Independent trial showed No Significant Benefit of Silk Clothing for Eczema kids

An eczema study1 published in April 2017 showed that there was

little evidence of clinical or economic benefit of using silk garments in addition to standard care, compared with standard care alone, in children with moderate to severe eczema.

As always, the team of researchers from the University of Nottingham in the U.K had taken on clinical studies that address questions raised by doctors and patients, with the view of having a direct impact on clinical practice. They had conducted very practical studies like softened water eczema trial and compared the efficacy of a short burst of potent topical corticosteroids versus prolonged period of mild corticosteroids. Their website also maps out the systematic reviews on eczema and list their ongoing studies (also found at the bottom of this post).

For this study, the key points are below:

Nature of study: Parallel-group, randomised, controlled, observer-blind trial

Participants: Children aged 1 to 15 year old with moderate to severe eczema; 300 children were included: 42% girls, 79% white, mean age 5 year old

Randomized groups: Participants were randomised to receive standard eczema care plus silk clothing (100% sericin-free silk garments; DermaSilk or DreamSkin) or standard care alone.

Measurement: At baseline, 2, 4 and 6 months against the Eczema Area and Severity Index (“EASI”)

Outcome: No evidence of a difference between the groups in eczema severity (EASI score) assessed by research nurses

Purpose of the study: Silk clothing is available on prescription (and online) but the randomized controlled trials previously done were for small group of participants. To provide direction for clinical practice as to whether to recommend silk clothing, this study was taken on. Silk garment claimed beneficial for eczema as they are smooth, helped regulate humidity and temperature, reduce scratching damage and have anti-microbial properties. These are important qualities that would benefit eczema to reduce scratching (versus a ‘scratchy’ fabric like wool), keep the skin cool and reduce likelihood of flucuating temperature triggering eczema flareups and reduce bacteria load as eczema skin is prone to staph bacteria colonization. However, from the outcome of this study, it would appear that standard eczema care such as regular emollient use and topical corticosteroids (or topical calcineurin inhibitors) for controlling inflammation would be adequate.

Study by the researchers at the University of Nottingham, UK on Efficacy of Silk Clothing for Eczema Children

Study by the researchers at the University of Nottingham, UK

Practical implication:

In my view, this study would really get parents who are spending a lot of money on silk clothing/ bedding to question if such money needs to be spent. These silk garments are not cheap but parents pay for them due to positive testimonies, anti-inflammatory/ anti-microbial properties of silk and that these clothing are soft, free of dye and will not irritate the skin (interviewed Dermasilk here). However, a lower-cost alternative of cotton may work as well, with standard care for eczema.

I’ve also contacted Professor Kim Thomas who is part of the research team for this study and she kindly shared this video on University of Nottingham’s website

Please refer to the CLOTHES Trial page here for information sheets for children of various age group.

My personal take is if you’re seeing benefits for your child with silk clothing and can afford it, there is no reason to stop using the clothing. However, if it hasn’t seemed to make much difference and you feel confident that the eczema therapeutics measures that you use for your child are sufficient, then it makes sense not to spend that money. See this post for the review of various eczema therapeutics and also the review study that Nottingham University had done.


Silk garments plus standard care compared with standard care for treating eczema in children: A randomised, controlled, observer-blind, pragmatic trial (CLOTHES Trial) Thomas KS, Bradshaw LE, Sach TH, Batchelor JM, Lawton S, et al. (2017) Silk garments plus standard care compared with standard care for treating eczema in children: A randomised, controlled, observer-blind, pragmatic trial (CLOTHES Trial). PLOS Medicine 14(4): e1002280.

Ongoing studies at Centre of Evidence Based Dermatology at Nottingham University:

Bath Additives in the Treatment of Childhood Eczema

Barrier Enhancement for Eczema Prevention (The BEEP Study)

Understanding the long-term management of eczema

Skincare intervention in Nurses

Impact of Lactic Acid Bacteria (LAB) Fermented Extract on Children’s Health (#Biogenics16 series)

Intestinal health has gained importance in recent years due to studies that showed the link between intestinal health and numerous other health conditions, (beyond gastrointestinal conditions) even to skin and allergic conditions. It is known that not all probiotic strains are effective and also not all probiotic supplements are of high density and quality to have an effect on intestinal balance.

Today’s sponsored post is on LAB Fermented Extract, known as Biogenics 16 in Singapore. Questions are answered by the manufacturer and its team of medical professionals, an aspect which I appreciate as it showed the level of commitment and transparency. The key features of Biogenics16 and its impact on a child’s health are the focus of this 2-part blog series.

Biogenics Probiotic extract children health

Feature #1 High Strength with 16 Unique Strains of LAB

LAB fermented extract is neither prebiotics or probiotics, but an extract of secretions and bacteria body substance of lactic acid bacteria from 16 high strength bacteria strains through a patented extraction technology. The 16 bacteria strains include L. acidophilus, L. brevis, L. casei, L. curvatus, L. fermentum, L. plantarum, L. rhamnosus and L. salivarius.

It was observed by the late Dr Kazuyoshi Masagaki that ingested probiotic supplements do not survive well in body temperature and the acidic stomach environment, thus expelled as the body may not recognize it as its own. Instead lactic acid bacteria (LAB) fermented extract helps the body proliferate and grow its own good bacteria. At the same time, it also strengthens the immune cells, 70% of the body’s immunity cells are found along the intestinal walls.

MarcieMom: I read your report that about 95% of probiotics ingested get destroyed by stomach acid and most probiotics degenerate at temperature more than 25 degrees C. It is indeed worrying as probiotics products are not cheap and if most of them get destroyed, it appears then it is of limited efficacy. On the other hand, Biogeneics 16 uses an organic, non-GMO soya bean broth as a culture medium, to cultivate and extract the friendly strains with patent technology to encourage the body to grow its own friendly bacteria while diminishing the bad bacteria.

Like to clarify:

a. When we talk about probiotics, we usually talk about the strains to be at least in billions of colony forming units (CFU). What is the equivalent unit of measure for Biogenics 16?

Biogenics 16 does not contain live bacteria. It is instead an extract of Secretions and Bacteria Body Substance of 16 strains of lactic acid bacteria that are clinically proven to increase natural growth of body’s own friendly bacteria effectively for better health. Thus, it is unnecessary to measure the forming units of bacteria.

b. If LAB’s Fermented Extract is able to encourage the growth of good bacteria, why is it recommended to be taken daily? i.e. should it be taken more initially and when the gut is able to produce the good bacteria on its own, the dosage can then be reduced?

Factors such as poor diet, stress, pollutants, prescription of drugs and antibiotics deplete the amount of good bacteria in our body while contributing to the proliferation of bad bacteria. The imbalance of intestinal flora may lead to many health problems especially constipation, indigestion and undischarged toxic waste accumulate and may leak back into the body. Thus, it is important to take LAB’s Fermented Extract daily so as to ensure the balance of good bacteria while continuing to inhibit the on-going growth of bad bacteria, in order to achieve optimum gastrointestinal health.

Feature #2 High Resilience and Higher Performance

LAB Fermented Extract had been tested in clinical studies to improve

  • Intestinal health – 1. The level of bad enzymes/ carcinogens decreased during the time of administering LAB; 2. The intestines appeared cleaner after taking LAB for 4 weeks to 2 months
  • Immunity – where a higher amount of bad bacteria led to increase in intestinal toxins in the intestine, bloodstream which can affect nutrient absorption and oxygen circulation
  • Bowel irregularity
  • Rash and skin texture – will be covered in part 2 of this series
  • Oral health

MarcieMom: Children suffer from a range of gastrointestinal conditions, such as indigestion, constipation and diarrhea. At the same time, parents want to feed their children healthy but if the healthy food is not absorbed due to gut imbalance, it seems pointless to have good nutrition. I’m interested in how LAB Fermented Extract helps in nutrition and immunity:

a. We won’t know if a child is absorbing nutrients properly – do you have pointers where a parent can use to ‘gauge’ if the child has enough good bacteria?

A healthy child with enough good bacteria does not fall sick as easily, has lots of energy, clear skin, bright eyes and a good appetite. His weight will also be within healthy range.

In contrast, one with an unhealthy intestine tract has low immunity, bowel irregularities (constipation/diarrhea), is more lethargic and easily succumbs to allergies and infections. These symptoms can be indicators that your child does not have enough good bacteria in their intestine.

b. How does having good bacteria in the gut translate to high nutrient absorption and immunity? And which of the 16 strains help with this?

The small intestine is the place where nutrients are being absorbed in the body. If there are insufficient good bacteria in the intestines, the ecology of the good and bad bacteria gets upset. With insufficient good bacteria to digest food, bad bacteria take over and undigested food that is not discharged regularly from the bowels will clog up the gut. Undischarged wastes create toxins and cause the body and its vital organs to work harder and this creates stress on the body. Nutrients absorption is naturally compromised.

LAB Fermented Extract in Biogenics 16 is produced from the co-culture of specially selected 16 strains of LAB. When consumed, Biogenics 16 works in three ways, namely:

  1. Creating a conducive gastro intestinal environment to encourage the natural proliferation of the body’s own bacteria, which is the best fit for the individual as compared to foreign ingested probiotics.
  2. Suppressing bad bacteria. As the good bacteria flourish in the environment facilitated by LAB Fermented Extract, the bad bacteria colony shrinks and its reproduction is inhibited.
  3. Strengthening the immune system and Peyer’s Patch (an immune sensor of intestine) to activate immunity cells. (70% of entire body’s immune cells – Gut-associated lymphoid tissue (GALT) are located in intestine).

Feature #3 Premium Quality and High Potency

The fermentation and maturation of Biogenics16 is maintained at a fixed temperature and humidity for a period of 1 year. The patented technology helps to deliver high quality and consistent active ingredients. The dosage is half a sachet for children two years and above, and 1 ml drop for children below two years old. Biogenics 16 is lactose-free and gluten free.

MarcieMom: On the dosage for children, I’m curious to find out if (a) taking a full sachet will have side effects or will it be ‘wasted’?, (b) the effect of taking LAB Fermented Extract on alternative day as opposed to daily?, (c) what if the child is already taking fermented drinks like Yakult and Vitagen or already taking probiotics supplement?

a) Biogenics 16 LAB Fermented Extract does not contain any live bacteria, sugar, additives, pesticides, colouring or flavouring, making it absolutely safe for children consumption.

b) Observing your child’s stool is a good way to gauge if he/she is actually taking enough. Yellowish brown and odorless stool would indicate that your child is having good intestinal health, while dark brown with foul odor would mean otherwise. Through this observation, you will be able to better decide how much LAB Fermented Extract your child actually requires.

c) According to Dr Hiromi Shinya, a pioneer of modern colonoscopic techniques and author of many bestselling books in Asia, taking fermented drink that contains non-resident (ie. Not the body’s own) bacteria are not fully effective in increasing the beneficial bacteria living in the intestine. This is because the live bacteria in fermented drink are not heat stable and as much as 95% of the bacteria are dead even before consuming. Thereafter, the remaining bacteria are easily destroyed when passing through our acidic stomach environment, or excreted in the stool if the body recognizes it as a foreign bacteria. Aside from that, fermented milk products may also contain high amounts of sugar, which is unhealthy for the child’s diet.

Biogenics 16 is 100% resistant to heat and stomach acids. It encourages the growth of our body’s friendly bacteria while inhibiting the growth of bad bacteria, while strengthening the immune cells.

Feature #4 High Safety Assurance and Patented Extraction Technology

Biogenics 16 is safe for all ages, including infants and elderly and in full compliance with the Japan Health Authority. There is no added sugar, preservatives, pesticides, artificial coloring and flavoring.

Feature #5 Proven Results, Trusted Choice

Biogenics 16 is an established product, researched for 100 years and backed by clinical trials.

MarcieMom: How long from the time it is manufactured can Biogenics 16 be safe to consume (product expiry)? And is there a certain period after which the product will degenerate?

The shelf life of Biogenics 16 is 3 years from the date of manufacturing. Made from high potency with controlled fermentation process and patented extraction technology in Japan, Biogenics 16 provides LAB Fermented Extract that is highly stable and provides the same effectiveness and benefits for consumption by the date of expiry.

Once again, thank you to Lifestream Group Pte Ltd, for sponsoring this series.

Get additional $5 of website price when you purchase Biogenics 16 at Simply quote coupon code MEI5OFF upon check out to get the discount.

  • Promotion valid from 3-31 Dec 2015
  • Terms & conditions apply

Lifestream manages LABO NutritionTM under which Biogenics 16 is distributed. It is very useful information for parents and certainly help parents to be more aware of the child’s intestinal health and also in assessing products for it. Next week’s sponsored post will help readers of this blog understand how LAB Fermented Extract affects skin and improves eczema.

Eczema News – Bioresonance : What?


The Bioresonance companies must be doing a good job marketing (in Singapore), via Google ads or other channels, because more parents are asking about this and whether they should try it. Offhand, I think the picture I chose says my first thought – I mean, seriously, cells give off vibes? But as always, I approach a topic methodically, by looking at information over the web and also at Pubmed. Let’s first find out what bioresonance is:

Abnormal Waves

Bioresonance is on the basis that certain medical conditions give off abnormal aka unhealthy waves, and a device is used to detect these ‘sick’ waves and then normalize the waves and sent back to treat the person. It is on the basis that a sick person likely has something (bacteria, allergens) that disrupt the normal electromagnetic oscillations of the cells. Diseases that bioresonance purport to treat include allergies, eczema, cancer, arthritis, liver problem and chronic fatigue. You can read this article on Healthxchange for more info.


If you search Pubmed, you’d see it being associated with many health conditions and to me, it seems strange how a ‘treatment’ can purport to treat so many varied conditions. I looked through the articles on Pubmed and those that support the efficacy of bioresonance are from bioresonance practitioners and limited to case studies. Other independent articles show:

Articles citing bioresonance as inappropriate test for allergy, here or unproven here.

Citing bioresonance as not proven treatment for eczema, here and here.

Medical sites like WebMD and Dr Weil also take the stand that it’s not medically proven.

My take?

I don’t think it’s medically sound but I understand that parents would want to try anything especially when the child is suffering from severe eczema, with bleeding, weeping/oozing skin with tears of pain and anguish. I don’t know if the bioresonance therapist will ask for patients to stop the conventional treatment – if they do, I would say no. Otherwise, if there’s no side effect (i.e. you still continue the treatment advised by your doc), then likely it may be money spent (and wasted).

Any parent has tried it? Is the consultation fun? I’m just thinking maybe if a child likes it, he/she will scratch less during the consultation time and be more aware not to damage the skin after but moisturize diligently? Do share your take in the comment!

Photo Credit: AlicePopkorn via Compfight cc

Eczema Research News – Does Homeopathy work?

Does Homeopathy Work for Eczema?

Does Homeopathy Work for Eczema?

This is part of a quarterly round-up of some of the recent eczema-related studies, so that we can be aware of possible treatments and their efficacy (and I can also keep myself updated with the latest eczema research!)

Today’s topic is on Homeopathy, does it Work? Firstly, I have to say I haven’t tried homeopathy on my child with eczema and secondly, there’s no blame or guilt meant to be placed on any parent for trying an alternative treatment. I’ve had quite a few moms who told me that they have tried or are trying homeopathy for their child, some remarked it seemed to work, or seemed to work for a while, or did not work. Similar to last week’s topic on antihistamine, let’s have a grasp on some basic information first before we look into the studies.

What is Homeopathy?

Homeopathy involves understanding a person’s health and history, including physical, emotional and psychological areas. A tailored treatment is recommended for each patient, and the substances provided in tablet form are usually highly diluted with the aim to trigger the body to heal itself naturally.

How does it Work for Eczema?

There are various ways to apply homeopathy, for instance choosing different substances to treat different appearance of eczema (ie. Blisters versus rashes). These can be applied topically in the form of creams or ointments, for instance that of calendula, sulphur, urtica urens and rhus toxicodendron. Recommendations on nutrition and lifestyle are also provided.

Are there any side effect of homeopathy?

There appears to be no known side effect, although the eczema may worsen if the conventional treatment is withdrawn in place of the homeopathic treatment.

What’s the studies on homeopathy’s impact on eczema?

Based on this study in January 2013, there is no significant difference between using homeopathic treatment versus conventional treatment, thus implying that the higher cost of homeopathy is unjustified. Similar conclusions in other studies at PubMed, here, here, here, here.

Have you tried homeopathy for your child? Is it effective? Do share in the comments, thank you!

TCM Series – Understanding Eczema from TCM’s Perspective

TCM Physician Lau Kiew Teck with Raffles Medical Group

Many parents have asked me “What about TCM?” while others have suggested that I explore TCM as an eczema treatment option for my child. I’ve looked into TCM briefly in this archive post, but felt I didn’t know enough to evaluate it. For this TCM Series, I’ve the privilege of interviewing TCM Physician Lau Kiew Teck of Raffles Medical GroupRaffles Chinese Medicine Clinic, whose special interests include respiratory conditions, dermatology, pediatrics, diabetes and digestive system disorders.

Refer to the first part of this interview here and the second part here.

Understanding Herbal Bath & Cream

MarcieMom: I read that herbal bath and creams are also prescribed by TCM physicians. What are the ingredients of the herbal bath & cream? Given that there is so much transparency being pushed for in labeling ingredients of skin care products, are ingredients in TCM products fully labeled?

Physician Lau: In my practice at Raffles Hospital, our products are fully labeled and certified by Singapore Health Science Authority.

MarcieMom: Moisturizers, bath oil, bleach bath and steroid topical creams are treatment prescribed by western medicine. Is herbal cream, herbal bath similar? (as in have properties to repair the skin barrier, kill staph bacteria and reduce inflammation)

Physician Lau: As the properties are different between the western medicine and the herbal cream, we are unable to compare. The herbal bath definitely helps in reducing the inflammation thus creating an environment for the skin to recover. Repairing of skin largely depends on the individual body’s nature.

MarcieMom: Acupuncture is also a treatment option used for eczema; how does acupuncture treat eczema and is it recommended for children?

Physician Lau: As mentioned previously, TCM focuses on the holistic approach where a combination of treatment of acupuncture and herbs are used. For instance, if you are suffering from eczema due to weak digestive health, TCM, be it herbs or acupuncture or both, is administered to treat the indigestion problems and subsequently, through the holistic approach, it will speed up the recovery of eczema. I will not recommend acupuncture for children.

MarcieMom: Also, where are TCM medicine produced in? How can a patient check the harvesting of the herbs (whether using insecticide), the manufacturing facility (use of chemicals) and the packing facility?

Physician Lau: Patients can check the manufacturer’s label to see where the medicine is produced in. It is impossible to check on the harvesting of the herbs with the looks of it. Such assessments have to undergo testing.

MarcieMom: I understand that in skincare products, there is a lot of emphasis of choosing a reliable company that conducts clinical trials and ensures no contamination in its manufacturing and not using ingredients that are common allergens such as preservatives, fragrance and parabens. Do TCM’s herbal cream have the same emphasis on these?

Physician Lau: Based on the guidelines of Singapore Health Science Authority, all TCM products dispensed in Raffles Hospital are certified.

MarcieMom: Thank you Physician Lau for helping us understand a little more on TCM in the treatment for eczema for the past three weeks.

TCM Series – Understanding Eczema from TCM’s Perspective

TCM Physician Lau Kiew Teck with Raffles Medical Group

Many parents have asked me “What about TCM?” while others have suggested that I explore TCM as an eczema treatment option for my child. I’ve looked into TCM briefly in this archive post, but felt I didn’t know enough to evaluate it. For this TCM Series, I’ve the privilege of interviewing TCM Physician Lau Kiew Teck of Raffles Medical GroupRaffles Chinese Medicine Clinic, whose special interests include respiratory conditions, dermatology, pediatrics, diabetes and digestive system disorders.

Refer to the first part of this interview here.

Herbal Medicine & its Compounds & Prescription

Herbs such as Flos Lonicerae (Jingyinhua), Herba menthae (Bohe), Cortex Moutan (danpi), Rhizoma Atractylodis (Cangzhu) and Cortex Phellodendri (hungbai) are herbs commonly prescribed by TCM physicians for eczema. They have anti-allergic, anti-inflammatory and reducing itchiness effects.

MarcieMom: Physician Lau, could you explain to us what compounds are made up in the herbs that you commonly prescribe to eczema children? (Compounds meaning containing which Vitamin or which carotenoid)

Physician Lau: These compounds are extensive and it is not possible to list them all down.

Marcie Mom: I searched for studies on TCM and effects on atopic dermatitis and it appear that studies which indicate positive results (meaning lower severity of eczema or less reliance on cortisteroids) have relatively small sample size (see here and here). In this review article, the authors from The Chinese University of Hong Kong, Pediatrics and Institute of Chinese Medicine departments, concluded that the “beneficial effects of Chinese medicine on children with atopic dermatitis have not been consistently demonstrated”. I would think this is due to limited studies, both in number of studies and the sample size of studies, which led to inconclusive results and the ambivalence of non-TCM practitioners to recommend their patients to explore TCM.

MarcieMom: Physician Lau, do you know of any conclusive large-scale study of TCM on eczema?

Physician Lau: Not that I know of.

MarcieMom: I also read that the TCM prescription is individualized and not standardized across eczema patients. Why is it not possible to be standardized? Would prescribing the common herbs for eczema and in a standard dosage makes it easier for studies to be conducted and also for greater transparency in TCM medicine?

Physician Lau: Each patient requires different attention and treatment and TCM does that. It customizes the treatment for the patient so patient can recover speedily.

MarcieMom: Related to the above, the individualized treatment characteristic of TCM makes it scarier for parents, what if their TCM physician prescribes the wrong potency or frequency? I’m thinking about western steroid creams, a mom would easily google the strength of the steroid and know if it ought not be used daily. Can you advise (1) what questions a parents should ask their TCM physician about the medicines given to their child and (2) what are the common dosage and length of taking these meds?

Physician Lau: Each consultation differs from patient to patient so there is no common dosage or length of taking these medications. The most frequently asked question is “are they safe?” Yes, they are safe and there are no known side effects.

MarcieMom: I read quite a few studies preparing for this interview and found that all of them measure the toxicity level in kidney and liver (and most conclude no toxicity effect). Why is this mentioned in the studies of TCM? Is there a risk of toxicity because the compounds in the herbal medicine are too potent?

Physician Lau: In fact, all medications including western medicine measures the toxicity level in the kidney and liver as these are important and immediate organs that has reactions to the medicine. All medication concoctions follow this benchmark.

MarcieMom: Thank you Physician Lau for the reply. Next week, we’d explore herbal bath and cream treatment options.

Traditional Chinese Medicine (TCM) Series – Understanding Eczema from TCM’s Perspective

TCM Physician Lau Kiew Teck with Raffles Medical Group

Many parents have asked me “What about TCM?” while others have suggested that I explore TCM as an eczema treatment option for my child. I’ve looked into TCM briefly in this archive post, but felt I didn’t know enough to evaluate it. For this TCM Series, I’ve the privilege of interviewing TCM Physician Lau Kiew Teck of Raffles Medical Group, Raffles Chinese Medicine Clinic, whose special interests include respiratory conditions, dermatology, pediatrics, diabetes and digestive system disorders.

More on Physician Lau: Physician Liu Qiao De graduated from Singapore College of Traditional Chinese Medicine in 1977 and has been practising TCM since. In the early 90’s, Physician Liu pioneered a Quit Smoking programme using auricular acupuncture. Physician Liu’s special interests include treating skin problems such as eczema and psoriasis. In pediatrics, he specializes in treating asthmatic conditions.

Eczema – A Multi-Factorial Condition

Eczema is a condition which is contributed by multiple factors like genetics, over-active immune system, damaged skin barrier, allergy, environment and persistence of staph bacteria residing on eczema skin. It is also a chronic condition, meaning treatment options are meant to manage the eczema instead of curing it.

From what I’ve read on the web, eczema is due to weaknesses or imbalances in body organs, in particular, the spleen, the lungs and the stomach, which leads to skin with eczema rash. Thus, various TCM options, such as herbal medicine and acupuncture, are ways to detoxify and strengthen these organs, specifically to (1) clear heat, (2) remove dampness and (3) remove wind.

Marcie Mom: Physician Lau, is this also TCM’s stand on eczema – that it is multi-factorial and chronic? Kindly help us understand the factors (from TCM’s perspective) that contribute to eczema and whether TCM is a treatment option to manage or to cure eczema. Can the factors/ causes of eczema be reconciled between TCM and western medicine?

Physician Lau: Eczema is both multi-factorial and chronic condition that is contributed by genes, immune system, damaged skin, allergy and environment. TCM focuses on the holistic approach where a combination of treatment of acupuncture and herbs are used. Patients can choose to use either TCM or western medicine or both to treat eczema; we don’t enforce any specific arrangement.

Foods to Avoid for an Eczema Patient

I read from the web that food and beverage such as alcohol, coffee, sugar, spicy food and deep-fried food are to be avoided. Also for fruits deemed “heaty” such as durian, mango, longan and lychee. Foods that are “cooling” such as green beans are encouraged.

MarcieMom: Physician Lau, can you help to explain “heaty” versus “cooling” food? Most of us in Asia are familiar with the use of “heaty” and “cooling” but it’s seldom heard of by our readers in US, UK and Canada.

Physician Lau: Food only becomes heaty or cooling when your body reacts to the food. In general, the food in its nature is heaty or cooling based on its properties.

MarcieMom: Above foods such as alcohol and spicy food are top triggers of eczema, while sugar and deep-fried food are inflammatory (further explained in this post). Green bean is an anti-inflammation food, featured in this post. Anti-inflammatory foods include those that contain anti-oxidants, Vitamin C, carotenoids, flavonoids, quercetin and kaemferol that can reduce oxidation, fight free radicals and inflammation.  Can I then understand the “heaty” food that TCM recommends to avoid as being inflammatory and those to have more as having anti-inflammatory compounds? 

Physician Lau: Fried and spicy food and alcohol in general.

MarcieMom: Thanks Physician Lau for replying to these questions – TCM still seem to be a complicated topic to understand and hope to learn more in next week’s interview.

Oliva Forte – Could its patented HIDROX, extracted from olives, help your child’s eczema through its anti-inflammatory property? (Cont’d)

Outstanding Application in Health Management in the Nutraceutical Business Technology Award ceremony in May 2011, Geneva

This is a continuation of the interview with Mr ManHon Shiew, CEO, CreAgri International on OLIVA Forte. You can read the 1st & 2nd parts of the interview here, here and on Mr ManHon here.

MarcieMom: What are the ingredients of Oliva Forte? I’ve read that allergy to olive is uncommon but are there additives used in Oliva Forte that parents ought to be aware of?

ManHon: There are several different products under the OLIVA Forte umbrella – ESSENCE, EASEFLEX and ENCHANT.  ESSENCE contains pure HIDROX®, whilst EASEFLEX is made up of HIDROX® and Glucosamine for joint health and ENCHANT is formulated with HIDROX® and Alpha Lipoic Acid for skin health and whitening effect. There are no other additives that should worry anyone. If a person is not allergic to olives, glucosamine or alpha lipoic acid, he can safely consume OLIVA forte. For parents who are thinking of giving OLIVA forte to their children, they should consider ESSENCE, since it is the purest form with no additives.

MarcieMom: Can you share with us if CreAgri controls the manufacturing process of Oliva Forte or is this part of the value chain handled by another party that purchases HIDROX® from CreAgri?

ManHon: As you know by now, CreAgri controls the manufacturing process and parameters of HIDROX®. Product formulations using HIDROX® are also developed by CreAgri. The actual production of finished products is contracted to external factories. These factories execute production based on parameters set by CreAgri.

Marcie Mom: Specifically on HIDROX®, it is made of the polyphenol known as hydroxytyrosol which has strong anti-inflammatory properties. It works by inhibiting nitric oxide and and prostaglandin which are pro-inflammatory compounds, protect against the damaging effects of free radicals and also aids reduction of ‘bad cholesterol’ (read more benefits on Dr Perricone’s website). Versus directly eating olives, it contains higher antioxidant effects as antioxidants are lost in the processing of olives for sale (see here for more FAQ).

I noted in your website that clinical trials for skin orders that include eczema have been conducted but the sample size is 10 patients. Are there other trials of a larger sample size?

ManHon:  You must be referring to the small trial conducted by Prof Fujio Numano from the Tokyo Vascular Institute. In addition to that, I like to draw your attention to a larger trial with more than 100 patients conducted by Arizona State University. More significantly is that this larger study was a double blinded placebo control trial. The results from this study confirm the anti-inflammatory properties of HIDROX®.

Marcie Mom: There are various product ranges in Oliva Forte – which one is recommended for children with eczema? What is the dosage recommended for children? And given that it is a very potent antioxidant, is there a need to take precautions when taking Oliva Forte? Is there certain food to take with Oliva Forte to ensure it can be better absorbed into the body? What is the difference between taking Oliva Forte and taking HIDROX® which is available in your online store in the form of powder? Can Oliva Forte be used as olive oil, e.g. in bath, removal of cradle cap?

ManHon: Let me first get the easy part of your question out the way. OLIVA Forte is formulated for consumption (ingestion) as capsule or in its natural liquid form. It is not suitable to be use topically as a bath additive or to remove cradle cap.

Now that we have clarified that, we recommend OLIVA Forte ESSENCE liquid for children with eczema. This allows parents to conveniently feed even young children who are not able to swallow capsules.  The liquid can be dropped into their favorite juices or just plain water. The natural olive flavour will remind children of their pizza with olive toppings!  The dosage for children below 6 years is 0.5mL TWICE a day whilst those above 6 (including adults) are recommended to take 1mL TWICE daily.  If the child is able to swallow capsules without problem, the equivalent is for them to take OLIVA Forte ESSENCE capsules. One capsule is the bio equivalent of 1mL of liquid.

HIDROX® is an ambiphilic molecule which means it is soluble in water as well as fat. This means you can consume OLIVA Forte either with or without food. CreAgri has conducted bioavailability studies (absorption) to show that HIDROX® is absorbed within minutes into the blood stream. This makes OLIVA Forte a highly versatile product with proven efficacy for eczema and other inflammatory conditions.

You can find out more about HIDROX® and see the organic farm in California including the Integrale Process in this video on CreAgri’s YouTube channel.

Marcie Mom: Thanks ManHon for being patient with me and answering all my questions on Olive Forte, it’s always a pleasure to meet a company that is open about its products. p.s. to readers of, I didn’t receive any money from Steward Cross, CreAgri or Oliva Forte for this interview.

Oliva Forte – Could its patented HIDROX, extracted from olives, help your child’s eczema through its anti-inflammatory property? (Cont’d)

CreAgri process olives in a more eco sustainable way and successfully eliminate toxic substances from the waste stream.

This is a continuation of the interview with Mr ManHon Shiew, CEO, CreAgri International on OLIVA Forte. You can read the first part of the interview here and on Mr ManHon here.

MarcieMom: Can you share with us what differentiates Integrale Process from other competitors that also extract polyphenol from olives (who also state the extraction process is solvent-free and chemical-free)?

ManHon:  The patented Integrale Process is different from other methods in several ways. CreAgri is always interested to preserve the integrity of the environment has always made this goal paramount to the company’s philosophy. CreAgri process olives in a more eco sustainable way and successfully eliminate toxic substances from the waste stream. It starts off with organic olives that are grown without use of any chemicals and pesticides.

Integrale focuses on retaining olive polyphenols in their original matrix instead of selectively extracting hydroxytyrosol the most potent molecule of all olive polyphenols.  Unlike other methods, Integrale does not actually “extract” polyphenols.  Any molecular extraction is only possible with the use of solvent. Instead, Integrale relies on the natural process of hydrolysis and incubation (between 6-8 months) to produce a unique olive polyphenol blend that is rich in hydroxytyrosol along with its naturally occurring sibling molecules such as tyrosol and oleuropein. If you care to read the patents of other competitors selling hydroxytyrosol and who claim “solvent-free” extraction process, you will invariably discover that those methods DO employ the use of alcohol solvents such as ethanol and methanol. We have even seen methods that employ industrial chemicals such as sulphuric acid (H2SO4) being promoted as “chemical free”.

This explanation is not complete without also explaining the importance and significance of retaining hydroxytyrosol and other olive polyphenols together in its natural state and balance. CreAgri holds the view that the benefits of natural molecules are most optimal when consumed as close to its natural state. Several studies have been published to show that hydroxytyrosol are more easily absorbed when consumed in a form that includes other polyphenols (Gonzales-Santiago 2010)  and more critically, that hydroxytyrosol if consumed as a single molecule (pure form) could in fact be harmful (Acin 2006). Both studies advocate the consumption of olive polyphenols in their natural form without extraction. The olive oil is a natural state of fatty acids recovered from the olive, whilst HIDROX® is the natural state of water fraction from the olive fruit.  This is the major difference between Integrale and other methods.

Coincidentally, CreAgri’s leadership in thought and polyphenol research was recognized recently by the International Society of Antioxidants in Nutrition and Health which accorded the company with the prestigious Paris Polyphenol 2012 award.

Marcie Mom: Also, I noted that formulation of HIDROX® is done at your R&D facility in California. What is unique about HIDROX® formulation (also why is formulation required after the polyphenol is extracted)?

ManHon: Hopefully by now, my explanation about the uniqueness of HIDROX® will help shed some light to this question. Since HIDROX® is a proprietary blend of olive polyphenols and not a standardized molecule, there is a need to ensure that the product meets the specification of formulation previously tested to be clinically efficacious. HIDROX® formulation is the core intellectual property of CreAgri and is kept in house as a matter of policy.  In this way, HIDROX® is always differentiated from other competing products.

MarcieMom: Thanks, it is very good to see a CEO taking the time to explain to its users on the process, instead of giving ‘marketing’ terms. The next post will talk more about the ingredients and consumption for kids.

Oliva Forte – Could its patented HIDROX, extracted from olives, help your child’s eczema through its anti-inflammatory property?

Hidrox – Awarded the Outstanding Application in Health Management in the Nutraceutical Business Technology Award ceremony in May 2011

MarcieMom was contacted by Steward Cross Pte Ltd, a pharmaceutical sales and marketing company, on their charity sales of the product Oliva Forte where 20 per cent of the proceeds would go to the Singapore eczema fund (a fund that is initiated by my donation and administered by the Asthma Association).

Oliva Forte is a health supplement containing HIDROX®, a standardised freeze dried blend of organic olive juice patented by CreAgri Inc, a US company that specializes in the development of olive and antioxidant polyphenols. As you know, MarcieMom doesn’t do product review but is open to understanding more of products that are targeted for eczema patients, so that you can have your questions answered before deciding on a purchase.

For this interview, MarcieMom asked ManHon Shiew, CEO, CreAgri International to explain more about OLIVA Forte. CreAgri International is the international arm of CreAgri’s venture responsible to advance the application of HIDROX® in the field of human dietary supplement. In his role, ManHon leads his team to launch and promote their brands OLIVA Forte, OLIVENOL and OLIVENOL Plus in different international markets. You can read more on ManHon’s background in featured guest.

Marcie Mom: Thank you ManHon for taking time for this interview. Before we go into the product, let’s first understand the company behind it, CreAgri Inc. CreAgri is a California company founded by Dr Roberto Crea who has been granted over 25 patents in his career, and is one of the scientific co-founders of Genentech, Inc. Could you let us know more about CreAgri, specifically when CreAgri is started, the number of employees and scientists it employs and its research facility?

ManHon:  CreAgri was founded following a serendipitous sequence of events triggered by the curiosity of a scientist. Back in the late 90s, fresh off a successful disposal of one of his US biotech company to a major pharma, Dr Crea was holidaying in Italy, his home country. It was then that he was introduced to a new method of producing olive oil developed by scientists in the University of Rome. There was a lot of interest in the scientific and medical community at that time in the health benefits of olive oils and olive derivatives.  The olive oil industry was focusing on improving the quality olive oil. The method developed by the University of Rome produced very high quality oil. It was Dr Crea’s curiosity that led him to question if it was possible to recover equally beneficial molecules from the discarded portions of the olive oil industry. This led him to look into wastewater that was disposed after oil is separated.  In summary, it was through this early endeavour that Dr Crea discovered that olive polyphenols responsible for health benefit from olive oil are available in abundance in the wastewater. CreAgri was founded to develop and exploit the discovery made by Dr Crea.

From its inception in 2001, CreAgri’s R&D team of 5 research scientists was kept in house in California where Dr Crea resides. Clinical studies on products and formulation produced by CreAgri were conducted in collaboration with external institutions such Tokyo Vascular Institute and Arizona State University. A total of 20 other staff makes up the rest of CreAgri Inc.

MarcieMom: On the product, Oliva Forte – It contains HIDROX® and CreAgri HIDROX® has been awarded the Outstanding Application in Health Management in the Nutraceutical Business Technology Award ceremony in May 2011, Geneva. Olive Forte is an improved formulation of Olivenol TM and is derived from the juice of organic olives. Olive is a rich source of polyphenols, a family of natural compounds found in plant foods, which have been associated with anti-inflammatory, anti-oxidant, anti-microbial and anti-tumour properties. However, in the production of olive oil, active polyphenols in the form of olive juice is disposed as wastewater. What CreAgri does is grow its own certified organic olive farm in California, harvest the olives early (for higher level of polyphenol) and then use a proprietary process (“Integrale Process”) to extract the polyphenol. HIDROX® is certified GRAS, Generally Regarded as Safe, meaning it has passed safety tests recognized by FDA.

In the next post, ManHon answers MarcieMom’s questions on the Integrale Process.

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