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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 th

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.

MagicMoonlight 4y ago
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.
- Someone1234 4y ago
  > 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.
- nsilvestri 4y ago
  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.
jasonhansel 4y ago
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.
- CorrectHorseBat 4y ago
  Where I live it's advised to introduce peanuts early to kids (before 8 months) because of this research
- davidcuddeback 4y ago
  There is actually pretty compelling evidence. Enough so that the AAP reversed its guidelines in 2017: https://publications.aap.org/aapnews/news/12250/New-guidelines-detail-use-of-infant-safe-peanut-to https://publications.aap.org/aapnews/news/12250/New-guidelin....
323 4y ago
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.
- elzbardico 4y ago
  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.
  - PaulHoule 4y ago
    I'm not sure if French people would think life is worth living if you couldn't eat the same food as everyone else.
    - m000 4y ago
      As Ivan Drago would say: If he dies, he dies.
  - chihuahua 4y ago
    Maybe it's because peanut butter is extremely popular in the U.S., but not very popular in most other countries?
    - elzbardico 4y ago
      I don't know. Lots of Chinese food have peanuts, as well as some Indian foods. Some regions in Brazil too. I know that as a child in Brazil, I ate a lot of "paçoca" which as peanut based sweet. Never ever heard of peanut allergies in my childhood.
- davidcuddeback 4y ago
  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.
davidcuddeback 4y ago
> 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 https://gimletmedia.com/shows/science-vs/2ohd7e [2]: https://publications.aap.org/aapnews/news/12250/New-guidelines-detail-use-of-infant-safe-peanut-to?autologincheck=redirected https://publications.aap.org/aapnews/news/12250/New-guidelin...
modeless 4y ago
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.

MagicMoonlight 4y ago

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.

Someone1234 4y ago
> 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.
nsilvestri 4y ago
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.

jasonhansel 4y ago

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.

CorrectHorseBat 4y ago
Where I live it's advised to introduce peanuts early to kids (before 8 months) because of this research
davidcuddeback 4y ago
There is actually pretty compelling evidence. Enough so that the AAP reversed its guidelines in 2017: https://publications.aap.org/aapnews/news/12250/New-guidelines-detail-use-of-infant-safe-peanut-to https://publications.aap.org/aapnews/news/12250/New-guidelin....

323 4y ago

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.

elzbardico 4y ago
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.
- PaulHoule 4y ago
  I'm not sure if French people would think life is worth living if you couldn't eat the same food as everyone else.
  - m000 4y ago
    As Ivan Drago would say: If he dies, he dies.
- chihuahua 4y ago
  Maybe it's because peanut butter is extremely popular in the U.S., but not very popular in most other countries?
  - elzbardico 4y ago
    I don't know. Lots of Chinese food have peanuts, as well as some Indian foods. Some regions in Brazil too. I know that as a child in Brazil, I ate a lot of "paçoca" which as peanut based sweet. Never ever heard of peanut allergies in my childhood.
davidcuddeback 4y ago
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.

davidcuddeback 4y ago

> 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 https://gimletmedia.com/shows/science-vs/2ohd7e [2]: https://publications.aap.org/aapnews/news/12250/New-guidelines-detail-use-of-infant-safe-peanut-to?autologincheck=redirected https://publications.aap.org/aapnews/news/12250/New-guidelin...

modeless 4y ago

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.