Data shows that the incidence of asthma, allergies and other autoimmune conditions like type 1 diabetes is on the rise. Especially in the West. I mean we have all seen it, with most schools now banning nuts completely (given the rise of severe nut allergies). Plus, more skin conditions like psoriasis and eczema. Not to mention the dreaded asthma, in young children than ever before.  In this article we take a look at the latest science to try and get a sense of one of the reasons why this could be on the rise and most crucially what you can do in order to potentially minimise the chances of serious allergies etc. 

So taking a step back: why are these conditions seemingly on the rise? 

Unfortunately, as usual, there doesn’t appear to be a single simple answer. However, the latest research is increasingly pointing in one direction: 

Guess what: it’s our environment and the way we now live our lives.

What’s causing this?

Asthma, allergies, eczema and autoimmune conditions are often broadly linked together. Primarily as they tend to have some commonalities. It’s a complex interplay, but they are all related to the immune system. Specifically our immune system not working quite as it should. It also usually involves our old friend chronic inflammation. Click here for a reminder why we are facing more trouble than ever with this.

Part of this is genetic, but it doesn’t explain it all…

Type 1 Diabetes, an autoimmune condition where the body attacks itself inhibiting the production of insulin, is a prime example. It is the most common autoimmune condition in young people. It is also highest ‘in European countries, probably due to environmental factors’ (Xie et al., 2014).

The science suggests that genetics accounts for around 60% (2). This leaves a good chunk potentially caused by other factors. This is where epigenegtics comes in click here for more. As a reminder, this is how our environment influences our body by switching particular genes on or off.

So what are these ‘environmental factors’?

One theory on the rise is the so-called ‘hygiene hypothesis’. As the name suggests, this is the argument that we have become ‘too clean’ or overly sterile. Particularly in the West, with our love of hand-sanitizers, antibiotics and overall germ-phobia. 

How credible is this and how does it make any sense?!

Interestingly this isn’t a new observation. It was first identified in the 80s, where it was shown that children in large families seemed to suffer less from a skin condition called atopic dermatitis. This was then followed up by a whole host of other studies showing that there were lower overall rates of allergic disease in children in rural Europe. Notably, those who lived lifestyles that involved raw milk/animal/stable exposure in the first year of life. The research following has strengthened this argument…

But, how can being ‘too clean’ have an effect?

It comes back to the gut and the microbes within it. The gut is one of the main heartlands of your immune system. It also appears that when it comes to optimum functioning, the more microbes you have (in good balance) the better. Click here for more. 

In fact when your gut microbiome isn’t in order, especially at the vulnerable stage when your immunity is developing, you open yourself up to malfunction. Specifically issues with allergy and autoimmunity. Amongst other things. The cleaner and more ‘antibiotic’ we are, the more microbes are eliminated. This can hurt the diversity of the gut microbiome and disrupt its delicate balance.

‘Allergies, mainly in the form of atopic eczema and later asthma, has been linked to specific microbial features. Numerous studies suggest that early development of the infant gut microbiota influences the risk of allergic diseases later in life. This has been attributed to an inappropriate development of gut microbiota and associated disruption of immune homeostasis during the first year of life’. (1)

Check out more from our resident specialist pediatrician Dr Mona Amin on her podcast. She talks about the rise of allergies in children. 

What equals an inappropriate development of gut microbiota?

Well as far as we understand it at this point (research is still ongoing): it is where you have low diversity and large imbalances. Click here for much more on this.

There are other factors that impact how a baby’s gut develops of course. Click here to learn more on how it is built and influenced. When these are missing we can get a further reduction of diversity and imbalances forming.

For example, ‘a host of additional studies, established that in addition to the findings noted above, absence of early antibiotic exposure, exclusive breastfeeding for the first 4 months of life, vaginal delivery, furry pets in the home during infancy, lack of maternal antibiotic use during pregnancy, and maternal animal exposure during pregnancy all were associated with lower rates of allergic disease. Taken together, these clinical observations established a strong link between microbes and the development of allergic disease’. (3) Click here for more about the specific factors that impact a baby’s gut construction.

Taking this a step further, when the microbes in our gut are knocked off, we see other linked issues like inflammation and also leaky gut. Click here for much more on inflammation.

What is leaky gut? Why is this a problem? This is essentially where the filtering mechanism that the gut is supposed to perform (allowing the right things through and stopping the bad) isn’t working as it should. The gut then becomes more permeable. This can means things that shouldn’t get into our blood stream do. This can lead to inappropriate immune reactions and inflammation. One of the ways this can show up is allergies. 

‘It has been shown that microbiota perturbations during early infancy may generate a proinflammatory environment that facilitates the development of autoimmune disease’. (1)

There is more: Less of the ‘right’ microbes (and the right food for them: prebiotics) also means less short chain fatty acids.

Why are these so important? These are produced by the gut microbes. They are also the secret heroes of the gut world. Research has shown they have powerful anti-inflammatory effects (click here to learn more). Partly, via their protection of the all important gut barrier. Essentially bolstering the body’s ability to ensuring nasties can’t get through into the bloodstream.

It appears that allergies are not the only thing we may be impacting when we knock the gut off balance. Gut dysbiosis has been linked to asthma, the skin and even the brain. Interestingly diseases like schizophrenia and autism are now considered to also have an inflammatory component, suggesting that these ailments could also be associated with changes in intestinal microbiota. (2)

For further insight on this click here to read more from the pioneer of work around the gut and neurological/immune development with Dr Natasha Campbell McBride. 

So what can we do about it??

‘By modifying the diet it might be possible to improve the intestinal microbiota to promote an anti-inflammatory response of a patient suffering from autoimmunity.’ (2)

One of the coolest things we have discovered is that there is a lot you can do to help your gut out pretty easily and quickly. In fact it has been shown that the makeup of the microbes in the gut can be changed in as little as 24 hours by what you eat click here for more on that.

What type of change do we want?

Click here for the top ways to improve your gut health but it appears: 

We need more diversity and not less. ‘Studies have indicated that a reduced microbial diversity of early-life microbiota directly correlates with later development of atopic eczema…a reduced gut microbiota diversity during the first month of life is associated with a higher prevalence of asthma in 7-year-old children.’ (1)

Increasing the barrier function: A study performed in Type 1 diabetic patients showed a significant increase in intestinal permeability compared to healthy controls. (2) Further a study looking at Italian affected children showed that the more the microbiota makeup was compromised, the greater the intestinal permeability. (2)

The earlier the better: We have learnt that the early days matter a lot. Particularly when it comes to appropriate immune response and reducing the risk of allergies. The time from conception to 2-3 years (when the gut microbiome is thought to stabilise) is key.

‘A direct association of specific microbial patterns early in life with the development of asthma years later has not yet been unequivocally established [in humans], since genetic, epigenetic, and other environmental factors also affect the development of the disease. Nevertheless, it is becoming increasingly clear that the intestinal microbiota plays a crucial role in the perinatal programming of asthma…recent evidence suggests that the risk of suffering from asthma is higher in infants who exhibited gut microbiota dysbiosis during the first 100 days of life and that this risk is associated with particular bacterial groups.’ (1)

Click here for more. 

Finally – linked back once again to the gut there is research that is strengthening the idea that prebiotic foods and fibre during pregnancy can have a meaningful effect reducing the incidence of one specific type of autoimmune condition: Celiac disease. Click here for much more.

Got that all?! Phew! For the quick and easy ‘How to’ boost your gut click here. 

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