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Published on Leave a comment on Benefit to Thumb Sucking and Nail Biting In Children?

Newly published research found that children who are thumb-suckers or nail-biters are less likely to develop atopic sensitization or allergic sensitivities (as measured by positive skin-prick tests to common allergens). And, if they have both 'habits', they are even less likely to be allergic to such things as house dust mites, grass, cats, dogs, horses, wool, or airborne fungi. The finding emerges from a longitudinal study which followed the progress of 1,037 persons born in Dunedin, New Zealand in 1972-1973 from childhood into adulthood. However, the researchers found no relationship to these 2 habits to allergic asthma or "hay fever" - a contradictory finding that the researchers don't have an answer for.

"Our findings are consistent with the hygiene theory that early exposure to dirt or germs reduces the risk of developing allergies," said Professor Sears (one of the researchers).  The researchers were testing the idea that the common childhood habits of thumb-sucking and nail-biting would increase microbial exposures, affecting the immune system and reducing the development of allergic reactions also known as atopic sensitization. 31% of the children were frequent thumb suckers or nail biters.

Among all children at 13 years old, 45% showed atopic sensitization, but among those with no habits 49% had allergic sensitization; and those with one oral habit - 40% had allergic sensitization. Among those with both habits, only 31% had allergic sensitization. This trend continued into adulthood, and showed no difference depending on smoking in the household, ownership of cats or dogs; or exposure to house dust mites.

Excerpts of the study from Pediatrics: Thumb-Sucking, Nail-Biting, and Atopic Sensitization, Asthma, and Hay Fever

The hygiene hypothesis suggests that early-life exposure to microbial organisms reduces the risk of developing allergies. Thumb-sucking and nail-biting are common childhood habits that may increase microbial exposures. We tested the hypothesis that children who suck their thumbs or bite their nails have a lower risk of developing atopy, asthma, and hay fever in a population-based birth cohort followed to adulthood. Parents reported children’s thumb-sucking and nail-biting habits when their children were ages 5, 7, 9, and 11 years. Atopic sensitization was defined as a positive skin-prick test (≥2-mm weal) to ≥1 common allergen at 13 and 32 years. 

Thirty-one percent of children were frequent thumb-suckers or nail-biters at ≥1 of the ages. These children had a lower risk of atopic sensitization at age 13 years  and age 32 years. These associations persisted when adjusted for multiple confounding factors. Children who had both habits had a lower risk of atopic sensitization than those who had only 1. No associations were found for nail-biting, thumb-sucking, and asthma or hay fever at either age.

What This Study Adds: Children who sucked their thumbs or bit their nails between ages 5 and 11 years were less likely to have atopic sensitization at age 13. This reduced risk persisted until adulthood. There was no association with asthma or hay fever.

The “hygiene hypothesis” was suggested by Strachan1 to explain why children from larger families and those with older siblings are less likely to develop hay fever. Strahan hypothesized that this could be explained if “allergic diseases were prevented by infection in early childhood transmitted by unhygienic contact with older siblings, or acquired prenatally from a mother infected by contact with her older children.” The hypothesis is supported by evidence showing that children who grow up in large families are at greater risk of coming into contact with more infections....The hygiene hypothesis remains controversial, however, as it is unable to fully explain many associations, including the rise of allergies in “unhygienic” inner-city environments, and why probiotics are ineffective at preventing allergic diseases.3

Thumb-sucking and nail-biting are common oral habits among children, although the reported prevalence varies widely, from <1% to 25%.4–7 These habits have the potential to increase the exposure to environmental microorganisms, and have been associated with the oral carriage of Enterobacteriaceae, such as Escherichia coli and intestinal parasite infections.8–12 It seems likely that thumb-sucking and nail-biting would introduce a wide variety of microbes into the body, thus increasing the diversity of the child’s microbiome. If the hygiene hypothesis is correct, it is plausible that this would influence the risk for allergies.... 

Of 1013 children providing data, 317 (31%) had ≥1 oral habit: there was no significant sex difference in prevalence of these habits. Of the 724 children who had skin-prick tests at age 13 years, 328 (45%) showed atopic sensitization. The prevalence of sensitization was lower among children who had an oral habit (38%) compared with those who did not (49%) (P = .009). The lower risk of atopic sensitization was similar for thumb-sucking and nail-biting. Children with only 1 habit were less likely to be atopic (40%) than children with no habit at all (49%), but those with both habits had the lowest prevalence of sensitization (31%) .

Published on Leave a comment on Early Childhood Experiences Key to Preventing Allergies

It's official - the medical community has accepted that a key element in preventing allergies and asthma is early childhood exposure to allergens - whether peanuts, dust, or pets. Instead of avoiding the allergens (which was the medical advice for decades) - getting early exposure to them is key to preventing allergies. Apparently growing up on a farm is best (with exposure to farm dirt and dust), especially a dairy farm with animals and raw milk (a number of studies have found that unprocessed raw milk and its microbes also helps health). But if one doesn't live on a farm, then having furry pets in early childhood is also beneficial in reducing the incidence of allergies. The following study shows that microbes are involved - pet microbes were found in the guts of many of those children who did not develop early allergies! From Medscape:

Furry Pets 'Enrich' Gut Bacteria of Infants at Risk for Allergies

In a small, preliminary study, infants in households with furry pets were found to share some of the animals' gut bacteria - possibly explaining why early animal exposure may protect against some allergies, researchers say. The infants' mothers had a history of allergy, so the babies were at increased risk. It was once thought that pets might be a trigger for allergies in such children, the authors pointed out online September 3 in the Journal of Allergy and Clinical Immunology.

"Earlier it was thought that exposure to pets early in childhood was a risk factor for developing allergic disease," coauthor Dr. Merja Nermes, of the University of Turku in Finland, told Reuters Health by email. "Later epidemiologic studies have given contradictory results and even suggested that early exposure to pets may be protective against allergies, though the mechanisms of this protective effect have remained elusive."Adding pet microbes to the infant intestinal biome may strengthen the immune system, she said.  ...continue reading "Early Childhood Experiences Key to Preventing Allergies"

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The researchers were interested in lifestyle factors that are associated with lower rates of allergies.  Prior research has shown that such lifestyle factors are : living on a farm, introducing fish into the child’s diet at an early age, having pets early in life, parental cleaning of the child’s pacifier by sucking it, crowded living conditions, early daycare attendance, and having siblings. This study found that in households washing dishes by hand, rather than in a dishwasher, there are lower rates of allergies and eczema in children. In addition, the study found that consuming fermented or farm-bought food could decrease the likelihood of allergies further. It is thought that early exposure to microbes stimulates the immune system in beneficial ways. Dishwashers leave fewer bacteria behind on dishes than hand washing dishes. Living in a household that hand-washes means family members are eating off of plates and cutlery that have more bacteria, and therefore they are getting more microbial exposure. There could also be more bacteria in the air when dishes are hand washed or even some other lifestyle factor that these households have in common.From NPR:

Kids, Allergies And A Possible Downside To Squeaky Clean Dishes

Could using a dishwashing machine increase the chances your child will develop allergies? That's what some provocative new research suggests — but don't tear out your machine just yet.The study involved 1,029 Swedish children (ages 7 or 8) and found that those whose parents said they mostly wash the family's dishes by hand were significantly less likely to develop eczema, and somewhat less likely to develop allergic asthma and hay fever.

The findings are the latest to support the "hygiene hypothesis," a still-evolving proposition that's been gaining momentum in recent years. The hypothesis basically suggests that people in developed countries are growing up way too clean because of a variety of trends, including the use of hand sanitizers and detergents, and spending too little time around animals.As a result, children don't tend to be exposed to as many bacteria and other microorganisms, and maybe that deprives their immune system of the chance to be trained to recognize microbial friend from foe.That may make the immune system more likely to misfire and overreact in a way that leads to allergies, eczema and asthma, Hesselmar says.

"The hypothesis was that these different dishwashing methods ... are not equally good in reducing bacteria from eating utensils and so on," Hesselmar says. "So we thought that perhaps hand dishwashing was less effective, so that you are exposed to more bacteria" in a way that's helpful.

In a study released Monday in the online version of the journal Pediatrics, the researchers report what they found: In families who said they mostly wash dishes by hand, significantly fewer children had eczema, and somewhat fewer had either asthma or hay fever, compared to kids from families who let machines wash their dishes.

Still, there are other possible explanations, Hesselmar and Mahr both caution. Though the researchers took economic status into account in the study, it could be that people who don't have dishwashers are alike in some other way that reduces their tendency to get allergies. Interestingly, for example, certain other lifestyle characteristics — eating fermented foods regularly, and tending to buy some foods straight from the farm — seemed to strengthen the "protective" effect in families without dishwashers.

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An argument for the need for human exposure to the microbes in rural environments. However, the role of diesel exhaust and other urban air pollutants is not discussed here (for example, diesel exhaust is linked to asthma). From Science Daily:

Rural microbes could boost city dwellers' health, study finds

The greater prevalence of asthma, allergies and other chronic inflammatory disorders among people of lower socioeconomic status might be due in part to their reduced exposure to the microbes that thrive in rural environments, according to a new scientific paper co-authored by a University of Colorado Boulder researcher.

The article, published in the journal Clinical & Experimental Immunology, argues that people living in urban centers who have less access to green spaces may be more apt to have chronic inflammation, a condition caused by immune system dysfunction.

When our immune systems are working properly, they trigger inflammation to fight off dangerous infections, but the inflammation disappears when the infection is gone. However, a breakdown in immune system function can cause a low level of inflammation to persist indefinitely. Such chronic inflammation can cause a host of health disorders.

Some scientists have hypothesized that the increase of chronic inflammation in wealthier Western countries is connected to lifestyles that have essentially become too clean. The so-called "hygiene hypothesis" is based on the notion that some microbes and infections interact with the immune system to suppress inflammation and that eliminating exposure to those things could compromise your health.

The authors agree that microbes and some types of infections are important because they can keep the immune system from triggering inflammation when it's not necessary, as happens with asthma attacks and allergic reactions.

But they say the infections that were historically important to immune system development have largely been eliminated in developed countries. The modern diseases we pick up from school, work and other crowded areas today do not actually lead to lower instances of inflammatory disorders.

During our evolutionary history, the human immune system was exposed to microbes and infections in three important ways: commensal microbes were passed to infants from their mothers and other family members; people came into contact with nonpathogenic microbes in the environment; and people lived with chronic infections, such as helminths, which are parasitic worms found in the gut and blood.

In order for those "old infections" to be tolerated in the body for long periods of time, they evolved a mechanism to keep the human immune system from triggering inflammation. Similarly, environmental bacteria, which were abundant and harmless, were tolerated by the immune system. According to Rook, a professor at UCL, "Helminthic parasites need to be tolerated by the immune system because, although not always harmless, once they are established in the host efforts by the immune system to eliminate them are futile, and merely cause tissue damage."

In contrast, relatively modern "crowd infections," such as measles or chicken pox, cause an inflammatory response. The result is that either the sick person dies or the infection is wiped out by the inflammation and the person becomes immune from having the same infection again in the future.

Collectively, the authors refer to the microbes and old infections that had a beneficial impact on the function of our immune systems as "old friends." Exposure to old friends plays an important role in guarding against inflammatory disorders, the authors said. Because the "old infections" are largely absent from the developed world, exposure to environmental microbes -- such as those found in rural environments, like farms and green spaces -- has likely become even more important.

The authors say this would explain why low-income urban residents -- who cannot easily afford to leave the city for rural vacations -- are more likely to suffer from inflammatory disorders. The problem is made worse because people who live in densely populated areas also are more likely to contract crowd infections, which cause more inflammation.