Well we changed our mind again!

Excellent article in the prestigious New England Journal of Medicine shows that feeding children peanuts early in life DECREASES peanut allergies.  This goes against not only common wisdom, but against what, until recently, was the official American Academy of Pediatrics recommendation!  In 2000 we recommended that parents NOT feed children peanuts until age 3 to help prevent development of allergies.  Later on that recommendation was retracted, as it became clear that it had been made without good evidence to support it.  Now this study concludes:

CONCLUSIONS

The early introduction of peanuts significantly decreased the frequency of the development of peanut allergy among children at high risk for this allergy and modulated immune responses to peanuts. 

So, not only did we get it wrong, we probably violated the old “primum non nocere” (Firstly cause no harm) by creating MORE kids with peanut allergies.  Did some of them DIE?  Hard to know but just another example of how you need to ask your doctor WHY you should do something and whether they have GOOD evidence to back it up.

The good news is that we are getting better about making sure we have that good evidence before we make broad proclamations.  The bad news is a lot of the old stuff is still out there.  Dietary advice in general is suspect.  Follow Dr. Nick’s easy diet:

EAT FOOD

Definition of food:

A)  If it wasn’t food 100 years ago it’s probably not food today

B) If you have to read the label to know what’s in it, it’s not food.

Dr. Nick

http://www.cnn.com/2015/02/24/health/peanut-allergy-prevention/

George Du Toit, M.B., B.Ch., et. al. for the LEAP Study Team

N Engl J Med 2015; 372:803-813February 26, 2015DOI: 10.1056/NEJMoa1414850

An article in the Los Angeles Times today outlines another problem – inadvertent consequences of medical technology.  Apparently they have some fancy scopes they use to perform ERCP’s (Endoscopic retrograde cholangiopancreatography – say THAT three times fast!).  Well that fact that the procedure can CAUSE pancreatitis is one thing, but now it wasn’t adequately sterilized and gave 100 patients “CRE.”  Now you should know that we like to name our REALLY nasty infections with letters.  It usually starts with the antibiotic that DOESN’T work anymore and then the bacteria.  In this case “carbapenem resistant enterococcus.”  We also have “VRE” (vancomycin), “MRSA,” (methicillin resistant staph aureus) and my favorite:  “MDR” for MULTI drug resistant.

UCLA claims they cleaned the scopes according to manufacturers recommendations, and I believe them.  Nonetheless, we killed two more in L.A.

Dr. Nick