Mayo Clinic Q And A: Number Of Children With Peanut Allergies Has Increased Significantly
DEAR MAYO CLINIC: Why is it that so many kids these days have peanut allergies? I dont remember it being an issue even 20 years ago. Is it something most kids will grow out of? I have heard of children doing a peanut allergy study to cure them of their allergy. What does that involve?
ANSWER: Youre correct that the number of children with peanut allergies has increased significantly over the last several decades. Although researchers have several theories, at this time theres no definitive explanation for the increase. A variety of studies are currently underway to better understand peanut allergies and to help find more effective ways of treating them.
Over the last several decades, the prevalence of peanut allergies in children in the United States has more than tripled. The reasons behind this dramatic increase are unclear. Lifestyle, diet choices and genetics all seem to play a role.
For example, one theory, called the hygiene hypothesis, highlights how the way people who live in developed countries may have an impact on childhood allergies, including peanut allergies. Babies born in developing countries have lower incidence of allergies than those in developed countries. But if a family moves to a more developed country, their childrens incidence of childhood allergies increases. So simply being in the environment of a developed country seems to change things.
Why Are Schools Telling Other Kids Not To Bring In Certain Foods To School Cant You Just Tell The Kids With Food Allergies Not To Eat Those Foods
Children can react to an allergen by eating a food theyre allergic to. They can also react by touching something that has traces of that food on it, such as peanut butter residue. Usually this will result in a local reaction like hives. If they have traces of food on their hands and put their hands in their mouth, they can have a more severe reaction.
Peanut Allergies Are On The Rise But So Are Lots Of Allergies
Trends in Allergic Conditions Among Children: United States, 1997-2011
The overall increase in allergies is still a big mystery in epidemiology. One of the leading explanations is the hygiene hypothesis, which posits that society has become too clean and hygienic. Essentially, children aren’t exposed to enough bacteria, viruses, and possible allergens early on, which in turn inhibits the development of their immune system. That leads to more problems later on, including allergies and asthma. Researchers are still trying to figure out if this hypothesis is true.
As for peanut allergies specifically, another new hypothesis is that Americans tend to eat their peanuts dry roasted and something about the roasting process introduces problematic molecules. A recent study published in the Journal of Allergy and Clinical Immunologyfound that dry-roasted peanuts cause more allergies in lab mice. But this is still far from conclusive. Many effects found in lab mice turn out to not translate to people.
Meanwhile, there’s been a long debate about what actually causes peanut allergies to form in individual people. Allergies arise from a combination of genetic and environmental factors and both of these are still being researched.
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Food Allergies: Are More Kids Allergic To Food Or Are We Just More Aware
From peanut-free school lunches to gluten-free birthday parties. If it seems like more and more kids have food allergies these days youre not alone in that thought. Most likely youve even had discussions with other parents about how food allergies werent an issue when you were growing up, and that everyone ate peanut butter and jelly sandwiches back in our day.
Exposure To Peanuts: Timing Is Everything
While there is a genetic aspect to allergies, some experts argue that an allergy can be primed if a subject is exposed to large amounts of that particular food before a certain age. For example, if the body has such a strong negative reaction, it may learn to always negatively react to that substance in the future.
Twenty years ago, shortly after the rapid rise of peanut allergies in the population, experts recommended waiting until after three years of age before exposing children to peanuts, and even recommending that women reduce their peanut or tree nut consumption during pregnancy to minimize the risk of the infant having the allergy. A little more than a decade later, more research had been done on the dietary patterns and peanut allergy frequency of children in other countries, where peanut exposure is made when kids are very young, even as young as four months. It was found that the likelihood of peanut allergies in those settings was very low.
In short, there isnt a definitive reason as to why peanut allergies are suddenly wreaking havoc across Westernized countries, denying an entire generation of PB& J joy. However, it is likely a combination of slightly weakened immune systems as a result of hygiene-obsessed behavior, a shift in our overall diet towards high-sugar and low-fiber diets, and a change in how we are exposing our children to different foods and other substances in the world.
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Precautions At School & Child Care
If youre the parent of a child with a peanut allergy, letting your child eat with friends at school or day care can be nerve-wracking. Even if youre careful about choosing safe foods, you worry about the food in the lunchboxes of all the other kids.
If you dont have food-allergic kids, the peanut guidelines in schools, preschools, day care centers, and after-school activities can be frustrating. Sometimes class treats have to be peanut-free. Sometimes parent-provided treats are prohibited altogether. And sometimes all kids are restricted from bringing peanut-containing foods in their lunchboxes. Its already difficult enough to pack nutritious lunches for picky young eaters. Having to keep them peanut-free adds to the challenges.
Until we have better methods for preventing allergic reactions to peanut, these inconveniences are an important safeguard. After all, if your child could go into anaphylaxis just from sharing a cookie with his friend at lunch, you would be frightened too.
Sometimes parents ask why its just peanuts that are restricted by these guidelines. If there are milk-allergic kids in the class, or kids with wheat allergy, why arent those foods restricted? The reasoning has to do with the severity of peanut allergy reactions, how quickly they strike, and how common they are.
That being said, MOST kids are not allergic, so most kids can eat peanuts just fine. If youre not allergic to peanut, eating it will not hurt you.
Is Peanut Allergy The Only Allergy That Is Serious What About Other Foods
Many foods in addition to peanuts can cause a serious allergic reaction. When children come into contact with the foods to which they are allergic, they can develop symptoms. This is an allergic reaction. Foods that cause an allergic reaction are called allergens. Sometimes, these reactions can be severe and life-threatening. No one can predict how severe a reaction will be.
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What Is Hygiene Could Changes In Hygiene Explain The Rise In Pediatric Asthma 19602000
In 1980 David Strachan, proposed that repeated exposure to respiratory or other infections could decrease allergic disease. At that time, his observations were primarily related to infections transmitted by older siblings. However, those observations were made on the basis of data within a country where water had been clean for many years, parasitic helminths were not a major problem, and only a small proportion of the population were exposed to farm animals. By contrast, in Africa, India, and South America there are today many pre-hygiene communities where i) water supplies are contaminated by untreated sewage, ii) helminth infection is common, iii) children go barefoot and iv) the houses are not a place where children would choose to stay during the day.
In addition, to studying differences between countries with a fully modern pattern of allergic disease and pre-hygiene communities there are three models where it is possible to study the effect of differences in hygiene within a community:
Countries such as Kenya, Ghana or Ecuador where changes are occurring currently.
Villages and small towns in Europe where farming families live close to non-farming families, .
The effects of having a pet or pets in the home.
Delaying Peanut Introduction Led To Peanut Allergy Spike
When many of us were babies, our parents and grandparents fed us solid foods whenever we were ready to eat themeven foods that were common causes of allergies.
According to Dr. Jonathan Spergel , around the 1960s, infants would begin eating foods like peanut products starting at just a few months of age. At that time, food allergy prevalence was very low.
Until the 1990s, doctors also recommended introducing allergy-causing foods like peanut early, in babys first year of life.
But in the late 1990s and early 2000s, doctors changed their approach. They mistakenly thought that delaying the feeding of peanut for several years was the best approach to preventing peanut allergies.
In fact, the American Academy of Pediatrics issued a recommendation in 2000, which directed parents to avoid feeding baby peanuts until they reached the age of three, especially if a baby was at high risk for a peanut allergy.
But when these recommendations to delay feeding peanut were introduced, there was no study to support these recommendations. Rather, they were just based on physicians guesses.
As Dr. Spergel explains, Back then, we gave people really bad advice. We told people to avoid food allergens But there was never any evidence for this. It was just based on a few physicians best guess. Theres never been any study that ever proved that food avoidance worked.
Learn more about the rise in food allergies from Dr. Spergel:
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Where Are Food Allergies Most Likely To Occur
The frequency of food allergy has increased over the past 30 years, particularly in industrialised societies. Exactly how great the increase is depends on the food and where the patient lives.
For example, there was a five-fold increase in peanut allergies in the UK between 1995 and 2016.
A study of 1,300 three-year-olds for the EAT Study at King’s College London, suggested that 2.5% now have peanut allergies.
Australia has the highest rate of confirmed food allergy. One study found 9% of Australian one-year-olds had an egg allergy, while 3% were allergic to peanuts.
The increase in allergies is not simply the effect of society becoming more aware of them and better at diagnosing them.
It is thought that allergies and increased sensitivity to foods are probably environmental, and related to Western lifestyles.
We know there are lower rates of allergies in developing countries. They are also more likely to occur in urban rather than rural areas.
Factors may include pollution, dietary changes and less exposure to microbes, which change how our immune systems respond.
Migrants appear to show a higher prevalence of asthma and food allergy in their adopted country compared to their country of origin, further illustrating the importance of environmental factors.
Allergies Are On The Rise And Here Are Three Reasons Why
Outrage over soaring prices for EpiPen, a life-saving allergy treatment, has drawn renewed attention to the number of children suffering from allergies.
As more children grapple with these ailments, the reasons behind the spike are still being debated. Lots of money is at stake: The diagnosis and treatment of allergies is a nearly $26 billion market, according to data from Grandview Research.
Research from the U.S. Centers for Disease Control and Prevention shows that food allergies in children have increased approximately 50 percent between 1997 and 2011, now affecting 1 in 13 children in the United States. This translates to roughly two students in every classroom.
About 90 percent of allergic reactions come from these eight foods alone: Milk, eggs, peanuts, tree nuts, soy, wheat, fish and shellfish. In total, food allergies cause about 300,000 ambulatory-care visits a year, just among children under age 18.
With those numbers on the rise, a few theories are being explored, including one linked to Western society’s obsession with fighting germs. The so-called hygiene hypothesis posits that a lack of exposure to infectious agents early in childhood can create a scenario where the immune system mistakes a food protein as an invading germ.
“We are being too clean,” Dr. Leigh Vinocur of the American College of Emergency Physicians told CNBC recently. “We’re essentially creating allergies for ourselves.”
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What Is An Allergic Reaction
Before we dig into the details of nut allergies, and try to explain why they are so common in todays generation, we should first look at allergic reactions as a whole.
Generally, an allergic reaction is an overreaction by the immune system when it encounters something it doesnt recognize, also known as an allergen. Detecting it as a foreign body, the antibodies of your immune system trigger the release of histamine by cells. This begins a further cascade of reactions, including dilation of blood vessels and other compounds, leading to an allergic reaction. Watering eyes in response to pollen or an upset stomach after eating eggs is not your body protecting you from danger, but merely overreacting to something harmless.
Peanut allergies are not only one of the most common, but also most severe reactions in those who suffer from it.
In the case of a peanut or tree nut allergy, your body is unable to recognize one or more of the proteins in that food, which triggers the immune system and kicks it into action. Peanut allergies are not only one of the most common, but also most severe reactions in those who suffer from it. Minor reactions may include hives, itching or tingling, while more moderate reactions could include swelling of the throat, lips and face, and in the most severe cases, anaphylaxis. If adrenaline is not provided, usually in the form of an epinephrine pen, exposure to peanuts can be fatal.
Experts Explain Why Peanut Allergies Are On The Rise And Reveal How To Prevent Them
Attempting to prevent peanut allergies could actually have been making the whole situation worse, according to scientists
When it comes to allergies, peanuts are among the most deadly foods in the world.
But the bad news is, peanut allergies are actually on the rise, with 1-2% of the global population unable to eat them.
And according to research by the Reactions YouTube team, the affected population in the US has more than tripled in the last decade.
Peanuts are actually a legume, which puts them in the same category as peas and soybeans, meaning they are not the same as other nut allergies.
In worst cases, peanuts can cause death, usually from anaphylactic shock which causes airways to close up and blood pressure to drop to dangerously low levels.
Peanuts are particularly deadly because they contain a whopping 13 proteins that have been identified to cause allergic reactions.
They also aren’t destroyed in your gut after consumption which means they get into your bloodstream with all the proteins relatively intact – and deadly to some people.
And it seems we may have made peanut allergies worse in recent years.
Advice was originally given to pregnant mothers to limit their peanut intake during pregnancy and avoid giving their children the food until at least the age of three.
But new research could suggest that actually, this is encouraging sensitivity to peanuts, and children should be introduced to the food at a much earlier stage.
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Regional Outbreaks Of Asian Lady Beetle Allergy And Delayed Anaphylaxis To Red Meat
In the United States, there have been two regional outbreaks of allergic disease in the last ten years. One was caused by infestation of homes by the Asian lady beetle , which had been introduced to control aphids, . Interestingly, lady beetles had not previously been identified as a source of allergens. The diagnosis had to be made with locally or individually made extracts and thus it is difficult to know anything about the overall prevalence. The more recent outbreak has been of delayed anaphylaxis to red meat. In this case, the cause appears to be a major increase in tick bites from the lone star tick. This increase is best explained by the truly dramatic increase of deer in both rural and suburban areas of the east coast. At present, it is not clear how far this epidemic will go but it is occurring in Australia as well as Germany, France and Sweden. This novel form of delayed allergic reaction is already the commonest cause of anaphylaxis among adults presenting to clinics in Virginia. It is not clear how this epidemic could be controlled, because both larval and adult lone star ticks are remarkably enthusiastic about biting humans.
Why The World Is Becoming More Allergic To Food
Around the world, children are far more likely than ever before to develop food allergies.
Inquiries into the deaths of British teenagers after eating buttermilk, sesame and peanut have highlighted the sometimes tragic consequences. Last year, a six-year-old girl in Western Australia died as the result of a dairy allergy.
The rise in allergies in recent decades has been particularly noticeable in the West. Food allergy now affects about 7% of children in the UK and 9% of those in Australia, for example. Across Europe, 2% of adults have food allergies.
Life-threatening reactions can be prompted even by traces of the trigger foods, meaning patients and families live with fear and anxiety. The dietary restrictions which follow can become a burden to social and family lives.
While we can’t say for sure why allergy rates are increasing, researchers around the world are working hard to find ways to combat this phenomenon.
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