Peanut Allergy Treatment Trial In UK "A Success" 192
cold fjord writes: "The BBC reports, 'Peanuts are the most common cause of fatal allergic reactions to food. There is no treatment so the only option for patients is to avoid them completely, leading to a lifetime of checking every food label before a meal. The trial ... tried to train the children's immune system to tolerate peanut. Every day they were given a peanut protein powder — starting off on a dose equivalent to a 70th of a peanut. Once a fortnight the dose was increased while the children were in hospital and then they continued taking the higher dose at home. The majority of patients learned to tolerate the peanut. ... Dr Andrew Clark, told the BBC: "It really transformed their lives dramatically, this really comes across during the trial. ... Dr Pamela Ewan added ... further studies would be needed and that people should not try this on their own as this "should only be done by medical professionals in specialist settings."' The story also notes, 'The findings, published in the Lancet, suggest 84% of allergic children could eat the equivalent of five peanuts a day after six months.'"
Standard practice... (Score:5, Informative)
in treating various allergies in the past 10 years. Good studies since 70's.
http://www.ncbi.nlm.nih.gov/pubmed/147019
Re:Standard practice... (Score:4, Insightful)
It's not a particularly surprising result but it's one thing saying that after the fact, and another to do a good quality trial. 90-99% of science (well, to be honest, pretty much of everything worth doing) takes skill and patience rather than a moment of brilliance.
Re:Standard practice... (Score:4, Interesting)
Who was it who said, "Most scientific discoveries aren't hailed with 'Eureka!', but rather with, 'Hmmm, that's weird.'"?
Re:Standard practice... (Score:5, Informative)
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Well...
No.
You need to prove it with a protein extract, if you hope to make a peanut allergy drug.
If you just want to treat peanut allergy, there is no really good reason that a tiny, tiny bit of peanut butter in a large meal won't work.
Start out at a dose which does not kill, and boost the dosage 10%/day.
Re:Standard practice... (Score:5, Insightful)
Yes there is. Peanut butter, no matter how well you stir it, will have random clumps of the allergen and people will die. More stirring does not solve the problem. Random does not mean equal distribution. It means random distribution, some of which will be in larger clumps.
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Homogenization and emulsification are the words you're looking for. There be, like, machines that do it, man.
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He's just being a bit obfuscatory, that's all. Homogenization done on peanut butter is not done well enough for this purpose. Peanut butter that's homogenized enough for accurate dosing in such an allergy treatment has texture quite unlike peanut butter. Even the basic taste seems very different.
I've tasted it myself, but it had nothing to do with allergies, it was merely a demonstration that homogenization is like purification. It isn't parameter-less.
Re:Standard practice... (Score:5, Informative)
However I could see a lot of parents trying this, to a disastrous effect, because it could be the kid who has extremely small tolerance, will get too much and hurt themselves. or increasing the dosage goes too fast for the child.
The real benefit of giving these kids treatments, isn't so they can have a peanut butter sandwich, but have foods that have touched nuts, and go to school and sit at the same table as someone eating a Peanut butter sandwich.
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However I could see a lot of parents trying this, to a disastrous effect, because it could be the kid who has extremely small tolerance, will get too much and hurt themselves. or increasing the dosage goes too fast for the child.
I can see this happening a lot in America. After all, any parents who want to do this will be faced with a $100,000 medical bill for this service, probably denied by insurance, so they'll resort to doing it themselves since it sounds so simple.
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On a side note, I think it's kind
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What I'm wondering is why I never even heard of peanut allergy when I was in school. It doesn't show up on the N-Gram radar until the mid-1980's. Is it really a new phenomena, a kind of epidemic? Or have people only recently become more aware of it?
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While another account is that hysteria over peanut allergies led swarms of new parents to avoid exposing their babies to peanuts at an early age (to prevent an allergic reaction) preventing their immune system from adapting to peanuts thereby manufacturing the very allergic reactions they were afraid of and making it a much more wide spread problem today than it was 20 years ago.
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How does that work?
http://www.telegraph.co.uk/hea... [telegraph.co.uk]
The government has already turned the corner, due to the previous recommendation against peanuts apparently "backfiring".
http://www.nhs.uk/conditions/p... [www.nhs.uk]
Peanuts are safe in pregnancy
Go ahead and eat peanuts or food containing peanuts (such as peanut butter) during pregnancy, unless you are allergic to them or a health professional advises you not to.
You may have heard that peanuts should be avoided during pregnancy. This is because the government previous
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Indeed. I'm too lazy go Google it, but I clearly recall a study from a couple of years ago that showed that the cultures with the least incidence of peanut allergies are those that start feeding peanut containing foods the earliest, around 6 months of age IIRC.
In contrast, the pediatricians around here very strongly suggest not even letting your kids near a peanut until they're 2 years old. Fortunately, neither of my children have peanut allergies.
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However I could see a lot of parents trying this, to a disastrous effect, because it could be the kid who has extremely small tolerance, will get too much and hurt themselves. or increasing the dosage goes too fast for the child.
Do you know many parents? Everyone I know with kids is overly protective of them.
If my sister suspected her kid had a dangerous peanut allergy, there is NO WAY she would try this at home. It's not like bricking your favorite phone, the stakes are ever-so-much higher.
Re:Standard practice... (Score:5, Interesting)
It is not as simple as splitting a peanut in 70 parts.
Excuse my ignorance but why isn't it that simple? If you started feeding people with 1/70 of a peanut and worked your way up wouldn't that have the same effect as extracting the protein responsible fro the reaction and doing the same thing?
Re:Standard practice... (Score:4, Insightful)
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I think you missed where this work was done. The NHS don't pay $100 a shot for many things.
As for how much the shots cost in the US, well that's anyone's guess. But the price in the States is unlikely to be a result of this research.
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What's even better, is that in the US it could cost wildly differently based on who the health provider is.
I did immunotherapy shots for seasonal allergies in the recent past, and the only reason I could afford it was because the HMO I was a patient of administered the shots via "nurse practitioners", so there was a $5 copay per shot plus 30 minutes of reading magazines to make sure I'm still breathing. And that's it.
I really miss that health plan - I'd still be with them if I hadn't moved across the count
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That's a cute, facile jab at Obamacare, but it's probably false. The kinds of plans that get cancelled under Obamacare are the kinds that Republicans think we should all have. High-deductable, catastrophic plans that lead you to believe you have insurance - and may actually help in a catastrophe, but in fact provide very little day-to-day coverage at all. HMO's are probably fine - though I suppose a particular one may need to be tweaked for specific requirements.
Obamacare plans still stink compared to th
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The other problem with plans are the ones that collect your premiums in the hope that you don't get sick. If you do and it is expensive, then they just find a pretext to disqualify you. Maybe they refund your premiums.
Re:Standard practice... (Score:4, Insightful)
Re:Standard practice... (Score:5, Informative)
Not every 70th part is the same. Not homogenous. There's different stuff on the surface, probably a couple layers, and then there's the germ of the seed vs the bulk which is food for the germinating plant, and so on.
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You would have to have a really tiny blender if you were only blending one peanut!
Re:Standard practice... (Score:4, Insightful)
Blend 70,000 peanuts. Administer to 1,000 people.
Re:Standard practice... (Score:4, Insightful)
;-)
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1,000 peanuts and 70,000 people
;-)
I'm glad this sort of thing doesn't happen with real doctors. Does it? [dailymail.co.uk]
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Or we can accept that the scientists already had a disscussion all but identical to the one we're having here so far and arrived at the conclusion they have arrived at because they've been talking about it longer than the 5 minutes we have here.
Seriously, when did we start quesitoning every little method just because we "think" we know better despite the obvious fact we are not all doctors... /rant
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Seriously, when did we start quesitoning every little method just because we "think" we know better despite the obvious fact we are not all doctors... /rant
Do I really need to say "you must be new here" ?
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Are you kidding? That Anonymous Coward guy has a zero-digit UID!
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Correct. But I suspect the hurdle here was to isolate the allergenic factor and administering it correctly. It is not as simple as splitting a peanut in 70 parts: you have to find the right protein, isolate it and dose it. It can be a bitch to do. The results prove that the protein was the right one and that the doses were ok. Finally, the treatment does not work with any substance: there are things that will remain lethal whatever happens as our immune system just cannot catch them. So that is another good news.
No you don't. You could just use ground peanuts.
Re:Standard practice... (Score:5, Informative)
It seems that it WAS standard practice for a long time then medicine forgot all about it for a few years and decided avoidance was the only useful strategy.
Now they seem to be back to the idea that desensitization works and avoidance just causes more allergies. Peanut allergy is a growing problem in the UK because expectant mothers were urged to avoid peanuts.
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I have to say I'm mystified. It's as if an entire profession suffered temporary amnesia.
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Oh yes but the peanut powder has been patented and costs $2000 per month to administer... ...probably...
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In the UK, no. It'll be dirt cheap, and probably free for the patients since the government takes care of that kind of thing.
In the USA, no. Your $2000/month figure is too low. Probably more like $10-20,000 per month. And it probably won't be covered by insurance, so we'll have a bunch of parents trying to do it themselves, to disastrous effect.
Re:Standard practice... (Score:5, Interesting)
My daughter's milk allergy (yes, milk allergy, not lactose intolerance) was treated this way. It started with an almost homeopathic dosage, one drop of milk diluted to 1/20 per day, gradually increasing the dosage over six months. Now she's able to use dairy products freely, which is great. But the treatment doesn't really get rid of the allergy, it just builds a resistance for it, requiring that she gets at least some milk protein in her diet daily. I'll echo the summary though - don't try this without a medical professional.
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So you work at a place that regulates what the kids do outside of school because they might cause a problem for one of the students when they return? Sounds pretty damned f'ed up to me.
How about a return to the days of staying out of society if being in society is so harmful to you instead of demanding that the rest of the population conform to your special situation.
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"Unimaginable" is a word that shouldn't be thrown around lightly.
Come on guys, as far as literary constructs used to convey meaning, comparing the initial dose to homeopathic values isn't crazy.
And nitpicking the correction that it SEEMED like it couldn't possibly have an effect is just being an asshole. Like most of your NSA rants.
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... is just being an asshole.
Welcome to the club.
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We don't wonder. We just wish liberal arts types had to take a couple of science courses. Polish down some of the those rough, dumb as a rock edges, is why.
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generally on the order of 1/100000000000 000000000 000000000 0000000 0000000 0000000 00000 00000
So basically, one molecule of the thing in a gallon of water?
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Yes, standard immunotherapy shots for seasonal allergies have been doing this for some time. But, it hasn't been an effective method of treatment for several allergies, specifically food allergies like shellfish and nuts.
Apparently we can take that last one off the list.
(Note: I underwent immunotherapy for seasonal allergies, which helped some, but did nothing for my main year-round allergy to dust mites, which are practically impossible to avoid.)
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Yup. Real science is repeatable, unlike the majority of health news headlines.
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the remaining 16% (Score:2)
were given nice funerals, or what?
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Re:the remaining 16% (Score:5, Interesting)
Contrary to the media hype, MOST people with peanut allergies don't have a fatal reaction. Just in case, the dosing was started in a hospital setting.
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They were the first members of the new super-secret Peanut Mutant Soldiers.
To avoid being called the PMS unit, they were later renamed (to avoid being called the PMS unit) to Peanut Elements Non Inmunized Soldiers.
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For most of them they probably got a shot of benadryl or some steroid to stop the allergic reaction. That is why this needs to be done under a doctors supervision.
Why? (Score:5, Interesting)
Not why do it, but why does the treatment work? The cited Lancet article doesn't seem to offer any answers (or hint at any efforts to find them).... development of enzyme reserves??
And what of the annecdotal relationship between peanut allergies and *not* breast feeding?
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as said above, this is normal. The reason for the allergy is an over-response to the antigen. upon normal exposue, The mast cells release their chemicals to try and attack what it regards as foreign. But, we do not want that. So, you put a little bit in there on a weekly basis and monitor the patient for 30 minutes. If no reaction, they are good. If reaction, then epipen can stop it. At that point, back it down. What is different here, is that they started with a much lower dose. IOW, nothing really differ
Re:Why? (Score:5, Informative)
Allergy is an immune system reaction to something that shouldn't be a problem in the first place. It thinks that something (in this case peanuts) is dangerous, and launches a full scale defense.
The trick here is simply to get the immune system used to the substance causing the reaction, so that it will think it's normal, rather than becoming defensive. This seems to work, as long as you increase the dose slowly. The method has been used with some success against other allergies for some time, but trying it on an often fatal allergy like peanut allergy is new.
Now, why peanut allergy is so much more dangerous than all the other allergies, I have no idea. But as this trial worked, it does indicate that peanut allergy works like any other allergy.
Re:Why? (Score:4, Interesting)
In terms of the actual mechanism: as far as I recall, immune cells develop with a random specificity: It's pure chance what they'll recognise.
If they're exposed to something that they will react to in their development time, they die: This is how we prevent them from reacting to ourselves.
So although it won't do anything to existing immune cells, the persistent presence of peanuts will at least prevent any new immune cells popping up that will react to them.
Luckily (Score:5, Funny)
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My name is Indigo Magenta. You killed my color. Prepare to dye!
Been There, Done That (Score:2, Funny)
Nutty parents (Score:5, Interesting)
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I know of parents that don't give peanuts to their kids since babies, just in case they have allergies. So the kid does not develop protection. They give them allergies out of paranoia
The problem is not that the kid doesn't develop protection. The kid develops a very strong protection mechanism against peanuts, so strong that it can kill. Because peanuts are unknown they are assumed to be a threat.
But you're right; it is a case where trying to protect the children is the worst you can do.
Re:Nutty parents (Score:5, Interesting)
The advice being provided by the state-provided Maternal and Child Health Nurses in Australia (or at least, the ones I know of) is now to start giving children pulverized nuts (so they don't choke on them) as part of their diet from the very beginning of consuming food, apparently for this exact reason.
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Most adults don't swell up and die just because they encounter something new.
So we shouldn't assume that it's such a great idea to intentionally introduce such allergenic foods to young children without independently reproducible proper scientific studies (too much fraud nowadays) proving that it's a better idea for most.
http://onlinelibrary.wiley.com... [wiley.com]
. The most effective dietary regimen is exclusively breastfeeding for at least 4â"6 months or, in absence of breast milk, formulas with documented reduced allergenicity for at least the first 4 months, combined with avoidance of solid food and cow's milk for the first 4 months.
I know some parents introduce some foods before the baby is even 6 months. But as the recommendation says - exclusive breastfeeding for at least 4-6 months
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All the research today shows at the very least no increase in risk of allergies by starting common allergens earlier, and several studies show improvement with it. If you don't have a family history of food allergies, there is basically nothing you cannot feed to your child as soon as they are able to safely chew and swallow it. The only exceptions are corn syrup and honey (which can cause infant botulism) and diary milk (mostly because it doesn't have enough iron and they should be on formula or breast m
breastmilk not a panacea (though still good) (Score:2)
I've got an iron constitution and can eat anything. Both my kids are sensitive to cow's milk and soy protein (not allergic, but it gives them stomach pains and bad gas). Nuts are totally fine.
When my wife was breastfeeding our first kid we noticed that *he* got symptoms when *she* consumed cow's milk. So whatever is problematic in the dairy was being transmitted through the breastmilk.
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Like recent research that illustrates a strong inverse relationship between having pets generally (and dogs specifically) in the family and childhood allergies (http://www.pediatrics.wisc.edu/featured-stories/allergies.html), my understanding is that there's a growing preponderance of clinical trials and evidence that suggests that MANY of the growing number of widespread childhood allergies have to do with controllable factors in the environment (ie hyper-clean environments, antibacterial soap, etc).
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Because the pediatricians tell us that if we give peanuts to a child under 2 years old, he will die (ok... they really just strongly advise against it). Should we ignore the advice of the pediatricians and medical practitioners that supposedly spent a long time in school, have followed studies related to childhood development and allergies, and whom we trust to help us fix our kid when he is running a 105 degree fever, covered in a rash, and vomiting?
We are also advised to avoid honey during the first year
suggestions are changing (Score:2)
"Because the pediatricians tell us that if we give peanuts to a child under 2 years old, he will die (ok... they really just strongly advise against it)."
That's just it, that *used* to be the recommendation, but now there are multiple studies coming out showing that the above advice may not be the best course of action. If your medical professionals are staying on top of things they may start to change their recommendations...
Re:suggestions are changing (Score:5, Informative)
And it is going to take a long time for those new recommendations to make their way into the general public. There are piles of parenting help books that old parents gleefully shovel onto new parents. There are articles and magazines and Grandma and the crotchety old lady down the street. Everyone has an opinion about how you should be raising your kids and how you are doing a shitty job at it and your kids are going to die or need therapy or be a bum because you didn't give them the special new omega whatever supplement that promotes brain growth.
And the advice is constantly changing. My husband is the youngest of three. His eldest brother slept on his stomach as a baby. Their mom was told to put the middle one on her side using this bizarre wedge pillow everyone had to buy or your baby would die, and by the time he was born, we had decided that babies had to sleep on their back. They just recently came out telling us to keep kids in rear facing car seats until they are two and they are pretty much in booster seats until they turn 21 now.
On top of that, you only ever really get one shot at being a parent. You might get a couple tries with different kids, but each kid is only ever a baby once.
So give the parents a break. They've never done this before, are sleep deprived, are the scourge of all the non-parents in the grocery store, and all they really want to do is go home, drink a beer, watch a TV show that doesn't involve a super hero named 'Word Girl' from the planet Lexicon, fall asleep, and not get woken up by a 30 lb bouncing bundle demanding pancakes at 5AM on a Saturday.
Feed your kids, people (Score:5, Insightful)
Feed your kids real food, people, and let them play in the dirt. Get a pet. If you want your kid to have a healthy normal life, expose them to things in normal life. If you wrap them in Triclosan-scented everything and feel them gluten/soy/sugarfree Brawndo for years, they'll never learn to metabolize or tolerate anything else. Life carries risk, and as much as public education has taught you that causality is a human construct, it ain't - learn to deal with things or they'll deal with you, you pussies.
Re:Feed your kids, people (Score:5, Insightful)
OK. So I have two kids. Both of them were raised essentially the same way. If anything, the younger was coddled more, and spent less time in daycare. Yet the elder has severe dairy allergy, and the younger has none. My brother and I grew up in the same house exposed to the same pets, playing in the same dirt. I am allergic to cats now. He is not. My wife has peanut allergy; her sister does not. The list could go on, but you get my point.
Are you really implying that people should feed their kids food they're allergic to? "Well son, sure you can't breathe and you're covered in hives, but at least Gothmolly doesn't think you're a pussy!"
Do you really think it's as simple as "go play in dirt and you won't get allergies"? I've got a different unsupported hypothesis pulled out of my ass. The reason why more sanitary countries have more allergies is because in the developing world, the people with allergies don't live long enough to pass their genes down to the next generation. Had I been born in some third world country, I would have died before I turned 10 due to respiratory problems.
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Of course things were less well known back then, but there were also smaller communities, so there were less chances of running into people with allergies. Now we have social sites where we see the communication of thousands of people we've never met in real life. I only know 4 people will peanut allergies personally, and only live near 2 whom I see on a regular basis, yet in this thread, I've already read posts from 10 or more people with the allergy. My point is, just becaus
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and even so some kids are still sensitive (Score:2)
We did all the right stuff (breastmilk, good food, have a cat, play in dirt, etc.)
However, both my kids are sensitive (not allergic) to soy protein and cow-based dairy products, and my older kid seems to react to gluten.
We discovered the dairy issue while he was still breastfeeding...he got really bad gas/bloating when my wife consumed dairy products. Took us months to realize what was going on.
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This works for some things better than others. I grew up allergic to just about everything (including peanuts). Easing into things, I can handle milk and poultry just fine as an adult. I have dogs but can still get stuffy if I don't clean up after them. Eating a peanut will still have me in full-blown anaphylaxis and needing medical care in about three hour (it happens by accident every couple of years). Sitting on a Southwest flight I will still get hay fever like symptoms due to the peanuts being ser
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Can you train to tolerate snake venom? (Score:2)
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Sorry (Score:2)
Who the hell didn't know this already? I've been bleating about it for ages.
It's almost entirely caused by the "avoid peanuts during pregnancy" self-fulfilling prophecy (if you do so, chances are the next generation will be more allergic to peanuts).
When I was a kid, the kid who was "allergic" was rare, one-in-a-whole-school kind of event. Nowadays, working in schools, I see medical lists in schools where something like 20% of their roll lists are allergic to something-or-other.
Nuts figure heavily, as doe
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The actual "disease" here is affluenza, or perhaps it's anxiety that overprotective mothers project onto their children. I grew up in a small town, had pets, played in the dirt every day. Nut allergies were unheard of. It's also very interesting that farmers and dirt poor people in 3d world countries don't get these allergies. This is a problem that city dwellers construct. It's called the hygiene hypothesis.
It is very suspicious that neither the BBC article nor the Lancet abstract report a mortality statis
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Well, the posting system stripped off my carefully inserted links. WTF, slashdot? I'd post the code to illustrate, but it just gets stripped out. Here are some URLS to go with my post:
http://www.nytimes.com/2009/01... [nytimes.com] Jane Brody on the hygiene hypothesis
http://www.slate.com/articles/... [slate.com] Broussard article on slate.com
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The actual "disease" here is affluenza, or perhaps it's anxiety that overprotective mothers project onto their children. I grew up in a small town, had pets, played in the dirt every day. Nut allergies were unheard of. It's also very interesting that farmers and dirt poor people in 3d world countries don't get these allergies.
I'm not saying you're wrong; I'm sure environment plays a part. But have you considered that one of the reasons why these things were "unheard of" until recently is that advances in communications have made it much easier for news of rarities to be widely disseminated?
The same kind of argument applies to cases of botulism from home canning. Prior to the 20th Century, if someone died from botulism due to home canning, it happened on a farm in the middle of nowhere and didn't have much effect outside of a fam
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Wow. Thanks for the insight. If only you could have been around to honor us with your knowledge a few years ago.
My wife routinely ate peanut butter during her first pregnancy but our child still has a peanut allergy. Maybe you should specify that it is the 'crunchy' variety everyone needs and not the 'smooth' that my wife prefers.
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just another reply to tell you that you're wrong. Wife is SE asian and consumed the normal mountain of peanuts and other nuts (and eggs) during pregnancy as she always does. Son has egg and nut allergies, his sister does not. Apparently no correlation with food consumed by mother, nor easily identifiable other environmental factor.
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Louis CK covered this (Score:4, Funny)
Louis CK: Of Course But Maybe [youtube.com]
Nuts to me (Score:2)
My allergy to peanuts and cashews has been going strong for over 50 years and I'm still alive. Peanuts and cashews are the worst, and to me, the difference is like between a bee (peanut) and yellow-jacket (cashew) sting. Similar reaction, but stronger and nastier. Peas, lima beans and lentils also cause an allergic sensation, but won't get me sick
As a kid, today you get protected, but once out on your own, shit happens. In third grade, I knew I couldn't eat the peanut butter candy we were making in cla
Of course, but maybe (Score:2)
http://youtu.be/wEb5a-I0kyg [youtu.be]
So its true... (Score:2)
Allergies mean you are a pussy.
Re:"There is no treatment" (Score:4, Insightful)
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