The End of Food Allergy Book Summary - The End of Food Allergy Book explained in key points

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The End of Food Allergy summary

Name: The End of Food Allergy
Rating: 4 (54 reviews)
Author: Kari Nadeau and Sloan Barnett

Kari Nadeau and Sloan Barnett

The First Program to Prevent and Reverse a 21st Century Epidemic

4 (54 ratings)

30 mins

Table of Contents

The End of Food Allergy
summarized in 10 key ideas

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What’s in it for me? Learn how science is beginning to put an end to food allergies.

The headlines might seem lifted straight out of a dystopian novel at the moment, but there’s some good news for at least two groups of people: those who suffer from food allergies and those who are at risk of developing them.

As far as they’re concerned, we’re living in the middle of a scientific and medical revolution. In recent years, our knowledge and understanding of food allergies have radically shifted, and we’ve made some major breakthroughs in being able to prevent and reverse these conditions that afflict millions of people around the world.

In the not too distant future, food allergies could even become a thing of the past. It’s a ray of hope in a time full of darkness, especially if you or any of your loved ones suffer from food allergies yourselves. But even if you’re lucky enough to be allergy-free, it’s a fascinating and inspiring development in modern medicine, and you’re about to learn some of the stories and science behind it.

One important thing to mention: if you suffer from allergies, please don’t make any changes to your diet without consulting your doctor.

In these blinks, you’ll find out

how a researcher trying a baby snack led to a ground-breaking hypothesis;
why food allergies are on the rise for a surprising reason; and
how some counterintuitive approaches could be the solution to the problem.

Allergist Gideon Lack developed a revolutionary hypothesis about food allergies.

Back in the late 1990s and early 2000s, a British researcher named Gideon Lack was feeling a mixture of puzzlement and alarm.

As a pediatric allergist at King’s College London, he’d seen the rate of peanut allergies in the UK double in just 10 years. Meanwhile, more British parents than ever were following the standard medical advice of the time. It boiled down to a simple message: don’t feed your baby peanuts. That way, you’ll avoid the risk of them developing a peanut allergy.

Sounds logical – but apparently it wasn’t working, and no one knew why.

Then something happened. During a trip to Tel Aviv, Lack stumbled upon a pair of facts that led him to a eureka moment. The result would be a hypothesis that turned the conventional wisdom on food allergies on its head.

The key message here is: Allergist Gideon Lack developed a revolutionary hypothesis about food allergies.

Lack had come to Tel Aviv to give a talk about peanut allergies to a group of Israeli clinicians. At one point during the talk, he asked his audience members for a show of hands: who here has treated at least one case of peanut allergy in the past year?

Whenever he asked this question in the UK, nearly all the hands would go up. But there, in Tel Aviv, only a couple did. Apparently, British children were suffering from peanut allergies at a much higher rate than Israeli children – ten times higher (1.85 versus only 0.17 percent), he later found out.

That was the first fact he stumbled upon. What explained it? Well, that brings us to the second fact.

One day, shortly after his talk, Lack was having lunch with some Israeli friends. One of them was a mother, who was feeding her baby some food. It was a very common baby snack in Israel, his friends informed him. Just out of curiosity, he asked if he could try it for himself.

The snack tasted like peanut butter.

It turned out that Israeli babies were eating food containing peanuts at a much higher rate than British babies – seven times higher (69 versus 10 percent) by the age of nine months old, he later determined.

Could the two facts be connected? Could early exposure to peanuts actually help children to be less likely to develop peanut allergies, rather than the other way around? So, was avoidance a misguided idea? And could the same thing be true of other food allergies as well?

Lack suspected the answer to all of these questions was yes. But it’s one thing to come up with a hypothesis. It’s another to test it, let alone confirm it.

Further research was necessary.

Food allergies are a global problem, afflicting both children and adults at alarmingly growing rates.

We’ll get back to Gideon Lack’s hypothesis a little bit later, but first, let’s zoom out and look at the bigger picture. You see, that rise in peanut allergies Lack was observing in the UK wasn’t just an anomaly. It was part of a much larger trend.

Around the same time, on the other side of the Atlantic, things were getting even worse in the US. In 1997, less than 0.5 percent of American children had peanut allergies. By 2018, that percentage had more than quadrupled to 2.2.

No single theory fully explains why people suffer from food allergies, and many factors are at play.

Before we go back to Gideon Lack’s hypothesis, let’s round out our bigger picture with some important caveats.

Food allergies have been on the rise in modern times, but they’re hardly a new phenomenon. Neither is the desire to understand them. All the way back in the fifth century BC, the ancient Greek physician Hypocrites observed people suffering from cheese allergies. He theorized that their “constitutions” were simply “hostile” to the dairy product.

The prevalence of peanut allergies can’t be explained by genetics or other medical conditions.

Alright, so now let’s return to Gideon Lack’s hypothesis. Does early exposure to peanuts really affect whether children subsequently develop peanut allergies?

After his trip to Israel, Lack had a hunch that the answer was yes. But at this point, it was only that, a hunch. To feel enough confidence to advance it as a scientific hypothesis, he first had to rule out some other possible explanations.

The dual-allergen exposure theory suggests that our skin might be one of the main conduits of developing food allergies.

To understand the connection between eczema and peanut allergies, it helps to remember what the point of having skin is in the first place.

From a biological standpoint, our skin is essentially a barrier between our bodies’ internal organs and the outside world. It prevents foreign substances like microbes from getting inside us and wreaking havoc.

Gideon Lack hypothesized that eating food containing allergens could help babies avoid food allergies – and vice-versa.

So does the dual-allergen exposure theory have any evidence in its favor?

Yes, it does. One study found that the skin of infants with peanut allergies was exposed to peanut residue ten times more often than their non-allergic counterparts, due to differences in their environments. Another study showed that just a little skin exposure to peanut oil could increase children’s risk of developing peanut allergies by the age of five years old.

The LEAP study confirmed Lack’s hypothesis that early exposure makes children less likely to develop peanut allergies.

We now arrive at the pivotal question: was Lack’s hypothesis correct? Does eating peanuts at an early age prevent babies from developing peanut allergies?

Starting in 2006, Lack and some colleagues set out to answer that question. It was called the LEAP study – a catchy acronym for a much less catchy phrase: Learning Early About Peanut Allergy.

Introducing babies to allergenic food seems to be a generally good idea, but there are some important caveats.

In the wake of the remarkable success of the LEAP study, food allergists from around the world were inspired to pursue many avenues of follow-up research. What came next was a veritable alphabet soup of acronyms. First, there was the LEAP-ON study. Then there were the EAT, PETIT, BEAT, STAR, STEP, and HEAP studies.

Now, if this were the Hollywood movie version of the story, the next part would be about how all this follow-up research confirmed the LEAP study’s initial findings about peanut allergies and then extended them to other food allergies as well.

Oral immunotherapy can reverse already-existing food allergies.

All of the mixed evidence and caveats notwithstanding, a new consensus is now forming within the field of food allergy science and the larger medical community: when it comes to babies’ diets, simply avoiding allergenic food is a misguided idea, and early introduction is a better approach, generally speaking.

That’s great news if you’re a parent of an infant who hasn’t yet developed any food allergies. But what if you or a loved one already suffers from them? Well, there’s great news for you too. An exciting new approach to food-allergy treatment has entered the medical scene. It’s called oral immunotherapy, or OIT for short.

OIT is becoming less demanding, dangerous, and time-consuming.

For people with food allergies, there’s good news and bad news about OIT.

Let’s start with some good news. It works. Numerous studies and clinical trials have shown it to be highly effective. For example, in a landmark 2019 study that treated people with peanut allergies, 84 percent of participants who received OIT were able to safely consume peanut proteins by the end of the treatment period.

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What is The End of Food Allergy about?

The End of Food Allergy (2020) shows how recent developments in science and medicine are beginning to solve a problem that has plagued humanity for thousands of years. Combining data-driven research with inspirational storytelling, it provides a window into one of the biggest scientific and medical revolutions of our time.

Who should read The End of Food Allergy?

Food allergy sufferers
Parents, teachers, and doctors of children with food allergies
Anyone interested in food research and scientific stories

About the Author

Dr. Kari Nadeau is the director of the Sean N. Parker Center for Allergy and Asthma Research at Stanford University, where she’s the Naddisy Foundation professor of Pediatric Food Allergy, Immunology and Asthma. She’s also a member of Stanford’s Maternal and Child Health Research Institute and the Stanford Institute of Immunity, Transplantation, and Infection. She holds both an MD and a PhD from Harvard Medical School.

Sloan Barnett is a lawyer and journalist who is the author of the New York Times best seller Green Goes with Everything. She’s the mother of three children whose allergies were reversed by Dr. Kari Nadeu’s immunotherapy program.

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