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BARTA—Allergies: Don’t blame it on the food – Green Valley News:

  • June 26, 2011 at 6:48 am

Two weeks ago, I wrote about the relationship of lactoseintolerance to psychological problems, resulting in widespreadoverdiagnosis.

Another “food allergy” that has been vastly overblown is peanutallergy.

Peanut butter has been a ubiquitous food item for the lastcentury. when I was young, no one ever mentioned “peanut allergy.”In the last 15 years, it seems to have blossomed into a nationalemergency.

Schools are forbidding peanut products if one parent claims hiskid has the allergy. In one bizarre case, the principal ofWalkersville Elementary School in Maryland wouldn’t allow gifts orcards, which might have candy attached, to be brought into theschool building for Valentine’s Day

“(Principal Stephanie) Brown said she and her staff didn’t wantto take the chance of causing problems for students with foodallergies,” according to a report.

Schools around the country have banned peanut products from thebrown bag lunches kids bring to school.

The main advocacy and “support” group for this issue, the FoodAllergy and Anaphylaxis Network, claims that 50,000 ER visits peryear are due to these allegories. they claim that 150-200 peopledie per year from peanut allergy. Contrast this with the Centersfor Disease Control data that showed on 33 deaths over a five-yearperiod from all anaphylactic reactions combined.

How is peanut allergy diagnosed. there lies the rub. Many casesare diagnosed simply by a doctor getting history of some adversereaction after someone eats peanut butter. however, the two mostcommon means to diagnose it are the skin-prick test and thepresence of antibodies in the system, using a blood test.

In the May 12, 2010, issue of the Journal of the AmericanAssociation, Dr. Jennifer Chafin of the Stanford Center for HealthPolicy and Research, and Dr. Marc Reidl, head of ClinicalImmunology and Allergy at UCLA, state:

“The concern with the latter two tests is that they’re notdefinitive: Patients with non-specific symptoms, such as a rash ordigestive troubles, and positive skin-prick or blood tests actuallyhave less than a 50 percent chance of having a food allergy. Inorder to make a proper diagnosis, they pointed out, physicians needto evaluate the data within the context of a patient’s history andhave a great understanding of symptoms consistent with true foodallergy.”

There is only one definitive test for peanut (and other foodallergy). that is the challenge test. This is done by having thepatient swallow a small amount of the food product in a highlycontrolled environment and observing for allergic reaction, such ashives, sneezing, etc. This is a safe test in the proper hands andcan definitively determine the real need for the elaborateprecautions that affect many kids and adults.”

In 2000, the American Academy of Pediatrics (AAP) published arecommendation that mothers not eat peanuts while breastfeeding andchildren below the age of 4 not be given peanut products. This wasbased on earlier reports that early exposure to peanuts was thecause of peanut allergy. it later was found that the exact oppositewas true. Early exposure may inhibit development of allergies. TheAAP then reversed its recommendation three years ago.

It’s interesting that the Royal Academy of Pediatrics continuesto recommend against early exposure of its future princes andduchesses to peanuts. This was despite the study that showed thatin the UK, where parents followed the recommendations, there was aten-fold higher incidence of reported peanut allergy in kids thanin Israel, where there was no such recommendation.

“It’s an unfortunate situation if a family with an inaccurateperception of the allergy leads a child to believe that a Snickersbar from 50 feet away is a lethal weapon,” according to Dr. RobertWood, head of childhood immunology and allergy at JohnsHopkins.

Dr. Nicholas Christakis of Harvard, an authority on hysteria,called the peanut fears “mass psychogenic illness” (previouslycalled epidemic hysteria).

Of interest, Christakis’ son attends a school in a district thatevacuated a school bus full of 10-year-olds when a stray peanut wasfound on the floor.

As Dr. Rahul K. Parikh said, “fear of peanut allergy isnuts.”

Charles Barta retired to Green Valley after 10 years as amedical director for several health care insurers. Before that, hewas physician-in-charge of Kaiser Permanente of Colorado and aprivate internist in Las Cruces, N.M. he had previously held amanagement position in the Medical Systems Division of Pfizer. Hiscolumn is published every other Sunday. he can be reached atCbar52@aol.com.

Read it online: All of Dr. Barta’s columns are available onlineat www.gvnews.com. go to Opinions on the top bar, then down toColumnists.

© 2011 Green Valley News. All rights reserved. This material may not be published, broadcast, rewritten or redistributed.

BARTA—Allergies: Don’t blame it on the food – Green Valley News:

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