As an allergist, the primary query I get from sufferers and buddies is: “Why are meals allergic reactions on the rise?” I at all times get excited when requested this, as a result of it’s a subject we don’t focus on sufficient nor have normal consciousness about. With meals allergic reactions greater than doubling over the past couple of many years, now we have an epidemic on our arms, however the causes for this rise will not be well-known.
There are just a few main theories behind the rise in meals allergic reactions. One is the “hygiene speculation,” suggesting our youngsters’s rising lack of publicity to germs (together with micro organism, viruses, and fungi) might enhance their susceptibility to allergic ailments. One other is adjustments in our meals system, such because the introduction of genetically modified organisms (GMOs) and chemical compounds in our meals. Briefly, the rise in allergic reactions seems to be multifactorial. We’re studying an increasing number of about this advanced course of as time (and analysis!) goes on.
Whereas we can’t say for sure why meals allergic reactions are on the rise, we will say now we have higher analysis round prevention. For instance, we now know the timing of meals introduction is essential. Should you wait to introduce allergens till 12 months of age, a baby is FOUR TIMES extra prone to develop a meals allergy!
Analysis round prevention is comparatively current. Once I was finishing my residency in pediatrics again within the mid-2000s, the American Board of Pediatrics beneficial dad and mom wait till their baby was three to introduce high-allergenicity meals like nuts and seafood. Since then, analysis has accomplished a whole 180, and pediatricians now advocate the introduction of high-allergenicity meals as early as 4 to 6 months of age to assist cut back the prospect of growing meals allergic reactions. It’s also essential infants ingest these meals as early and constantly as potential to assist “train” the immune system that these meals will not be harmful intruders to the physique.
There appears to be a important window of time earlier than a baby begins consuming solids, nevertheless, the place there could also be various exposures that influence the way in which a baby’s immune system learns to take care of these allergenic meals. That is particularly essential for infants who’re extra inclined to meals allergic reactions based mostly on genetics or household historical past.
Epicutaneous sensitization: growing allergic reactions by the pores and skin
Mockingly, and importantly, it seems not all early publicity helps stop meals allergic reactions. Current analysis suggests early publicity to allergens by your pores and skin might put you at a increased threat of growing meals allergic reactions! We’re studying extra about epicutaneous sensitization, which is the speculation that allergic reactions can develop by pores and skin publicity. There’s proof supporting the concept that an impaired pores and skin barrier, as we see in children with atopic dermatitis (eczema), might contribute to the event of meals allergic reactions by elevated publicity to the allergen through the pores and skin. This can be one of many explanation why youngsters with eczema typically have a considerably increased threat of meals allergic reactions.
Apparently, the human physique responds in a different way to meals ingested orally versus absorbed by the pores and skin. Often, allergenic protein publicity by the pores and skin is minimal since solely a small quantity finally ends up absorbed into the bloodstream. Whereas the main points of the pores and skin barrier involvement are nonetheless being explored, there was an elevated deal with interventions geared toward repairing the pores and skin barrier as a manner of stopping meals allergic reactions and different varieties of pores and skin allergic reactions.
Though we nonetheless have a lot to study, our understanding of the rising epidemic of meals allergic reactions is bettering. We now have made vital strides in figuring out methods to stop meals allergic reactions in infanthood, however further analysis is required earlier than the allergist group can extra definitively reply to the “why the rise” query—as a result of the quick reply is: we nonetheless don’t know.
— Anjuli Mehrotra, MD
