Maybe part of it is a consequence of the risks of honey, which can actually spawn camp infants with botulism. But it seems that fear spread to everything.
Are there missteps? Certainly. Figuring out what is effective, what has bad secondary effects (fragility, allergies etc) and what is simply wrong is an ongoing effort and that's great, but less dying is a pretty nice baseline and progress on that front is inarguable.
I don't particularly believe this, but it fits Occam's razor, so it seems to deserve some examination.
Also this "more fragile people" argument assumes the "fragility" is both inherent and of a lifelong kind. This ignores that most causes of infant mortility are external, and that for many of those being exposed to them results in a lifelong increased mortality risk. Excessive hygiene leading to more allergies is a direct example of this.
How? You can use that to decide between two (or more) explanations, but you only presented one.
For clarity, I will include both here:
The two explanations for increased adult fragility are:
forgotoldacc> Parents shelter their children too much and have created adults that have additional allergies as a result of lack of childhood exposure
rocqua> Increased sheltering of children has allowed more of the fragile ones to survive to adulthood, increasing the number of fragile adults we observe today.
There’s been a similar shift with people letting their dogs roam free. When I was a kid I remember hearing stories about a dog getting run over by a car every year. I rarely hear these stories anymore because people usually keep their dogs supervised or in a fenced yard. I don’t have any hard data, but I suspect there’s something to these cultural shifts.
Also, the most common type of accidental death is car accidents. So is this kids not getting to play outside anymore, or is it radial tires and crumple zones?
Pretty irrational, but definitely celebrated.. eventually
If the best available means to perform an experiment carries some risk, it could still be entirely rational to do it rather than forfeit the knowledge gained from the experiment.
One could argue that science being celebrated too much leads to this type of present-day outcome. Science can tell you how to do something, but not why, or even what we should do to begin with.
Science failed here.
Telling anxious parents to have their kids avoid peanuts caused harm that wouldn’t have happened otherwise. I guess it’s valuable to better understand allergies, but learning at others’ expense isn’t worth it.
Your math isn’t checking out here.
doing nothing is better than something if that something might hurt people without understanding how and why
This research shows physicians harmed kids recommending they avoid allergens like peanuts, is that something we should ignore because all the benefits of science are “worth it”?
Science is amazing not because it’s always right, but because it (should) strive to always do better next time
For baby number 2, soap and water is enough. There's no time for Sterile Field nonsense. This kid isn't allergic to anything.
There was a local mom who had 4 thriving kids. When their baby dropped the pacifier in the dirt, it just got brushed off and handed back to the baby. I don't think those kids had any allergies.
The thing I'm a bit curious about is how the research on peanut allergies leading to the sort of uhhh... cynic's common sense take ("expose em early and they'll be fine") is something that we only got to in 2015. Various allergies are a decently big thing in many parts of the world, and it feels almost anticlimactic that the dumb guy take here just applied, and we didn't get to that.
Maybe someone has some more details about any basis for the original guidelines
I'm pretty sure it is.
I've brought up this example many times before, but Measles is a great example. Measles resets your immune system and breaks immunological memory for anywhere up to three years after having recovered from it. But now we have a bunch of people that assume any diseases can simply be dealt with in a natural way by your immune system thanks to the logic above, and well, the consequences of that are becoming clear.
"Mithridatism is not effective against all types of poison. Immunity is generally only possible with biologically complex types which the immune system can respond to. Depending on the toxin, the practice can lead to the lethal accumulation of a poison in the body. Results depend on how each poison is processed by the body."
"A minor exception is cyanide, which can be metabolized by the liver. The enzyme rhodanese converts the cyanide into the much less toxic thiocyanate.[12] This process allows humans to ingest small amounts of cyanide in food like apple seeds and survive small amounts of cyanide gas from fires and cigarettes. However, one cannot effectively condition the liver against cyanide, unlike alcohol. Relatively larger amounts of cyanide are still highly lethal because, while the body can produce more rhodanese, the process also requires large amounts of sulfur-containing substrates."
Our immune, metabolic, and other systems are built to be adaptable, and some things are easy to adapt to, but other things are difficult or impossible for them to adapt to.
Nobody is suggesting you go and add some heavy metals to your corn flakes (except you).
The post that I am responding to does in fact deal in absolutes by asserting that "What doesn't kill you makes you stronger" is a natural law. Please don't troll by attributing that to me.
My more detailed take on this is here: https://news.ycombinator.com/item?id=45653240
It is in response to someone else who is dealing in absolutes. It seems pretty common, actually. Must be a lot of Sith around today.
Maybe we live in bubbles.
I am from Asia. I have only seen people need to be taken to emergency hospital in American tv shows for any allergies. Here I've never seen it in my whole life and didn't even know allergy can be this dangerous. We don't have peanut allergy too. First time even I saw it in TV, I was very confused.
Allergies do exists here, but "not to the extent" like what I've seen in American TV shows or heard online.
Only thing I remember is people need to take medicine for to allergy from venomous caterpillar hairs, they mistakenly touched those. And stung by honey bees, wasp etc.
A quick google search says Asians populations have more allergies to buckwheat, royal jelly, and edible bird nests from swiftlets. Shellfish is still one of the highest allergies anywhere.
The UK seems to be a bit of an exception. And it shows, the only two countries I've been asked if there are any allergies by waiters as a standard are the US and the UK.
I always think about how animals eat - basically their food is never clean and always mixed with dirt. Evolution dealt with this problem since forever.
The real problem is some of those claims and reports were true, but we were so inundated with the rhetoric that everything was going to kill us that many of us sort of lapsed into apathy about it. Stepping back, the food industry in the US clearly does not have consumer health at heart and we struggle to find healthy options that avoid heavy processing or synthetic fillers. Those parents who sheltered their babies back then may have been on to something when it came to stuff we consume and we should have been on the path to demand better from our food sources had more of us been more diligent with our grocery choices (myself included, at the time), but instead we ended up with bread that lasts unnaturally long and has an allowable amount of sawdust as an ingredient.
In 2000, the American Academy of Pediatrics recommended not allowing your kids peanuts until they were 3 years old. It was just parents following doctor's (bad) advice.
There wasn't much information one way or the other on what avoidance did as far impacting development of allergies, and with the evidence available, delaying exposure seemed prudent.
Is this true? What percentage of doctors are scientists?
Infants in SE Asia are probably getting near daily exposure to peanuts.
https://www.jacionline.org/article/S0091-6749(08)01698-9/ful...
But generally speaking, the USA is an outlier on the prevalence of Peanut Butter specifically, and to a lesser extent peanuts in general.
It will be interesting to see what happens with allergies for those who were born in the 2020-2023 timeframe.
No allergies.
Must've been the garden hose water.
I hadn't heard of this. Very intriguing that only camp infants would be affected.
The hygiene hypothesis is not impossible, but evidence for and against it is questionable. But anyway, for peanuts it's not the hygiene.
It's a much more complex mechanism that retrains your immune system from using the non-specific rapid-response allergic reaction to the T-cell-mediated response.
The same method can be used to desensitize yourself to poison oak or ivy. You need to add small amounts of them into your food, and eventually you stop having any reaction to urushiol contact with the skin.
I don't agree that this is "all" that it has done.
There are many cases where reducing exposure as much as possible is the correct thing to do. Lead is the best-known example.
As the other reply pointed out, the second-order effect, the nuance that comes later is that sometimes this isn't the right thing to do.
But it would be basically incorrect to reduce it to blanket, binary, "all good" vs "all bad" black-or-white conclusions, just because the there is a smaller course correction when it's found out to be not entirely good. Concluding that "all it's done is cause problems" is a knee-jerk reaction.
Not just parents sheltering kids. Take a look at this (in)famous tweet https://x.com/d_spiegel/status/1271696043739172864 from *June 2020* ...
"[eg] women aged 30–34, around 1 in 70,000 died from Covid over peak 9 weeks of epidemic. Over 80% pre-existing medical conditions, so if healthy less than 1 in 350,000, 1/4 of normal accidental risk"
Putting China to one side, broadly speaking weren't the most stringent and prolonged restrictions mostly in wealthier, highly-developed countries?
"Older adults are at highest risk of getting very sick from COVID-19"[0]
I had to decide which of two sets of peer-reviewed publications that contradict each other was least guilty using the data to support the conclusion rather than letting the data speak for itself and making an honest conclusion.
Compared to PhDs, MDs hate designing an experiment and would rather just extrapolate a different conclusion from the same longitudinal study by cherry-picking a different set of variables. The only articles I bother reading from the NEJM anymore are case studies because they're the only publications that consist of mostly-original information.
https://www.astralcodexten.com/p/book-review-from-oversight-...
Notable citation:
> A system that began as a noble defense of the vulnerable is now an ignoble defense of the powerful.
Your personal health profile or family history may also put you at higher risk for cartilage degeneration from running, which would shift the balance in the other direction.
Blanket statements about medical outcomes like that are useful for medical practice in general, but can be misleading for individuals making health decisions if they ignore other relevant factors. There's also plenty of doctors who will not take those other relevant factors into account and just go by whatever the last training or research they were exposed to (which, incidentally, is also why big pharma companies invest in salespeople to target doctor offices - because it works).
For example say 3 papers are rediculous, could you say "they are all rediculous, there is nothing learned, we know nothing new from them"
After going through the desensitization program at an allergist, we're on a maintenance routine of two peanuts a day. It's like pulling teeth to get her to eat them. She hates peanut M&Ms, hates salted peanuts, hates honey rusted peanuts, hates plain peanuts, hates chocolate covered peanuts, hates peanut butter cookies, and will only eat six Bamba sticks if we spend 30 minutes making a game out of it.
I highly recommend being very rigorous about giving them the peanut exposure every single day. It would have saved us a lot of time.
So you did nothing wrong. The six week pause was completely meaningless.
I honestly can't tell if this entire post is some kind of parody or what. That cannot be real - I don't know anyone or have ever heard of anyone basically force feeding their child peanuts to maybe avoid peanut allergy later in life. It sounds insane, just like the presumption that because you missed some imaginary time window in their development your daughter has developed peanut allergy. That cannot possibly be real.
With a child that has PA on anaphylaxis-level and has had such an reaction a couple of times, and she has thusly built up a fear and anxiety, not being able to casually just let her attend b-day parties etc etc etc, I can assure you it's not a joke to us.
And no, we are not overly clean, in fact love going outdoors into the woods and getting dirt under our fingernails. Nor did we hold her off peanuts when small, her first reaction came when she just had learned to walk at about 10 months and ate a tiny piece found on the floor. And we as parents work very hard on trying to have a casual attitude towards life and work on her anxiety, and not let the PA define who she is or does. But then something like last week happens - those who make the food for school messed up her box of food and she ate mashed pea pattys and got really, really bad, worst in years. Boom, all her confidence in school down the drain.
It's heartbreaking, really. To find her have all that fear and pain, and we can only do so much to help her with that. And it's heartbreaking to see it being a joke to some. When I see such attitudes, I try to think that it comes from someone who is living a happy-path life, and well, good for you.
Thanks for coming to my TED talk, and smash that bell button.
In this case: "allergies and intolerances are made up stuff for weaklings, haha".
Like if you walk into a store and they offer you coffee or even a glass of prosecco, I would also say to my wife "oh we're in that kind of store now" because you know you're about to be ripped off in some way. Not that other stores are for weaklings.
Even with parachutes, you could do a study (not a RCT) by looking at historical cases of people falling with and without parachutes. The effect would be so strong that you wouldn't need those clever statistical tricks to tease it out.
If this theory (that early exposure teaches the immune system not to overreact) is right, then another logical consequence would be that kids who play outside in their early years would have fewer pollen allergies than kids who mostly play indoors and are exposed to far less pollen than the outdoors-playing kids. I don't know where to look for studies to prove or disprove that thesis; anyone have any pointers?
E.g. from age 27 weeks my daughter has played in a little herb garden full of mud and grass I built for her. She grabs and eats leaves from the herb plants (the basil is entirely denuded so that’s a complete loss). At first I just wanted her to play in the garden out of the same naïve exposure to tolerance model. I never would have considered that skin exposure is different from oral exposure. As it so happened she ate the plant leaves and it doesn’t matter either way since this part of immunity (to microbes here) doesn’t work in the same way as peanuts anyway.
For instance the "cry it out method" did massive amounts of psychological damage to more than one generation, but it seemed to work in the short term as the babies eventually learned to "self-soothe".
Even now I still see parents and grandparents suggesting it in parenting groups; and taking extreme umbrage at the idea that it might have damaged them/their children.
Anaphylactic shock is scary and peanut fear was a big deal in the late 1990s but actual risk of harm was very low. The guidance was more about the psychosocial burden placed on parents when there was no guidance. Anxious parents have been studied, that mechanism is reasonably well understood and that harm can be quantified.
They know that skin and mucosa sensitization can occur in response to allergens.
A reasonable hypothesis is that there’s some boot-up process with the immune system that needs to occur before anything happens. The kids are dying today. “Avoid the thing that can cause sensitization” is a conservative position.
It is unusual that it should have been opposite and that oral exposure induces tolerance. It’s the fog of war.
The standard conservative intervention has helped in the past: I’m pretty sure seatbelts didn’t have strong mortality data before they were implemented. If it had turned out that more people were killed by seatbelts that trapped them in vehicles it would make for a similar story. I think they also got rid of all blood from donors who were men who have sex with men during the initial stages of the HIV pandemic (no evidence at the time).
Edit for response to comment below since rate-limited:
Wait, I thought it was on the order of ~150/year people dying from food anaphylaxis though I didn’t research that strongly. It was off my head. If you’re right, the conservative advice seems definitely far too much of an intervention and I agree entirely.
What? That's insane, 4-5 kids were dying a year. The whole thing was mass hysteria, that then started to create the problem when there had been none.
There's a dark pattern hiding in the modern era where we assume hard evidence to exist where it doesn't, a projection of CAD engineering onto idle theory crafting and opinion.
Objective: We sought to determine the prevalence of PA among Israeli and UK Jewish children and evaluate the relationship of PA to infant and maternal peanut consumption
NOT ON MY WATCH.
Just one or two nights of pain and the baby was on normal formula without any issues.
That kid can now enjoy milk and cheese, and not be a little bitch.
At some point through the times of civilizations, humans started having less work to do and more idle people around. The idle people started spending their time for preaching a life style other than what was evolved naturally through centuries and millennia. They redefined the meaning of health, food, comfort and happiness. The silliest thing they did was creating norms, redefining good and bad based on their perception of comfort and happiness and enforcing those norms on populations.
Human race continued to live under the clutches of perceptions from these free-thinking idle people whose mind worked detached from their bodies and thus lacked the knowledge gained from the millennia of human evolution.
Some people become vegetarians, some people become vegans, some people believe eating big steaks of red meat is healthy, some people avoid pork, others do not eat cooked food on some days of the week, others eat only fish on special holidays, some people tell you that yoghurt is good for your gut, others tell you to avoid dairy at all cost, some tell you to avoid carbohydrates, ....
Some of these are backed by science, some are batshit crazy, some are based on individual preferences.
I don't think this is a new phenomenon. People just love coming up with rules, and even if our society allows you to eat pretty much whatever you want, people still seek out restrictions for themselves (and their kids...)
I think that's just common sense, but at least in my home of Austria you can still easily get un-pasteurized milk if you really want. I'm not sure how the "government" controls my food choices? (In some cases I would actually prefer more regulation, because some producers make some questionable choices. I would prefer to buy cured meat without nitrates, but it's quite hard to find)
The mind tries to compensate the loss with experimentation that can't undergo the same extent of evolution. Then it dictates body to follow the results of these puny and tiny experiments, and ignores the rich knowledge already encoded in the body.