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Kids with nut allergies face increasing social stigma

Dominika Osmolska Psy.D.'s picture

Nut allergies are on the rise. Increasing numbers of children are being diagnosed with various food allergies, of which tree nut and peanut allergies constitute a significant proportion. Not being able to enjoy tasty foods that others take for granted is hard enough; being treated like a pariah, teased and bullied because of one’s food sensitivities just adds insult to injury. Yet that is precisely the rising trend in schools, a new study reveals.

The study, conducted in the UK, reveals that families with children with a food allergy often feel isolated, stigmatized, or unfairly excluded from activities. In fact, serious food allergies can feel more like a disability than a medical condition due to the stigma they seem to bring on.

“Families reported some really very difficult and unpleasant experiences when they were trying to keep their child safe from risk,” says coauthor Mary Dixon-Woods, professor of medical sociology at the University of Leicester. “I was expecting to hear about problems with labeling and so on, but the extent of the stigma families reported was very troubling.”

Peanuts are both the most common and the most lethal trigger of anaphylactic shock, the most serious reaction to a food protein. Peanut allergies are also on the rise, doubling in children between 1997 and 2002. About 1% of children in the U.S. have peanut allergies. No one is sure why there is a rise in nut and other food allergies. Some experts believe that the increased statistics reflect a combination of a real increase in allergies and an increase in the number of patients seeking diagnosis (i.e., getting allergy tests that turn up very low levels of reaction that might otherwise have gone undiscovered). Others suggest that an overly hygienic lifestyle may hamper the body's ability to build up proper immunities.

Along with the rise in nut allergies have come more restrictions on schools and other public places, including nut-free classrooms and airplanes, as well as better labeling for products.

Recent years have seen a backlash against the focus on nut allergies, partially in reaction to incidents such as these:

• Five years ago, at a San Francisco elementary school, a nurse stood by to ensure that the children scrubbed their hands as they arrived, while their packed lunches were confiscated and searched for nut products. The measures were a precaution to protect a 5-year-old boy at the school who had a severe nut allergy.

• In 2006 a town in Connecticut felled three hickory trees more than 60 feet high after a resident learned that the trees leaning over her property produced nuts and complained that they posed a threat to her grandson, who had nut allergies.

• Recently, a Massachusetts school district evacuated a school bus full of 10-year-olds after a stray peanut was found on the floor.

The last incident prompted Harvard Medical School professor Nicholas A. Christakis, whose son was on the bus, to write an editorial for the British Medical Journal examining whether these so-called precautions are snowballing into something more like a societal hysteria. The physician and social scientist — best known for his work on the social "contagiousness" of characteristics such as obesity and happiness – wonders if our societal priorities have not become seriously skewed.

"My interest is in understanding [the reaction to nut allergies] as a spread of anxiety," he says.

In other words, Christakis is asking whether our collective mania for the purported dangers of nuts is not simply a substitute for other, larger but more amorphous, undefinable fears. Consider, for example, that of the roughly 3.3 million Americans who have nut allergies, about 150 die from allergy-related causes each year, notes Christakis. Compare those figures with the 100 people who are killed yearly by lightning, the 45,000 who die in car crashes and the 1,300 who are killed in gun accidents.

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Between 1997 and 2007, the number of children under 18 who suffered from food allergies jumped 17%, according to the Centers for Disease Control and Prevention. Experts don't disagree that the incidence of food allergies has increased, but there isn't much consensus as to why. Christakis emphasizes that it is important to distinguish between an epidemic of diagnoses and an epidemic of allergies, a difficult call to make when a disease or condition becomes “du jour.” It is a fact that certain disorders become diagnostic superstars for a period of time. Bipolar disorder and ADHD are examples in recent memory. They accounted for a statistically disproportionate number of diagnoses in children for a number of years.

On some level the public is collectively, albeit unconsciously, aware of such fads, which may help explain the baffling reactions the current British study reported. Interview transcripts from the study reveal several scenarios in which parents felt ridiculed, ignored, or challenged on the subject of food allergies.

• In the lunchroom at school, children might feel bullied. “She was teased and things like that, people saying…‘I’ve got nuts and I’m gonna come and touch you,’” said one participant.

• Said one participant about a family camping trip: “He’d caught her sort of pulling faces and complaining to other people that they’d had to put the peanuts away…they all laughed and it was awful…”

• At a social gathering, the hosts thought the family was overdramatizing the problem. “We got invited up for a party…gave them a list of what he could eat,” said one study participant. “[We] walked in there and I couldn’t believe my eyes, big bowls of peanuts in between all the food.”

• Forgetful or disbelieving relatives aren’t uncommon. In one family, a grandparent gave a child candy with nuts. “Now whether it was deliberate or not, I don’t know, but I blew a fuse,” said one participant. “I suppose in my heart of hearts I felt that he’d given it deliberately; my husband doesn’t want to believe that his father would do that.”

The comments reveal a clear reaction against a focus on nut allergies which is perceived as exaggerated. Many grandparents can attest that children have always suffered food allergies which they eventually outgrew. Back in the old days, they would argue, no one made a fuss about it, kids continued to eat the offending foods, itched and scratched and got over it.

It is undoubtedly true that many children develop some food sensitivity most of the time, and that they outgrow that sensitivity in time. And no one would disagree that children who suffer from life-threatening allergies need to be protected. The problem is that the growing trend of demonizing nuts only fuels general parental anxiety, says Christakis.

Instilling in the general public the idea that nuts are a "clear and present danger" does little beyond heightening panic. "There are kids with severe allergies, and they need to be taken seriously," he says, "but the problem with a disproportionate response is that it feeds the epidemic."

Dixon-Woods says that better food labeling, more education, and stricter regulation is necessary to reduce misunderstanding and negative attitudes about nut allergies—especially in the United States, where peanut-based products are ubiquitous and the word allergy is frequently used to describe non-life-threatening conditions such as hay fever.

“It may be time to come up with a new term to describe the condition,” Dixon-Woods says. “‘Nut allergy’ is so poorly understood that it really is not a helpful term anymore.”

The study, published Monday in the journal Chronic Illness, was funded by the British charity Midlands Asthma and Allergy Research Association.

Image credit: Wikimedia Commons