Monday, May 28, 2018

Monday Forum - Science Magazine: What’s really behind ‘gluten sensitivity’?

Kelly Servick in Science had a really fascinating piece, What’s really behind ‘gluten sensitivity’?  I mention it in part because it really is interesting as an example of the complexity involved in establishing not just what reactions are real, but also because its shows the difficulty in analysis where there may be multiple causative factors including the influence of fashion and news.

A week or so back on the Armidale Families Past and Present site someone listed a whole set of current medical conditions and asked how many people remembered from their child hood. Many of the members of the site are older, while it's a big group with over 2,100 members. So it's a reasonably representative sample.

Few members could, although a a retired teacher noted that ADHD might explain difficult children that she had to deal with. Still, I was left with an impression (one that I already had) that children (and adults) suffered from far more ailments now than in the past? I might be wrong, but I simply do not remember things like the range of allergies that are now around.

Are we becoming sicker or is it simply a matter of awareness and reporting? What were the main diseases or conditions when you were a child?

This is the Monday Forum post. As always, go where you want.      


Anonymous said...

Measles, chicken pox, mumps, and of course colds and the occasional boil - which was uncomfortable, and probably diet-related.

I think it was only chicken pox I had of those 3, but maybe measles? I have a still very stark memory of being detailed off (as a 7-8 year old) to visit a classmate who became afflicted with polio. Even this many years later I can immediately tell you her name was Pauline, and she was very nice, but uncomfortably frail, with a large head, on a wasted body. That's 60 years ago, with a small boy's memory, but it is still very clear.

The ABC had a piece up briefly today, now disappeared down the mine behind the inevitable TrumpbashingofthedayandgeezImheartilysickofthatnonsense.html about "health professionals concerns that our ultra clean living spaces might not really be such a good idea" - or something like that.

Puts me in mind of words I wrote upon the birth of my first granddaughter - along the line that my hope for her was that her parents had the courage to let her climb trees and slippery dips and, yes, maybe fall and bark her shins.

Dirt is actually quite healthy, in small doses - or so the scientists have now found :)


Cara Membuat Pupuk Organik dari Kotoran Kambing said...

thank you for this helpful information, but gluten free is always the best

2 tanners said...

I'm with kvd on everything he said, but I also recall the sickly kids who never seemed to flourish. They could have had undiagnosed allergies. (I also recall the sickly uni students who seemed to nearly all be vegetarians by choice and quite possibly malnourished.) The diseases of my youth were rubella, chicken pox, measles, mumps, polio, rare cases of TB, whooping cough, scarlet fever etc. The frail kids were less likely to survive than the captain of the footy team. By implication *maybe* allergic sensitivities and the more deadly diseases prevalent were part of the reason for the higher child mortality.

But yeah, dirt is good.

Anonymous said...

Interesting evisceration of my former profession in The Guardian:

It pains me to say it, but I couldn't agree more.


Jim Belshaw said...

I'm sorry, both, for the delayed response. I have been trying to complete a NET chapter. You may see connections with past discussions on food. I am going to run some of those discussions, I think, as a chapter in its own right. You deserve your places in the sun!

One additional disease that I would identify as more common is Pneumonia, a condition that might pick up other things.

I do think that reduced exposure certain foods plus more sterile living has contributed to higher health issues. I would also accept that "sickly" children may be symptoms of unrecognised conditions as with "difficult" children at school. However, at least with my own school cohorts, I'm not sure about the child mortality question. I don't have stats, of course, but my impression is that child mortality rates among school age children were not apparently higher. More precisely still, child mortality rates for some of the identified diseases may have been higher since treatment has (I think) improved, but adjusting for that overall mortality rates among school children have not improved greatly. I said my own cohort, for I do not remember (that memory may be faulty) a single school death. There were deaths later but they were connected first with accidental death.

The generations born from towards the end of Second World War are lucky because they came into a world where antibiotics were becoming available.

kvd, I have bookmarked that big four story to come back too.

2 tanners said...

I was trying to make a link between child mortality and overall child health. There is a specific linkage in the literature (the DALY measure), but it quickly gets lost in healthspeak mumbo-jumbo. Higher mortality is a pointer to lower overall child health.

The movement in child mortality is significant but not the whole story. Child mortality, speaking simplistically, is a combination of things including accidents being treated as normal but also illness being somewhat inevitable. I wasn't pointing at child mortality as being the outcome solely of untreated undiagnosed allergies, but that these would have contributed. In answer to your question, about three kids died at my primary school, two of illness (measles and scarlet fever) and one due to a hit-and-run. There may have been others I wasn't aware of.

As an aside, and begging the indulgence of Jim and my co-commentators, due to circumstances beyond my control, my writing won't be as clear as I would like for some considerable time.

Jim Belshaw said...

I hope that you are ok, 2t. That last sentence does not sound good.

The distinction between mortality and health is an important one, I think. You may have certain diseases or death events (accidents, for example) that cause death, but the children (or others) who survive may be healthy. Conversely, medical advances may reduce mortality and thus affect life expectancy statistics even though the population may be less healthy in fact.

A distinction needs to be made between epidemiological studies which provide statistics for whole populations and specific diseases or causes of death. A health measure may improve outcomes in an aggregate statistical sense without having any individual meaning because the changes at individual level are statistically insignificant.

The question of whether some conditions have got worse, new conditions emerge, is an epidemiological one that reflects both stats and changing definitions (new conditions and medicalisation) used in creating the stats. I think that there is enough evidence to suggest both have happened. I was interested in testing here.

The conversation has been useful in drawing issues out. I need to consolidate the discussion into a new story!

2 tanners said...

Hi Jim.

In researching, have a look at DALY figures. The disability-adjusted life year (DALY) is a measure of overall disease burden, expressed as the number of years lost due to ill-health, disability or early death. It was developed in the 1990s as a way of comparing the overall health and life expectancy of different countries.

I've always found the name counterintuitive, but disease burden less so. As you note, part of epidemiology is the ability to diagnose in the first place. DALY is a bit more robust since it takes into account days lost through inability to work/study without necessarily diagnosing the illness (e.g. diarrhoea can have a multitude of causes but results in a measurable DALY).

A lot of it is very unsatisfactory to my tidy mind, but it is scientific research trying not to jump to conclusions. Amusing and connected note for the day: "Empiric" means a doctor who ignores current theories in favour of the evidence in front of his eyes. As a result, the alternate meaning is a quack. Hmm.