Comment by jasonhansel
4 years ago
Unfortunate that we're doing so little to stop the massive increase in food allergy rates that has occurred over the past few decades. Labeling is good, but we should invest in prevention also.
4 years ago
Unfortunate that we're doing so little to stop the massive increase in food allergy rates that has occurred over the past few decades. Labeling is good, but we should invest in prevention also.
Is there enough of a scientific consensus on how to prevent food allergies to drive policy, or are you just talking about research at this point?
I've heard things like early exposure, breast feeding, and mother's nutrition can help, but always got the impression that allergies are pretty random.
> Is there enough of a scientific consensus on how to prevent food allergies to drive policy
To be honest, this may have already happened, but it would take a generation to see the effects. There was a major breakthrough on this a few years ago. I first heard about it on an episode of Science Vs [1]. That was merely weeks after my second child was born. It was interesting to see the advice from the pediatrician a few months later. The American Association of Pediatrics updated their advice accordingly [2], and my kids' pediatrician handed out informational fliers calling out "this has changed," etc. Hopefully other pediatricians are also updating their advice and doing a good job of educating families.
Check out the Science Vs episode [1] if you want details. The gist of it is that in a controlled study, they found that introducing allergens early reduced the prevalence of allergies by 86% compared to avoiding allergens. This means old advice (what I was told with my first-born) about avoiding allergens could actually increase the risk. The Science Vs episode goes into details about what led researchers to look into this and possible explanations about the mechanism involved.
[1]: https://gimletmedia.com/shows/science-vs/2ohd7e
[2]: https://publications.aap.org/aapnews/news/12250/New-guidelin...
I'm talking about research, but in particular research testing potential interventions.
There has been a fair amount of research (but no solid consensus) on why allergy rates are increasing.
But AFAIK there have been fairly few attempts to try to use any of those competing hypotheses to devise preventive treatments whose effectiveness could be tested experimentally.
There is actually pretty compelling evidence. Enough so that the AAP reversed its guidelines in 2017: https://publications.aap.org/aapnews/news/12250/New-guidelin....
Where I live it's advised to introduce peanuts early to kids (before 8 months) because of this research
Yes. Early introduction of foods is proven to dramatically reduce allergies, and not just for peanut. Everyone should be doing it and we should have recommendations and guidelines for parents.
There is also a lot of evidence that SLIT and OIT are effective treatments for food allergies and most importantly that they are far more effective and safer when started very early, before 2 or even before 1 if possible. Early SLIT and OIT should be prioritized for research.
The current theory is that allergies exploded because our (first) world is too clean and the immune system needs something to do, so it focuses on what it can find - peanuts.
Citation? I think there might be a bit of "telephone game" happening here. The current science shows that avoiding allergens increases the risk of developing allergies. The hypothesis for how that happens is that if an infant's first exposure to an allergen is on their skin (e.g., peanut oil), then their body may classify it as invasive and develop anti-bodies to attack it. If they are first introduced to an allergen as food, then their body classifies it as food. By avoiding feeding allergens to infants, you increase the time window for their bodies to be exposed through the skin and classify it as invasive. I could certainly see this idea transmuting through word of mouth into the "first world is too clean" idea in your comment, but that's pretty far off.
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Anecdotally, this is insufficient to explain the evidence.
I have approximately no allergies but was exposed to a very diverse and not sterile environment from early on, with other siblings being similar. I have two brothers close to my age that did have significant and in some case deadly allergies, who were born and raised in the same environment.
Among my siblings, it is a completely mixed bag of sensitivity. Some were highly sensitive to many things, others were sensitive to almost nothing. If mere exposure to non-sterile environments was sufficient then we should all have had similar sensitivity to allergens but the variance in fact was quite high.
It is a current theory. It is far from being the current theory, and IMO a woefully insufficient one. I'm not a clean freak by any means and still developed a couple dozen food allergies as an adult. Ultimately the immune system is hopelessly complex and this will likely take decades more for us just to arrive at the right theory.
But this is kind of strange, as for example in France, you definitely don't see the same level of allergies as in the US.
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Yes. It’s been proven that if you expose babies to all the allergens early on they never develop the allergy.
But not only that. If they already have the allergy, you can actually cure it by slowly building up exposure until they stop reacting to it.
> If they already have the allergy, you can actually cure it by slowly building up exposure until they stop reacting to it.
Very important to note that not everyone can be cured this way, it can be dangerous even fatal, and under medical supervision only. Far too many people think they can cure their own allergy, allergies aren't "real," or cases of grandparents trying to YOLO fix their grandkid by putting small amounts of e.g. peanuts in their food and causing airway obstruction.
This research is, undeniably, exciting, but people overstate it and act like we could just roll it out to everyone with allergies and they'd disappear (and that everyone who still has allergies is "choosing" to). That isn't at all where the science is at today.
I can't eat gluten. I ate plenty of wheat growing up, and suddenly developed a problem digesting it at 18. I was on a full-gluten diet when diagnosed and still felt sick all the time.
So, as someone who was exposed as a baby, and was pretty much doing maximal exposure therapy, you need to write better test cases.
Obviously I don't disagree with you, but trust me, this mountain is far steeper than anyone tends to think. Medical science has absolutely zero clue why my body decided to become allergic to roughly 30 different foods at age 30 after a lifetime of eating whatever I wanted.
The reality is that we are decades away from solving this, if ever. Not to mention the vast majority of science is funneled towards child food allergies, which ironically are the only kind to go away. If the mechanisms involved were similar, I wouldn't have a problem, but it's very possible that child and adult food allergies have completely different causes. People such as myself who develop food allergies as an adult are very simply fucked.
Beyond that, just look at the sickening replies in this very thread. On the whole people view people like me as a nuisance and would rather us die than deal with whatever comparatively minuscule alterations to their lives required to accommodate us. You wouldn't believe the things people have done and said to me to my face. It's one of the more invisible disabilities for sure.
Prevention would ideally be reducing the rates of food borne allergies, in as much as it is possible to do so.
After having two flights recently where our food service was cancelled due to a flyer with a nut allergy, I’m ready for us to invest whatever it takes to reverse this trend.
How long was the flight? I can see this being an issue for people with some other health conditions - type 1 diabetics come to mind. If it's a long flight and they assume food service and then it's removed and they have nothing to eat for their blood sugar, that's not great.
If getting food on a flight is a medical issue, someone should be bringing their own food.
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you can always ask the flight attendant for food. they have something
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This made me chuckle, imagining us starting a Manhattan Project for allergies because Delta didn't distribute their customary snack packet one too many times.
I mainly meant that if the quantity of people who can die from simple exposure to food is now such a high proportion of the population that I’m regularly encountering it in this and other contexts, that seems like a significant enough potential loss of lives/reduction in quality of life to merit a serious effort to fix the problem.
I am curious why airlines seem to be the holdouts regularly putting nuts in everything/distributing nuts as the main snacks. And they all do it.
And early family support. Since my wife can die from a sesame seed, this topic is naturally important in our family. We have read the research we've found and tried to do what we could, but we got no external support for this -- if it hadn't been important to us it wouldn't have happened at all.
It's particularly tricky with sesame exposure. Since we can't have it at home, we have no idea how our children react to it. Relatives did promise to throw hummus parties, but those never happened and now everyone is afraid to be the one who almost killed our child, naturally.