Allergies

Medical Advice with a Grain of Salt

Today’s blog post talks about a tricky subject. A pediatrician recently wrote an article in The Upshot for the New York Times called “The Whiplash from Ever-Changing Medical Advice.” We’re constantly swamped with new findings about food, lifestyle, gadgets, or habits that could help us or harm us, according to the medical community. The author of the article, Dr. Aaron Carroll, notes that while medical researchers need to publish their work and news organizations need to report these findings, sometimes these results have a neutral effect at best. Other times, new results could actually reverse previous research that was released only a few years ago, which may confuse the general public.

 

The eternal debate about food allergies is a good example. Recently, the National Institute of Allergy and Infectious Disease recommended that we begin giving babies peanut extract or powder in their food before they are six months old, in order to reduce the odds that they develop peanut allergies. There was substantial evidence for the effectiveness of this method, especially for children who were at risk of developing these allergies.

 

Yet back in the early 2000s, the American Academy of Pediatrics warned against giving children who were at risk of developing peanut allergies any peanut-derivative products before the age of three. In hindsight, this recommendation might have actually increased the number of children with these allergies.

 

This “medical whiplash” about conflicting advice can really exhaust readers, especially parents who are trying to make healthy decisions on behalf of their children. Dr. Carroll has written articles expressing his concerns that these recommendations, “which were not supported by strong evidence, may be doing more harm than good.”


Physicians like Dr. Carroll will be the first to agree that “simple lifestyle changes may be more influential than many medical interventions.” Interventions that work for some people might not work for others, but not all medical or news organizations will definitively admit that. It’s important to keep moderation in mind as a priority, and to be receptive but critical of the plethora of medical research that comes out every day.   

Understanding Food Allergies

We hear a lot about diverse kinds of food allergies, and whether or not they are getting more common as a whole. However, a new report published by the National Academy of Sciences says insufficient data or research methodologies make the number of people in the U.S. who actually have food allergies difficult to determine. Also, despite the general agreement among many health experts that food allergies have increased over time (and not just due to better methods of diagnosis), it remains difficult to confirm this with data.

 

According to an NPR report on this announcement, an important reason for the difficulty in getting these numbers is that it is challenging for parents to recognize and diagnose their children’s allergies. Food allergies and other conditions, like lactose intolerance, sometimes have “[overlapping] symptoms,” as explained by Dr. Virginia Stallings, a nutrition pediatrician at the Children’s Hospital of Philadelphia, for the NPR article. The difference is that food allergies can potentially be dangerous, while lactose intolerance, while very uncomfortable, does not pose an immediate danger to the person.

 

The more severe symptoms of food allergies - some examples given in the NPR report include difficulty breathing and swollen lips - should receive immediate medical attention. However, since symptoms are often milder than these, and since there is no single blood test or other procedure that precisely points out a food that a child can be allergic to, it is best to rely on expert advice to navigate the path to finding out a child’s allergy.

 

Some experts have noted that parents have their children unnecessarily avoid a food for fear of an allergy. According to a pediatric food allergy program director interviewed in the article, a common “gold standard” test that they use to diagnose a food allergy, the “oral test challenge,” is surprisingly obvious. Patients [literally] eat small portions of foods they might be allergic to, and if they start having an allergic reaction, the medical supervisor stops the test and administers treatment. Such a method might be perplexing to parents who are looking for more sophisticated science in identifying their children’s allergies, but more research is needed to develop these methods.

 

Children also sometimes outgrow their allergies, and can be determined allergy-free with the same kinds of tests. In the meantime, parents and teachers can do more to learn about children’s food allergies in case an emergency happens at home or at school when there are no nurses around. According to the article, school nurses are usually the only ones trained to administer potentially life-saving epinephrine shots in many schools. The National Academy of Sciences suggests that more school officials be trained to react to food-allergy related emergencies.