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Comment by Udo | Hacker News Reader

Something's still missing. Peanut allergies seem to be very common in the US, but almost unheard-of in the EU. Yet, I would say the US is the country with way more peanut products and more peanut exposure. In northern Europe (my main experience is Germany), peanut butter has made the mass market only relatively recently (I'd say about 20 years max), while before most peanuts were being consumed by adults in the form of salted nuts as a late-evening snack. Compare that to the US where peanut butter has been a staple food ingredient since at least the sixties.

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An allergist I spoke to said that the recent explosive increase in child peanut allergies has them examining the possibility that some recent change in the ingredients in some medication, or possibly a food, given to pregnant moms or babies or toddlers is somehow tricking the immune system into an extreme reaction to peanut proteins.

I realize that my recollection here amounts to an uninformed rumor, but my point is that there may be some, possibly very minor, mystery ingredient that has recently been added or substituted for something else in some food or medication, that just happens to have the right chemical structure to trigger a crazy mal-adaptation in a new immune system. If so, identifying it might require years of detective work.

Entirely possible that Parent in the United States are paranoid over what they feed their children, and have been given strict guidance by their pediatricians to not feed peanuts prior to age three under threat of being a "Bad Parent."

We have suspected that parents are too protective.

http://www.m.webmd.com/a-to-z-guides/features/kids-and-dirt-...

I've also heard a theory that U.S. federal assistance to mothers gave lots of peanut butter, possibly leading to more allergies. I can't find the reference, though.

Giving more peanut butter to people might discover an existing allergy, but I was under the impression that more exposure to allergens lowers the risk of the immune response to the allergen. That's the idea behind allergy shots.

I'm not a doctor, though, so some clarification on that would be helpful from anyone who knows more than I do.

Which is entirely contrary to the results of this research, which indicates that exposure to peanut proteins at a young age radically reduces peanut allergies.

That doesn't explain the massive increase in wealthy children with these allergies.

I don't know if it's better to give children under three peanuts or not, but I don't see why it's fair to characterize the people who advise against it, as accusing people of being "Bad Parents".

Has the advice been presented in a particularly emotive or extreme way, that would justify your characterization? If not, I think you are muddying the debate by using this kind of language.

I'd say that giving children under three peanuts is a bit miserly - give them at least half a dozen. They're pretty cheap... :)

I read it this way the first time, too.

> almost unheard-of in the EU

Not really true in my experience in the UK. Most schools around here have no nuts policies for food brought in by children, because of the prevalence of nut and peanut allergies. (And I know peanuts aren't nuts, still).

Schools do have that policy, but in my years in school and indeed adult life since then I've never been aware of knowing anyone with a peanut allergy (anecdote not data etc.)

I live in the US and I don't think I've ever known anyone with a peanut allergy either...

My wife's an infant teacher (5-6yo), and I'm a governor of my son's school (they take 4-11yo). There are about 200 students in each. And there is at least one severe nut allergy in each (i.e. epi pen level), and in both my wife's class and my son's class there is one more minor nut allergy (rash level).

If we're doing anecdata, I know two people in England with peanut allergies.

Same here.

Also, if nut allergies were unheard of in the EU.. why would nut-allergy news be on the BBC's front page?

Some allergies are activated by exposure. For instance, health care workers (or any other job that requires latex gloves) have a far higher rate of latex allergy than the general population.

Could that just be that health care workers are more likely to notice a latex allergy due to repeated exposure?

Somewhat unlikely. Latex is in LOTS of stuff you might not think about - like bath mats, baloons, etc. Even duct tape contains latex. Anything containing natural rubber.

Maybe there's a spectrum of responses and the people on the gentle end just don't have difficulty putting up with the symptoms unless the material is literally pressed to their skin for hours on end?

My hands feel slightly puffy and look slightly red after handling some types of rubber. I can wear latex gloves without issue, so that's not it, but if there are people who react to latex like I react to certain kinds of rubber then I can easily imagine the allergy going unreported.

True, but it's one thing to blow a balloon or stick a piece of duct tape, another is to use a glove for hours a day.

And some are mitigated by exposure. Cashew shell / mango skin / poison ivy, as an example.

It's what makes addressing it so difficult - we know it's an immune response, but don't understand the mechanism that triggers it.

Yep! New research couldn't come sooner - while luckily I'm not deathly allergic to anything, I have moderate reactions to a wide spectrum of environmental stuff. I got shots for years in my teens which helped a lot, but now I've noticed in my early 30's some of that immunity seems to be decaying.

Are dishwashers less common in the EU than the US?

NPR had a piece on washing dishes by hand vs. using a dishwasher: http://www.npr.org/blogs/health/2015/02/23/387553285/kids-al...

According to the "hygiene hypothesis" people are growing up in environments too clean to properly train their immune system, and it leads to allergies and other autoimmune disorders.

That addressed specific things, like hayfever, asthma, eczema. Kids are exposed to lots of peanuts via ingestion, so that would not be it. Unless you're seeing a linkage between those allergies and peanut allergy. to me that would be unlikely.

> Are dishwashers less common in the EU than the US?

Everyone I know here in Norway has a dishwasher. Of course, we didn't have one growing up (I'm late 30s).

I thought we already knew that allergies can be activated by exposure and existing allergies can be exacerbated by repeated, intermittent, exposure; what this suggests that is new is that peanut allergies can be prevented by early and continuous exposure (I think that there is already information that at least some allergies that are already formed can be mitigated by continuous exposure, as well.)

What's "missing"?

I live in the UK and I'm relatively good friends with 3 people with potentially fatal peanut allergies, all in their mid 20s. I wouldn't be surprised if I've known more to a lesser degree who haven't said anything about it.

Fortunately we have statistics! In the UK[1] it was 1 in 200 (0.5%) (no date given) and in 2002 was found to be 1 in 70 (1.4%). In the US the prevalence has also risen, from 0.4% in 1997 to 1.4% in 2010.[2]

So certainly the UK doesn't have less peanut allergies. It would be interesting to know how it varies across Europe. It would be interesting to know to what extent genetics is a factor (although that would probably require genetic sequencing of everyone involved in a study, which would be expensive)

[1]: http://www.anaphylaxis.org.uk/userfiles/files/statistics%20-... [2]: http://well.blogs.nytimes.com/2014/02/03/as-peanut-allergies...

The local college here in Sweden is a peanut free zone, with signs at the entrance and in the cafeteria declaring it so.

The dutch think they invented it.

European here. I tried peanut butter once. It was disgusting.

Also European here. You might not have tried the right peanut butter. Many big-name brands add sugar and salt, and also palm oil (to prevent separation). If you try peanut butter that's actually just 100% peanuts (you'll know if you have to stir it first) then you might have a different experience. Or you might not.

I lived with a guy from France a few years ago and he absolutely hated peanut butter and couldnt figure out why we all ate it so much. Had no problem adjusting to pepperoni cheese steaks though!

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