-12 National Nutrition and Physical Activity Survey
Background: Nut intake is not associated with increased body weight, which may be explained by their metabolisable energy, among other factors. Therefore, total energy intake may be overestimated among nut consumers. This study aimed to describe the metabolisable energy from nuts and nut consumption patterns in the Australian population. Methods: A nut-specific database was expanded to include metabolisable energy of nuts (based on nut type and form) and applied to the 2011–12 National Nutrition and Physical Activity Survey (NNPAS). Participants were Australians aged 2 years and older from the 2011–12 NNPAS (n = 12,153, with n = 4,765 nut consumers). Mean metabolisable energy intake was compared with mean energy intake using Atwater factors in nut consumers. Additionally, nut consumption patterns were explored, including the proportion of nuts consumed at meals and snacks. Results: Among nut consumers, mean metabolisable energy from nuts based only on nut type was 241.2 (95% confidence interval [CI]: 232.0, 250.5) kJ/day and mean metabolisable energy considering both nut type and form was 260.7 (95% CI: 250.2, 271.2) kJ/day. Energy intake from nuts using Atwater factors was 317.6 (95% CI: 304.8, 330.3) kJ/day. Nuts were more likely to be consumed at snack occasions, with approximately 63% of nut intake occurring as a snack. Conclusion: Application of metabolisable energy to the 2011–12 NNPAS has a significant impact on calculation of energy intake from nuts. Nut consumption patterns identified a majority of nut consumption occurring as snacks. These findings may inform strategies to support nut consumption in Australia.
https://doi.org/10.1111/jhn.13278
Prunes preserve cortical density and estimated strength of the tibia in a 12-month randomized controlled trial in postmenopausal women: The Prune Study
Summary: Non-pharmacological therapies, such as whole-food interventions, are gaining interest as potential approaches to prevent and/or treat low bone mineral density (BMD) in postmenopausal women. Previously, prune consumption preserved two-dimensional BMD at the total hip. Here we demonstrate that prune consumption preserved three-dimensional BMD and estimated strength at the tibia. Purpose: Dietary consumption of prunes has favorable impacts on areal bone mineral density (aBMD); however, more research is necessary to understand the influence on volumetric BMD (vBMD), bone geometry, and estimated bone strength. Methods: This investigation was a single center, parallel arm 12-month randomized controlled trial (RCT; NCT02822378) to evaluate the effects of 50 g and 100 g of prunes vs. a Control group on vBMD, bone geometry, and estimated strength of the radius and tibia via peripheral quantitative computed tomography (pQCT) in postmenopausal women. Women (age 62.1 ± 5.0yrs) were randomized into Control (n = 78), 50 g Prune (n = 79), or 100 g Prune (n = 78) groups. General linear mixed effects (LME) modeling was used to assess changes over time and percent change from baseline was compared between groups. Results:_ The most notable effects were observed at the 14% diaphyseal tibia in the Pooled (50 g + 100 g) Prune group, in which group × time interactions were observed for cortical vBMD (p = 0.012) and estimated bone strength (SSI; p = 0.024); all of which decreased in the Control vs. no change in the Pooled Prune group from baseline to 12 months/post. Conclusion: Prune consumption for 12 months preserved cortical bone structure and estimated bone strength at the weight-bearing tibia in postmenopausal women.
https://doi.org/10.1007/s00198-024-07031-6
Daily Cashew and Brazil Nut Consumption Modifies Intestinal Health in Overweight Women on Energy-Restricted Intervention: A Randomized Controlled Trial (Brazilian Nuts Study)
Background: Increased intestinal permeability and dysbiosis are related to obesity. Nuts can provide nutrients and bioactive compounds that modulate gut microbiota and inflammation, enhancing the beneficial effects of weight loss. Objectives: To evaluate the effect of consuming cashew nuts (Anacardium occidentale L.) and Brazil nuts (Bertholletia excelsa H.B.K) on intestinal permeability and microbiota, fecal SCFAs and pH, inflammation, and weight loss in energy restriction condition. Methods: In this 8-week randomized controlled trial, 40 women with overweight or obesity were assigned to energy-restricted groups (-500 kcal/d): control group (free of nuts) or Brazilian nuts group (BN: 30 g of cashew nuts and 15 g of Brazil nuts per day). Permeability was analyzed by the lactulose/mannitol test and the microbiota by sequencing the 16S gene in the V3-V4 regions. Plasma concentrations of inflammatory cytokines (TNF, IL-6, IL-10, IL-8, IL-17A) and C-reactive protein were analyzed. Results: In total, 25 women completed the intervention. Both groups lost weight without statistical differences. Lactulose excretion increased only in the control group (P < 0.05). The BN consumption increased fecal propionic acid and potentially beneficial bacteria, such as Ruminococcus, Roseburia, strains NK4A214 and UCG-002 from the Ruminococcaceae family, but also Lachnospiraceae family, Bacteroides, and Lachnoclostridium, when compared to the control group. Changes in intestinal permeability were correlated to a greater reduction in body fat (kg), and IL-8, and increases in Ruminococcus abundance. Conclusion: Our findings demonstrate a positive impact of BN consumption within an energy-restricted context, linked to the augmentation of potentially beneficial bacteria and pathways associated with body fat reduction. Besides, BN consumption mitigated increased intestinal permeability, although its capacity to diminish permeability or enhance weight loss proved limited. This trial was registered at the Brazilian Registry of Clinical Trials as ReBEC (ID: RBR-3ntxrm).
https://doi.org/10.1016/j.tjnut.2023.12.022
Marketing Orders: February 2024
USA: Assessment Rate Decreased for California Walnuts
A rule issued by the U.S. Department of Agriculture (USDA) implements a recommendation from the California Walnut Board to decrease the assessment rate for California walnuts handled under Marketing Order No. 984. This rule decreases the assessment rate for California walnuts handled under the Order from US$0.0125 per in-shell pound, the rate that was initially established for the 2023–2024 and subsequent marketing years, to US$0.011 per in-shell pound. The rule takes effect on February 29, 2024, and will remain in effect indefinitely unless modified, suspended or terminated.
Food Safety Update: February 2024
EU: Restrictions on Use of Flavoring Substances
Commission Regulation (EU) 2024/238, published in the Official Journal of the European Union on January 16, 2024, introduces restrictions on the use of certain flavoring substances.
| Substance | Food category | Maximum level |
| 2-Phenylcrotonaldehyde | Processed fruits and vegetables | 0.05 mg/kg |
| 5-Methyl-2-phenylhex-2-enal | Processed fruits and vegetables | 1.10 mg/kg |
| 4-Methyl-2-phenylpent-2-enal | Processed fruits and vegetables | 0.09 mg/kg |
Although the restrictions will apply as of the twentieth day following publication, transitional measures are envisaged for certain products lawfully placed on the market before the entry into force of the regulation.
EU: Plant Protection Products Update
Commission Implementing Regulation (EU) 2024/324 extended the approval periods for several active substances:
| Substance | New expiration of approval date |
| Mecoprop-P | May 15, 2025 |
| Pyraclostrobin | September 15, 2025 |
| Flutolanil | June 15, 2025 |
| Fluazinam | April 15, 2026 |
| Mepiquat | October 15, 2025 |
| Cyflufenamid | June 30, 2027 |
| Bromuconazole | April 30, 2027 |
| Buprofezin | December 15, 2025 |
| Phosphane | March 15, 2026 |
| Fluopyram | June 30, 2026 |
| Metsulfuron-methyl | August 31, 2026 |
| Benzovindiflupyr | August 2, 2026 |
| Lambda-cyhalothrin | August 31, 2026 |
New maximum residue limits (MRLs) were recently published for the following substances in or on nuts and dried fruits:
| Substance | Commodity | MRL (mg/kg) |
| Oxamyl(1) | Stone fruits | 0.001 |
| Berries and small fruits | 0.001 | |
| Dates | 0.001 | |
| Figs | 0.001 | |
| Etridiazole(2) | Fruits, fresh or frozen; tree nuts | 0.01 |
| Oilseeds and oil fruits (including peanuts) | 0.01 | |
| Difenacoum(2) | Fruits, fresh or frozen; tree nuts | 0.01 |
| Oilseeds and oil fruits (including peanuts) | 0.01 | |
| Potassium permanganate(2) | Fruits, fresh or frozen; tree nuts | 0.01 |
| Oilseeds and oil fruits (including peanuts) | 0.01 | |
| Indoxacarb(3) | Tree nuts | 0.01 |
| Stone fruits | 0.01 | |
| Berries and small fruits (except cranberries) | 0.01 | |
| Cranberries | 1 | |
| Dates | 0.01 | |
| Figs | 0.01 | |
| Peanuts | 0.01 | |
| Diethofencarb(4) | Berries and small fruits | 0.01 |
| Fenoxycarb(4) | Fruits, fresh or frozen; tree nuts | 0.01 |
| Famoxadone(5) | Table grapes | 0.01 |
| Acrinathrin(5) | Fruits, fresh or frozen; tree nuts | 0.01 |
| Oilseeds and oil fruits (including peanuts) | 0.01 | |
| Prochloraz(5) | Fruits, fresh or frozen; tree nuts | 0.01 |
| Oilseeds and oil fruits (including peanuts) | 0.03 | |
| Sodium hypochlorite(5) | Fruits, fresh or frozen; tree nuts | 0.01 |
| Oilseeds and oil fruits (including peanuts) | 0.01 | |
| (Z)-13-hexadecen-11-yn-1-yl acetate(5) | Fruits, fresh or frozen | 0.01 |
| Tree nuts | 0.01 | |
| Oilseeds and oil fruits (including peanuts) | 0.01 | |
| (Z,Z,Z,Z)-7,13,16,19-docosatetraen-1-yl isobutyrate(5) | Fruits, fresh or frozen | 0.01 |
| Tree nuts | 0.01 | |
| Oilseeds and oil fruits (including peanuts) | 0.01 | |
| Haloxyfop(6) | Fruits, fresh or frozen; tree nuts | 0.01 |
(1) This MRL shall apply from May 11, 2024. More information
(2) This MRL shall apply from August 12, 2024. More information
(3) This MRL shall apply from August 14, 2024. More information
(4) This MRL shall apply from August 12, 2024. More information
(5) This MRL shall apply from August 12, 2024. More information
(6) This MRL shall apply from August 19, 2024. More information
Finally, on February 5, 2024, the Commission published Implementing Regulation (EU) 2024/425 concerning the non-approval of the active substance asulam-sodium. This regulation will enter into force on the twentieth day after its publication. More information
Latest Trade News and Agreements: February 2024
EU: Increased Controls on Certain Organic Products
The European Commission, together with the Group of Experts on Organic Production, has assessed the information in the Organic Farming Information System (OFIS) and concluded that increased control and reporting measures are necessary for certain imported products.
The additional control measures will be applied to the following organic products (among others) from January 1, 2024 to December 31, 2024:
| Country | Product | CN code | Sampling percentage |
| China | Peanuts | 1202 42 00 | 10% |
| Egypt | Peanuts | 1202 41 00
1202 42 00 |
10% |
| Tunisia | Dates | 0804 10 00 | 10% |
| Vietnam | Cashews | 0801 32 00 | 10% |
USA: USDA Announces Two Investments to Strengthen Specialty Crops Sector
On January 29, 2024, the U.S. Department of Agriculture (USDA) announced two investments designed to support the American specialty crops industry, which includes fruits, vegetables, tree nuts, dried fruits, horticulture and nursery crops. The Assisting Specialty Crop Exports (ASCE) initiative will provide US$65 million for projects that will help the specialty crop sector increase global exports and expand to new markets. Additionally, US$72.9 million in grant funding will be available to support the specialty crops industry through the Specialty Crop Block Grant Program (SCBGP), which will fund innovative projects designed to bolster the competitiveness of the expanding specialty crop sector.