Peanut Allergies- surely not something new?

January 18, 2008 10:00 AM

A then-and-now type question on food (specifically peanut) allergies. Mrs. Worker_bee and I were watching a TV show last night on which paramedics were treating a small boy for an allergic reaction to peanuts. We know many kids at our sons school that have allergic reactions to peanuts and know that it is best to ask before serving stuff or making cookies, etc. for friends. But we were talking about the show and neither of us could recall any of our friends or friends of friends that had an allergy to peanuts when we were at school (elementary thru high school).

Everyone we knew took peanut butter and jelly sandwiches to school or had them dished up at home. We were never told not to give other kids peanuts or peanut products. In short we just don't remember this being an issue when we were kids.

So was it just not recognized as an allergy by doctors in the late 60's and 70's when we were growing up? Did they just think it was something unconnected to peanuts and so treated it as something else?

posted by worker_bee to health & fitness (36 comments total)

The kid who lived across the street from me died at home from accidentally ingesting something with peanuts in it. That was many decades ago. We didn't tell kids to wear helmets when they rode bikes back then either. These are cautious times.
posted by caddis at 10:09 AM on January 18, 2008

The short answer is-- peanut allergys are increasing, but no one is sure why. So when you were at school, it's quite possible you didn't know someone with the allergy.
posted by Static Vagabond at 10:10 AM on January 18, 2008

What Static Vagabond said and not caddis. An adult keeping a peanut-allergic kid away from peanuts isn't being cautious with the times, they are trying to stop their child from dying. These allergies are very real and they ARE increasing. No one does know why, exactly. So yes, they seem more prevalent today cause they are.
posted by agregoli at 10:11 AM on January 18, 2008

There is a boatload of theories as to why peanut and other allergies have exploded in children in recent years. But the real reason is unknown. Peanut allergies have doubled in Canada in the past ten years with 1 in 100 children with the allergy.

I remember I first met someone with an allergy to peanuts in the mid-eighties and it was very unusual at that time. I worked in elementary schools from the early nineties to the early naughties and the number of students in my schools (all over 1000 students) went from one or two students with allergies to literally dozens. I don't think it was undianosed before this time, I think the change in food processing has changed our tolerance to certain foods. I actually know one woman who will not give her child ANY peanut products (the child has no allergies) because she does not want to risk her child developing an allergy.
posted by saucysault at 10:14 AM on January 18, 2008

I found "Everyone's Gone Nuts: the Exaggerated Threat of Food Allergies" in Harper's Magazine a very interesting read.
posted by kuujjuarapik at 10:15 AM on January 18, 2008

Allergies in children are increasing nation-wide in the US. Food allergies as well as (alarmingly) allergic asthma. No one knows why. Increased reporting has largely been ruled out, but there are some interesting ideas, such as the hygiene hypothesis. Nothing conclusive, though.
posted by mr_roboto at 10:15 AM on January 18, 2008

There were a handful of kids in my school (1970-early 80s) who were allergic to peanuts and/or tree nuts, and I have a couple of pseudo cousins who are allergic to tree nuts. While my sister and I had PB&J sandwiches in our lunches, we knew not to just share, and always checked before sharing cookies if Mum made them (she put nuts in the chocolate chip cookies and brownies).

I think the big difference is that there are a lot more kids with peanut allergies, and the allergic reactions are much more severe (and it seems to take less of the allergen to trigger a reaction). I was curious about that myself, and asked my kids' pediatrician (who has been in practice since the 1970s), and she said that she sees a lot more kids with allergies (of all sorts) now than she did 30 years ago.
posted by jlkr at 10:15 AM on January 18, 2008

I've wondered about this often as well. I clearly remember peanut butter-and-honey sandwiches on the menu in my gradeschool lunchroom, which would be unthinkable today. On the plus side, I'd read semi-recently that a means of removing the allergen had been discovered. It's damn baffling for me as a parent, even though none of our kids have the allergy.
posted by jquinby at 10:17 AM on January 18, 2008

Scientists have also noted the increasing prevalence of peanut allergy in children.

Peanut allergy: a growing phenomenon.

Factors associated with the development of peanut allergy in childhood: "The prevalence of peanut allergy appears to have increased in recent decades."

Other interesting research:

"Other research, by scientists at the University of Bristol, UK, has shown that using certain skin creams containing peanut oils in young children raises their risk of developing the life-threatening allergy by almost seven times.

The study followed 14,000 infants from birth, of which 49 had a history of peanut allergy. Children given soya milk also showed an increased risk of having the allergy, by 2.6-times"

I'd read semi-recently that a means of removing the allergen had been discovered.

There is work on a drug, TNX-901, to prevent peanut allergy.
posted by ericb at 10:24 AM on January 18, 2008

I would suspect that poorer medical care 20+ years ago allowed all the kids with life threatening allergies to die before they ever got to school age.
posted by gjc at 10:27 AM on January 18, 2008

@saucysault - What change in food processing has occurred in the last ~20 years would account for peanut allergies?
posted by gjc at 10:29 AM on January 18, 2008

"Eczema is a sign that your child is at a higher risk of developing a serious peanut allergy."
posted by ericb at 10:33 AM on January 18, 2008

"Eczema and peanut allergy are both part of the lifetime pattern of allergic disorders that is known as the 'Allergic March.'
posted by ericb at 10:39 AM on January 18, 2008

I would suspect that poorer medical care 20+ years ago allowed all the kids with life threatening allergies to die before they ever got to school age.

What? It's not like pediatric medicine was in the Dark Ages 20+ years ago. Besides, then we'd all know someone who's little sister died of unknown causes back then. FWIW, 37 years ago my sister was diagnosed with a milk allergy. In spite of it being the Stone Age, they knew how to diagnose allergies.
posted by oneirodynia at 10:40 AM on January 18, 2008

I actually know one woman who will not give her child ANY peanut products (the child has no allergies) because she does not want to risk her child developing an allergy.

According to a Report of the NIH Expert Panel on Food Allergy Research:

Other epidemiologic studies have reported that early life exposure to peanut is associated with remarkably low rates of peanut allergy. For example, more than 90 percent of Israeli children eat a popular peanut snack beginning in the first year of life. In contrast, young children in the United States, Europe, and Australia generally avoid peanuts or consume relatively small amounts. The prevalence of peanut allergy in Israel is 0.04 percent, roughly 10-20 fold lower than is observed in the United States, Europe, and Australia. Independent observations suggest that the immunological and clinical response to peanut allergens may also depend on cooking and preparation methods; roasting peanuts at high temperatures appears to alter the structure of allergens, possibly making them more allergenic.
posted by vacapinta at 10:49 AM on January 18, 2008 [3 favorites]

Maybe it has to do with breast feeding versus formula.
posted by thewalrusispaul at 11:08 AM on January 18, 2008

perhaps, there appears to be a higher incidence in breast fed babies
posted by caddis at 11:18 AM on January 18, 2008

I was going to post the Harper's article as well, but was beaten to it.
posted by chunking express at 11:19 AM on January 18, 2008

If the NIH panel report that vacapinta linked is indeed correct, that could certainly be a factor in explaining increased frequency of peanut allergy.

Due to an increase in severe allergic reactions, parents are not exposing their children to peanuts at all. Instead of preventing an allergic reaction, it instead increase the chances of one developing. This leads to more children who could have potential reactions and more chances of a reaction occurring. And the cycle continues.
posted by Nelsormensch at 11:20 AM on January 18, 2008 [1 favorite]

gjc - It is only a theory, but the past twenty years in Canada many people have moved away from eating fresh/raw foods to more frozen/heavily processed items and these foods have more chemicals/non-necesssary ingredients added. There may also be a soy/peanut link with the increased use of soy products, so it is not just food processing but also dietary changes. There are lots of theories floating around and I know many scienctists are working on the problem. I feel so lucky allergies haven't affected my children because it really is time consuming to check every item's label in the grocery shop.

vacapinta: I've seen other studies like that as well which is why I let my children have peanut butter whenever they want.
posted by saucysault at 11:25 AM on January 18, 2008

I've had a serious peanut allergy all my life and I'm in my late 40's. When I was a child and in school I self-policed because my reaction was so severe, unpleasant and scary that even at the tender age of 6 or 7 I was highly motivated to stay away from peanuts. My mom discovered my allergy when I was a toddler--she gave me a cracker on which she'd spread a little leftover PBJ from a sandwich she'd made my brother--handed me the cracker, turned away and turned back to see me with a rash all over my face, sitting on the floor wheezing. I was hospitalized then, and have had several exciting emergency room trips since-but mostly avoid exposure.

No accomodations were made for me at school or even at home. Peanuts were around and I kept myself away from them. There is a tiny, mean part of myself that looks at all the current hysterical parent stuff and thinks, "wimps," but that's just sour grapes after years of having to be solely responsible for keeping arms length. It was a particular problem when flying as an adult--had to train myself not to put my hands near my face on planes because folks would eat the free peanuts and wipe the salt on the armrests, I'd get peanut dust on my hands and if I touched my face I'd get off the plane with an eye swollen shut or looking like I'd been punched. So I'm happy they are serving fewer peanuts on planes.

OK, I feel better now I've vented.
posted by agatha_magatha at 11:25 AM on January 18, 2008 [4 favorites]

There's the hygiene hypothesis, which is well regarded in immunology circles as far as I can tell, that's basically a lack of exposure to real pathogens make our bodies more likely to develop immune reactions against benign things. I have no scientific evidence to back up caddis's statement, but I do know someone who didn't know her infant died because of a wheat allergy until decades later, so it's not impossible that some of the kids you knew had siblings that died very early.
posted by fermezporte at 11:31 AM on January 18, 2008

In case your interested, Leonard Lopate did an interview with the Harper's writer that was linked above. It was an interesting interview...if I remember correctly her thesis was that food alergy awareness is increasing but rarely are the food alergies fatal.
posted by mmascolino at 11:49 AM on January 18, 2008

I would suspect that poorer medical care 20+ years ago allowed all the kids with life threatening allergies to die before they ever got to school age.


gjc, if you're being sarcastic, it's kinda not coming through.
posted by desuetude at 12:23 PM on January 18, 2008

[comment removed - this is about allergies not your opinions on today's parents.]
posted by jessamyn at 12:52 PM on January 18, 2008

Again with the Jan 08 Harper's Index:

Minimum number of U.S. deaths from food allergies each year, according to the Food Allergy & Anaphylaxis Network: 150
Number recorded by the CDC: 12
posted by Flashman at 2:20 PM on January 18, 2008

Peanuts themselves may have changed over time, too, and may be very different in terms of their ability to promote allergies now than they were, or when grown in different parts of the world, or conceivably even in different adjacent fields, all depending on resident populations of soil bacteria, I suspect.

There is some evidence that lectins in peanuts are the most dangerous allergens, and the peanut (and soybean and other legumes) use lectins, which are proteins which bind to very specific patterns of individual sugar molecules in sugar polymers (polysaccharides), to manage the nitrogen-fixing bacteria in their root nodules. These bacteria are the ultimate source of the amino acids which give legumes the high protein content which has made them such an indispensable food for us. The lectins manage the bacteria by binding to the outside coats (glycocalyces) of the bacteria, which are made of polysaccharides, and these vary from strain to strain of bacterium and within strains according to the environment in the soil.

The lectins in the peanut must vary accordingly as well, and very possibly the immune responses they give rise to in tandem.

The hygiene hypothesis is interesting from this point of view, since it posits a general beneficial effect in preventing allergies by exposure to dirt in the environment; perhaps exposure to the dirt the peanuts grew in would be highly beneficial, and this certainly would have been more likely in the past with its much greater prevalence of local farming.

The specific mechanism of action for a beneficial effect of exposure to dirt similar in its bacterial population to the dirt the peanut grew in might be as simple as having populations of bacteria in your digestive tract, including your mouth, and on your skin, which came from that dirt and have glycocalyces that will bind to the peanut's lectins and prevent them from ever having much contact with your immune system in the first place.
posted by jamjam at 3:18 PM on January 18, 2008 [3 favorites]

flagged as chatfilter, unless someone here really has a study to support allergic prevalence over six decades.

Clin Exp Allergy 2004; 34:1007–1010
J Allergy & Clin Immun 2002; 110:784-789
Science 2002; 296:490 - 494
posted by mr_roboto at 3:36 PM on January 18, 2008

Lancet 1997; 350:1015-1020
posted by mr_roboto at 3:38 PM on January 18, 2008

Lancet 2006; 368:733-43

I gotta get back to work now.
posted by mr_roboto at 3:53 PM on January 18, 2008

No, not being sarcastic. Why is it so inconceivable? Infant mortality is going down, diagnoses of life threatening allergies are going up. Presumably some of those deaths were unrecognized allergies. We're talking about increased awareness, that presumes that there was less awareness in the past.

Interesting theory about the peanuts themselves changing. It's more plausible that the nuts are changing than people are changing.
posted by gjc at 4:27 PM on January 18, 2008

gjc, the last twenty years is an infinitesimal blip. Any upturn or downturn in infant mortality or diagnoses of allergies are statistically insignificant at this point.

Also, this:
I would suspect that poorer medical care 20+ years ago allowed all the kids with life threatening allergies to die before they ever got to school age.

Is just a bizarre assertion. How would ALL the kids 20+ years ago die before school age? All kids with lethal allergies were exposed to lethal does of those allergens without access to an ER before age six? (Does that include the Jewish kids with lethal shellfish allergies? What about the kids with peanut allergies who don't like peanut butter?)
posted by desuetude at 8:42 PM on January 18, 2008

You're jumping on ALL with far more intensity than I meant it, it was poor word choice on my part. If we're seeing more cases, logic says that either prevalence is increasing or past prevalence went undetected. Why is it bizarre to think that plenty of "choking deaths" or "unknown asphyxiations" weren't misdiagnosed allergic reactions?
posted by gjc at 10:01 PM on January 18, 2008

Funny, my wife and I were talking about this two days ago. Neither of us have ever met, or heard about, someone with a peanut allergy here in Mexico. My mother-in-law just arrived for breakfast and we asked her. Same result. This is Mexico City, mind you, not an isolated little town in the sierra.

Kids here are exposed to peanuts early and often. They're part of the traditional piñata filling and are served as snacks everywhere. I suppose that's the reason. Either that, or less processing of the peanuts during production.
posted by Cobalt at 8:04 AM on January 19, 2008

gjc, if you had said 100 years ago I wouldn't quibble as much. But 20 years ago? Recognizing the signs of lethal allergic reaction is not brand-new medicine.
posted by desuetude at 12:29 PM on January 19, 2008

I have heard that feeding kids peanuts before a certain age can increase their risk of developing the allergy. Same thing with feeding kids solids too early in general.

IANAD, and that may just be crazy parent gossip, I don't know. Just throwing it out there in case someone has links to studies and wants to expand on it.
posted by fructose at 9:28 AM on January 20, 2008