1. European Laboratory for Food Induced Diseases (ELFID) University of Naples Federico II University of Naples Federico II Prof. Luigi Greco

2. WHAT IS MEDICEL? MEDICEL is a Mediterranean Network dedicated to the Food Induced Disease in Children. This is an emerging public health issue concerning at least 5 millions individuals in the Mediterranean Area These diseases produce malnutrition, growth failure and severe morbidity

3. In the first year we will focus on gluten induced 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 CELIAC DISEASE

4. 1. Capacity building and development of guidelines for the care of food induced disease in infants and children OBJECTIVES 2.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. 3.Development of local sustainable strategies to support the dietary care of children affected by food induced diseases 4.Identification of genetic and environmental risk factors for food induced intolerance in children 5.Develop preventive measures to reduce the burden of food induced diseases in children OBJECTIVES

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 GuideNancy Lapid 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. Celiac Disease and Gluten- free Diet Information Since 1995

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 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 pasteBelazu

9. EXPECTED RESULTS 1.Dissemination of knowledge and practical skills for the identification and management of food induced disease in infants and children. 3.Set sustainable diagnostic tools, applicable at field level, for the point-of-care diagnosis of at risk children. 2.Establishment of a MEDI-CEL network, expanded in the field outside the reference hospitals.

10. 6.Field Actions to support the optimal strategies to feed children and avoid food induced diseases. 5.Establishment of tools for the risk stratification of newborn, infants and children (where risk is genetic, infectious diseases, malnutrition) 4.Establishment of a central repository of diagnostic facilities and risk stratification. EXPECTED RESULTS

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

12. PLAN OF ACTIVITIES 1.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 1.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. 3.The ‘hub & spoke’ methodology will be adopted for the progressive training at national level. 2.In field training will be activated together with an in build evaluation system 2.In field training will be activated together with an in build evaluation system.

13. 4.Each Participant country will propose one reference person for the project 5.In field training will be activated together with an in build evaluation system. 6.MEDICEL will be related to the PREVENT-CD EU Project and to the European Society for Pediatric Gastroenterology and Nutrition (ESPGHAN) PLAN OF ACTIVITIES

14. We have to implement innovative up-to-date dissemination strategies Target : Health Professionall (all caders) Beneficiaries : At Risk Population Priorities : Infants and Children By WEB-Based national dissemination strategies Point-of-care networking Mobile Phone based High Tech

15. RR RR 123456789101112131415161718192021222324 TIME TABLE OF MEDICEL PROJECT Start up & Planning- WEB site of Network Development of on-the-field evaluated guidelines Capacity Building & Knowledge sharing Development of a common data and bio bank Dissemination of diagnostic tools Development of sustainable strategies for the care of food induced diseases patients Analisis of Genetic and environmental Risk factors Dissemination of results and reporting

17. Next meeting: 15 September 2010 Waiting for you in NAPLES…..