Only twenty years ago it seems the default lunch served to kids was a peanut butter and jelly sandwich. Today, few parents and virtually no teacher, coach or activity leader would make that choice. How have we gone from peanuts and tree nuts being a common and innocuous part of life to being such a threat?
There have been many environmental and dietary theories put forward to explain why rates of occurrence of allergies and intolerances have increased. The most common explanation centers around what is known as the hygiene hypothesis. The thought is that a lack of early childhood exposure to infectious agents, symbiotic microorganisms and parasites increases susceptibility to allergic diseases by suppressing natural development of the immune system.
The developed world has experienced higher rates of allergic disease growth than the rest of the world, which is consistent with the hypothesis. Further, other theories, such as those that point to the impact of changes in infant feeding, overexposure to certain allergens and pollutants, point to the divide between disease rates in the undeveloped world and the industrialized world. Finally, the developed world is characterized by the relative availability of effective (especially preventative) medical care. It seems that the more we shield ourselves the weaker we become.
As it pertains to peanut allergies and tree nut allergies in particular, there are proteins in tree nuts and peanuts that trigger very aggressive immune system responses. The immune system is our protector, ready to defend us and always looking for a good fight! In the absence of many of the traditional and historical enemies, the immune system seems to focus much of its excess capacity on these proteins.
In 1997, it was believed that 0.6% of children had a peanut or tree nut allergy. Today, it is believed that the rate of occurrence has grown to 3.1% and is expected to continue to increase going forward.
Today, an estimated 4% of American adults and 8% of American children are afflicted with food allergies. Peanut and tree nut allergies are the most common, with 38% of these food allergic children having an allergy to peanuts and/or tree nuts.
That’s an estimated 6 million adults and children who have a peanut and/or nut allergy. This number will continue to grow at an increasing rate as both the overall rate of incidence grows and the rate of adult disappearance of these allergies remains low.
However, focusing only on the individuals directly affected by the allergy understates the problem. It is an issue that impacts families, playgroups, teams, community groups, classrooms and schools.
There are a few reasons for this. First, peanut and tree nut allergies are the most common food allergies and the rate of growth is truly extraordinary.
Second, while each patient has his or her own unique sensitivity to nuts, every patient is potentially susceptible to a life threatening reaction called Anaphylaxis. That’s why the protocol for every person (and most people are diagnosed as children) with these allergies is a prescription for an EpiPen and instructions how to use it or a similar device. Think about that. Millions of parents have sat down with a physician and been given instructions on how to inject a needle into their child if they ingest something that for most of those parents lives was viewed as harmless. No wonder so many elementary schools have been declared nut-free zones.
Finally, unlike many other allergies (such as milk and egg) and intolerances (such as gluten) which can spontaneously disappear in late childhood, the vast majority of children with peanut and tree nut allergies will have them for life. Only an estimated 20% of children with peanut allergies and 10% of children with nut allergies will ever outgrow their conditions.
In summary, peanut and tree nut allergies are the most common, the fastest growing and among the most dangerous and permanent of allergies.
Additionally, most who suffer from these allergies have to learn how to deal with this condition in childhood and many foods (many staples and a large percentage of treats) which characterize childhood are particularly dangerous.
As schools, parents and organizations try to handle this growing problem, many of these kids feel excluded. Ask any parent of a child with nut allergies and you will hear stories of kids not getting a piece of cake at a birthday party and sometimes having to eat lunch at the designated nut allergy table rather than with their friends.