60k kids have avoided peanut allergies due to 2015 advice, study finds

"What doesn't kill you makes you stronger" makes for a fun little statement. It's not actual natural law though, right? I feel like it's fairly well documented that good hygiene is a win for humanity as a whole, so I have some skepticism for generally saying "well let the kids eat dirt". We did that for centuries already!

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

> "well let the kids eat dirt"

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.

And most of them die young.

But mostly not because of what they have eaten.

You have to balance the future immune system with current dysentery.

A justification I read once is that the human immune system evolved to deal with a certain amount of pathogens. If you don’t have enough exposure to pathogens, the immune system still tries to do its job, but winds up attacking non-pathogens.

And one of the ways evolution dealt with this problem is evolving intelligence the can then tell you to improve hygiene practices to reduce the "natural" death rate

> Various allergies are a decently big thing in many parts of the world

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.

Yes, evolution kills the weak. I don't think you're saying "let them die"?

It makes for good TV. I think only a couple hundred Americans die a year from anaphylaxis. And many of those are from medication allergies.

> "What doesn't kill you makes you stronger" makes for a fun little statement. It's not actual natural law though, right?

I'm pretty sure it is.

https://en.wikipedia.org/wiki/Immunological_memory

https://en.wikipedia.org/wiki/Supercompensation

No, it is not in any way a universal principle. The counterexample is Lead. A little lead in the diet does not make you stronger.

If it makes you feel better I’m nearly 50 and I have never in my life heard of people needing to take allergy medication for mistakenly touching caterpillar hairs.

Only a sith deals in absolutes.

Nobody is suggesting you go and add some heavy metals to your corn flakes (except you).

My dog will eat literal street crap at the first opportunity. She’ll also just throw it up on the carpet 2 hours later if she’s not feeling it. Not sure that’s a really an improvement.

Well they are, if they're suggesting that "what doesn't kill you makes you stronger" is anything beyond a catchy saying.

> (except you)

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.

Or maybe the prevalence of peanut allergies is really low.

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.

More generally regarding poisons, see https://en.wikipedia.org/wiki/Mithridatism . TLDR: YMMV.

"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.

Same in a decent chunk of Europe too. Allergies exist, but are rare and more of the type where you're not quite sure you believe the person telling you they're allergic because it hadn't even occurred to you there can be an allergy for that. Like tomatoes, peppers, raw carrots.

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 funny thing about trying to apply this logic in reality is that it often breaks down in ways that can be really, really bad.

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.

While that deals with deliberate poisoning, when it comes to environmental contaminants such as lead and other heavy metals, or PM10s from vehicle exhausts, the other by-products of coal power stations and wood fires etc. I suspect that long-term exposure to these is not something where "you can build a tolerance" is a useful framing at all. Even if you technically do, it's irrelevant to the harm caused over time to whole populations.

also:

https://en.wikipedia.org/wiki/Hormesis

>only got to in 2015

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?

Citation needed.

What doesn't kill you postpones the inevitable. Sometimes it makes you stronger, often it makes you weaker. E.g. if your arms get amputated you're extremely unlikely to break your bench press personal best afterwards.

Not true generally. For example, catching Measles can wipe out your immune system thereby making you more likely to get sick. Other pathogens can also work this waym

Most animals die. Most babies die, too, until medicine and hygiene.

Those are not normal food where I'm. Never eaten any of those. Basically I've never heard people getting allergy from foods that we eat here.

That one incident was serious, the person slept over a caterpillar getting stung all over body. Here all caterpillars have venom in hair. Personally I've touched many times by mistake, but didn't have to take medicine, the itchiness & swelling goes away within a hour.

>Evolution dealt with this problem since forever.

For humans, that solution may have been 9-month gestation periods and two-decade fertility windows. A solution, to be sure, but not very desirable.

Speaking as someone who has had a lot of experience talking with doctors in poorly-understood clinical situations over the years, most doctors display a need to establish informational authority over their patients.

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.

There are tons of counterexamples. Chronic traumatic encephalopathy. Limb amputation. Displaced bone fractures that are never set. Crohn's Disease. Being in a coma for six months and losing all of your muscle mass. Third degree burns over 90% of your body. Plenty of things that don't kill you also don't make you stronger.

> "What doesn't kill you makes you stronger" makes for a fun little statement.

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.

I think this is selection bias. I know plenty of people in Asia who have plenty allergies to some degree or another (selection bias on my side as well)

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".

Sorry I might have expressed myself badly, I get it works sometimes but it's not a hard law for "everything", even if... maybe it's a good default? maybe?

Plenty of stuff is poison to animals as well as humans! Lots of animals get sicknesses and like parasites from everything they eat.

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.

Google says HLA-DQ and HLA-DR genes vary more in Asian populations. Seems like it’s a factor in both allergies, immune systems, and an increase in diabetes.