Why are more people getting allergic to stuff?
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There are so many different types of foods that you can be allergic to. There's peanuts, sesame, bee pollen, even mangoes or bananas. And we are getting so much more allergic to things now. There is evidence that allergies are getting more and more common. And shops and restaurants are getting more careful about letting you know what's in the food that you buy. So in this episode, you're going to hear why are we getting more allergic to stuff. And we're also going to talk about some new treatments for people with allergies around the world.

I'm Hannah Gelbart, and you're listening to What in the World from the BBC World Service. To find out more, I am here with BBC journalist Frances Mao. Hello. Hello. Welcome to the podcast. Thank you so much for having me. What actually is an allergy and why?

And what causes your body to react in those quite extreme ways sometimes? Yeah, exactly. So with allergies in particular, what sets apart an allergy from just an intolerance is it's more than just mild discomfort. What actually gets triggered is a whole chemical system in your body where the immune system has flagged for...

often, you know, incorrect reasons that this is a threat. So it instructs your body to have created these cells that will then go into kind of attack mode. And that's what leads to things like an allergy attack or even a severe allergic reaction, you know, so like welts, you know, rashes, in more severe situations, you're having difficulty breathing, airways closing up. And if untreated, that can obviously really be quite actually life-threatening.

Is it like a malfunction of your immune system? Because you say it's a perceived threat, like peanuts aren't really going to kill you, but your body thinks that they are really, really dangerous. So it's going to put up all of its defences to make sure that they don't attack you. Is that what's going on? Exactly. So like it's your immune system actually going wrong. So what are some of the most common things that people are allergic to globally? Yeah. So I think, you know, we always hear about, you know, food allergies, parasites.

penile allergy being like the classic thing. But actually, the most common allergy that people have globally is respiratory allergy, you know, pollen. So that's things like things in the atmosphere, things in your environment.

If you've got a serious allergy, it can be really stressful managing it and making sure that the stuff you eat and come into contact with isn't going to harm you. So let's hear what that is like for Mia, who's in the U.S.

My name is Mia Silverman, I am a college student at New York University and I am a food allergy advocate, also known as @allergieswithmia on TikTok, Instagram, and YouTube. And I live with over 50 food allergies and I've had these allergies my entire life.

My 50 plus allergies include all nuts and their oils, all seeds except for sunflower seed oil. I'm allergic to eggs unless it's cooked in a cake. Dairy, I'm allergic to dairy completely. I'm allergic to all fish except for cooked tuna and cooked codfish.

lots of random fruits like peaches, apples, pears, cherries. And having these 50 plus allergies impact my life every single day. So when it comes to going to restaurants, having to call ahead of time, talk to the manager, talk to the chef, make sure that the restaurant can accommodate me, that they can make me something safe and use protocols to prevent any sort of risk of any allergens touching my dish. When it comes to socializing, it can be kind of hard sometimes because I want to make sure that my friends don't feel

inconvenienced or feel like I'm being a burden. So you know when it comes to going out to dinner with my friends, my friends usually let me pick the restaurant. When it comes to going out to parties and functions, I usually either bring my own safe food or I will either eat before or after the event because most of the time when we go to an event or a party there's not really any safe options for me.

I have to always be aware that things I'm allergic to could be present without me even realizing. So if I'm going to the library to study, I usually will wipe down my entire seat and desk because I always am worried that someone that sat there before me could have eaten like a peanut butter and jelly sandwich or had something that contained seeds that I'm allergic to. I always carry my life-saving medication on me which is my EpiPens, my Zyrtec because in case of an emergency I want to be prepared as possible.

While I now have a positive social experience and social life, it wasn't always that way. I experienced a lot of bullying growing up in school where people or kids in my class would make jokes reading out my allergy list in front of the whole class and make fun of it, or they would threaten to sneak nuts into my food to see what would happen. So it never

always been that way it wasn't until I went to college where I met people who were mature and who were empathetic and who were kind and if anything they embrace my allergies and want want to do the extra steps to make me feel safe and loved and valued. Frances what is the evidence that we are getting more allergic to stuff? Yeah we are getting more allergic to things unfortunately and

There are a few different factors and we're still grappling with what the exact factors are. But essentially, these are some of the broad factors. OK, so increasing urbanisation, certainly in many like Western developed countries, you know, like more people live in cities. They're away from my kind of more rural areas where they might have been kind of like more exposed to, I guess, in like less built up environments, right?

So we're not rolling around in the mud anymore. Yeah, exactly. Not as much as we used to. Actually, yeah, sort of like we're not, yeah, you know, no dirt. Less dirt. Less dirt. Different type of dirt. We're too clean.

Clean is another bit. So, like, there's also the hygiene hypothesis. Right. We live in a more sterile environment, right? We do live in a more sterile environment. It feels like we live in a more sterile environment. Absolutely. I have my kitchen clean. Yes, precisely. But does that also mean, and it seems so, that, you know, infants, they're being less exposed to that microbiome, which has, you know, good bacteria. But then also lifestyle factors, you know, things like diet, change.

changing diets. And the other thing which is really interesting too, and not to kind of drill into the niche of it, but, you know, we're a more global society too, right? So people live in different environments too, the ones not only that they were born in, but also the ones which, you know, perhaps their genetic predisposition is used to. And you can see that actually in some of the studies in Australia where

where babies and kids who were, who are born in Australia, but come from, say, countries in Asia, um,

They have a higher rate of allergies than kids from Caucasian backgrounds in Australia or Indigenous backgrounds in Australia. However, the same research found that kids who were born in Asia and spent their first few years in Asia and then moved to Australia, they don't have the same higher rates. I think it's Australia. Yeah.

I would say it's Australia. It could be Australia too. You're from Australia, which has been called the allergy capital of the world. What is it about Australia in particular that is making people more allergic? Australia is termed the allergy capital of the world because due to the research and the data, that shows that almost one in 10 infants have...

marked an allergy and often that's a food allergy or a respiratory allergy and that does drop off once they're a bit older, age six or so it goes down to about six percent and then as an adult it goes down to like three percent. Let's hear a bit more about why allergies are thought to be so high in kids in Australia now and the role of vitamin D. Professor Kirsten Perrett is the director of the Australian National Allergy Centre of Excellence.

We believe it's most likely a result of our modern lifestyle, the type of environment children are exposed to early in life and to a lesser extent, our genes.

Vitamin D actually plays a role in helping to regulate the immune system. And we know that not having enough of it has been linked to a higher chance of developing food allergies. In fact, in our HealthNut study previously, we've shown that babies who are vitamin D deficient were three times more likely to have an egg allergy and 11 times more likely to have a peanut allergy at age one. So at the Murdoch Children's Research Institute, we've been conducting a globally unique trial

involving over 2,700 babies testing whether daily vitamin D supplementation in the first year of life can actually prevent food allergy. And in fact, if it's successful, vitamin D supplementation in the first year of life would be a readily available, safe and very low cost intervention that could be widely deployed.

which would be very exciting. Frances, Kirsten mentioned a study in Australia about vitamin D and I was also reading about one which is a bit like peanut butter therapy. Yeah, so it's really interesting and they've done a lot of work on it the past year or two years in kind of rolling out in a national trial. It's been led by the Medoc Children Research Institute which is a very pioneering children's research body based in Melbourne in Australia.

And essentially, it's basically a form of like immunotherapy. There's been a lot of willingness from parents wanting to participate in this trial, which essentially is...

Identifying babies or infants like very early on, like 12 weeks actually, who do have this allergy to peanuts. And then in a very formulated, careful way, they're having small dosages of peanut powder administered to them and ingested.

It's just kind of slowly introducing peanut to them and that can increase those dosages over weeks. This is so interesting. So instead of like avoiding the allergen, it's how do we get your body used to it little by little? Exactly. Yeah. So they're directly introducing it to the infants. Right.

Huge caveat. This is definitely a don't do it at home sort of thing. Yeah, because if it goes wrong... Absolutely. And there have been some, from me speaking to the researchers at this institute, there have been some reactions, you know, both in hospital settings and at home from, you know, from the people being tested. However, you know, and it's early days, but...

The results so far have shown kind of promising. Well, we will watch this space and see what the outcome of these trials are because it could be potentially life-changing for people with allergies. Frances, thank you so much for coming on the podcast. Thanks so much for having me. So what is it like to have immunotherapy for an allergy? Well, it turns out that Maria Clara from the What in the World team has had it. I have all sorts of different allergies to different types of pollen and different types of trees in Spain, but the most severe was to olive trees.

So when blossoming was happening, I will have shortness of breath, I will have rashes sometimes in my body and my nose will be very runny and at some point antihistamines wouldn't be enough for me to feel okay. One night I had a very heavy asthma attack so I ended up going to A&E and it was very severe.

The doctor at that point told me that she hadn't seen anyone with such big allergy to the pollen of olive trees. And at that time, my uni was full of olive trees. So it was very difficult to me to go there and not feel shortness of breath. So they offered me a treatment, which would be a vaccine or medicine.

something that is also known as immunotherapy. And that will mean that they will put a bit of the pollen of the olive trees in my body every month. And then that will sort of help me to not have such a heavy reaction every month for four years and a half.

I got an injection of olive tree pollen in my arm and they don't guarantee that it will disappear completely, but it definitely got milder and it really improved my living, especially during the summer months and the months that the blossoming was there. Thank you for listening to this episode of What in the World from the BBC World Service. I'm Hannah Gelbart and I'll see you next time. Bye.

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