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?
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.
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.
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.
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.
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.
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"
Putting China to one side, broadly speaking weren't the most stringent and prolonged restrictions mostly in wealthier, highly-developed countries?
"Older adults are at highest risk of getting very sick from COVID-19"[0]
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
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.
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.
I'm pretty sure it is.
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.
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.
Pretty irrational, but definitely celebrated.. eventually
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 don't particularly believe this, but it fits Occam's razor, so it seems to deserve some examination.
How? You can use that to decide between two (or more) explanations, but you only presented one.
Science failed here.
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.
https://www.astralcodexten.com/p/book-review-from-oversight-...
In this case: "allergies and intolerances are made up stuff for weaklings, haha".
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
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.
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.
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...)
NOT ON MY WATCH.
Just one or two nights of pain and the baby was on normal formula without any issues.
That kid can now enjoy milk and cheese, and not be a little bitch.
ChrisArchitect•3h ago