MEDITERRANEAN NETWORK FOR THE MANAGEMENT OF FOOD INDUCED DISEASES

1. MEDITERRANEAN NETWORK FOR THE MANAGEMENT OF FOOD INDUCED DISEASES European Laboratory for Food Induced Diseases (ELFID) University of Naples Federico II Prof. Luigi Greco

2. MEDICEL is a Mediterranean Network dedicatedto the FoodInducedDisease in Children. Thisisanemerging public healthissueconcerning at least 5 millionsindividuals in the Mediterranean Area WHAT IS MEDICEL? These diseases produce malnutrition, growth failure and severe morbidity

3. In the first year we will focus on gluten induced disease CELIAC DISEASE which is by far the most frequent of these diseases : more than one individual over 100 is affected, but the large majority (90-95%) are not recognized neither cared for

4. OBJECTIVES Capacity building and development of guidelines for the care of food induced disease in infants and children Establishment of a Mediterranean network to share know how and technology for the diagnosis and management of food induced disease in children, with special attention to the pandemic of wheat gluten intolerance

5. OBJECTIVES Development of local sustainable strategies to support the dietary care of children affected by food induced diseases Identification of genetic and environmental risk factors for food induced intolerance in children Develop preventive measures to reduce the burden of food induced diseases in children

6. Gluten free diet in Egypt ! • Help, I'm celiac (allergic to wheat flour, barley, malt, oats etc.) and going to be in Egypt for 2 months! Think I'll survive? any suggestions? I don't want to eat americanized food while in Egypt but it seems a lot of Egyptian foods have flour in them, or at least are usually eaten with a good stack of bread.

7. The Jewish Holiday of Passover: A Gluten-Free Bonanza Why Is This Holiday Special For Celiacs?From Nancy Lapid, former About.com Guide • I recently was in Israel in Jan 07 and found that most food labeling includes listing sources of gluten (its pronounced and spelled phonetically the same in Hebrew). Eating out most people knew about gluten (compared to here where they don't). Many chefs walked me through buffets or their menus; and everyone was willing to make new batches of food to avoid cross-contamination. FYI buffets are very, very popular in Israel so be sure to ask about cross-contamination.

8. Morocco Forum: Gluten free food • 1. Re: Gluten free food Jul 13, 2009, 7:18 AM • Destination Expert  for Morocco • If you stick to tagines, brochettes and salad you should be fine but you will have to avoid the bread that is served with every meal. Couscous can be made from a variety of grains so you will have to check before you eat it. There are also lots of fresh fruit available plus nice yoghurt. • Moroccan Chicken with Coriander & Lime Dressing • I'm a big fan of harissa, and Belazu do a lovely very authentic one with rose petals, its a hot and spicy aromatic paste

9. EXPECTED RESULTS Dissemination of knowledge and practical skills for the identification and management of food induced disease in infants and children. Establishment of a MEDI-CEL network, expanded in the field outside the reference hospitals. Set sustainable diagnostic tools, applicable at field level, for the point-of-care diagnosis of at risk children.

10. EXPECTED RESULTS Establishment of a central repository of diagnostic facilities and risk stratification. Establishment of tools for the risk stratification of newborn, infants and children (where risk is genetic, infectious diseases, malnutrition) Field Actions to support the optimal strategies to feed children and avoid food induced diseases.

11. OUTCOME INDICATORS N° of health professional trained in the field Development of agreed and on-the-field evaluated guidelines N° of diagnostic test performed, quality controls done by ref laboratories N° of families reached by the preventive messages N° of children diagnosed and brought to care Identification of 4-5 risk factors in the different communities N° of diets developed and applied for the care of infants

12. PLAN OF ACTIVITIES The European Laboratory for Food Induced Diseases (ELFID) , from the University of Naples Federico II, will take the burden of the co-ordination of the activities. In field training will be activated together with an in build evaluation system. The ‘hub & spoke’ methodology will be adopted for the progressive training at national level.

13. PLAN OF ACTIVITIES Each Participant country will propose one reference person for the project In field training will be activated together with an in build evaluation system. MEDICEL will be related to the PREVENT-CD EU Project and to the European Society for Pediatric Gastroenterology and Nutrition (ESPGHAN)

14. We have to implement innovative up-to-date dissemination strategies • Target : HealthProfessionall (allcaders) • Beneficiaries : At RiskPopulation • Priorities : Infants and Children • By • WEB-Basednationaldisseminationstrategies • Point-of-carenetworking • Mobile Phonebased High Tech

15. TIME TABLE OF MEDICEL PROJECT

16. We still have many missing points !

17. Next meeting: 15 September 2010 Waitingforyou in NAPLES…..