My child’s father and I engage in frequent spirited debates. Some might call them squabbles. Or something midway between debates and squabbles… Can I coin the new term “squabate?” Our most recent squabate sprang forth from an article that I read in the San Francisco Chronicle. Apparently, a woman let her four-year-old eat a peanut butter sandwich in the front seat of a Target shopping cart, leading to an all-out mommy war in the comments section of a New York parenting blog. The majority of moms were chastising this woman for her insensitivity toward other children with nut allergies who might have used that cart after her. They claimed that peanut residue left on the handle of the cart could have put other children’s lives at risk. Some moms simply commented that feeding a child a sandwich in a shopping cart is unhygienic and low brow.
My child’s father said that the moms were grossly overreacting and that the perceived prevalence of food allergies is the result of “soft millennials over-babying their children.” He felt that simply wiping the cart down should prevent any risk. My concern was that peanut allergies have become so severe in recent years that skin contact or even proximity to peanut products could be dangerous to other kids. Isn’t that why they’ve taken complimentary peanuts off of commercial flights?
Our squabate became so enthusiastic that we ended up calling Kaiser to get answers from an experienced professional on the front line. According to the nurse we spoke with, airborne food allergies are exceedingly rare and skin contact would lead to mild inflammation at worst. However, it’s NOT all in our heads: Food allergies are definitely on the rise in children.
Food Allergy Stats
The CDC reports that prevalence of food allergies in children increased by a whopping fifty percent between 1997 and 2011 (latest published stats), with peanut allergies nearly tripling between 1997 and 2008. Food allergies now effect 5.9 million children under the age of 18, which is 1 in 13 children. Additionally, the rate of children hospitalized with food allergies tripled between the late 1990’s and mid-2000’s, and about 40% of children with food allergies have experienced a severe reaction such as anaphylaxis (deadly if not treated immediately).
Food Allergy Causes
In this Insider article, Editor-in-chief Nicholas Carlson tells the harrowing story of how his nine-month old boy experienced a severe allergic reaction from the accidental ingestion of a cashew. Luckily, his brave wife was able to keep a cool head in the moment and administer the EpiPen shot that surely saved little Arthur’s life. As Nicholas sat watching his son recover in the hospital, he wondered: “Why is this happening?…What mistake of evolution led to this?” The answer as it turned out, was parasites.
Nicholas spoke with Dr. David Stukus of the Nationwide Children’s Hospital in Columbus, Ohio. Dr. Stukus, an allergy expert, explained that humans developed a defense system against the accidental ingestion of parasitic worms thousands of years ago. A blood protein called Immunoglobulin E would send an alarm through the body any time a parasite entered. In response, weaponized cells would then release histamine to flush the enemy out. This would happen in various forms – vomiting, sneezing, diarrhea – depending upon where in the body the enemy parasite had nested. This defense worked so well that all humans would evolve to have it.
Eventually though, the defense system became defective in some people, mistaking food items like eggs, nuts, or milk as dangerous foreign bodies. This leads to an overdose of histamines released within the body, which can cause lungs to swell shut and blood to swell within the veins, cutting off oxygen delivery to the brain. Ironically, as Nicholas points out, a person’s body can attack itself in an effort to save itself.
Theories on the Rise
The fact that food allergies are on the rise is certainly a terrifying trend, but interestingly enough, scientists are not sure exactly why. There are however a few prevalent theories. This article from The Heart MD Institute breaks it down.
The first theory is that our modern, Western diet is to blame. Our delicate gut ecosystems might be getting thrown off by our diets, which are often high in sugars, carbohydrates, genetically modified foods, and meats pumped with drugs and antibiotics. Support for this theory comes from a study published by the National Academy of Sciences, comparing gut bacteria between rural African children and urban Italian children. The study found a “more favorable microbiome of bacterial strains” in the guts of the African children, whose diets consisted of food such as ancient grains, legumes, vegetables, non-animal proteins, and lots of fiber. In contrast, the Italian children in the study had diets higher in animal protein, sugar, and starches, and lower in fiber. To put it simply, the diet of the African children in this study was conducive to “good gut bacteria,” while the diet of the Italian children was conducive to “bad gut bacteria.” According to the study, a reduction of good gut bacteria can trigger food allergies and may attest for the dramatically different rate of allergies between these two populations.
Another theory on the rise of both dietary and environmental allergies is what’s called the “hygiene hypothesis,” a phrase coined in the 1980’s by epidemiologist David Strachan, who stated that early exposure to things we consider dirty (bacteria, viruses, parasites) will strengthen children’s immune systems and protect them as they grow. By challenging the immune system with small threats over time, we develop a callus that prevents our bodies from reacting overdramatically. However in today’s society, we have a recent tendency to over-sanitize our children’s surroundings. According to The Heart MD Institute, “We should be letting our kids play in the dirt, rather than dousing them in hand sanitizer [and we] shouldn’t completely freak out if they lick the shopping cart.” Pointing back to the children of rural Africa, they often live in unsanitary conditions, are exposed to more illness, and are rarely vaccinated, yet incidences of allergies – dietary or environmental – are nearly unheard of.
Early Prevention Now Recommended
A third allergy theory is that children aren’t being exposed to a variety of foods early enough. For years, pediatricians were advising parents to avoid giving their babies foods that they might be allergic to. The standard advice was to avoid giving babies eggs, dairy, seafood, or wheat in the first year. And to wait until your child is two years old to feed him nut products. According to Doctor Claire McCarthy of The Harvard Health Blog, this was misguided advice.
Dr. McCarthy sites a 2016 study which divided 1,000 exclusively breastfed 3-month-old babies into two groups. The parents of one group were told to give their babies only breast milk for six months, (as traditionally recommended by the American Academy of Pediatrics). The parents of the other group gave their babies six foods that are known to cause allergic reactions: peanut products, eggs, wheat, cow’s milk, sesame, and whitefish. Among the parents who were able to feed their picky infants these foods, fewer children ended up with peanut or egg allergy when tested between 1 and 3 years of age. And the researchers didn’t find decreases in allergies to the other foods, but they didn’t find increases either.
…And this circles back around to the findings of our great allergy squabate! The nurse that we spoke with left us with a key piece of advice: Expose your children to a variety of foods early on! Go ahead and give that baby some peanut butter – it’s good for her and it might just prevent food allergies from developing. (Just don’t let her smear any on the grocery cart because the other moms will riot.)