
Allergies seem nearly impossible to avoid — unless you're Amish
'Generally, across the country, about 8 to 10 percent of kids have asthma. In the Amish kids, it's probably 1 to 2 percent,' said Carole Ober, chair of human genetics at the University of Chicago. 'A few of them do have allergies, but at much, much lower rates compared to the general population.'
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Now, Ober and other researchers are trying to discover what makes Amish and other traditional farming communities unique, in the hopes of developing a protective treatment that could be given to young children. For instance, a probiotic or essential oil that contains substances found in farm dust, such as microbes and the molecules they produce, could stimulate children's immune systems in a way that prevents allergic disease.
'Certain kinds of farming practices, particularly the very traditional ones, have this extraordinary protective effect in the sense that, in these communities, asthma and allergies are virtually unknown,' said Donata Vercelli, a professor of cellular and molecular medicine at the University of Arizona. 'The studies that have been done in these farming populations are critical because they tell us that protection is an attainable goal.'
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The Amish are members of a Christian group who practice traditional farming - many live on single-family dairy farms - and use horses for fieldwork and transportation. As of 2024, around 395,000 Amish live in the United States, concentrated mostly in Pennsylvania, Ohio and Indiana.
Over the past century, the incidence of allergic diseases - including hay fever (allergic rhinitis), asthma, food allergies and eczema - has increased dramatically. Hay fever, or an allergic reaction to tree, grass and weed pollens, emerged as the first recognized allergic disease in the early 1800s, climbing to epidemic levels in Europe and North America by 1900.
The 1960s saw a sharp increase in the prevalence of pediatric asthma, a condition in which the airways tighten when breathing in an allergen. From the 1990s onward, there has been an upswing in the developed world in food allergies, including cow's milk, peanut and egg allergies.
Urbanization, air pollution, dietary changes and an indoor lifestyle are often cited as possible factors.
Preparing a horse team for work on a farm in Pulaski, Pennsylvania.
Keith Srakocic/Associated Press
The 'hygiene hypothesis' - first proposed in a 1989 study by American immunologist David Strachan - suggests that early childhood exposure to microbes protects against allergic diseases by contributing to the development of a healthy immune system.
The study found that hay fever and eczema were less common among children born into larger families. Strachan wondered whether unhygienic contact with older siblings served as a protection against allergies.
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Subsequent findings have given support to the hygiene hypothesis, such as that children who grow up with more household pets are less likely to develop asthma, hay fever or eczema. Perhaps even more beneficial than having older siblings or pets, however, is growing up on a farm. (More than 150 years ago, hay fever was known as an 'aristocratic disease,' almost wholly confined to the upper classes of society. Farmers appeared relatively immune.)
This 'farm effect' has been confirmed by studies on agricultural populations around the world, including in the United States, Europe, Asia and South America. But even among farming communities, the most pronounced effect appears to be in the Amish. In a study of 60 schoolchildren by Ober, Vercelli and their colleagues, the prevalence of asthma was four times lower in the Amish as compared with the Hutterites, another U.S. farming community with a similar genetic ancestry and lifestyle.
The prevalence of allergic sensitization - the development of antibodies to allergens and the first step to developing an allergy - was six times higher in the Hutterites. The researchers first ruled out a genetic cause; in fact, an analysis showed that the Amish and Hutterite children were remarkably similar in their ancestral roots. Instead, the main difference between these two populations seemed to be the amount of exposure as young children to farm animals or barns.
'The Hutterite kids and pregnant moms don't go into the animal barns. Kids aren't really exposed to the animal barns until they're like 12 or so, when they start learning how to do the work on the farm,' Ober said. 'The Amish kids are in and out of the cow barns all day long from an early age.'
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When analyzing samples of Amish and Hutterite house dust, they found a microbial load almost seven times higher in Amish homes. Later experiments showed that the airways of mice that inhaled Amish dust had dramatically reduced asthmalike symptoms when exposed to allergens. Mice that inhaled Hutterite dust did not receive the same benefit.
On Route 11 near Patten, Maine, in 2017.
The Boston Globe
Now, Ober and Vercelli are beginning to identify the protective agents in Amish dust that prevent allergic asthma. In 2023, their analysis of farm dust found proteins that act like delivery trucks, loaded with molecules produced by microbes and plants. When these transport proteins deliver their cargo to the mucus that lines the respiratory tract, it creates a protective environment that regulates airway responses and prevents inflammation.
'We don't really talk about the hygiene hypothesis as much anymore because we now understand that it's not really about how hygienic you're living,' said Kirsi Järvinen-Seppo, director of the Center for Food Allergy at the University of Rochester Medical Center. 'It's more like a microbial hypothesis, since beneficial bacteria that colonize the gut and other mucosal surfaces play a significant role.'
During the first year or two of life, a baby's immune system is rapidly developing and highly malleable by environmental stimuli, such as bacteria. Some experts believe that exposing young children to certain types of beneficial bacteria can engage and shape the growing immune system in a way that reduces the risk of allergic diseases later in life. Farm dust contains a hodgepodge of bacteria shed from livestock and animal feed that isn't harmful enough to cause illness, but does effectively train the immune system to become less responsive to allergens later in life.
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In 2021, Järvinen-Seppo and her colleagues compared the gut microbiomes of 65 Old Order Mennonite infants from a rural community in New York with 39 urban/suburban infants from nearby Rochester. Like the Amish, the Old Order Mennonites follow a traditional agrarian lifestyle. Almost three-fourths of Mennonite infants in the study were colonized with B. infantis, a bacterium associated with lower rates of allergic diseases, in contrast to 21 percent of Rochester infants.
'The colonization rate is very low in the United States and other Western countries, compared to very high rates in Mennonite communities, similar to some developing countries,' Järvinen-Seppo said. 'This mirrors the rates of autoimmune and allergic diseases.' These clues about the origin of the farm effect represent a step toward the prevention of allergic diseases, Järvinen-Seppo says.
Whatever form the treatment takes, the impact on prevention of allergic diseases, which affect millions of people worldwide and reduce quality of life, could be enormous, experts say.
'I don't know that we can give every family a cow. … But we are learning from these time-honored and very stable environments what type of substances and exposures are needed,' Vercelli said. 'Once we know that, I don't think there will be any impediment to creating protective strategies along these lines.'
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On a special episode (first released on July 24th) of The Excerpt podcast: The question is: Why do we struggle to sleep? Jennifer Senior, a staff writer at The Atlantic, joins The Excerpt to talk about insomnia and what we can do about solving our sleep issues. Hit play on the player below to hear the podcast and follow along with the transcript beneath it. This transcript was automatically generated, and then edited for clarity in its current form. There may be some differences between the audio and the text. Podcasts: True crime, in-depth interviews and more USA TODAY podcasts right here Taylor Wilson: Hello, I'm Taylor Wilson, and this is a special episode of the Excerpt. According to a report released by the American Medical Association earlier this year, one-third of American adults experience acute insomnia, an inability to fall or stay asleep for several days at a time, but one in 10 adults suffer from chronic insomnia. That's an inability to fall or stay asleep three nights a week for three months or more. The condition has potentially debilitating health impacts, including an increased risk of depression, anxiety, substance abuse, and even car accidents. So the question is, why can't we sleep? Here to help me dig into the issue is Jennifer Senior, a staff writer at The Atlantic who recently went on her own journey to solve her insomnia and who shared her story in the magazine. Thank you for joining me, Jennifer. Jennifer Senior: Thanks for having me. Taylor Wilson: So let's start with I guess a 30,000-foot view of the issue. I know you spoke with a lot of sleep specialists, did a lot of independent research for your piece. Jennifer, what's the big picture here on American's trouble with sleep? Jennifer Senior: Right. Yeah. What's funny, I think the story was a little misnamed. I mean, this is really more story about, well, if you can't sleep, don't feel awful about it because there are so many shaming stories about people, whatever solutions people seek out. I do talk in the beginning about the way that the modern world absolutely conspires against sleep, that it just lays waste to your circadian rhythms. That people work two jobs, 16.4% of us work non-standard hours. If you're a white collar kind of professional, you've got these woodpecker like peck, peck, peck, incursions into your life all night and weekend long from your boss's work sort of never ends. I mean, we're just no longer yoked to the rhythms of the earth anymore. We're just part of this whirl of a wired world. Taylor Wilson: In the course of doing your research, was there something in particular that surprised you most about the problem? Jennifer Senior: I'll tell you what surprised me most, just generally. 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Taylor Wilson: Well, you talked Jennifer about the modern world conspiring against us and our sleep, and I guess let's try to outline a few of the possible causes of what you call a public health emergency, right? What can you share with us here on this? Jennifer Senior: About other causes, you mean besides the kind of modernity itself and kids working on... Kids being assigned homework online, kids socializing online. I mean, adolescents are desperate for sleep. They're so hungry for it, and modern high schools and middle schools have them waking up preposterously early when their circadian rhythms are pitched forward. We've got a substantial sandwich generation that's taking care of young kids and their elderly parents. That's going to conspire against it. These are all immutable things. Also, there are elevated levels of anxiety now in our world, and anxiety itself is a huge source of... Or can be a source of sleeplessness, certainly can make one prone. 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And to this day, I don't know what happened, but once that happens, the whole cycle starts to happen, then people suddenly become very afraid of not falling asleep and whatever kicked it off whether it's mysterious or known becomes irrelevant because then what you do is you start getting very agitated and going, oh my God, I'm not sleeping. Oh my God, I'm still not sleeping. Now it's 3:00 in the morning. Now it's 4:00 in the morning. Now it's 5:00 in the morning. Oh my God, I have one more hour, et cetera. Taylor Wilson: Well, you did write in the piece about the many different recommendations that she tried to solve your own sleep issues. What were some of them, Jennifer, and did any of them help? Jennifer Senior: Oh God, I tried all the things. This is before I sought real professional help, but I did all the things. I would took Tylenol PM, which did not work. I did acupuncture, which were lovely, but did not work. I listened to a meditation tape that a friend gave me, did not work. I listened to another one that was for sleep only that did not work. I ran. I always was a runner, but I ran extra, did not work. Gosh, changed my diet. I don't remember. I did all sorts of things. I tried different supplements, Valerian root, all these things. Melatonin, nothing, nothing. Taylor Wilson: You wrote in depth about one therapy that was recommended to you, and that was CBTI. That's cognitive based therapy for insomnia. Jennifer, first, what is this? And second, did you find any success by using this? Jennifer Senior: So cognitive behavioral therapy for insomnia, as you said, is the gold standard for treating insomnia. It's portable. You can take it with you. It's not like if you leave your sleep meds at home. The main tent pole of it, which is sleep restriction, which I'll get to in a minute, is very hard to do. I found it murder, the kind of easier parts, although they're still in a funny way, kind of paradoxical, are you have to change your thinking around this is the cognitive piece around sleeping and insomnia. You have to decide, okay, I'm not sleeping. So what? Now, this is kind of funny because there's this din surrounding us that says, oh my God, you're not sleeping. You're going to die of a heart attack. You're going to die of an immune disease. You're going to get cancer. All these things, right? You have to set that all aside and decide one more night's sleep that I can't sleep. So what? Right. That's one thing. You have to change your behaviors, deciding that you are going to consistently go to bed at the same time, wake up at the same time, all that, and not use your bed for anything other than just for sleeping and sex. The hard part and the most powerful part that I found it brutal was the part that said you have to restrict your sleep. If you had only five hours of sleep, but you're in bed for nine hours, you have to choose a wake-up time. Let's say it's 7:00 and then you have to go to bed five hours earlier, 2:00 to s7:00. That's all you can give yourself, and you cannot stop with that schedule until you've slept for the majority of those hours. That's very hard for a sleepless person. And then once you've succeeded, all you get to add on is 15 more minutes of sleep, and then you have to sleep the majority of those hours for three nights running. This is always for three nights running, and the idea is to build up a enough sleep pressure to regularize yourself. You basically capitulate to exhaustion and you start to develop a rhythm. I couldn't stick with it. I was so kind of stupid and depressed with sleeplessness by the time I started it that it probably was impractical and I refused to take drugs to help me fall asleep at the exact right hour, which many clinics recommend. If you're going to go to bed and sleep from 2:00 to 7:00, take something at 1:30 so that you fall asleep at two. But I was afraid of being dependent on drugs, and you can really wean yourself if you do it for a limited amount of time. You can wean yourself anytime really, if you're shrewd about it and if you taper. But I think that I would tell people to try it and to try it sooner rather than later, and to be unafraid of doing it in combination with drugs so that the schedule worked. Taylor Wilson: Well, I am happy you brought up drugs. I did want to bring that up just in terms of what experts are saying about their impact. Even just drugs and alcohol kind of writ large, but sleeping pills specifically. What did you find in researching this in terms of drugs and alcohol? Jennifer Senior: Well, there's a real stigma taking sleep medication, and I'm frankly a little sick of it. I'm not sure why this is so very stigmatized. Like, oh, they're drug addict. They're hooked on sleeping pills. It's framed as addiction, and no one says that someone is addicted to their Ozempic, even though a lifestyle change could perhaps obviate the need. No one says that they are addicted... Oh, that person is totally addicted to their blood pressure medication, even though maybe a change in lifestyle would help change that. Or that they're addicted to their statins, So I sort of bristle. And those who prescribe these medicines say like, look, if the benefit outweighs the risk and they're used properly, sometimes the real side effect is just being dependent on these drugs, and there's a difference between dependence and addiction. A surprisingly small number of people who take these drugs regularly, like benzodiazepines, like Ativan and Ambien and Klonopin, all these things, a surprisingly small number, like 7% increase their doses if they take it every night. So that's very small. However, there are cognitive decrements over time... Or not decrements. It can interfere with your memory and it can increase your odds of falling as you get older. And those are, to me, the real persuasive reasons to get off. Taylor Wilson: I want to back up a minute here to talk about something many may not be aware of, and that's that historically, at least in some eras, people used to sleep in two blocks. What do you know about this? How did this function and really why did this kind of sleep pattern work for some folks? Jennifer Senior: Well, it was sort of, I think, natural. It seemed that this is, and it has not been proven everywhere, but there's plenty of both historical evidence and also some in a lab by this wonderful guy named Tom Ware that shows that if you sort of just put someone in a room, 14 hours of darkness, what will happen is that their sleep will naturally split into two. They'll sleep for a phase, wake up for a phase, and then sleep for a phase again. And historically, there's all sorts of evidence that people would sleep for a phase, get up and read for a while, do some quiet things, do light tasks, maybe sing, maybe have sex, and then go back to bed. So there seemed to be two phases, and this was much easier to do when midnight was actually midnight. You were going bed when the sun had set, or just after were you were tethered to the rhythms of the earth as opposed to a wired electricity run world. Taylor Wilson: What is something you wish you knew when you first started on this journey? Jennifer Senior: To get on it earlier and to not be as afraid... Cognitive behavioral therapy is, I think, often done in conjunction with taking something like Klonopin or Ativan or Ambien, and I was so petrified of becoming hooked on them that I didn't... I refused to take them and I couldn't get my sleep to contract as a result of it. My body was so completely dysregulated and confused about it was so all over the place that I really needed something to regularize it and stabilize it, and I flipped out, and I think if anybody goes and tries CBT, I and their practitioner says to them, and I'm going to have to be on their recommendation, do this in concert with a drug, because you really need it. Don't sit there and freak out and think that you can't or shouldn't, because it happens a lot and people freak out a lot. Taylor Wilson: All right, Jennifer Senior, thank you so much for coming on the Excerpt. Jennifer Senior: Thank you so much for having me. Taylor Wilson: Thanks to our senior producers, Shannon Rae Green and Kaylee Monahan for their production assistance. Our executive producer is Laura Beatty. Let us know what you think of this episode by sending a note to podcasts@ Thanks for listening. I'm Taylor Wilson. I'll be back tomorrow morning with another episode of USA TODAY's the Excerpt. This article originally appeared on USA TODAY: Insomnia is a global epidemic. How do we fix it? | The Excerpt


Fox Sports
12 hours ago
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Following Venus Williams' comment on health insurance, here's what to know about athlete coverage
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NHL NHL players who have played more than 160 games with the league, which is about two seasons, are eligible to buy NHL health insurance for their retirement. The retirement insurance plan is eligible for partial subsidization from the league. MLB Baseball players who spent at least four years in the league have the option to pay premiums to stay on the MLB's healthcare plan indefinitely. Minor League Baseball has its own separate CBA, which also guarantees health insurance for active players. In the minors, however, players who get cut or leave the league lose coverage at the end of that month. ___ AP sports: in this topic