We’re the ‘allergy capital of the world’. But we don’t know why food allergies are so common in Australian children

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Australia has often been called the “allergy capital of the world”.

An estimated one in ten Australian children develop a food allergy in their first 12 months of life. Research has previously suggested food allergies are more common in infants in Australia than infants living in Europe, the United States or Asia.

So why are food allergies so common in Australia? We don’t know exactly – but local researchers are making progress in understanding childhood allergies all the time.

Miljan Zivkovic/Shutterstock

What causes food allergies?

There are many different types of reactions to foods. When we refer to food allergies in this article, we’re talking about something called IgE-mediated food allergy. This type of allergy is caused by an immune response to a particular food.

Reactions can occur within minutes of eating the food and may include swelling of the face, lips or eyes, “hives” or welts on the skin, and vomiting. Signs of a severe allergic reaction (anaphylaxis) include difficulty breathing, swelling of the tongue, swelling in the throat, wheeze or persistent cough, difficulty talking or a hoarse voice, and persistent dizziness or collapse.

Recent results from Australia’s large, long-running food allergy study, HealthNuts, show one in ten one-year-olds have a food allergy, while around six in 100 children have a food allergy at age ten.

https://www.shutterstock.com/image-photo/skin-rashes-babies-concept-1228925236
A food allergy can present with skin reactions. comzeal images/Shutterstock

In Australia, the most common allergy-causing foods include eggs, peanuts, cow’s milk, shellfish (for example, prawn and lobster), fish, tree nuts (for example, walnuts and cashews), soybeans and wheat.

Allergies to foods like eggs, peanuts and cow’s milk often present for the first time in infancy, while allergies to fish and shellfish may be more common later in life. While most children will outgrow their allergies to eggs and milk, allergy to peanuts is more likely to be lifelong.

Findings from HealthNuts showed around three in ten children grew out of their peanut allergy by age six, compared to nine in ten children with an allergy to egg.

Are food allergies becoming more common?

Food allergies seem to have become more common in many countries around the world over recent decades. The exact timing of this increase is not clear, because in most countries food allergies were not well measured 40 or 50 years ago.

We don’t know exactly why food allergies are so common in Australia, or why we’re seeing a rise around the world, despite extensive research.

But possible reasons for rising allergies around the world include changes in the diets of mothers and infants and increasing sanitisation, leading to fewer infections as well as less exposure to “good” bacteria. In Australia, factors such as increasing vitamin D deficiency among infants and high levels of migration to the country could play a role.

In several Australian studies, children born in Australia to parents who were born in Asia have higher rates of food allergies compared to non-Asian children. On the other hand, children who were born in Asia and later migrated to Australia appear to have a lower risk of nut allergies.

Meanwhile, studies have shown that having pet dogs and siblings as a young child may reduce the risk of food allergies. This might be because having pet dogs and siblings increases contact with a range of bacteria and other organisms.

This evidence suggests that both genetics and environment play a role in the development of food allergies.

We also know that infants with eczema are more likely to develop a food allergy, and trials are underway to see whether this link can be broken.

Can I do anything to prevent food allergies in my kids?

One of the questions we are asked most often by parents is “can we do anything to prevent food allergies?”.

We now know introducing peanuts and eggs from around six months of age makes it less likely that an infant will develop an allergy to these foods. The Australasian Society of Clinical Immunology and Allergy introduced guidelines recommending giving common allergy-causing foods including peanut and egg in the first year of life in 2016.

Our research has shown this advice had excellent uptake and may have slowed the rise in food allergies in Australia. There was no increase in peanut allergies between 2007–11 to 2018–19.

Introducing other common allergy-causing foods in the first year of life may also be helpful, although the evidence for this is not as strong compared with peanuts and eggs.

A boy's hand holding some peanuts.
Giving kids peanuts early can reduce the risk of a peanut allergy. Madame-Moustache/Shutterstock

What next?

Unfortunately, some infants will develop food allergies even when the relevant foods are introduced in the first year of life. Managing food allergies can be a significant burden for children and families.

Several Australian trials are currently underway testing new strategies to prevent food allergies. A large trial, soon to be completed, is testing whether vitamin D supplements in infants reduce the risk of food allergies.

Another trial is testing whether the amount of eggs and peanuts a mother eats during pregnancy and breastfeeding has an influence on whether or not her baby will develop food allergies.

For most people with food allergies, avoidance of their known allergens remains the standard of care. Oral immunotherapy, which involves gradually increasing amounts of food allergen given under medical supervision, is beginning to be offered in some facilities around Australia. However, current oral immunotherapy methods have potential side effects (including allergic reactions), can involve high time commitment and cost, and don’t cure food allergies.

There is hope on the horizon for new food allergy treatments. Multiple clinical trials are underway around Australia aiming to develop safer and more effective treatments for people with food allergies.

Jennifer Koplin, Group Leader, Childhood Allergy & Epidemiology, The University of Queensland and Desalegn Markos Shifti, Postdoctoral Research Fellow, Child Health Research Centre, Faculty of Medicine, The University of Queensland

This article is republished from The Conversation under a Creative Commons license. Read the original article.

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  • The Midlife Cyclist – by Phil Cavell

    10almonds is reader-supported. We may, at no cost to you, receive a portion of sales if you purchase a product through a link in this article.

    Whether stationary cycling in your living room, or competing in the Tour de France, there’s a lot more to cycling than “push the pedals”—if you want to get good benefits and avoid injury, in any case.

    This book explores the benefits of different kinds of cycling, the biomechanics of various body positions, and the physiology of different kinds of performance, and the impact these things have on everything from your joints to your heart to your telomeres.

    The style is very much conversational, with science included, and a readiness to acknowledge in cases where the author is guessing or going with a hunch, rather than something being well-evidenced. This kind of honesty is always good to see, and it doesn’t detract from where the science is available and clear.

    One downside for some readers will be that while Cavell does endeavour to cover sex differences in various aspects of how they relate to the anatomy and physiology (mostly: the physiology) of cycling, the book is written from a male perspective and the author clearly understands that side of things better. For other readers, of course, this will be a plus.

    Bottom line: if you enjoy cycling, or you’re thinking of taking it up but it seems a bit daunting because what if you do it wrong and need a knee replacement in a few years or what if you hurt your spine or something, then this is the book to set your mind at ease, and put you on the right track.

    Click here to check out The Midlife Cyclist, and enjoy the cycle of life!

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  • The Five Key Traits Of Healthy Aging

    10almonds is reader-supported. We may, at no cost to you, receive a portion of sales if you purchase a product through a link in this article.

    The Five Keys Of Aging Healthily

    Image courtesy of Peter Prato.

    This is Dr. Daniel Levitin. He’s a neuroscientist, and his research focuses on aging, the brain, health, productivity, and creativity. Also music, and he himself is an accomplished musician also, but we’re not going to be focusing on that today.

    We’re going to be looking at the traits that, according to science, promote healthy longevity in old age. In other words, the things that increase our healthspan, from the perspective of a cognitive scientist.

    What does he say we should do?

    Dr. Levitin offers us what he calls the “COACH” traits:

    1. Curiosity
    2. Openness
    3. Associations
    4. Conscientiousness
    5. Healthy practices

    By “associations”, he means relationships. However, that would have made the acronym “CORCH”, and decisions had to be made.

    Curiosity

    Leonardo da Vinci had a list of seven traits he considered most important.

    We’ll not go into those today (he is not our featured expert of the day!), but we will say that he agreed with Dr. Levitin on what goes at the top of the list: curiosity.

    • Without curiosity, we will tend not to learn things, and learning things is key to keeping good cognitive function in old age
    • Without curiosity, we will tend not to form hypotheses about how/why things are the way they are, so we will not exercise imagination, creativity, problem-solving, and other key functions of our brain
    • Without curiosity, we will tend not to seek out new experiences, and consequently, our stimuli will be limited—and thus, so will our brains

    Openness

    Being curious about taking up ballroom dancing will do little for you, if you are not also open to actually trying it. But, openness is not just a tag-on to curiosity; it deserves its spot in its own right too.

    Sometimes, ideas and opportunities come to us unbidden, and we have to be able to be open to those too. This doesn’t mean being naïve, but it does mean having at least a position of open-minded skepticism.

    Basically, Dr. Levitin is asking us to be the opposite of the pejorative stereotype of “an old person stuck in their ways”.

    Associations

    People are complex, and so they bring complexities to our lives. Hopefully, positively stimulating ones. Without them to challenge us (again, hopefully in a positive way), we can get very stuck in a narrow field of experience.

    And of course, having at least a few good friends has numerous benefits to health. There’s been a lot of research on this; 5 appears to be optimal.

    • More than that, and the depth tends to tail off, and/or stresses ensue from juggling too many relationships
    • Fewer than that, and we might be only a calendar clash away from loneliness

    Friends provide social stimulation and mutual support; they’re good for our mental health and even our physiological immunity (counterintuitively, by means of shared germs).

    And, a strong secure romantic relationship is something that has been found time and again to extend healthy life.

    Note: by popular statistics, this benefit is conferred upon men partnered with women, men partnered with men, women partnered with women, but not women partnered with men.

    There may be a causative factor that’s beyond the scope of this article which is about cognitive science, not feminism, but there could also be a mathematical explanation for this apparent odd-one-out:

    Since women tend to live longer than men (who are also often older than their female partners), women who live the longest are often not in a relationship—precisely because they are widows. So these long-lived widows will tend to skew the stats, through no fault of their husbands.

    On the flipside of this, for a woman to predecease her (statistically older and shorter-lived) husband will often require that she die quite early (perhaps due to accident or illness unrelated to age), which will again skew the stats to “women married to men die younger”, without anything nefarious going on.

    Conscientiousness

    People who score highly in the character trait “conscientiousness” will tend to live longer. The impact is so great, that a child’s scores will tend to dictate who dies in their 60s or their 80s, for example.

    What does conscientiousness mean? It’s a broad character trait that’s scored in psychometric tests, so it can be things that have a direct impact on health, such as brushing one’s teeth, or things that are merely correlated, such as checking one’s work for typos (this writer does her best!).

    In short, if you are the sort of person who attends to the paperwork for your taxes on time, you are probably also the sort of person who remembers to get your flu vaccination and cancer screening.

    Healthy practices

    This means “the usual things”, such as:

    Want to learn more?

    You can check out his book, which we reviewed all so recently, and you can also enjoy this video, in which he talks about matters concerning healthy aging from a neuroscientist’s perspective, ranging from heart health and neurodegeneration, to the myth of failing memory, to music and lifespan and more:

    !

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  • Is Fast Food Really All That Bad?

    10almonds is reader-supported. We may, at no cost to you, receive a portion of sales if you purchase a product through a link in this article.

    Yes, yes it is. However, most people misunderstand the nature of its badness, which is what causes problems. The biggest problem is not the acute effects of one afternoon’s burger and fries; the biggest problem is the gradual slide into regularly eating junk food, and the long-term effects of that habit as our body changes to accommodate it (of which, people tend to focus on subcutaneous fat gain as it’s usually the most visible, but that’s really the least of our problems).

    Cumulative effects

    There are, of course, immediate negative effects too, and they’re not without cause for concern. Because of the composition of most junk food, it will almost by definition result in immediate blood sugar spikes, rising insulin levels, and a feeling of fatigue not long afterwards.

    • Within a week of regularly consuming junk food, gut bacteria will change, resulting in moderate cravings, as well as a tendency towards depression and anxiety. Mood swings are likely, as are the gastrointestinal woes associated with any gut microbiota change.
    • Within two weeks, those effects will be greater, the cravings will increase, energy levels will plummet, and likely skin issues may start to show up (our skin mostly works on a 3-week replacement cycle; some things can show up in the skin more quickly or slowly than that, though).
    • Within three weeks, the rest of our blood metrics (e.g. beyond blood sugar imbalances) will start to stray from safe zones. Increased LDL, decreased HDL, and the beginnings of higher cardiovascular disease risk and diabetes risk.
    • Within a month, we will likely see the onset of non-alcoholic fatty liver disease, and chronic inflammation sets in, raising the risk of a lot of other diseases, especially immune disorders and cancer.

    If that seems drastic, along the lines of “eat junk food for a month and get cancer”, well, it’s an elevated risk, not a scheduled diagnosis, but the body is constantly rebuilding itself, for better or for worse, and if we sabotage its efforts by consuming a poor diet, then it will be for worse.

    The good news is: this works both ways, and we can get our body back on track in fairly short order too, by enjoying a healthier diet; our body will be thrilled to start repairing itself. And of course, all these effects, good and bad, are proportional to how well or badly we eat. There’s a difference between doing a “Supersize Me” month-long 100% junk food diet, and “merely” getting a junk food breakfast each day and eating healthily later.

    In short, if your diet is only moderately bad, then you will only be moderately unwell.

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    It’s Q&A Day at 10almonds!

    Have a question or a request? You can always hit “reply” to any of our emails, or use the feedback widget at the bottom!

    In cases where we’ve already covered something, we might link to what we wrote before, but will always be happy to revisit any of our topics again in the future too—there’s always more to say!

    As ever: if the question/request can be answered briefly, we’ll do it here in our Q&A Thursday edition. If not, we’ll make a main feature of it shortly afterwards!

    So, no question/request too big or small

    ❝I’d like to read articles on gut health and anxiety❞

    We hope you caught yesterday’s edition of 10almonds, which touched on both of those! Other past editions you might like include:

    We’ll be sure to include more going forward, too!

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  • Finish What You Start – by Peter Hollins

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    For some people, getting started is the problem. For others of us, getting started is the easy part! We just need a little help not dropping things we started.

    There are summaries at the starts and ends of sections, and many “quick tips” to get you back on track.

    As a taster: one of these is “temptation bundling“, combining unpleasant things with pleasant. A kind of “spoonful of sugar” approach.

    Hollins also discusses hyperbolic discounting (the way we tend to value rewards according to how near they are, and procrastinate accordingly). He offers a tool to overcome this, too, the “10–10–10 rule“.

    Also dealt with is “the preparation trap“, and how to know when you have enough information to press on.

    For a lot of us, the places we’re most likely to drop a project is 20% in (initial enthusiasm wore off) or 80% in (“it’s nearly done; no need to worry about it”). Those are the times when the advices in this book can be particularly handy!

    All in all, a great book for seeing a lot of things to completion.

    Get your copy of “Finish What You Start” from Amazon today!

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  • Half of Australians in aged care have depression. Psychological therapy could help

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    While many people maintain positive emotional wellbeing as they age, around half of older Australians living in residential aged care have significant levels of depression. Symptoms such as low mood, lack of interest or pleasure in life and difficulty sleeping are common.

    Rates of depression in aged care appear to be increasing, and without adequate treatment, symptoms can be enduring and significantly impair older adults’ quality of life.

    But only a minority of aged care residents with depression receive services specific to the condition. Less than 3% of Australian aged care residents access Medicare-subsidised mental health services, such as consultations with a psychologist or psychiatrist, each year.

    An infographic showing the percentage of Australian aged care residents with depression (53%).

    Cochrane Australia

    Instead, residents are typically prescribed a medication by their GP to manage their mental health, which they often take for several months or years. A recent study found six in ten Australian aged care residents take antidepressants.

    While antidepressant medications may help many people, we lack robust evidence on whether they work for aged care residents with depression. Researchers have described “serious limitations of the current standard of care” in reference to the widespread use of antidepressants to treat frail older people with depression.

    Given this, we wanted to find out whether psychological therapies can help manage depression in this group. These treatments address factors contributing to people’s distress and provide them with skills to manage their symptoms and improve their day-to-day lives. But to date researchers, care providers and policy makers haven’t had clear information about their effectiveness for treating depression among older people in residential aged care.

    The good news is the evidence we published today suggests psychological therapies may be an effective approach for people living in aged care.

    We reviewed the evidence

    Our research team searched for randomised controlled trials published over the past 40 years that were designed to test the effectiveness of psychological therapies for depression among aged care residents 65 and over. We identified 19 trials from seven countries, including Australia, involving a total of 873 aged care residents with significant symptoms of depression.

    The studies tested several different kinds of psychological therapies, which we classified as cognitive behavioural therapy (CBT), behaviour therapy or reminiscence therapy.

    CBT involves teaching practical skills to help people re-frame negative thoughts and beliefs, while behaviour therapy aims to modify behaviour patterns by encouraging people with depression to engage in pleasurable and rewarding activities. Reminiscence therapy supports older people to reflect on positive or shared memories, and helps them find meaning in their life history.

    The therapies were delivered by a range of professionals, including psychologists, social workers, occupational therapists and trainee therapists.

    An infographic depicting what the researchers measured in the review.

    Cochrane Australia

    In these studies, psychological therapies were compared to a control group where the older people did not receive psychological therapy. In most studies, this was “usual care” – the care typically provided to aged care residents, which may include access to antidepressants, scheduled activities and help with day-to-day tasks.

    In some studies psychological therapy was compared to a situation where the older people received extra social contact, such as visits from a volunteer or joining in a discussion group.

    What we found

    Our results showed psychological therapies may be effective in reducing symptoms of depression for older people in residential aged care, compared with usual care, with effects lasting up to six months. While we didn’t see the same effect beyond six months, only two of the studies in our review followed people for this length of time, so the data was limited.

    Our findings suggest these therapies may also improve quality of life and psychological wellbeing.

    Psychological therapies mostly included between two and ten sessions, so the interventions were relatively brief. This is positive in terms of the potential feasibility of delivering psychological therapies at scale. The three different therapy types all appeared to be effective, compared to usual care.

    However, we found psychological therapy may not be more effective than extra social contact in reducing symptoms of depression. Older people commonly feel bored, lonely and socially isolated in aged care. The activities on offer are often inadequate to meet their needs for stimulation and interest. So identifying ways to increase meaningful engagement day-to-day could improve the mental health and wellbeing of older people in aged care.

    Some limitations

    Many of the studies we found were of relatively poor quality, because of small sample sizes and potential risk of bias, for example. So we need more high-quality research to increase our confidence in the findings.

    Many of the studies we reviewed were also old, and important gaps remain. For example, we are yet to understand the effectiveness of psychological therapies for people from diverse cultural or linguistic backgrounds.

    Separately, we need better research to evaluate the effectiveness of antidepressants among aged care residents.

    What needs to happen now?

    Depression should not be considered a “normal” experience at this (or any other) stage of life, and those experiencing symptoms should have equal access to a range of effective treatments. The royal commission into aged care highlighted that Australians living in aged care don’t receive enough mental health support and called for this issue to be addressed.

    While there have been some efforts to provide psychological services in residential aged care, the unmet need remains very high, and much more must be done.

    The focus now needs to shift to how to implement psychological therapies in aged care, by increasing the competencies of the aged care workforce, training the next generation of psychologists to work in this setting, and funding these programs in a cost-effective way. The Conversation

    Tanya Davison, Adjunct professor, Health & Ageing Research Group, Swinburne University of Technology and Sunil Bhar, Professor of Clinical Psychology, Swinburne University of Technology

    This article is republished from The Conversation under a Creative Commons license. Read the original article.

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