Peanut allergy on the rise

The incidence of peanut allergy among Australian toddlers has doubled in the past nine years, a new study suggests.

The study of children living in the Australian Capital Territory reports the increase has come despite increased efforts by parents to avoid giving toddlers peanuts in their diet.

Co-author Dr Raymond Mullins, an allergy expert at the John James Medical Centre, says the findings highlight the need to invest heavily in research to understand what has led to the allergy epidemic of the past decade.

And, he says, it adds to growing evidence that guidelines promoting peanut avoidance in young diets may be counterproductive.

For the study, Dr Mullins and colleagues at the University of Melbourne and Australian National University looked at the characteristics of 778 peanut allergy sufferers aged from four months to 66 years across a 13-year period.

The retrospective study, published online in the Journal of Allergy and Clinical Immunology, found no differences in age of onset, sex distribution, severity of reaction or age of first reaction during that period.

However, the incidence of peanut allergy by age 72 months for children born in 2004 was double that for those born just four years earlier in 2001.

Dr Mullins says the Australian findings match data from the US and UK that shows peanut allergy prevalence is also on the rise in those countries.

 

Generation allergy

 

He says the increase in children with the condition will lead to increasing health costs to the nation as what he terms Gen-A (generation allergy) matures into teenagers and adults.

Dr Mullins says the study rejects suggestions that the increase in allergies is the result of over-anxious parents.

"The fact that severity did not change undermines the community perception that the increase is the result of anxious parents presenting with milder cases. The increase is real, and for 80 per cent of those affected, they will still be allergic for decades to come" Dr Mullins said.

Dr Mullins says there is a growing body of thought that avoidance is the wrong strategy to combat peanut allergy.

He says a study published in the November edition of the Journal of Allergy and Clinical Immunology compared peanut allergy rates of Jewish children living in Israel and in the UK.

The study showed that Israeli children eat an average 7.8 grams of peanuts per month from eight to 14 months of age, while the UK children averaged 0 grams.

But the rate of peanut allergy among the UK toddlers was 10 times higher than in the Israeli children.

Last weekend British researchers revealed they had been able to build tolerance for peanuts in children who normally had a severe reaction to the food.

The researchers gave small daily doses of peanut flour to children with a severe peanut allergy to help them build tolerance to the nuts during a six-month period.

By the end of the trial, the researchers had determined that eating 12 nuts a day did not lead the children to have a life-threatening reaction in the form of anaphylaxis.

 

More research needed

 

Dr Mullins says his team's study highlights the need for more funding to be directed at understanding the cause of the increase.

"There is more evidence about what food allergy is not due to then what it is," he said.

Among the factors that have been discounted are a mother's diet during pregnancy and breastfeeding, genetically modified food, additives and preservatives in food.

"The proteins triggering allergic reactions are the same ones that did so when Moses was a kid," he said.

He also says the too-clean hygiene theory has also been targeted as a candidate, but this has yet to be studied in detail.

There is also some evidence emerging that Vitamin D deficiency may play a role.

Dr Mullins says the five-year Leap Study currently under way at Evelina Children's Hospital in the UK, is a controlled study comparing avoidance with early introduction of peanuts with the risk of a peanut allergy developing.

He says its results will help determine if the "public health measures to avoid or delay exposure to allergenic food ... might have in part contributed" to the increase in peanut allergies.

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