ISSUE #3 - FEBRUARY 2010
LEAP STORIES
The Newslette r fo r Fa m i l i e s o f Pa r t i c i p a n t s i n t h e L E A P S t u d y
Welcome to the third LEAP New Study on
Snowy Owl Ward
Study Newsletter! In November 2009 we were joined
by a second study on Snowy
The New Year is already a few your child’s salt intake and another
Owl Ward – the EAT Study
weeks old, but we hope you all had delicious biscuit recipe.
a good start to 2010 and were not (www.eatstudy.co.uk). The EAT
We are introducing our brand new Study is a randomised controlled trial
too seriously affected by the snow. Emergency and Travel Plans –
Thank you for your continued of the early introduction of allergenic
please check the insert for more
commitment to the LEAP Study, foods in a normal population and the
information. And of course we have
especially in those weeks when visits our regular Staff News feature,
team are currently recruiting infants
had to be cancelled and rescheduled with pictures of new team members younger than 3 months of age to
due to snowfall. Despite the tricky included. So you’ll be able to join the study. As a result you will
weather conditions we have now recognise faces when you come to find Snowy Owl Ward busier than
completed virtually all visits at 12 visit us on Snowy Owl Ward! We in recent months, therefore please
months, with visits at 30 months look forward to seeing you then be sure to let us know that you are
progressing at a good pace. and we welcome any suggestions attending the LEAP Study as soon as
In this issue we look at a day in the you may have for future newsletter you arrive.
life of our dietitians, who have been editions. Please email us at info@
very busy with home visits and leapstudy, quoting “newsletter” in
preparations for end of study visits the title.
(visit at 60 months or “V60”). You
will also find hints on how to reduce
We'd like to hear
from you!
Something you'd like to ask
one of our doctors, nurses
or dietitians? Got a favorite
recipe? Website or book rec-
ommendation you'd like to
share with other LEAP families?
Send it to info@leapstudy.co.uk ,
we'd LOVE to hear from you!
A recent v30 visit
LEAP STORI ES
A day in the life of...
LEAP Study Dietitians
MARY FEENEY and CHARLOTTE STEDMAN
CHARLOTTE also travelled overseas to Dublin in
Ireland. We have some participants
A typical day will start with either
who have moved to exotic locations
myself or Mary going on a home
such as Argentina, South Africa,
visit. All participants on the study
Australia, New Zealand, Dubai and
will receive a home visit when they
the USA but unfortunately the LEAP
reach 21 months of age (and at 9
budget doesn’t stretch to sending us
months if they were enrolled on
off to these home visits! However,
the study before 6 months of age).
we keep in regular phone contact
The purpose of the home visit is to
with our overseas participants and
collect the usual data about your
catch up with them when they visit
child’s progress on the study and
the UK.
to give parents a chance to ask
any questions they may have in a When we are not on a home visit,
more relaxed atmosphere, in the Mary and I will be back at HQ LEAP Dietitian Charlotte Stedman
comfort of their own home. Many on Snowy Owl Ward at Evelina
of the study participants have food Children’s Hospital, where we MARY
allergies and are on restricted diets spend our time booking more
It is hard to believe, but our first
(e.g. milk/egg/wheat free). We are home visits, dispatching peanut
participants are already approaching
often asked by parents for recipe snacks for participants in the peanut
5 years of age and therefore are due
ideas and help to ensure their child consumption group, answering diet-
for their final end of study visit (or
is getting all the nutrients they related telephone queries and giving
V60). Each member of the LEAP
need to grow and develop healthily dietary advice to parents bringing
team is busy with preparations
and, with most of the children their children for a visit to the Unit.
for these final visits. Most of the
approaching their second birthday, We also spend several hours a week
clinical procedures such as skin
we are often asked about fussy analysing study participants’ food
prick testing, blood tests and other
eating ˗ a common problem at this diaries and then giving food diary
measurements will be similar to
age. We are happy to spend as much feed-back to parents if the analysis
previous visits at 12 and 30 months
time as you need to discuss any shows that the diet has too much or
but we will also be doing a food
questions you may have or to direct too little of a particular nutrient. The
challenge to find out whether your
you to the most appropriate place most common issue that arises is too
child is tolerant or allergic to peanut.
for help. much salt in the diet. We all eat too
These food challenges will help us
much salt – most of it coming from
Another benefit of the home visit is find out whether avoiding peanuts
everyday foods such as breakfast
that it saves parents a journey into or regularly eating peanuts works
cereals, bread, soup, pasta sauces
London, which can be challenging best for preventing peanut allergy.
and ready meals. If children have
with small children – particularly if
too much salt, this could affect their Some families will already be
they have a long distance to travel.
health in the future. It could also familiar with food challenges but
To date, we have completed 480
give them a taste for salty food, essentially they involve giving the
of the 635 home visits and have
which means they are more likely to child small amounts of a peanut-
travelled many miles to all four
continue eating too much salt when containing food and then carefully
corners of the UK. We have been as
they grow up. Please see the box observing to see if they develop
far North as Edinburgh in Scotland,
on page 3 for ways to reduce your any allergic symptoms. Some
South to Truro in Cornwall, East
child’s salt intake. will be simple Open Challenges
to Norwich in Norfolk and West
(i.e. everyone, including the child
to Wrexham in Wales. We have
2
ISSUE 3 | FEBRUARY 2010
knows that the food they are eating
contains peanut). Other participants
will need to have a more sensitive How Much Salt Should Children Have?
type of challenge called a Double Children under 11 years old should have less salt than adults
Blind, Placebo Controlled food because they are smaller. Children under 1 year need even
challenge where the child will not less than toddlers because their kidneys can’t cope with larger
be able to tell if the food they are amounts.
given contains peanut. In this case,
two foods that look and taste the The daily recommended maximum salt intake depends on age:
same are given: one food is ‘blinded’ • Up to 1 year 1g salt a day (0.4g sodium)
(i.e. contains hidden peanut) and • 1 to 3 years 2g salt a day (0.8g sodium)
the other food (called a ‘placebo’) • 4 to 6 years 3g salt a day (1.2g sodium)
doesn’t contain any peanut. • 7 to 10 years 5g salt a day (2g sodium)
Much of our work time in the past • 11 and over 6g salt a day (2.4g sodium)
few weeks has been spent in the Note: these are maximums, so it is better to have less.
King’s College kitchens developing
various recipes for the double blind How to Reduce your Toddler’s Salt Intake
food challenges. Charlotte and
I have been experimenting with Don’t:
foods such as muffins, biscuits and • add salt in cooking or at the table.
fruit smoothies to find recipes that • give your toddler salty snacks such as crisps.
meet all our requirements. It might • give your toddler adult ready meals or take-away foods
sound straightforward but aside unless you have checked the nutritional information. If you
from the practical considerations can’t avoid it, then serve a small portion with some extra
of choosing a food that a 5 year old vegetables.
will want to eat, it also needs to be • give food with added salt if they already contain salty foods
suitable for those who have multiple such as bacon or cheese. Added salt will be listed in the
food allergies and contain adequate ingredient list.
amounts of peanut to confirm
Do:
allergy or tolerance to peanut in
real life. On top of this, we need to • check nutritional information on all food labels and choose
ensure the children are unable to tell the ones lower in salt. This is important even if you are
which food contains peanut... it has giving foods that are manufactured for children and
certainly stretched our abilities in babies.
the kitchen! • choose cereals that contain less than 0.7g of salt (or 0.27g
of sodium) per 100g of cereal. Avoid cereals that are high
We have been conducting food in sugar and fat and choose wholegrain cereals some of
tasting tests among the LEAP team the time.
to find out what they think of our • limit intakes of food that are high in salt such as bacon,
recipes before trying them out on ham and sausages.
children. Gathered together on the • make sure that family meals are low in salt.
unit, the team taste a variety of
recipes each with a placebo and For further information please visit:
peanut-containing version and then http://www.eatwell.gov.uk/healthydiet/fss/salt/howmuchsalteat
give comments on which foods they
think contain peanut and how they
like the texture, taste and portion
size. They don’t hold back! In the keep going with the cooking until We look forward to meeting you at
next few weeks we’ll be back in we have found some really tasty your next visit, whether it is at home
the kitchen tweaking the recipes recipes that everyone likes. In the or at the Unit.
before testing them on some 5 year meantime, you'll find one of the
olds to see what they think. We will staff favourites on the back page.
3
LEAP STAFF NEWS
Following a number of staff changes to communicating with all our The nursing team
in early 2009 the LEAP Team has LEAP families! has also welcomed
now settled again, with just a few our third research
departures and arrivals in the last AINE SHERIDAN, nurse, MABLE
six months. our senior research ABRAHAM.
nurse, has returned
Our long-term LEAP Study from maternity We are delighted
Administrator ERICA HARRIS leave in October to have these
left in summer 2009. newcomers and
2009. Her role has one returning team member on
now been taken on In September 2009, CHARLOTTE board and are looking forward to
by CATHERINE STEDMAN, our second research the challenges of 2010 as a strong
CLARKE, on a dietitian, joined us. team.
part-time basis. We said farewell to LYN
Catherine is CLOUGH, one of our research
looking forward nurses, in the summer.
Mary's New Year Ginger Biscuit Recipe
Makes 12 Biscuits
Ingredients
• 140g plain flour (or 140g wheat free flour
+ ¼ tsp xanthan gum)
• ½ tsp ground ginger
• ½ tsp ground cinnamon
• ½ tsp bicarbonate of soda
• 20ml vegetable oil
• 70g soft brown sugar
• 50g chopped ready-to-eat prunes
• 60ml orange juice
• 1 tbsp golden syrup
• 2 tsp treacle
• 20g creamed coconut (grated) LEAP Dietitian Mary Feeney in King’s College
University Diet Kitchen baking ginger biscuits
Method
• Preheat the oven to 180ºC / 350F / Gas mark 4
• Add dry ingredients to a bowl and mix well
• Cook prunes on a low heat to a paste in the orange juice, then add golden syrup, treacle and
grated creamed coconut and mix well
• Add wet ingredients to dry and mix well together to form a dough ball – easiest done by hand
• Turn out onto a lightly floured surface and knead gently. Roll out to ½ cm thick and cut into small
biscuits approx. 5cm in diameter
• Bake for 15-20mins, then cool on a wire rack. Decorate using icing pens or dust with icing sugar.
Tips:
If using wheat free flour, the mixture holds together better if biscuits are cut into smaller shapes.
Baking the biscuits for a shorter time so that they are slightly underdone also improves the texture.
LEAP STORIES SUPPLEMENT - FEBRUARY 2010
Emergency & Travel Plans Bamba supply
for Food-Allergic Children Some of you will have
experienced delays to your usual
We are now in possession of If your child has a food allergy, delivery of Bamba or recently
new Emergency and Travel and you wish to make use of this received some with a short expiry
Plans for food-allergic children. plan rather than your existing date. The problems have arisen
These plans are designed to plan, please let our administrator due to our suppliers moving
be personalised and easily Catherine know. We will then premises and changing over to an
understood – much the same as issue an appropriate Emergency entirely new staff. We apologise
the written plans we may have and Travel Plan depending on for any inconvenience this has
issued to you in the past. The your child's specific clinical caused you.
plans have been approved for use scenario. Please let us know We are expecting to get our new
by various patient and medical exactly which contact details you stock by mid-February, so you
representatives within our NHS would like included. You could should receive your delivery
Trust, and we are happy for you then place a photograph of your shortly after that. Please contact
to use them on the study if you child on the plan, copy the plan, us by phone (020 7188 9784) or
so wish. and laminate. email (info@leapstudy.co.uk) if
you are concerned that you will
run out of supplies before then.
Retention update
The LEAP Study Team is proud to
report that retention on the study
remains exceptional, i.e. less than
1% of the 640 study participants
have left the study. Once again
we are extremely grateful to all
participants and their families
for staying with us throughout
this journey as we all attempt to
answer important scientific and
public health questions.
LEAP Facts & Figures
Children enrolled: 640
9 month home visits: 74
21 month home visits: 480
Number completed visit 12: 624
Number completed visit 30: 291