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(UK) "Extreme food allergies on the rise": 'great mysteries of our time'

July 15, 2023, Guardian: ‘It’s one of the great mysteries of our time’: why extreme food allergies are on the rise – and what we can do about them

More and more youngsters are experiencing serious reactions to everyday foods – and even our pets are suffering. We meet one family who lost a son to anaphylaxis and ask what can be done

When five-year-old Benedict Blythe woke up on the morning of 1 December 2021, he was excited that Christmas was coming. He came downstairs to open the first box in his Advent calendar containing a plastic springy frog and a dairy-free white chocolate (Benedict was allergic to milk, along with many other foods including soy, sesame, eggs and nuts). It was Benedict’s first term at school – Barnack primary in Stamford – and he loved it so much that back in September, he had cried when he learned that there were no classes at the weekend. That morning, he went off cheerfully to school with a small packet of dairy-free McVitie’s Gingerbread Men for snack time. He seemed happy and healthy when he arrived but by the afternoon, he was dead, having collapsed with anaphylaxis….

Having never suffered from allergies themselves, it was a shock to Helen and her husband Pete when Benedict had his first violent allergic reaction at four months old. On Christmas Day, he had a mouthful of baby rice then, two days later, baby porridge containing traces of whey powder and immediately went very red in the face and started blowing “bile bubbles” out of his mouth. They phoned 999 but by the time the paramedics arrived, the bile bubbles had stopped and Helen had the impression that “they thought we were dramatic parents”. A few weeks after this, they tried him on a tiny bit of formula milk along with his breastmilk and he started crying loudly and vomiting until every last drop of the formula was out of his body.

Despite these extreme reactions, Benedict’s GP insisted it was probably a virus causing his symptoms rather than the whey powder and Helen – a management consultant – had to fight to get him referred to an allergy clinic and eventually diagnosed. “Milk and eggs are part of everyone’s everyday culture,” Helen says. “It’s a hard mindset to see milk through a dangerous prism.”….

The average time between consuming a food and cardiorespiratory arrest is only 30 minutes

Food allergy, as the paediatric allergist Adam Fox has remarked, is the only chronic condition that can take a child from perfectly fine to unconscious in a classroom in such a short space of time. When disaster hits, it happens at lightning speed. In cases of anaphylactic death, the average time between consuming a food and cardiorespiratory arrest is only 30 minutes. Yet despite this, I was astonished to learn that there is not a legal requirement for British schools even to have an allergy policy. At the pre-inquest hearing, it was noted by a lawyer for the family that Barnack primary school did have a four-page allergy policy but that it was not very specific about what to do in cases of anaphylaxis. When I contacted Peterborough council to ask whether the school or the council had changed its allergy policy in the light of Benedict’s death, it emailed to say: “Following the incident, our health and safety team carried out a review of the school’s policies and did not identify any concerns.”…

The rise in food allergies is one of the great mysteries of our time. Foods that are positively healthy for most of us can be toxic to someone with allergies, even in quantities smaller than a teaspoon. From celery to walnuts, fish to sesame seeds, peas to wheat, the list of major food allergens gets ever longer. What’s more, allergies – which were once seen as mostly limited to childhood – are now more likely to continue well into later life. …

No one is born with a food allergy, although it does seem to run in families to some extent, so something in the modern environment is driving it. MacPhail points out the startling fact that pets are now suffering the same allergic symptoms as their owners, with “skin eruptions and persistent scratching and grooming” in dogs, whereas species of animals that do not live alongside humans seem to be free from allergies so far. The impossible part is figuring out what in the environment – from our stress levels to what we eat – is doing this. In some ways, our world is too dirty now – the rise in asthma is clearly linked to increased air pollution – and in other ways, it is too clean. One of the most popular theories is the “hygiene hypothesis”:

the idea that we grow up in a “too clean” environment, which could make our immune systems become sensitised. Another related theory is that our sedentary indoor lives are depriving us of vitamin D from sunlight (vitamin D appears to offer some protection against allergies).

Perhaps the most persuasive explanation is the changing composition of gut microbes in modern times, but this is really just another way of saying that food allergies are caused by “everything”, given that the composition of our gut microbes is affected by everything from eating ultra-processed food to being born by caesarean section….

Whatever the causes of the allergy epidemic, MacPhail’s concern is that “it’s a prickly problem that we have no idea how to handle”, and that it will only get worse as the number of children with allergy continues to rise. Ten years from now, she says, “We are talking about 10 or 20 students out of every 100 … That’s a problem we can’t ignore and we don’t have any processes in place to deal with it except for the EpiPen.” …


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