Health



December 15, 2008, 3:11 pm

Are Nut Bans Promoting Hysteria?

INSERT DESCRIPTIONWorries about nut allergies are intense in some circles. (Lars Klove for The New York Times)

Every parent of a school-age child has heard the warnings about nut allergies. Some schools ban nuts entirely, while others set aside special nut-free tables. Parents are often quizzed about the ingredients and preparation methods for birthday treats they send to school. One parent told me she was asked whether a clean knife used to cut brownies had ever been used to spread peanut butter.

While nut allergies are clearly a risk to some children, often the response to this health concern represents “a gross overreaction to the magnitude of the threat,” argues Dr. Nicholas A. Christakis, an internal medicine doctor and professor at Harvard Medical School, in a recent column in the British medical journal BMJ.

In the column, Dr. Christakis points out that about 3.3 million Americans are allergic to nuts, and even more — 6.9 million — are allergic to seafood. But of 30 million hospitalizations each year, just 2,000 are due to food allergies, and about 150 people die annually from serious allergic food reactions. That’s the same number of people killed by bee stings and lightning strikes combined. About 10,000 children are hospitalized annually with traumatic brain injuries from sports, 2,000 children drown each year, and about 1,300 die in gun accidents, he writes.

Dr. Christakis notes that while it’s reasonable for schools and parents to take basic precautions, there is no scientific evidence that nut bans are particularly effective at protecting children. But more important, he argues, is that limiting widespread exposure to nuts can make things worse. The “policy of avoidance” means that fewer children are being exposed to nuts, likely increasing their risk for developing an allergy. A 2008 study in The Journal of Allergy and Clinical Immunology of 10,000 British children found that early exposure to peanuts lowers risk of allergy, rather than increasing it.

Dr. Christakis is best known for his work on social networks and the effect they can have on health issues like obesity, smoking and even happiness. He also argues that extensive efforts to protect children from nuts has created a culture of anxiety that spreads.

“We try to relieve anxiety about nut allergy by signs saying, ‘this is a nut free zone,’ which suggests that nuts are a clear and present danger,” Dr. Christakis said. “But in doing so, we increase the anxiety.”

To read more about Dr. Christakis’s research, go to his Web site, where you will also find a link to the full BMJ article, “This Allergies Hysteria Is Just Nuts.”


From 1 to 25 of 583 Comments

1 2 3 ... 24
  1. 1. December 15, 2008 3:23 pm Link

    I’m with Christakis. If you develop an allergy, you develop an allergy. For those already diagnosed with an allergy it’s a different thing altogether, of course.

    — Susanna
  2. 2. December 15, 2008 3:40 pm Link

    I’m sensitive to peanuts and tree nuts. (I can be around people who are eating them, but if I eat them myself, my stomach gets very angry at me, to put it politely.) I learned very early to pretty much stay away from cookies, brownies, and other sweets unless I know they’re nut-free.

    I wonder how many children have true nut allergies, or go into anaphylactic shock (can’t breathe) when exposed to them. The horror stories spread by the media about these seemingly rare individuals have fed the nut phobia.

    — Heron
  3. 3. December 15, 2008 3:56 pm Link

    Thank goodness for common sense. My friends’ children don’t leave their houses for fear of interacting with nuts on play date. It’s, well . . . nuts.

    — jessica
  4. 4. December 15, 2008 3:57 pm Link

    Obviously Dr. Christakis does not have a child who is allergic to nuts.
    Nut allergy is a new phenomenon, which both parents and medical personnel are still trying to figure out.
    Even though for medical personnel it is a interesting subject of study, for parents sending their allergic kids to schools it is a very worrisome issue. Therefore any effort on the school’s part to alleviate this worry is most welcomed by parents.
    If schools decide to follow Dr. Christakis’s advice parents like us will be forced to remove our kids from such schools and place them in schools more sensitive to our concerns.

    — Anu
  5. 5. December 15, 2008 3:58 pm Link

    I just wonder when we are going to accept that the world is a dangerous place, and start living life again. As a professional scientist, I have had conversations with fellow scientists convinced that their child would die if someone had a peanut butter sandwich in the same room–these people ought to know better! These sorts of bans help no one, least of all the children they are supposed to protect.

    — Marcus D. Collins
  6. 6. December 15, 2008 4:00 pm Link

    Do schools really ban nuts in an effort to prevent students from developing an allergy? My understanding is that it was to protect the kids that already have a severe allergy – for whatever reason something that is a lot more common today than it used to be. Maybe sometimes the precautions can be a little overkill (such as asking was the knife ever used to spread peanut butter), but as a teacher, would you really want to risk a child having a potentially life threatening allergic reaction in your classroom? Wouldn’t you rather err on the side of caution?

    — Jessica
  7. 7. December 15, 2008 4:01 pm Link

    Nuts are delicious! Some kids do have severe allergies, and appropriate accomdations should be made for them. But most kids have consumption, and not airborne problems. The excessive fear of nuts is unwarranted.

    — DC
  8. 8. December 15, 2008 4:02 pm Link

    It’s not just “nut bans”.

    We have gone ban crazy in an attempt to sanitize all the danger out of our lives

    If I was the parent of a child with a serious nut allergy, I would probably push for the ban.

    Would I be overreacting?

    Probably, but I wouldn’t care.

    But, I am not that parent. And I see these bans as a slippery slope towards an even more politically correct society where politicians care only about re-election.

    Dr. Christakis has prescribed us a good dose of common sense combined with medical knowledge.

    Let’s listen to the good doctor

    — DR
  9. 9. December 15, 2008 4:04 pm Link

    Growing evidence indicates that young children benefit from exposure to potential allergens (dirt, animals, a wide variety of foods) because their immune systems learn to tolerate them.

    — richard schumacher
  10. 10. December 15, 2008 4:04 pm Link

    As someone with a tree nut allergy, I think all the hysteria just makes people ultimately less inclined to take such allergies seriously. When all they hear are “nut free zones” and high danger, they’re more inclined to think people are just overreacting. Label things appropriately (not – this product manufactured in a facility that at one point in time may have contained a nut), and teach children who have allergies common sense rules about not sharing others’ food and what to do if they have a reaction.

    — Heather
  11. 11. December 15, 2008 4:05 pm Link

    I am getting allergic to the news

    — Sean K
  12. 12. December 15, 2008 4:05 pm Link

    After reading what the Doctor says, perhaps designating an area “a nut free zone” is really an oxymoron.

    — Tim
  13. 13. December 15, 2008 4:06 pm Link

    I wonder if Christakis has young children who have severe food allergies. My younger brother is highly allergic to nuts and I’ve run to the ER many times alongside my parents when he’s accidentally been exposed to nuts in food we never imagined contained nut products.. The mere smell of nuts causes an intense, uncontrollable biological reaction that causes him great discomfort.
    To call heightened awareness of a life-threatening condition “hysteria” isn’t overreacting. Doing so is incredibly disrespectful, especially if that condition is not threatening to you or the ones you love.

    — Sasha
  14. 14. December 15, 2008 4:09 pm Link

    #1 That would be me. I am allergic (severely) to nuts and being in close proximity to peanuts especially can be quite uncomfortable. I have had some especially difficult times in airplanes when the bags of peanuts were all around.
    the increased awareness is good. I do agree in general that as a country we do go overboard on just about everything..

    — Todd
  15. 15. December 15, 2008 4:11 pm Link

    There is no hope for us. We will inevitably be overrun by healthy nut-eating hordes from other, less paranoid countries. Which, by the way, includes all other countries. The empire is in decline; signs are everywhere.

    — izzie
  16. 16. December 15, 2008 4:13 pm Link

    The lifelong health benefits of eating nuts far outweighs the small number of children with allergies. Schools need to keep separate preparation facilities, not ban nuts outright.

    — Seth
  17. 17. December 15, 2008 4:14 pm Link

    I don’t see how Christakis’ comments provide a way forward for the growing numbers of children with food allergies. My daughter (age 2) has a severe allergy to peanuts. How should schools accommodate children with food allergies? Are the parents of small children with food allergies supposed to keep them at home to prevent a friend at the lunch table offering a bite of a pbj?

    — ssn
  18. 18. December 15, 2008 4:15 pm Link

    So what precisely is so wrong with a school setting up a separate lunch table for children with well documented sever allergies?
    I have the feeling Mr. Christiakis might change his opinion after several visit to the emergency room with his child’s life in danger. Or would he expose his son or daughter to the toxis in order to strenghthen their immune system.
    It is reasuring to see that Mr. Christiakis prefers to play with harmless numbers rather than practice internal medicine. I would not want my child to be his patient.

    — piotr
  19. 19. December 15, 2008 4:17 pm Link

    We could also make the same argument to ban any kind of sugary food that attracts bees, which routinely get indoors.

    The point is that we can’t ban everything, and those who are at risk need to be cautious.

    — jack
  20. 20. December 15, 2008 4:17 pm Link

    I was once on an international flight where the flight attendant announced that due to a child with an allergy, no nuts of any kind would be served on flight. The only children on the flight were spoiled, bratty, ill behaved and being completely catered to by their ridiculous parents. Made me think of natural selection actually…

    — Andrea
  21. 21. December 15, 2008 4:18 pm Link

    Peanut allergy diagnoses have increased significantly over the last ten years — hospitalization statistics nothwithstanding. Our son is highly allergic to peanuts (e.g., anaphylactic level) and soon will start school. We’re certainly not being hysterical in working to minimize if not eliminate his risk of exposure to peanut.

    — Ken
  22. 22. December 15, 2008 4:19 pm Link

    agreed.

    and add anti-bacterial everything to the hysteria too.

    do people REALLY think that they can completely avoid nuts or germs?

    — david f
  23. 23. December 15, 2008 4:20 pm Link

    I think we should ban the nut who perpetuated this hysteria.

    — Peter
  24. 24. December 15, 2008 4:21 pm Link

    As a parent of a nut-allergic child, I must take issue with the attitude esposed by Dr. Christakis. I frankly couldn’t care less about anxiety provoked by nut bans among the parents of non-nut allergic children. The legitimate anxieties of parents with severe nut allergies (read clinically diagnose allergy), however, can be alleviated by such bans. The concerns of families coping with severe food allergies are REAL not invented. Unlike other, more prevalent types of debilitating conditions mentioned – traumatic brain injury and sports injuries – food allergies can be exacerbated by the actions of others, not just the allergic child. Food brought into the classroom that contains nuts is a threat to my child if he is exposed. There are campaigns and policies promoted to protecting children from injuries that can cause disability and death, so why the backlash against efforts to protect allergic children from trips to the emergency room and potential death? Believe me, school officials would rather take steps to prevent emergency situations from inadvertent exposures than deal with the potential liability.

    — Heather
  25. 25. December 15, 2008 4:21 pm Link

    As someone with a life-threatening peanut allergy, I am deeply troubled by Christakis’ logic. His counting hospitalizations is irrelevant–the vast majority of severe food reactions result in ER visits, not hospitalization. The risk of severe food allergies is anaphylactic shock, which comes within minutes, and can result in the swelling shut of the throat. If the reaction is severe enough, the person will likely die long before reaching the hospital. Thus, the choices are ER or morgue. Not hospital. I’ve had a half-dozen ER visits in my time, none of which resulted in hospitalizations.

    The scary swiftness of food allergy attacks is precisely why nut bans are in place: often young children don’t respond quickly enough. Keep in mind we’re talking about a population of youth that is instructed to carry an EpiPen shot with them everywhere they go. This is serious.

    Also problematic: Nut allergies have tripled in the last thirty years, so Christakis’ saying that 3.3 million Americans have the allergy is misleading–it’s heavily swayed toward youth, a percentage widely sourced at 1-2%, meaning that in every elementary school, there are at least a handful of kids who can die from a nut exposure. Is it really an overreaction to request that a food that is essentially a potent poison to these children be kept off of school grounds? No one is suggesting that adults should stop eating nuts (witness: airplanes, which have a couple nut allergic passengers on every flight), but around children who can unknowingly put a classmate in grave danger, or parents who can accidentally harm a child by putting the plain brownies on the same plate as the nut brownies, nut bans are simply common sense.

    — Melinda
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