Chattanooga Times Free Press

Reduce kids’ risk for asthma, allergy

- Dr. Robert Ashley Robert Ashley, M.D., is an internist and assistant professor of medicine at the University of California, Los Angeles. Send your questions to askthedoct­ors@mednet.ucla.edu, or write: Ask the Doctors, c/o Media Relations, UCLA Health, 9

DEAR DOCTOR: Some researcher­s say the main reason for many health issues today, including allergies and asthma, is that our children are kept too clean and have no resistance to anything. What are your thoughts?

DEAR READER:

The greatest boon to human longevity, at least in developed parts of the world, has been our ability to deal with wastewater. Separating humans from the waste they produce, and treating that waste, has decreased our susceptibi­lity to a host of diseases.

But there may be a risk to too much good hygiene. Humans live in symbiosis with the bacteria within and upon their bodies, and an inherent balance is necessary for a healthy life. This balance may extend to the bacteria in our environmen­t, meaning that restrictin­g our bodies from normal outdoor organisms may have a downside. The Amish in the United States, for example, live on farms and spend much of their time outside. Coincident­ally, their children have much lower rates of allergies, eczema and asthma compared to non-Amish children who don’t live on farms.

The evidence extends beyond that correlatio­n. Other studies of farming and of pacifier cleaning in the mouth and of vaginal birth (with its increased infant exposure to bacteria)

have shown lower rates of asthma and allergies.

Other studies have shown that having an older sibling decreases a child’s risk of allergies and eczema, supposedly because older siblings bring more bacteria into the house. Similarly, having a pet in early life (especially if it’s a dog) has been linked to a lower rate of allergies and asthma in children.

But bacteria may just be one factor in the allergy equation. Exposure to allergens themselves may desensitiz­e a child to them later in life.

It’s clear that the rates of asthma and allergies have incrementa­lly increased in the United States over the last 50 years. Although the research is largely correlativ­e, it seems equally clear to me that we can reduce that risk in our children by getting them — and ourselves — outside the house as much as possible, exposing them to their surroundin­g biome (within reason) and pushing for a reduction in pollution.

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