The big allergy epidemic
These days, it seems everybody’s allergic to something. Most – but not all – are telling the truth. Nel Staveley investigates
Go out for dinner these days and you can guarantee at least half the people sitting at your table will either be asking for ‘the burger, but without cheese’, substituting the pasta for some sort of vegetable, or dosing themselves up with anti-hay fever tablets. Or possibly even doing all three.
If you’re sitting on the other half of the table, doing none of these things, it’s easy to dismiss the claims of lactose/gluten/pollen allergies as a modern fad. It’s easy to say those ‘suffering’ have probably half-read something about a celebrity diet and are now meekly following in their very misguided footsteps.
But you’d be wrong.
A VERY REAL PROBLEM
“The rise in the prevalence of allergies is real, particularly in the UK and developed world,” says Professor Kaminski, consultant immunologist, Nuffield Health Plymouth Hospital.
Certainly, figures from Allergy UK (www.allergyuk.org) confirm this – revealing that an estimated 21 million adults in the UK suffer from at least one allergy, and an estimated 10 million adults suffer from more than one. Food allergies alone have lead to a 500% increase of hospital admissions since 1990.
WEST IS NOT BEST
The topic was explored recently in BBC Two’s Horizon – Allergies: Modern Life And Me. As usual, a lot of the blame, perhaps predictably, fell on our sanitised Western lifestyle.
“[The rise in allergies] is happening because of our higher standard of living,” agrees Kaminski. “Our immune system has developed over millennia to deal with microorganisms. However, our improved standard of living has led to decreased exposure to certain microorganisms and parasitic worms, which in turn, has led to a dysregulation of the immune system, causing allergy.
“Factors in our environment that reduce the overall microbial burden and increase allergy are: antibiotics, immunisations, hygiene and reduced exposure to microbe-rich dirt.”
SOME PEOPLE DO MISDIAGNOSE
So, clearly, the rise in allergies is genuine. But surely, there are still some of us who are just jumping on the bandwagon?
“Although many people do correctly self-diagnose allergies, some incorrectly diagnose conditions as being allergies,” Kaminski admits.
“This is mainly due to incorrect information about allergies being available in the public domain, and also to some alternative practitioners using unscientific tests to make such diagnoses.”
Many people also misread what is actually just an intolerance – which while also uncomfortable, is not as dangerous as an allergy.
BE TOLERANT
“An allergy is a reaction mediated by the immune system to harmless environmental substances such as pollens, animal hair, house dust mite and foods. Allergies cause typical symptoms such as a rash, facial swelling or anaphylaxis,” explains Kaminski. “Most allergies are triggered by an antibody called IgE, which can be tested for by a blood or skin prick test.”
An intolerance, however, is “an idiosyncratic reaction to food”. Tyramine-rich foods – generally fermented foods like aged cheeses, smoked fish and cured meats – can often trigger migraines, for example.
“And wheat and milk can cause abdominal bloating. Such reactions are not mediated by the immune system, though, and therefore there are no reliable tests to diagnose them. Intolerances are the most common condition misdiagnosed as an allergy by lay people.”
WHAT NEXT?
For those genuinely affected though, is there any hope?
“As a society, there’s little we can do to reduce allergies, because of our higher standard of living (and less life-threatening infectious diseases). Much research is going into trying to understand this, for example, there are ongoing trials in which patients with allergies are being given helminths (worms).
“In the future, it may be possible to alter the immune system (e.g. with a vaccine) to prevent allergies occurring in later life, but this will almost certainly have to be done in early childhood (the first six months), as this seems to be the crucial period in life for developing an allergic tendency.”
INTOLERANT OR ALLERGIC?
“True milk allergy is relatively rare and more common in children than adults. The symptoms are generally a rash or facial swelling and, in children, abdominal symptoms can also occur,” says Kaminski. “Lactose intolerance is a deficiency of the enzyme lactase which is necessary to digest milk. The symptoms are diarrhoea. This is far less common than people claim.
“True gluten intolerance is called coeliac disease and is an immunologically mediated condition, which can be tested for. However, many people have a wheat intolerance, leading to bloating.”
Do you have any allergies or intolerances?
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