The rise of an allergy nation

Posted on: Sat, 10/28/2006 - 12:45pm
2BusyBoys's picture
Joined: 09/03/2004 - 09:00

Our Western lifestyle is making us allergic to our environment and food, and treating this has become a multibillion-dollar industry, Erin O'Dwyer writes.

TAPED to the wall of a child-care centre in inner-city Sydney is a four-page spreadsheet of children's allergies.

One little girl brings her own water and one little boy can drink only soy milk. There are three vegetarians and a handful of gluten-frees. One poor soul can't eat honey, strawberries, peanuts, eggs or sesame products.

It's a compelling snapshot of our itchy, scratchy nation, in which about 40 per cent of Australians have an allergic disease, including asthma, eczema, food allergies, and hay fever.

Another week, another health fad? Sure, it's easy to dismiss our obsession with gluten-free diets and ayurvedic medicine as the latest consumer craze. Vogue magazine recently described health as the new Prada - another thing to show off and lavish money on. Yet startling international research shows that allergies are indeed on the rise. The International Study Of Asthma And Allergies In Childhood found the number of children with allergies rose worldwide in the 1990s.

The study, published in British medical journal The Lancet last month, involved 56 countries, including Australia, and interviewed 500,000 children aged six or seven and 13 or 14 about their symptoms. It found rates of asthma, eczema and hay fever increased between 1991 and 2003, with the younger age group most susceptible.

The Australian data, collected from a group of Melbourne schoolchildren in the younger age group only, showed increases in eczema and hay fever but decreases in asthma. The asthma finding is supported by research suggesting a plateauing in the number of asthma cases in the first part of this decade, and possibly a decrease now. So why?

"That's the $64,000 question," says Dr Rob Loblay, director of the allergy unit at Royal Prince Alfred Hospital in Sydney.

The hospital's food allergy case load has more than doubled in recent years and accounts for more than a third of the unit's patients. Loblay is trying to understand the dramatic rise in anaphylaxis - the most severe form of allergic reaction. It can happen in minutes and cause life-threatening constriction of the airways.

The condition first gained national prominence in 1991 when Sydney mother Richelle Townsend suffered irreparable brain damage after eating a Thai meal containing traces of peanuts.

The death of 13-year-old Hamidur Rahman after eating peanut butter on a school camp in 2002 prompted calls for mandatory allergy education for teachers across Australia.

Teachers in NSW receive specialist training, and photographs of children with severe allergies are taped to the walls of classrooms and canteens. In some schools, canteens are nut free.

Peanut allergies and bee stings are the best-known triggers of anaphylaxis, but also high on the list of potentially lethal foods are milk, eggs, sesame, fish and soya. In Britain, peanut allergies have more than doubled in the past nine years.

Data in Australia is limited, although figures collated from national hospital admissions are due to be released early next year. Loblay has seen the raw data and says the numbers are startling, especially considering they do not include ambulance call-outs.

Ambulance call-outs are mind-boggling, too. In 2005-06 there were 2086 anaphylaxis call-outs in NSW alone - a 33 per cent increase since 2001-02. Which, of course, makes redundant a 2002 study by the Australian Pediatric Surveillance Unit, in which 110 reported cases of acute food-induced anaphylaxis were counted.

"The ambulance figures were not so much surprising as sobering," Loblay says. "We know from our own clinical experience that there are lots of cases, but any one clinic only sees a fraction of the cases. So it's sobering to see the numbers when you add it up for the entire state."

THE HUMBLE peanut is the key cause for concern. The increases in peanut allergies have not been paralleled in egg and milk allergies.

Again, why?

"Generally the particular foods people get allergies to are a reflection of what foods are being consumed most, so there has to be a change in the exposure of the young children to peanuts," Loblay says.

"There is some evidence that contact with broken skin can make people allergic. For example, some of the moisturisers contain various nut oils, and that's one means of exposure. That would be more common in kids with eczema because they have dry skin, and there is a correlation between kids with eczema and skin allergies."

But that's not the full story. New evidence suggests nursing mothers who eat nuts might be contributing to allergies in their babies.

"Food proteins come out in the breast milk, so are mothers eating more peanuts? That is something we're exploring now," Loblay says.

"Interestingly, now that people are becoming more aware of peanuts, a lot of families are avoiding peanuts but having other nuts instead. Which is why we are now seeing cashews appearing on the radar."

At the Children's Hospital, Westmead, Andrew Kemp, a professor of pediatric allergy, has several theories as to the rise of our allergic nation. But he is stumped about the findings that asthma has plateaued while eczema and food allergies keep climbing.

"Nobody can say why," he says. "The general increase in allergic disease this century seems to have something to do with Western lifestyle because it happens in the West, and when people move from developing countries to a First World environment they seem to get more allergies."

He says the theory that our cleaner living environment means we are less exposed to bacteria and thus more susceptible to allergic reactions does hold water, but cautions that it is not the full story.

He also cautions against gluten-free diets and other regimes of the moment, saying self-diagnosis can do more harm than good.

"Certainly in our field there is a small subset of people who are unnecessarily on strict diets without any evidence that it will do them any good and some evidence that it might do them harm," he says. "There are lots of people peddling unorthodox advice. If you are going on a restrictive diet, you really do need to have a proper diagnosis."

These days, gluten-free products are almost everywhere, but it was not always so.

Better labelling and a more diverse range of gluten-free breads and pastas has made life easier for Australia's estimated 250,000 coeliacs - for whom the gluten in wheat, rye, barley and oats is poison.

Not surprisingly, the increase in the market for allergy-free food products has been fuelled by an increase in the number of allergy sufferers. Each year there is a 15 per cent increase in the numbers diagnosed. This is due partly to increased awareness and partly to increased incidence, says Coeliac Society of Australia spokesman Graham Price.

A lifelong gluten-free diet is essential for coeliacs, but plenty more have jumped on the bandwagon.

Price says this means that true coeliacs are sometimes at risk of being dismissed as among the newest group of hip health-food consumers. "There are a number of people who self-diagnose a gluten restriction," Price says. "They do that because they feel better. If that's the case, then we strongly advise them to have the proper test for coeliac disease."

Dietitian Clare Collins says people who impose on-again, off-again restrictions can make their reactions to those problem foods worse. Self-diagnosing can contribute to a food intolerance later in life, as distinct from a true food allergy, which is more common in childhood.

"A true food allergy has [an] immediate onset and symptoms that are quite dramatic - it's like a lock-and-key set up," she says.

"A food intolerance is more [like] if you keep bumping on the door, you'll break it down. They tend to be much more common and much harder to diagnose."

Collins is a believer in the hygiene hypothesis. She also considers that the rise in food allergies could be attributed to more chemicals, preservatives, colourings and flavourings in food. She says that peanuts, in particular, are more common in food processing than before.

"In general you are wise to avoid additives, colours and flavours, and doing that will improve the quality of your diet," she says. "But if you think it may be a particular thing, start to take notice of what causes it. Write a diary of what you eat and see a dietitian."

OUR FASCINATION with all things allergic has led to Australia's first Allergy Expo and Gluten-Free Food Show, planned for the Sydney Convention and Exhibition Centre next month. Organiser Dave Whimpey began researching allergies after his own daughter was struck down.

The show has attracted 140 stall holders, and many had to be turned away. Whimpey expects 20,000 people to attend the show - a record for a first showing at the centre.

And he says that small niche companies are no longer alone in investing in products that don't cause allergies.

"We started doing some research and the statistics were frightening - up to 40 per cent of Australians suffer from some sort of allergy," Whimpey says.

"We decided that there was an opportunity here to help people seek out and find all of the necessary solutions for them to improve their quality of life."

One company well placed to ride the wellness wave is cosmetics giant Dr Hauschka. Established in the 1920s and based on the life-in-harmony philosophies of Rudolph Steiner, it is a super brand in Europe. Dr Hauschka is gaining prominence in Australia with its line of organic and wild-plant skin-care formulas.

The cost of certified organic skin care is considerable, but Dr Hauschka's business manager, Arthur Manrique, says an increasing number of Australians with skin allergies are turning to all-natural products because of their benefits.

"The skin is the largest organ of the body and, as such, it has the greatest ability to absorb anything that is applied to it," he says, citing a study from research company Organic Monitor, which shows that 60 per cent of what is applied to the skin is absorbed by the body.

"It's like a glass of water. You can only fill the glass so much and then it overflows, and you have free toxins flowing through your body."

Manrique says rising allergy rates are due partly to the increased levels of pollutants we breathe and feed into our bodies. He says also that the market for organic and hypoallergenic products is about to boom.

"We've reached a tipping point," he says. "We're on the cusp of the wellness wave and companies like us are fortunate that we can take that wave in."

Hardly surprising then that in 2002 Australians spent more than $2 billion on complementary medicines - more than double what they spent in 1993.

The new Prada indeed.

Corporate stress buster Anne Palmer - whose consultancy Zen at Work offers corporate stress management training - says there can be no doubt that our frantic lifestyles are contributing to our poor health.

Allergies and digestive problems are just some of the key stress symptoms that she sees day after day in our wired-up workplaces. And she suggests just chilling out might be a good place to start.

"The more stressed the person is, the more their health suffers," she says.

"Traditional medicines do have their place, but unless one finds out what the cause of the problem is we'll never treat the symptoms."

Australians at risk of developing allergies

* One in three Australians will develop allergies at some time during their life, one in five will develop atopic dermatitis, one in 10 will have asthma; and one in 20 will develop a food allergy.

* Only one in 100 will have a life-threatening allergy known as anaphylaxis, however research shows this is on the rise.

* Doctors say the best ways to prevent your children from developing allergies are: breastfeed during the first six months where possible, do not smoke during pregnancy and avoid exposing children to tobacco smoke.

* People who believe they are suffering from a food allergy should seek the advice of an accredited dietitian.




Source: The Australasian Society of Clinical Immunology and Allergy

Source: The Sun-Herald

Posted on: Sat, 10/28/2006 - 2:54pm
McCobbre's picture
Joined: 04/16/2005 - 09:00

Man, this article is all over the place! What's really en vogue is bad, unclear writing that starts out and ends up sensationalistic. The stuff in the middle was okay with this exception:
"A true food allergy has [an] immediate onset and symptoms that are quite dramatic - it's like a lock-and-key set up," she says.
Yes, well, not for those of us who have delayed GI reactions--up to two hours later (or even later).
This article kept hammering on the dangers of self-diagnosis. Is that really an issue?
I don't know--I just hated what we have to live with day in and day out likened to fashion week in Milan.

Posted on: Sat, 10/28/2006 - 2:54pm
McCobbre's picture
Joined: 04/16/2005 - 09:00

Man, this article is all over the place! What's really en vogue is bad, unclear writing that starts out and ends up sensationalistic. The stuff in the middle was okay with this exception:
"A true food allergy has [an] immediate onset and symptoms that are quite dramatic - it's like a lock-and-key set up," she says.
Yes, well, not for those of us who have delayed GI reactions--up to two hours later (or even later).
This article kept hammering on the dangers of self-diagnosis. Is that really an issue?
I don't know--I just hated what we have to live with day in and day out likened to fashion week in Milan.

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