6 ms·

I still can’t get over that the official guidelines for years were the opposite of this, and it seems to have led to a tremendous increase in severe peanut alle

by dap 4y ago

I still can’t get over that the official guidelines for years were the opposite of this, and it seems to have led to a tremendous increase in severe peanut allergy. I get that public health organizations have to make recommendations in the face of uncertainty. But to get it so wrong, with severe consequences — was there a postmortem or investigation of how that happened? How are people to trust public health guidelines when that stuff happens without explanation?

azinman2 4y ago
If you zoom out, people used to use leaches for disease. Humans generally go through waves of health care trends. Generally speaking the progress gets better over time.
- boomboomsubban 4y ago
  Leeches are still used in some medical situations, usually various types of tissue grafting.
  - hguant 4y ago
    Or in any situation where there's necrotic tissue! They're incredibly selective about only eating dead tissue.
    - GrinningFool 4y ago
      Those would be maggots. Leeches are the blood drinkers.
- slingnow 4y ago
  What does one have to do with the other? We live in a time of significantly more advanced medicine and understanding of the human body. Just because we used to do something questionable in the past doesn't give a free pass for people to make boneheaded decisions in the present day. It still makes sense to ask why we got this so wrong. Not just "this technique doesn't work the way we thought it did". We're talking COMPLETELY backwards.
  - magicalist 4y ago
    It's absolutely not backwards. More children developed allergies (almost definitely because of the lack of exposure), but it wasn't known that would happen. What we did know is not exposing children to a trigger of anaphylaxis would prevent them from dying from anaphylaxis, so, similar to many dangers, the most logical course of action is to remove the risk altogether. Yes, it's well known doing that with anything can have unknown secondary effects, but there's also a million everyday things we logically don't let infants do or be exposed to that we aren't establishing the statistical significance of either. Incidentally, with all of our advanced medicine and understanding of the human body, we still don't understand why some people develop severe allergic reactions to some foods and others don't, so let's not pat ourselves too hard on the back for developing better food exposure protocols from trial and error over decades.
    - dap 4y ago
      > It's absolutely not backwards. But it is. The best population-level guidance (now) is early exposure. We told people to do the opposite. The result was a lot more kids with anaphylaxis-level allergy. (I don't know if this increased the total number of people who died. That'd be an interesting question, but given that we reversed the guidance, I assume from a public health perspective people now believe the original guidance was exactly the wrong thing to do.) The best you can say is this was the best we knew at the time, but it's exactly wrong. > What we did know is not exposing children to a trigger of anaphylaxis would prevent them from dying from anaphylaxis, so, similar to many dangers, the most logical course of action is to remove the risk altogether. I think you mean that it's intuitive, but I don't think it's logical, for exactly the reason that it turns out not to be a good idea. It's based on a wrong model of how the world works. Yes, that wasn't known. But I feel like we have to account for the fact that we might not know everything. (Admittedly, this drives me particularly nuts because I think this fallacy pervades so much public health advice, especially for kids.) Like I said above, I get that people need to make recommendations in the face of uncertainty. But I feel like when we find that we've recommended the exact opposite of what was good (i.e., exactly flipped the previous guidance) with such severe consequences, it seems appropriate to step back and look at our methodology to ask if something went wrong or if there's something we can do to improve it?
- Gordonjcp 4y ago
  Leeches are awesome for haemochromatosis.
dboreham 4y ago
My understanding of this is that the original problem was children choking on whole peanuts. Hence the advice not to eat peanuts. This somehow got lost in translation and became "don't eat any peanut-based food". Disclosure: son has severe peanut allergy.
- dawnerd 4y ago
  Guessing same with honey? I hear people freak out a lot about infants having anything with honey in it. I feel it might be more along the choking lines with raw honey too.
  - Herodotus38 4y ago
    The problem with honey is that it can cause botulism. Infants under 1 are most susceptible.
    - mlindner 4y ago
      Honey is usually sold pasteurized though so botulism wouldn't be an issue. Just don't go for the fancy natural/raw stuff.
      - justusthane 4y ago
        I have a 6mo daughter, and coincidentally I was just reading about this earlier today in the childhood nutrition book "Food to Grow On". According to that book, botulism spores can survive the temperature that honey is pasteurized at (the same book does recommend feeding peanut products to young babies, so it is up-to-date with that area of research at least). Unless you're positive that botulism wouldn't be an issue in pasteurized honey, I would suggest qualifying your comment with a note that you're just speculating rather than stating it as a fact.
      - phyzome 4y ago
        I don't think honey is usually pasteurized. It's usually heated in the process of producing a clear product with no grittiness, but that's not necessarily pasteurization. And botulism spores are incredibly durable.
hot_gril 4y ago
Tradition easily beats science when it comes to diet because food science hasn't progressed far enough yet. I'll eat as similarly as possible to the way my great-grandparents ate, disregarding any contradicting health recommendations, which have always been wrong so far. The most scientific explanation I can give is that humans have evolved around their diets, which I recognize as a hand-wave. This works for nuts too. If people were fine with nuts for so long, I'm not going to believe that it's suddenly a problem. They made a first-world problem, and it's going to take more studies like this (this is just one) to conclude that scientifically.

by dap 4y ago

azinman2 4y ago

If you zoom out, people used to use leaches for disease. Humans generally go through waves of health care trends. Generally speaking the progress gets better over time.

boomboomsubban 4y ago
Leeches are still used in some medical situations, usually various types of tissue grafting.
- hguant 4y ago
  Or in any situation where there's necrotic tissue! They're incredibly selective about only eating dead tissue.
  - GrinningFool 4y ago
    Those would be maggots. Leeches are the blood drinkers.
slingnow 4y ago
What does one have to do with the other? We live in a time of significantly more advanced medicine and understanding of the human body. Just because we used to do something questionable in the past doesn't give a free pass for people to make boneheaded decisions in the present day. It still makes sense to ask why we got this so wrong. Not just "this technique doesn't work the way we thought it did". We're talking COMPLETELY backwards.
- magicalist 4y ago
  It's absolutely not backwards. More children developed allergies (almost definitely because of the lack of exposure), but it wasn't known that would happen. What we did know is not exposing children to a trigger of anaphylaxis would prevent them from dying from anaphylaxis, so, similar to many dangers, the most logical course of action is to remove the risk altogether. Yes, it's well known doing that with anything can have unknown secondary effects, but there's also a million everyday things we logically don't let infants do or be exposed to that we aren't establishing the statistical significance of either. Incidentally, with all of our advanced medicine and understanding of the human body, we still don't understand why some people develop severe allergic reactions to some foods and others don't, so let's not pat ourselves too hard on the back for developing better food exposure protocols from trial and error over decades.
  - dap 4y ago
    > It's absolutely not backwards. But it is. The best population-level guidance (now) is early exposure. We told people to do the opposite. The result was a lot more kids with anaphylaxis-level allergy. (I don't know if this increased the total number of people who died. That'd be an interesting question, but given that we reversed the guidance, I assume from a public health perspective people now believe the original guidance was exactly the wrong thing to do.) The best you can say is this was the best we knew at the time, but it's exactly wrong. > What we did know is not exposing children to a trigger of anaphylaxis would prevent them from dying from anaphylaxis, so, similar to many dangers, the most logical course of action is to remove the risk altogether. I think you mean that it's intuitive, but I don't think it's logical, for exactly the reason that it turns out not to be a good idea. It's based on a wrong model of how the world works. Yes, that wasn't known. But I feel like we have to account for the fact that we might not know everything. (Admittedly, this drives me particularly nuts because I think this fallacy pervades so much public health advice, especially for kids.) Like I said above, I get that people need to make recommendations in the face of uncertainty. But I feel like when we find that we've recommended the exact opposite of what was good (i.e., exactly flipped the previous guidance) with such severe consequences, it seems appropriate to step back and look at our methodology to ask if something went wrong or if there's something we can do to improve it?
Gordonjcp 4y ago
Leeches are awesome for haemochromatosis.

dboreham 4y ago

My understanding of this is that the original problem was children choking on whole peanuts. Hence the advice not to eat peanuts. This somehow got lost in translation and became "don't eat any peanut-based food". Disclosure: son has severe peanut allergy.

dawnerd 4y ago
Guessing same with honey? I hear people freak out a lot about infants having anything with honey in it. I feel it might be more along the choking lines with raw honey too.
- Herodotus38 4y ago
  The problem with honey is that it can cause botulism. Infants under 1 are most susceptible.
  - mlindner 4y ago
    Honey is usually sold pasteurized though so botulism wouldn't be an issue. Just don't go for the fancy natural/raw stuff.
    - justusthane 4y ago
      I have a 6mo daughter, and coincidentally I was just reading about this earlier today in the childhood nutrition book "Food to Grow On". According to that book, botulism spores can survive the temperature that honey is pasteurized at (the same book does recommend feeding peanut products to young babies, so it is up-to-date with that area of research at least). Unless you're positive that botulism wouldn't be an issue in pasteurized honey, I would suggest qualifying your comment with a note that you're just speculating rather than stating it as a fact.
    - phyzome 4y ago
      I don't think honey is usually pasteurized. It's usually heated in the process of producing a clear product with no grittiness, but that's not necessarily pasteurization. And botulism spores are incredibly durable.

hot_gril 4y ago

Tradition easily beats science when it comes to diet because food science hasn't progressed far enough yet. I'll eat as similarly as possible to the way my great-grandparents ate, disregarding any contradicting health recommendations, which have always been wrong so far. The most scientific explanation I can give is that humans have evolved around their diets, which I recognize as a hand-wave. This works for nuts too. If people were fine with nuts for so long, I'm not going to believe that it's suddenly a problem. They made a first-world problem, and it's going to take more studies like this (this is just one) to conclude that scientifically.