By Henry Ehrlich
At $150 per ounce and up, Beluga caviar is not currently in my grocery budget. My most vivid memory of it is not from eating, although I have, but watching Tom Hanks trying to wipe the taste from his tongue with a cocktail napkin in the movie “Big”. Beluga is an appropriate player in the allergy mystery explored by Dr. Eva Untersmayr in her guest editorial. Not that the mystery is so hard to solve. Because the patient had eaten it so infrequently, the culprit was easily identified. Rather, like plenty of mystery classics, the “howdunnit” is more important than the “whodunnit.”
Discussions of the causes of the food allergy epidemic often seem like cosmic indictments of modern living. The way we live, the way we wash our hands, the way we grow our food, the way we birth our babies, the way we treat illness—all these have their adherents in explaining how we got into this mess, but no one seems to be able to point to direct cause and effect or offer politically practical ways to do things differently. Even the newish and compelling discussion of what we have done to the microbial environment of our gut raises many more questions than it answers, and leaves us with the problem of what to do after our infant children require life-saving courses of antibiotics.
Dr. Untersmayr provides insight into a possibly important piece of one part of the puzzle. We know that highly allergenic proteins are harder to digest than less allergenic ones, and that that cooking methods can affect their digestibility. But Dr. Untersmayr points out that the ability to process it can be altered by the manipulation of the acidity of our digestive tract. Add antacids to antibiotics on the list of medications whose use should be weighed carefully when looking at long-term health. (Untersmayr doesn’t mention whether the “purple pill” is advertised on Austrian television.)
Is stomach pH “the” answer? Well, unlike other “usual suspects” such as city living, hand-sanitizer, chemicals in our water supply and food chain, and processed foods, we have a plausible, scientific, smoking-gun link to one part of the problem for some patients. Ever wonder what the term “leaky gut” really means? It’s the fact that a child’s digestive system isn’t strong enough to break down certain foods and allows them to leak into circulation where they can provoke an immune response.
But it’s not the whole story, as Dr. Untersmayr underscored in an email to me:
In babies and infants there is the additional factor that the digestive system is not mature and gastric pH levels are anyway elevated during the first years. That could be one of the reasons why they are even more susceptible and food allergies are more frequently observed in young children. However, there is much more research needed to define all contributing factors.