Maybe part of it is a consequence of the risks of honey, which can actually spawn camp infants with botulism. But it seems that fear spread to everything.
I hadn't heard of this. Very intriguing that only camp infants would be affected.
Not just parents sheltering kids. Take a look at this (in)famous tweet https://x.com/d_spiegel/status/1271696043739172864 from *June 2020* ...
"[eg] women aged 30–34, around 1 in 70,000 died from Covid over peak 9 weeks of epidemic. Over 80% pre-existing medical conditions, so if healthy less than 1 in 350,000, 1/4 of normal accidental risk"
It will be interesting to see what happens with allergies for those who were born in the 2020-2023 timeframe.
The thing I'm a bit curious about is how the research on peanut allergies leading to the sort of uhhh... cynic's common sense take ("expose em early and they'll be fine") is something that we only got to in 2015. Various allergies are a decently big thing in many parts of the world, and it feels almost anticlimactic that the dumb guy take here just applied, and we didn't get to that.
Maybe someone has some more details about any basis for the original guidelines
If this theory (that early exposure teaches the immune system not to overreact) is right, then another logical consequence would be that kids who play outside in their early years would have fewer pollen allergies than kids who mostly play indoors and are exposed to far less pollen than the outdoors-playing kids. I don't know where to look for studies to prove or disprove that thesis; anyone have any pointers?
I had to decide which of two sets of peer-reviewed publications that contradict each other was least guilty using the data to support the conclusion rather than letting the data speak for itself and making an honest conclusion.
Compared to PhDs, MDs hate designing an experiment and would rather just extrapolate a different conclusion from the same longitudinal study by cherry-picking a different set of variables. The only articles I bother reading from the NEJM anymore are case studies because they're the only publications that consist of mostly-original information.
Objective: We sought to determine the prevalence of PA among Israeli and UK Jewish children and evaluate the relationship of PA to infant and maternal peanut consumption
I always think about how animals eat - basically their food is never clean and always mixed with dirt. Evolution dealt with this problem since forever.
They know that skin and mucosa sensitization can occur in response to allergens.
A reasonable hypothesis is that there’s some boot-up process with the immune system that needs to occur before anything happens. The kids are dying today. “Avoid the thing that can cause sensitization” is a conservative position.
It is unusual that it should have been opposite and that oral exposure induces tolerance. It’s the fog of war.
The standard conservative intervention has helped in the past: I’m pretty sure seatbelts didn’t have strong mortality data before they were implemented. If it had turned out that more people were killed by seatbelts that trapped them in vehicles it would make for a similar story. I think they also got rid of all blood from donors who were men who have sex with men during the initial stages of the HIV pandemic (no evidence at the time).
Edit for response to comment below since rate-limited:
Wait, I thought it was on the order of ~150/year people dying from food anaphylaxis though I didn’t research that strongly. It was off my head. If you’re right, the conservative advice seems definitely far too much of an intervention and I agree entirely.
After going through the desensitization program at an allergist, we're on a maintenance routine of two peanuts a day. It's like pulling teeth to get her to eat them. She hates peanut M&Ms, hates salted peanuts, hates honey rusted peanuts, hates plain peanuts, hates chocolate covered peanuts, hates peanut butter cookies, and will only eat six Bamba sticks if we spend 30 minutes making a game out of it.
I highly recommend being very rigorous about giving them the peanut exposure every single day. It would have saved us a lot of time.
E.g. from age 27 weeks my daughter has played in a little herb garden full of mud and grass I built for her. She grabs and eats leaves from the herb plants (the basil is entirely denuded so that’s a complete loss). At first I just wanted her to play in the garden out of the same naïve exposure to tolerance model. I never would have considered that skin exposure is different from oral exposure. As it so happened she ate the plant leaves and it doesn’t matter either way since this part of immunity (to microbes here) doesn’t work in the same way as peanuts anyway.
For instance the "cry it out method" did massive amounts of psychological damage to more than one generation, but it seemed to work in the short term as the babies eventually learned to "self-soothe".
Even now I still see parents and grandparents suggesting it in parenting groups; and taking extreme umbrage at the idea that it might have damaged them/their children.
At some point through the times of civilizations, humans started having less work to do and more idle people around. The idle people started spending their time for preaching a life style other than what was evolved naturally through centuries and millennia. They redefined the meaning of health, food, comfort and happiness. The silliest thing they did was creating norms, redefining good and bad based on their perception of comfort and happiness and enforcing those norms on populations.
Human race continued to live under the clutches of perceptions from these free-thinking idle people whose mind worked detached from their bodies and thus lacked the knowledge gained from the millennia of human evolution.
In 2000, the American Academy of Pediatrics recommended not allowing your kids peanuts until they were 3 years old. It was just parents following doctor's (bad) advice.
The hygiene hypothesis is not impossible, but evidence for and against it is questionable. But anyway, for peanuts it's not the hygiene.
It's a much more complex mechanism that retrains your immune system from using the non-specific rapid-response allergic reaction to the T-cell-mediated response.
The same method can be used to desensitize yourself to poison oak or ivy. You need to add small amounts of them into your food, and eventually you stop having any reaction to urushiol contact with the skin.
What? That's insane, 4-5 kids were dying a year. The whole thing was mass hysteria, that then started to create the problem when there had been none.
Are there missteps? Certainly. Figuring out what is effective, what has bad secondary effects (fragility, allergies etc) and what is simply wrong is an ongoing effort and that's great, but less dying is a pretty nice baseline and progress on that front is inarguable.
Maybe we live in bubbles.
I am from Asia. I have only seen people need to be taken to emergency hospital in American tv shows for any allergies. Here I've never seen it in my whole life and didn't even know allergy can be this dangerous. We don't have peanut allergy too. First time even I saw it in TV, I was very confused.
Allergies do exists here, but "not to the extent" like what I've seen in American TV shows or heard online.
Only thing I remember is people need to take medicine for to allergy from venomous caterpillar hairs, they mistakenly touched those. And stung by honey bees, wasp etc.
https://www.astralcodexten.com/p/book-review-from-oversight-...
I don't particularly believe this, but it fits Occam's razor, so it seems to deserve some examination.
Pretty irrational, but definitely celebrated.. eventually
"Older adults are at highest risk of getting very sick from COVID-19"[0]
Even with parachutes, you could do a study (not a RCT) by looking at historical cases of people falling with and without parachutes. The effect would be so strong that you wouldn't need those clever statistical tricks to tease it out.
The mind tries to compensate the loss with experimentation that can't undergo the same extent of evolution. Then it dictates body to follow the results of these puny and tiny experiments, and ignores the rich knowledge already encoded in the body.
Some people become vegetarians, some people become vegans, some people believe eating big steaks of red meat is healthy, some people avoid pork, others do not eat cooked food on some days of the week, others eat only fish on special holidays, some people tell you that yoghurt is good for your gut, others tell you to avoid dairy at all cost, some tell you to avoid carbohydrates, ....
Some of these are backed by science, some are batshit crazy, some are based on individual preferences.
I don't think this is a new phenomenon. People just love coming up with rules, and even if our society allows you to eat pretty much whatever you want, people still seek out restrictions for themselves (and their kids...)
Science failed here.
One could argue that science being celebrated too much leads to this type of present-day outcome. Science can tell you how to do something, but not why, or even what we should do to begin with.
I'm pretty sure it is.
Notable citation:
> A system that began as a noble defense of the vulnerable is now an ignoble defense of the powerful.
For baby number 2, soap and water is enough. There's no time for Sterile Field nonsense. This kid isn't allergic to anything.
There was a local mom who had 4 thriving kids. When their baby dropped the pacifier in the dirt, it just got brushed off and handed back to the baby. I don't think those kids had any allergies.
No allergies.
I don't agree that this is "all" that it has done.
There are many cases where reducing exposure as much as possible is the correct thing to do. Lead is the best-known example.
As the other reply pointed out, the second-order effect, the nuance that comes later is that sometimes this isn't the right thing to do.
But it would be basically incorrect to reduce it to blanket, binary, "all good" vs "all bad" black-or-white conclusions, just because the there is a smaller course correction when it's found out to be not entirely good. Concluding that "all it's done is cause problems" is a knee-jerk reaction.
Your personal health profile or family history may also put you at higher risk for cartilage degeneration from running, which would shift the balance in the other direction.
Blanket statements about medical outcomes like that are useful for medical practice in general, but can be misleading for individuals making health decisions if they ignore other relevant factors. There's also plenty of doctors who will not take those other relevant factors into account and just go by whatever the last training or research they were exposed to (which, incidentally, is also why big pharma companies invest in salespeople to target doctor offices - because it works).
If the best available means to perform an experiment carries some risk, it could still be entirely rational to do it rather than forfeit the knowledge gained from the experiment.
Infants in SE Asia are probably getting near daily exposure to peanuts.
The post that I am responding to does in fact deal in absolutes by asserting that "What doesn't kill you makes you stronger" is a natural law. Please don't troll by attributing that to me.
My more detailed take on this is here: https://news.ycombinator.com/item?id=45653240
It is in response to someone else who is dealing in absolutes. It seems pretty common, actually. Must be a lot of Sith around today.
For clarity, I will include both here:
The two explanations for increased adult fragility are:
forgotoldacc> Parents shelter their children too much and have created adults that have additional allergies as a result of lack of childhood exposure
rocqua> Increased sheltering of children has allowed more of the fragile ones to survive to adulthood, increasing the number of fragile adults we observe today.
A quick google search says Asians populations have more allergies to buckwheat, royal jelly, and edible bird nests from swiftlets. Shellfish is still one of the highest allergies anywhere.
With a child that has PA on anaphylaxis-level and has had such an reaction a couple of times, and she has thusly built up a fear and anxiety, not being able to casually just let her attend b-day parties etc etc etc, I can assure you it's not a joke to us.
And no, we are not overly clean, in fact love going outdoors into the woods and getting dirt under our fingernails. Nor did we hold her off peanuts when small, her first reaction came when she just had learned to walk at about 10 months and ate a tiny piece found on the floor. And we as parents work very hard on trying to have a casual attitude towards life and work on her anxiety, and not let the PA define who she is or does. But then something like last week happens - those who make the food for school messed up her box of food and she ate mashed pea pattys and got really, really bad, worst in years. Boom, all her confidence in school down the drain.
It's heartbreaking, really. To find her have all that fear and pain, and we can only do so much to help her with that. And it's heartbreaking to see it being a joke to some. When I see such attitudes, I try to think that it comes from someone who is living a happy-path life, and well, good for you.
Thanks for coming to my TED talk, and smash that bell button.
I think that's just common sense, but at least in my home of Austria you can still easily get un-pasteurized milk if you really want. I'm not sure how the "government" controls my food choices? (In some cases I would actually prefer more regulation, because some producers make some questionable choices. I would prefer to buy cured meat without nitrates, but it's quite hard to find)
For example say 3 papers are rediculous, could you say "they are all rediculous, there is nothing learned, we know nothing new from them"
I honestly can't tell if this entire post is some kind of parody or what. That cannot be real - I don't know anyone or have ever heard of anyone basically force feeding their child peanuts to maybe avoid peanut allergy later in life. It sounds insane, just like the presumption that because you missed some imaginary time window in their development your daughter has developed peanut allergy. That cannot possibly be real.
There wasn't much information one way or the other on what avoidance did as far impacting development of allergies, and with the evidence available, delaying exposure seemed prudent.
Anaphylactic shock is scary and peanut fear was a big deal in the late 1990s but actual risk of harm was very low. The guidance was more about the psychosocial burden placed on parents when there was no guidance. Anxious parents have been studied, that mechanism is reasonably well understood and that harm can be quantified.
"Mithridatism is not effective against all types of poison. Immunity is generally only possible with biologically complex types which the immune system can respond to. Depending on the toxin, the practice can lead to the lethal accumulation of a poison in the body. Results depend on how each poison is processed by the body."
"A minor exception is cyanide, which can be metabolized by the liver. The enzyme rhodanese converts the cyanide into the much less toxic thiocyanate.[12] This process allows humans to ingest small amounts of cyanide in food like apple seeds and survive small amounts of cyanide gas from fires and cigarettes. However, one cannot effectively condition the liver against cyanide, unlike alcohol. Relatively larger amounts of cyanide are still highly lethal because, while the body can produce more rhodanese, the process also requires large amounts of sulfur-containing substrates."
Our immune, metabolic, and other systems are built to be adaptable, and some things are easy to adapt to, but other things are difficult or impossible for them to adapt to.
But generally speaking, the USA is an outlier on the prevalence of Peanut Butter specifically, and to a lesser extent peanuts in general.
Like if you walk into a store and they offer you coffee or even a glass of prosecco, I would also say to my wife "oh we're in that kind of store now" because you know you're about to be ripped off in some way. Not that other stores are for weaklings.
Telling anxious parents to have their kids avoid peanuts caused harm that wouldn’t have happened otherwise. I guess it’s valuable to better understand allergies, but learning at others’ expense isn’t worth it.
Is this true? What percentage of doctors are scientists?
So you did nothing wrong. The six week pause was completely meaningless.
There's a dark pattern hiding in the modern era where we assume hard evidence to exist where it doesn't, a projection of CAD engineering onto idle theory crafting and opinion.
The UK seems to be a bit of an exception. And it shows, the only two countries I've been asked if there are any allergies by waiters as a standard are the US and the UK.
The real problem is some of those claims and reports were true, but we were so inundated with the rhetoric that everything was going to kill us that many of us sort of lapsed into apathy about it. Stepping back, the food industry in the US clearly does not have consumer health at heart and we struggle to find healthy options that avoid heavy processing or synthetic fillers. Those parents who sheltered their babies back then may have been on to something when it came to stuff we consume and we should have been on the path to demand better from our food sources had more of us been more diligent with our grocery choices (myself included, at the time), but instead we ended up with bread that lasts unnaturally long and has an allowable amount of sawdust as an ingredient.
Also this "more fragile people" argument assumes the "fragility" is both inherent and of a lifelong kind. This ignores that most causes of infant mortility are external, and that for many of those being exposed to them results in a lifelong increased mortality risk. Excessive hygiene leading to more allergies is a direct example of this.
There’s been a similar shift with people letting their dogs roam free. When I was a kid I remember hearing stories about a dog getting run over by a car every year. I rarely hear these stories anymore because people usually keep their dogs supervised or in a fenced yard. I don’t have any hard data, but I suspect there’s something to these cultural shifts.
A lot of people who today would be considered to have a condition which is entirely treatable by doing (a), taking (b), not doing/avoiding (c), etc, would, a century ago, have just been kind of deemed broken. Coeliac disease is a particularly obvious example; it was known that there was _something_ wrong with coeliacs, but they were generally just filed under the 'sickly' label, lived badly and died young.
(And it generally just gets worse the further you go back; in many parts of the world vitamin deficiency diseases were just _normal_ til the 20th century, say).
doing nothing is better than something if that something might hurt people without understanding how and why
I've brought up this example many times before, but Measles is a great example. Measles resets your immune system and breaks immunological memory for anywhere up to three years after having recovered from it. But now we have a bunch of people that assume any diseases can simply be dealt with in a natural way by your immune system thanks to the logic above, and well, the consequences of that are becoming clear.
https://www.jacionline.org/article/S0091-6749(08)01698-9/ful...
Also, the most common type of accidental death is car accidents. So is even that difference from kids not getting to play outside anymore, or is it radial tires and crumple zones?
This research shows physicians harmed kids recommending they avoid allergens like peanuts, is that something we should ignore because all the benefits of science are “worth it”?
Science is amazing not because it’s always right, but because it (should) strive to always do better next time
Essentially all of this was infant mortality, i.e. kids who died before the age of 1, and that in turn was more related to things like sanitation and vaccines and pre-natal screening.
I am sorry, but am I going crazy?
We have been giving infants small amounts of peanut butter, egg etc... for decades where I live. But also let them play outside, get dirty put stuff in their mouths to train the immune system.
This is common knowledge to me.
“it’s worth it” is a horrible argument when people’s health is on the line.
Like in rich neighborhoods people cannot talk and should be babysat by the serving staff.
It's kind of similar to the Whole Wheat Bakery asking you whether you're OK with gluten. If you aren't, you made a big mistake walking in.
However this doesn't need to continue very long until basic cleanliness and medicine can be used effectively without harm.
FWIW I tell people that running is bad for your knees, but relative to other exercises! If someone wants to only run, then go do it... better than nothing.
- Before the age of 1, top cause of death were defects (prematurity/immaturity, birth injuries) and congenital deformations.
- Age 1-4 it was accidents (e.g., drownings, burns, traffic) followed by influenza/pneumonia.
Affluent areas in general have more variety. The ice cream shop may be a place where you can get all kinds of ingredients that you wouldn't find at other places. This is 100% true for "fine dining" and it's one reason why they ask.
They will also have substitutes for an allergy to make the experience just as pleasant, thus they ask.
I think a lot of the delay is it took a while for people to realise there was a problem. The perhaps excessive hygiene thing didn't really get going till the 1960s and so you didn't really see the rise in allergies till a couple of decades after, then maybe scientists started figuring it like in the 90s and then it takes a while to get proven enough to recommend to parents?
> Affluent areas in general have more variety.
No, it's definitely a difference in cultural norms, not something driven by the store inventory.
> They will also have substitutes for an allergy to make the experience just as pleasant
This is not the case for dairy in an ice cream shop, or for wheat in a "whole wheat bakery".
For me, as a kid: very, very allergic to cats, kinda allergic to many food items and a little to horse hair (only noticable when shedding in the spring)
As a young adult: Only 2-3 food allergies remain, cats still strong, hayfever starts.
Then I took some shots against the hayfever for 2-3 years, and the cat thing has mostly improved and the hayfever is basically gone. So only 2-3 food items remain.
Careful studies have shown that violence used with children percolates back out of them, in rather rapid fashion. Something like a great majority of them go on to use violence to interact with others in the next two weeks.
So, yes, as it turns out: a little spanking did hurt... specifically, it hurt innocent bystander kids.
Isn't that one of the fundamental things being taught to nascent minds as a prerequisite to participating in society -- starting the earliest stages of development, at which point neither one's mind nor one's body really has much of a say in the matter?
That was just the catchy title, similar to peer-reviewed literature reviews published on nih.gov: not necessarily the creme-de-la-creme, just good enough to pass peer review. I real question is whether concern for cartilage erosion is well-founded, and whether or not it outweighs the scientific consensus that running improves bone density of the tibia and fibula. Again, literature had strong evidence for the latter while the former was still a major controversy in kinesiology.
I didn't even touch cardiovascular health, because to be fair we live in a world with bicycles and affordable YMCA lap pools.
Here's the cop-out answer: It's a literature review- the very requirements are merely one step removed from those blog articles Harvard Medicine publishes for mass-consumption. I followed instructions, one of which was to adhere to a maximum of 2 1/2 pages, and I got a Northwestern 95 on the assignment.
> "we're in that part of town."
Given that lactose intolerance impacts non-caucasians much more, this reeks of racism
Lactose intolerance Prevalence by Race:
African Americans: 75-95%
Asian Americans: 70-90%
Native Americans: 70-80%
Hispanic Americans: 50-65%
Caucasians: 15-25%
> Just one or two nights of pain
you shouldn't be allowed near children if that's your approach
We went from about 50% infant mortality to maybe 1 in 1000.
I'm not convinced that we understand the human immune system quite that well.
Speaking as someone with three kids and (sadly) quite the handful of apparently inherited medical conditions in the family.
As it stands we have:
* coeliac (me, plus two of the three kids... and the third kid already tested positive on the coeliac genetic test)
* childhood asthma (me, plus one of the three kids)
* severe allergies (me, plus two of the three kids)
No nut allergies, so far. We're still counting :/
I do love just getting out and running though!
Cycling is however a lot more interesting if you have somewhere good to ride.
By the time my second daughter was born in 2014 they'd told us some of the preliminary results, so we followed the guidance even though she wasn't in the trial – no peanuts in the house so she couldn't get any on her skin until she was able to eat solids, and then peanut butter was her first solid food and we fed it to her throughout her infancy. I don't know if that's the cause, but she still eats it by the bucketload.
Pretty common expectation in many countries. I was surprised to see this is not normally a thing in the US, given how we're led to believe how much you guys love to sue each other.
I still maintain its mostly in foods people don't generally give to toddlers. People may give a PB & J to a 5 year old, but they don't generally feed that to a 6 month toddler. Not because they are protecting them from peanuts but because generally people dont give sandwiches to toddlers.
https://www.google.com/search?q=infant+co-regulation+vs+self...
https://en.wikipedia.org/wiki/Emotional_self-regulation
So if the "dumb guy" take is "just expose the kids, they'll adapt to it", in the absence of hard evidence to the contrary (and maybe even with it) the average doctor is going to _reflexively_ take the opposite position, because that shows that you (or the conventional wisdom) were wrong.
There are exceptions, and they are either the ones that just don't care at all, or they're the best docs you'll ever find.
[1] https://www.nationaljewish.org/clinical-trials/seal-study-st...
Skipping rope would be my favorite were it not for the fact that you need a lot of headspace for the rope. This makes it unviable except outdoors or at a gym/facility.
It comes from a philosopher, talking about something that is completely not related to health-care, and ironically a strong criticism claiming that people that say things like that are stupid by one of the people most vilified in history by being misunderstood when claiming that things are stupid.
It's just a completely ridiculous thing to check. Like warning that the boiled peanuts contain peanuts, or that a pencil sharpener should not have fingers inserted into it.
There's absolutely some perfect middle ground of "just enough" running that will strengthen, but not deteriorate too quickly, your knees - but again where that point is will vary by individual. It also may not be something that can be determined except in hindsight, partly because medical professionals generally don't start monitoring cartilage until the person is reporting pain or mobility issues (or a known condition they're checking for symptoms of).
Point being that statistically there are useful trends in aggregate data that can be observed, but, paradoxically, those trends don't necessarily translate to good general medical guidance. One counterexample where those trends do translate would be something like that peanut allergy study from 2015 that was linked on HN recently about introducing allergens earlier and frequently to babies, resulting in fewer teen/adult allergies.
You know who "those people" are, don't pretend you don't. You just don't want them mocked either because they make you feel comfy or because you get mistaken for them.
Rowing machines are fine. I'm not sure why they have a he-man scale going up to 11 when the on-water experience is mostly below 4, but I guess people need goals. Bad back goals.
For example take the famous mask debate. It could easily be solved by having volunteers willing to stand in a room with people with covid at various distance, each using randomized masks/no mask. There would be plenty of volunteers for such a study but there's no way it would be approved.
The FDA doesn't count lives lost due to inaction and slow approval of new drugs and treatments. As Munger always said "show me the incentive and I'll show you the outcome." By any rational calculus, that one Thalidomide win by the FDA has caused incalculable death, pain and suffering by pushing out the timeline on not only recently discovered cures but all those built on top.
Imagine for example the number of lives saved if GLP-1 was purchasable over the counter in the 1990s when it was first discovered.
It sucks, as I can't find whatever paper I thought I read that implicated trans fats in allergies. Searching "trans fats allergies" shows several. I'm assuming it was one of the main results.
So my question is largely, why would it be more likely that the advice is why allergies reduced? Seems if there was evidence that trans fats were leading to increased allergies, that removing them would be by far the bigger driver?
Peanut butter isn't something I ever saw before being adult and well into 90s, it simply wasn't a thing, I guess evil capitalist invention with the only goal to subvert our fine communistic paradise, like ie Star wars movies. Raw peanuts were frequent though, I guess one of very few things that actually made it through very badly functioning central planning and wasnt stolen by aparatchicks and collaborants for themselves. Never ever met a single kid having any sort of peanut allergy during growing up, never knew its a thing. I recall one or two with asthma, hay fever and thats it. But same could be said about any form of mental diseases/issues for whatever reason, anxiety, adhd variants and so on... either ignored, undiagnosed or really on much lower levels, dont know.
Kid misbehaving? A fine smack or some other physical punishment settled things at least in primary school. Then things started to change a bit till they overcorrected these days.
What is heartbreaking for me is all the wasted effort and pressure parents are putting on their children for little tangible gain.
Our daughter recently developed EILO. It sounds silly and totally illogical, but more than once, I've found myself wondering if there is anything we could have done to have helped her avoid it.
So yes, that feeling just comes with being a parent, I guess.
I've been to 40+ countries and not once have I been asked about allergies at a restaurant or food shop (i.e., ice cream, etc.)
Further if the restaurant asks ahead of time, that's a signifier that they take it seriously. If you have to tell them, it's much more likely you will encounter cavalier treatment of cross-contamination and such. For some people, that really can be life or death.
Okay, but I’m still noting that if you google this exact claim, numerous recent studies found that running is found to build cartilage, contrary to past assumptions
Imagine this: we are all born with a functional immune system which is pre-programmed with knowledge of what bacteria, viruses, and many parasites look like, so it can immediately deal with these without prior exposure. This is the innate immune system, and in many organisms is the only immune system.
On top of that, a database is created which consists of fragments of all our bodies' molecules. This database is used to train the adaptive immune system. The thymus will then present these molecules to new white (T) cells, and screen out the ones that recognize these "self" molecules. This is the adaptive immune system.
Still on top of that, there's another tier, because maybe 0.1% of T cells escape the first-pass screening. You now have a series of checks and balances which screen for these escaped cells outside the thymus, and either reduce their functioning or eliminate them entirely. This is peripheral tolerance (what the Nobel prize in medicine was awarded for this year).
And when there's an actual infection, this system is able to spin up a few VMs, run a large bug-search model, and create a pool of tailor-made antibodies and T cells specific to the new bug, which in most cases are enough to deal with the infection.
So when all is said and done, and the system is trained and working as expected, you now have an immune platform which, on top of recognizing all its own molecules, can also recognize pathogens, including differentiating disease-causing ones from the benign ones; can also deal calmly with the enormous diversity of things we put in our mouths, noses, and other orifices; and in most cases doesn't actually go rogue.
But sometimes, it can be overcome by peanuts.
People in anaphylactic shock sometimes (often?) need more than one dose, and antihistamine should be taken asap. The epinephrine just bridges the gap until the antihistamine kicks in.
I liked the Ana-kit because the syringe had 2 doses in it (you turned the plunger 90° for the second dose) and the antihistamine. It was much cheaper, and it was pretty easy—- just pull off the needle cap, stick your thigh to the hilt, and press the plunger.
Despite the relative ease of autoinjectors like EpiPen, I was pretty upset when Ana-kit was discontinued and I had to start carrying EpiPens. That’s why I always get the generic 2-pack prescribed and keep it in a ziplock bag with a couple Benadryls.
[1] Darwinian medicine and the ‘hygiene’ or ‘old friends’ hypothesis. https://pmc.ncbi.nlm.nih.gov/articles/PMC2841838
Hell, most of hayfever season in Tokyo is a bunch of people with allergies!
I think you should remember that American TV shows will use certain kinds of extreme scenarios to make a story. Lots of people who are allergic to things in a fairly benign way.
And also just more generally, I think Americans will be more likely to identify that _they have a shrimp allergy_ when every time they eat shrimp they feel bad. But I know plenty of adults who just go through life and be like "I guess I feel sick every time I eat this" and not be willing to use the word "allergy".
Like with humans, though, animals have immune systems which help. This is the trouble with food hygiene arguments: you can eat "dangerous" food and 99% of the time be fine. But it's still good for people to not roll the dice on this stuff, even with a 1% hit rate. We eat food 3 times a day, so that's potentially 9 very adverse events per year!
"Yeah I get food poisoning once every month or two" is a thing that some people live through, and I do not believe they enjoy it. I have not have food poisoning for a very long time, and appreciate it a lot.
https://pubmed.ncbi.nlm.nih.gov/25713281/
tl/dr: In families who use hand dishwashing, allergic diseases in children are less common than in children from families who use machine dishwashing. We speculate that a less-efficient dishwashing method may induce tolerance via increased microbial exposure.
And some gluten free things are pretty good (I'll generally take a gf brownie, cornbread, or carrot cake over the alternative).
But since when is accessibility a bad thing? Are people really troubled by there being options?
Few studies on it. https://pubmed.ncbi.nlm.nih.gov/19000582/
But it’s not actually a joke.
I guess that’s the weird thing about jokes. They often get very close to something that is true but they come at it sideways, so it’s funny instead.
This world makes little sense, but I guess I'm here for it!
Living with a deadly allergy for the rest of one's life is no fun at all. A large part of social life is eating together in various locations where the allergen may not be so strictly controlled. Either one faces an easy death weekly or one opts out of many social activities. It is awful, and not wanting that for one's child seems natural to me, not insane.
I deliberately expose my child to a lot of things I want them to have in their life: climbing, swimming, the game of go, Unix command-lines, Newton's laws, musical instruments, etc. Doesn't seem odd to add peanuts to the list. (Well, for us it is logistically inconvenient because another member of the household has a deadly allergy, but if it weren't for that it would be sensiblre.) Not insane either.
Is it the idea of exposure leading to lower prevalence that sounds insane? That's been relatively strongly established in randomised trials. Not insane.
My first was born in 2000, and her pediatrician told us to ignore the allergen advice. I wonder how many kids Dr Nguyen and others like her saved from debilitating allergies by being willing to go against the bad practices of the time. She also told us to ignore the autism/mmr talk that was popular at the time.
Very often mechanisms are so complex, or simply hard to detect that it is only feasible to look at biomarkers and not the actual cause.
Be careful! You still need to explain why early exposure to lots of bacteria is good, but exposure to lots of heavy metals is (presumably) bad.
Eczema often comes with digestive issues, bowl inflammation, loose stool, blood in the stool etc.
Eczema essentially gives you wounds, if you allow allergens to enter the bloodstream directly without going through the digestive tract you are at an increased risk of developing allergies.
For kids/babies with these kind of issues it's probably better to delay introducing common allergens until their gut can heal or you will end up causing allergies rather than preventing them.
So stuff like ADHD symptoms were definitely not unheard of.
For example, the presence of rats or cockroaches are associated with their own grave impacts on childhood health.
Are farms healthy for farmers or not? Maybe it depends on whether you live above your livestock.
Might it not have mattered? Sure. Might it have prevented their kid from getting the allergy? There's a decent chance.
(If you're allergic to something more exotic, you also know to not blindly trust the reassurances of people who, while good natured and friendly, never had reason to learn the fine points of allergy stuff.)
Also, people don't generally identify with their allergies, it's not like acknowledging the existence of allergic people in a redundant way validates them or something. A sign notifying that milk-free options are available is plenty.
A bridge is built upon a solid foundation of something empirically tested, a hard science and good engineering practice if you will. And if not, it will not remain a bridge for long.
The innumerable electronic subcomponents in any of your electronic devices work very well for years. The MTBF is clearly high or it would be dead on arrival or soon afterwards.
We too easily extrapolate this reliability pattern onto the softer sciences, creating a biological mythology with an underpinning built on inherited opinion and untested speculation.
> "My doctor said blood letting will cure my tuberculosis"
> "Less stress and less coffee will cure my stomach ulcers"
> "Keep Peanuts away from my kid until he can legally drink so he won't be allergic to them!"
The romans built bridges that are still bridges 2000 years before any of above quotes went out of style. Whatever kept them alive for so long can be nothing but a weakly described, but very durable and still present dark pattern of the mind and the public discourse.
source: https://www.visualcapitalist.com/cp/charted-peanut-butter-co...
yes, there were some surprises to me there. I suspect that it's a cooking ingredient in Satay sauce for the top countries. Not on e.g. sandwiches as in the USA.
But the UK is not the same in USA.
I have no data but I think most people simply don't know how to run, urbanites will spend $600 on carbon shoes and run like absolute clowns wondering why their fancy shoes don't prevent injuries... run barefoot in a field and you'll get your natural running gait
I'm leaning towards you in this case, since it's so strongly associated ice cream <-> dairy, but nowadays there are all kinds of frozen ice cream-ish products. But yes, a sign is often enough. Not always, since if the allergy is severe enough, you also can't risk the server not to use the same spoon as peanut ice cream, or a separate spoon but rinsed in a bucket with the others. And it's enough with one slipup.
So, for me, I take it as a positive signal that such a place is likely more aware than other places, and is more comfortable with my probing questions. Many places aren't, and yet others try to assert something they actually can't live up to.
It ain't easy, being highly allergic.
Daughter, highly allergic to peanuts since infant. Had a couple of anaphylactic reactions. This causes your whole system to want to f** you up, as violently and as quickly as possible. Rocket vomiting, throat swelling, asthma constricting your airways, intense feeling of heat and sweating and rashes. And anxiety deluxe, since you feel like you are gonna die, since that's literally what happens. It's a cascading system fault, which will lead to organ failure unless you stop it quickly. You do that with an Epipen, which is bug effin needle that hurts (I've taken one), and leaves you shaking from the adrenaline. And you'll be so full of anxiety and stress so you can't take one yourself, you need someone to give it to you. So you hope that adults around you know to recognize what's going on, and know where your shots are, and know how to administer one.
But you are still not safe, since that might not be enough, you may need another shot within perhaps ten minutes, or six hours from rebound effects. And you know, that due to all this you can't just "take a shot and chillax the rest of the day", you'll need an ambulance and stay under observation for those hours, then you'll be tired like after running a marathon, for several days.
Now consider what that does to you, when just a tiny tiny slip-up from someone is enough to send you down that funnel, and you constantly need to be sure you have your shots with you, anything you eat is safe. It's a constant state where you can't just relax and eat snacks with friends, or a million other things you take for granted.
We as parents do what we can do, and try our hardest to not let her get stuck in thinking about it. She should not have to be responsible for those things working, she should just be another kid to the fullest extent.
Then, as mentioned, a reminder comes in the form of school lunch messed up and the teacher that found her panicked on the thought of giving her that needle, so they gtfo out of there.
Final thoughts. I understand, there are those parents who think that their little angel is the most tender fragile thing in the world. I don't know how warranted that is, perhaps there is a real risk for their child, perhaps not. People take risks differently. I can only offer another perspective and hope for better understanding.
It would be one thing if there was no known link between the two. But it was literally a time when people were not being paranoid when they cautioned to avoid a single ingredient on foods that you buy. They were terrible for you and there is a reason they were eradicated from all food by 2015.
So, I wouldn't expect that this would have no impact. I just question any improvements in the 2008-2015 timeline that doesn't acknowledge how much progress we got from removing trans fats.
Oh I see, thanks for explaining, you are rejecting the underlying science. What about the study do you not find convincing?
We're doing 2200 covers tonight. If you know what that means then you know I don't have a few seconds to spare, and if you don't then you're not really qualified to have this discussion.
>Further if the restaurant asks ahead of time, that's a signifier that they take it seriously. If you have to tell them, it's much more likely you will encounter cavalier treatment of cross-contamination and such
These are provable statements. Prove them.
Mistakes (or unfortunate genetics) in this process along with a mix of unknown environmental factors (smoking? EBV infection?) can affect how likely you are to develop autoimmune conditions where the body attacks itself. For example, people with the HLA-B27 "hash function" are much more likely to develop ankylosis spondylitis, but this gene may protect against viruses such as HIV or Hepatitis C. A lot of the research for the treatment of these autoimmune conditions now is on how to treat the condition without shutting down the entire immune system.
Southern US; I live in a modest-size metro of about 400k and spend plenty of time in bigger cities.
There's a big difference between air resistance and magnetic resistance machines. Air resistance scales with the square of velocity, the same as real rowing, while magnetic resistance is linear. On an air resistance machine you can get a good workout by keeping the difficulty setting realistically low and rowing faster, but on a magnetic resistance machine you'll end up going so fast it becomes difficult to maintain good technique. The higher difficulty settings are more useful on a magnetic resistance machine.
I certainly do no such thing.
>>What about the study do you not find convincing?
I do find it convincing, what I don't find convincing is OP's assertion that because they missed some time period in their daughter's life feeding her peanuts she developed a peanut allergy. It's not an "if X then Y" system - and the study does talk about it in terms of probabilities, not certainties.
We think of smoking as something that kills by eventually causing cancer, but it is much worse.
The "my child developed a peanut allergy because I didn't feed her peanuts, so I recommend feeding your child peanuts every day to increase exposure" part.
Not that the science behind it doesn't support the fact that exposure reduces a chance of developing an allergy - but to go from there to "feed your child peanuts every day" is the insane part.
>>Living with a deadly allergy for the rest of one's life is no fun at all.
You are making an emotional argument where one doesn't need to be made - we all understand that deadly allergies are no joke.
For example: https://www.nejm.org/doi/full/10.1056/NEJMoa013536 https://d1wqtxts1xzle7.cloudfront.net/74207249/j.1399-3038.1...
It is also the case that after sensitization, avoiding the food can lead to eventual desensitization (although it is riskier in the meantime), which was interpolated to support avoidance: https://onlinelibrary.wiley.com/doi/abs/10.1002/j.1536-4801....
"To slow absorption of injected antigens (e.g., insect stings), a tourniquet may be placed proximal to the injection site. "
https://www.aafp.org/pubs/afp/issues/2003/1001/p1325.html
The article says that tourniquets are no longer recommended. It doesn't seem like a tourniquet would be of any help if you ingested something but reasonable for insect stings. Anyone who has taken a first aid course gets warned multiple times about the danger of leaving a tourniquet on too long but maybe random people aren't aware of it.
https://www.thelancet.com/journals/lancet/article/PIIS0140-6... is an older study that supports this pretty directly. Is a big part of why they were removed from the "safe" category in 2015.
Forty years ago, children were more than twice as likely as they are today to die during childhood.
Nature is overrated.
You can argue that this is only in a mouse model. And fair, but evidence is still there that they can directly lead to food allergies.
Do we have direct causal links to children food allergies? No, but nor do we have direct causal evidence for early exposure. My prior is still that people are better at managing their dietary intake when the problem ingredient is literally removed from the ecosystem than when they are just advised to do better.
If you scroll down you'll see they do give context about the African countries. They're major peanut producers, and it's used in a lot of traditional cuisine.
You can grow whatever food you want, and if you want to drink maybe-deadly milk you can raise your own goats or cows. What you can't do is stochastically murder your customers.
US science can not be completely trusted anymore until trump and his idiot brigade are driven out of town.