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Allergies

The rise of food allergies and First World problems

All of a sudden, everyone’s allergic to something. What happened? The rise of allergy is likely due to a number of factors that are mostly the result of an increasingly wealthy, sophisticated, modern Western society. In other words, First World Problems.

IF YOU have spent any time inside an elementary school classroom over the past few years, you have likely noticed signs banning peanuts or other types of food. The bans, which can apply to individual classrooms or entire school systems, are relatively new, especially in their widespread use. Teachers, aides, and other administrators are now frequently trained in the use of EpiPens, an auto-injector that can deliver a life-saving dose of epinephrine to a child.

The reason for all the precaution: the dramatic rise in food allergies among children over the past two decades. The exact numbers are up for debate, but the general trend is not. A study of 40,000 families conducted by Dr Ruchi Gupta from Children’s Memorial Hospital and an associate professor of pediatrics at Northwestern University’s School of Medicine found that eight percent of kids had a food allergy.

Another found that almost 15 million children were allergic to cow’s milk, egg, soy, wheat, peanuts, tree nuts, shellfish, or fish.

Dr Scott H Sicherer, a professor of pediatrics and chief of the Division of Allergy and Immunology at The Mount Sinai Medical Center’s Jaffe Food Allergy Institute conducted a random calling in 1997. It showed one in 250 children were allergic to peanuts. When they did the same study in 2008, the number jumped to one in 70.

“That sounds crazy, because it’s a tripling, but the numbers from other countries are similar,” the American Academy of Allergy, Asthma & Immunology (AAAAI) fellow said, pointing to similar studies with similar results from Canada, the UK, and Australia. (Hay fever, asthma, and eczema are also on the rise.)

Is the rise due to increased awareness about allergies or an actual rise in the percentage of people developing allergies? Allergists in the field generally agree that it’s a little bit of the former but more of the latter.

“We are convinced that there has been a true increase above and beyond better recognition,” said Dr Robert Wood, who works at the Johns Hopkins University School of Medicine and is a colleague of Sicherer’s at the AAAAI. Dr. Kevin McGrath, an allergist and fellow of the American College of Allergy, Asthma and Immunology, agrees: “People are more aware of it so it’s getting diagnosed more, but I think there’s also a real increase.”

Anecdotally, those observations bear out as well. The country, hopefully, would have noticed if school children kept falling into anaphylactic shock 25 years ago.

PEOPLE DEVELOP ALLERGIES BASED on both genetics and environment. Sicherer and his team ran a study of peanut allergies on identical and fraternal twins. While only seven percent of fraternal twins had the same allergy, in identical twins—kids with the same genes—the rate of allergy was two-thirds.

“That tells you two things,” he said. “One is that there’s a strong genetic component. But on the other hand, one-third of the identical twins didn’t share the allergy. So environment has a lot to do with it. And for the rate of allergies to increase over a 20-year period, clearly there is some environmental thing going on because genes don’t change that quickly.

Environmental factors include a wide variety of things. For example, scientists have found that a child who grows up on a farm or lives in a family with at least one other sibling is less likely to develop allergies. (Interestingly, if they do, however, they are more likely to get asthma as well.)

These facts and observations lead, meanderingly, to one of the leading theories about the rise of allergies. The so-called Hygiene Theory states that changes in our environment—things like cleaner water, fewer parasites, and the use of antibiotics—have resulted in changes in the body, specifically the immune system.

An allergy is nothing more than the immune system’s response against proteins in the body and the environment. According to the Hygiene Theory, the immune system can’t find anything harmful to attack, so it mistakes harmless food protein (or pollen, cat dander, etc) for something invasive that needs to be remedied.

The Hygiene Theory has many advocates, and it’s likely part of the picture, but it’s not the entire explanation…..

Pacific Standard: Read the full article

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