Allergies of all sorts are increasing, and odds are you or someone you know suffer from an environmental, food or drug allergy. It is estimated that anywhere from 10 to 30 percent of the global population has hay fever, 240 to 550 million may have a food allergy and up to 10 percent of the population is affected by drug allergies. Medical anthropologist Theresa MacPhail tackles the subject in her new book, Allergic: Our Irritated Bodies in a Changing World (Random House); she delves into the whys and what we can learn from the increase. In this Q&A, MacPhail takes on the changing recommendations for how to avoid food allergies, pet allergies, tips for alleviating seasonal allergies and more.
Q _ Climate change is one factor causing increased respiratory allergies. What about the equally dramatic rise of eczema and food and drug allergies? Is our natural environment to blame for them as well?
A _ Climate change is just one factor that is contributing to the problem. For our skin and gut, changes in our lifestyles and other man-made environmental changes are adding to the stresses on our immune cells. There are more than 85,000 chemicals listed under the EPA's Toxic Substances Control Act, and obviously we're interacting with things we wouldn't have even 70 years ago. Also, the types of food we eat are dramatically different, and we're consuming more processed foods than ever before. For example, most Americans don't get enough natural fiber in their diets and that can dramatically affect the normal bacteria in our guts. It's just everything all at once, combined, that is making things worse for our ancient immune systems.
What's the most surprising thing you learned when researching this book?
The fact that our own individual T cells, key components of healthy immune systems, can make different decisions about an allergen even though everything else is the same: diet, environment and genetics. When I come into contact with something, some of my cells will decide that it's harmless and some will decide it's not. So really, our immune response is about tipping that balance with more cells deciding something is a problem than tolerating it. And we largely have no idea why our cells are making those choices.
Allergic conditions are common in families, even if members don't all suffer from the same ones. Is there any way to prevent them? What can we do to limit allergies?
There aren't any hard and fast ways to avoid developing an allergy, but we do know that in general more exposure to more things early on in life are better. Letting our kids interact with other kids, cutting back on unnecessary antibiotics and antimicrobial cleaning products, playing with dogs...these all correlate with lower rates. But again, there's a lot we still don't know. I would tell anyone who has kids with allergies not to feel guilty about what they have or haven't done. You didn't cause your child's allergies.
Allergies can be very expensive for the patient, from special food to essential medications. The mental load can be extraordinary too, yet it is so often hidden. What can be done to offer support?
I think educating more people about the economic and emotional burdens that come along with a moderate to severe allergy diagnosis would go a long way to alleviating some of what allergy patients have to cope with. Recognizing that allergies are actually more of a problem for people than we have been socialized to think they are would be a terrific start. And never assume someone is faking or exaggerating an allergy. Try to remember that folks with allergies don't want to ruin your cookout—they're just trying to protect themselves or their kids.
Advice to minimize food allergies has changed over the last 20 or so years—first recommending complete avoidance of allergens like peanuts for young children and now encouraging early exposure (in most cases). If you were a new parent, how would you assess all the different guidance coming out? Why is there so much change?
Being a parent is more difficult than ever. All the latest guidance is based on what we currently know—and that can and probably will change as we learn more. But that's just how science works. We keep trying to figure out the basic biological mechanisms behind allergy and, as we do, we'll be able to give better advice. But for now, early introduction of trace amounts is doing a better job of preventing serious allergic reactions than the former advice to hold off until they are older.
Is exposure to allergens generally recommended as a treatment for all types of allergies now? How is that consistent with—or at odds with—the idea that the body's immune system gets hyperreactive with more exposure?
This is a tricky one! Immunotherapy—or the process of introducing trace amounts of an allergen and gradually increasing those amounts over months to years to induce tolerance—doesn't actually work for everyone. Immunotherapy shots for respiratory allergies are especially difficult to predict; they have far worse success rates than immunotherapy for something like peanut allergy. The other thing to remember is that even if treatment is successful, that tolerance isn't permanent or stable without regular maintenance doses.
In your book you say that pets have allergies, too. Do all animals get allergies? Do pet owners need to worry about their furred companions suffering?
As far as we know, no animals "in the wild" develop allergies—just the ones that live alongside us. Typically, the symptoms are itch for dogs, birds and horses, and cough or wheezing for cats. Usually, the culprit is their food. Allergies in pets seem to be on the rise, so pet owners should definitely be on the lookout for anything unusual. Your vet may be able to help with their worst symptoms.
Are your environmental allergies worse lately, too? Do you have any tips for managing them?
Absolutely. I used to have a pretty easy time of it, but in the last year or two as pollen loads have increased and the pollen seasons have lengthened, I definitely have noticed a lot more itching and wheezing and sneezing. I start taking my meds early, before the pollen season starts, and I take showers immediately after coming home if I've been spending a lot of time outdoors. We're basically coated in pollen when we get back home, so it's not a bad idea if you're suffering.
-
-
-
-
Periscope World
-
-
-
