Finland's National Allergy Program Successfully Reduces Allergic Diseases
102 comments
·March 15, 2025justaj
stavros
When I was young, I would play in my (outdoor) sandbox and then lick the dirt off my hands, because it tasted good. I still got asthma, though.
My hypothesis for why children in rural areas get less asthma is because there's less air pollution, not because they eat dirt.
rwyinuse
It's all quite random and also depends on genetics. I lived in rural area with very little air pollution, played outside. Yet I got multiple allergies, including hay fever, and hay was plenty in the area. Many of my close relatives have some auto-immune related diseases as well.
xboxnolifes
These sort of events tend to happen at the statistical level, not the individual level. You can't disprove them from one instance of a negative outcome. It's like saying you smoke but never got cancer, or you don't smoke but still got cancer.
somedude895
Licking dirt off your hands isn't the same as being exposed to pollen.
lazide
In an outdoor sandbox? Sure it is. Where do you think all that pollen goes when it falls out of the air?
TheSpiceIsLife
Is there more or less pollen in rural areas?
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DebtDeflation
This is known as the "Hygiene Hypothesis".
https://en.wikipedia.org/wiki/Hygiene_hypothesis
The basic rationale for it is that the human genome did not evolve in a sterile environment, it evolved in an extremely hostile environment, and so developed pretty harsh defense mechanisms, which if not trained (via early exposure) on the appropriate targets will instead learn to target harmless compounds as well as the body itself.
rdedev
I see it as more of a side effect of an immune system that is designed to adjust itself for whatever pathogens are present in its environment.
Depending on where you are born, you can be exposed to a completely different set of microorganisms or compounds present in the environment. Your body first needs to know which of those are benign and not. A simple heuristic is to tolerate most of these that you have been exposed to till a certain age.
But hey this is just my armchair biology. Don't know if there is anything supporting it
krisoft
> first 10000 days
A 10000 day old “child” is in their late twenties.
jl6
Whippersnappers, we call ’em.
grues-dinner
Reminds me of the comment in Gattaca that his heart is 10000 beats overdue. Which is about 3 hours.
kbelder
First 10000 days, second 10000 days, then you die.
makeitdouble
This reasoning seems to work for some cases and not others, so there might be a ton of other factors, potentially more impacting depending on your situation and genes. The article points at food and other immune elements (e.g. smoking, so I assume pollution also) for instance.
For instance Japan has a known pollen problem. There there's no correlated action to keep small kids out of pollen (that would mean masks, not playing outside at school etc. which are measures extremely hard to take), nor to prevent anyone from getting pollen if they're not known allergics. They go to school and have to be outside for significant time.
Yet the allergy rate increased twofold in a decade, as the pollen presence also increased.
cyco130
Reminds me of a dark joke I sometimes make: Why are there no Turkish people above forty with nut allergies? Because they all died in early childhood.
selcuka
I get the joke, but I was born and raised in Turkey and I have never met a child or adult with nut allergy while I was there. I'm not saying it doesn't exist, but it's incredibly rare.
cyco130
I’m Turkish as well (and over forty). It’s a joke, I have no data on its prevalence except anecdotal. It does seem much more common nowadays than when I was a kid though.
lazide
Eh, no idea about Turkey, but sometimes it’s also a ‘what do people talk about when you’re around’ thing, and what do people actually recognize?
For instance ‘Asthma is incredibly rare in India’. Yet, having lived in India, I constantly ran across people with telltale Asthma symptoms (loud wheezing, lethargy, difficulty exercising, etc.).
I bet if you put those people on a peak flow meter, they’d all be diagnosed. I only knew 1 that got diagnosed though because ‘Asthma is incredible rare in India’, and also who can afford the time and energy to go to the Doctor?
Talking to a couple pulmonologists about Asthma in India (I got it when there!), they basically just laughed and said ‘at least this isn’t Delhi here, that is a gas chamber’.
For allergies, lots of people over time I’ve heard complain about things ‘tasting spicy’ that weren’t spicy, or seen people get facial swelling or hives after eating things. They just chalk it up to ‘oh yeah, that does it for me somehow. I guess I should stop?’. If asking if they have allergies, they just said no, we don’t get allergies here.
lotsofpulp
My parents' generation (1950 to 1970), born and raised in South Asia, had near zero infant mortality, and have zero food allergies. I have never met an aunt or uncle (out of hundreds) who have had a dietary restriction, and south Asian food uses just about every nut and spice and vegetable on earth.
In addition, the subsequent generation, my cousins, also have zero allergies. It isn’t until the kids born in 2000 and later that we see any allergies.
I found it funny when US doctors prohibit honey for kids until 1 year old due to risk of botulism, but one of the first things my culture does after a baby is born is give it a drop of honey for good luck. I wonder what the risk of botulism really is, because I have never heard of a baby suffering from botulism in my parents’ and my generation.
lostlogin
Are you claiming that their country had zero infant mortality, or zero infant mortality from allergies?
potamic
Checks out in India as well where allergy levels are as low as hygiene levels.
I think you have typo with 10000 days.
justaj
I suppose as with everything, there's supposed to be some kind of balance / ideal set of circumstances.
And yes, I mistakenly added an extra 0.
addicted
India doesn’t have low hygiene levels.
Thats nothing more than a racist TikTok trend.
Indians do have a different conception of public urban space which matches more closely with how the urban public in Europe would treat public space a 100 years ago, but that’s not surprising because proper urban cities in India are about as old as urban cities in Europe were a 100 years ago.
rdedev
Look I've lived in India my whole life and this is how it is there. People take a lot of effort to keep their homes clean but public property? Nope. Not my responsibility not my problem, that's how the thinking goes there.
And besides what is the point of talking about how Europe did it 100 years ago? We know better now and still we are not taking an effort to instill some basic civic sense here.
birksherty
You are wrong. Either you don't live in India or live in a bubble in rich area and too privileged.
It's not racist when it's true. People are disgusting here and makes me want to vomit in times from what I see. There is no self awareness among Indians unless they live in rich well off area in India and move in their expensive cars.
mightypirate
you either never been in India or outside of India (not Pakistan)
ajuc
I have allergy, asthma, colitis ulcerosa. I'm allergic to hay, pollen of trees and grasses, dust mites, cat saliva, etc. I've lived in countryside till my 20s, then moved to a big city.
My allergies got better when I moved to a city (probably because there's less allergens), but when I return to the countryside it's still bad (usually it's the worst for the first few days). At least it's not as bad as when I was young (I usually spent a few weeks each year at hospital because of asthma befoer I got 18).
When it comes to air pollution - I grew up during communism in Poland - we had asbestos roof (eternit), everybody was heating their homes with dirtiest and cheapest coal during the winter, and A LOT of people smoked like locomotives. It changed slowly over time.
IMHO there's way too many factors to reduce this to one factor (like sterile environment early on). It probably helps not to have it, but it's not a simple 1-1 relationship.
sofixa
> The reasoning went like this: We've spent most of our evolution in caves digging in dirt, and now (relatively) recently we have been transported into an environment where we can pretty much have the cleanest settings. What do you think this will do to our immune system?
The same it did to our infant and maternal mortality, make it lower?
mixermachine
Less protection then? Yes. So when something hits you later on, the system is not trained for it.
It's not about throwing infants in a dunghill first thing after birth and let nature take its course. It's about gradual exposure when the system can slowly get used to it.
throwawayabcdef
There is more to it than this. My children have had severe food allergies since birth: we know this b/c they had reactions to breast milk based on what mom would eat.
The also have had eczema since birth and one developed life threatening asthma at one year old. His trigger is the normal cold virus which he is constantly exposed to.
With that said, however, my kids are filthy all the time and play outside constantly in the dirt. One of the seven allergies has resolved completely and one appears to be resolved (haven't done a full challenge yet). No luck with the other five foods yet though.
We don't know about the asthma. Seems better but its managed with meds. Its also way scarier than anaphylaxis (and will be triggered by anaphylaxis and gets worse over the course of a week until he is in the hospital unless we aggressively treat it the moment he has breathing symptoms). The eczema comes and goes. Sometimes it responds to various treatments but usually it doesn't.
Its complicated. But kids should be filthy most of the time.
mft_
> There is more to it than this.
Humans are really complex, and something that is proven to work for many on a population scale may not work in every individual case.
And the flip-side is that anecdotes to the contrary do not mean that a population-scale observation is invalidated.
(I know this isn't the point you're making, but others in this thread are.)
rhinoceraptor
The hygiene theory also doesn't make 100% sense to me, I had no food allergies, no pollen allergies or asthma as a kid. Then in my late 20s, I got an egg allergy bad enough to require an epipen, as well as seasonal allergies, both out of nowhere.
I used to eat eggs several times a week, and now I have the type of egg allergy now where I can't even eat baked eggs, so no muffins, brioche bread, cookies, etc.
Aromasin
It's probably a bit of one, a bit of two. Despite spending everyday in the garden growing up, I've always struggled with allergies and they've changed throughout my life. I was deathly allergic to tomato's and eggs as a child but grew out of it around 11-12, became very allergic to pollen and pet dander at 5, which is now life long, and recently in my late 20s become allergic to hazelnut and some other foods I've yet to pin down (my mouth comes up in hives with no rhyme or reason while eating occasionally). I've also developed oesophagitus in my late 20s, to the point where I choke on foods daily unless chewed to a pulp before swallowing.
To me, it seems the parasite theory makes sense in tandem with hygiene. Some people by upringing become predisposed to allergies, while others have genetically as a result of humanities constant fight against intestinal worms. As our genetic profile changers as we age, so does how our bodies express said genes which would be designed to fight something we no longer have.
llm_nerd
The immune system is a complex, only partly understood system, and there isn't a single unifying solution to all of its edges. Broad understandings don't necessarily translate to individual cases.
At some point your immune system faced an adversary and conquered it, but one of the signatures it learned from the enemy encounter unfortunately also matches some molecular component of eggs. There is evidence that some people come out of norovirus infection with an egg allergy, for instance. Similar to how a bite from a lone-star tick can give you a meat allergy.
All sorts of auto-immune diseases can be kicked off by relatively benign things, and often we might never discover the cause. Our immune system learned the heuristics of something, but it's too broad so ends up looking too much like our thyroid glands, nerve myelin, pancreas, etc.
Maybe one day we'll be able to enum all of the signatures an immune system has learned and delete some of them.
rdedev
The hygiene hypothesis is mostly for childhood allergies and even then it wouldn't explain everything. Here is a counter anecdote: my sister has some skin allergies but I don't. I was allowed to play outside and used to just run around in my backyard and my neighbours. Those places can be pretty muddy. My sister was not allowed to and she has allergies.
hooli_gan
Sound very stressful. I hope you and your family are doing well. I had problems with asthma in kindergarten and it is very scary for the first few times, after that I at least knew the drill and that I wouldn't die.
aklemm
The hygiene hypothesis is compelling, as many in this thread demonstrate. But there is sort of an opposite less tidy explanation which needs to be studied further: our immune systems are confused by a barrage of foreign antagonists in the modern industrial world and causing it to go haywire.
misja111
Did you read the article? I think we can stop calling it a hypothesis, asthma emergency visits went down by as much as 60% within 10 years after the programme started.
bryanlarsen
The hygiene hypothesis seems likely to be a good explanation for part of the problem, but there is good evidence that it is only a part explanation.
aklemm
Yes, and I believe the hygiene hypothesis is one of the mechanisms at play, for sure. Didn’t mean to imply otherwise. But this other idea I think could ALSO be a factor and it’s not as neat and tidy for people to understand, so it’s important to not oversimplify.
Sharlin
Kids should be allowed to eat dirt. They should be exposed to rich, biodiverse environments, not just asphalt, rubber safety mats or impoverished monocultural lawns (although the latter are better than nothing, at least unless they're chock full of pesticides and herbicides…) Adults should, too, for that matter.
jajko
We did that. Not letting them eat big chunks of dirt or mud, but not being too strict with clean hands, picking up food from floor etc. And yes few times for some reason they chugged in some small piece of outright dirt.
Its much easier when the amount of nasty diseases they can get from dirty hands is minimal on western world, compared to many parts of 3rd world countries with next to 0 sanitation and usually no sewage separation.
No allergies so far but its too early to tell.
ThatMedicIsASpy
At my last wedding kids were competing in who can get the highest/most: licking the windows
jfengel
In French, "licking the windows" means window shopping (looking without buying).
Sounds like the kids were having more fun though.
lostlogin
How many weddings have you had?
croissants
At least in moderately urban parks in the USA, one complicating factor is that a lot of the dirt has dog poop scattered on top.
bitshiftfaced
The CDC advises not to let small children play directly in dirt patches because of the lead risk.
Sharlin
Not a problem in these parts I don't think, except possibly on old industrial lots and similar. Though as a child I did used to live in a brownfield area that was in the middle of development – there was a lot of very contaminated earth and other hazardous things that of course invited kids to explore. Thankfully I was already past the dirt-eating phase.
echelon
The hygiene hypothesis [1] is real.
Let kids play in the dirt, otherwise they'll develop severe allergies to innocuous substances. Early development is when the immune system trains on what is actually harmful. If you don't stimulate it, you wind up with pollen and peanut allergies instead of parasite and bacteria immune responses.
From the paper:
Primary prevention
Support breastfeeding, with solid foods from 4–6 months onwards
Do not avoid exposure to environmental allergens (foods, pets), if not proven necessary
Strengthen immunity by increasing contact with natural environments (e.g. by taking regular physical exercise and following a healthy diet such as a traditional Mediterranean or Baltic diet)
Antibiotics should only be used in cases of true need (the majority of microbes are useful and build a healthy immune function)
Probiotic bacteria in fermented food or other preparations may balance the immune function
Do not smoke (parental smoking increases the risk of asthma in children
santiagobasulto
> Antibiotics should only be used in cases of true need
This is going to be a big deal in the next 20 years.
I’m from a third world country and the usage of antibiotics is SO irresponsible. People take them (and give them to their children) as candy.
OutOfHere
Consider the Pharmaceutical Advisor custom GPT for advice on which pharmaceutical medications could be relevant for a given issue. You may have to tell it the name of the country in question so it can tailor its recommendations.
https://chatgpt.com/g/g-67ccde8fedd48191a1cb1131bc42b6e1-pha...
Also remember to check Drugs.com or a similar site for dosage, side effects, and interactions.
mog_dev
Traditional baltic diet ? Please I want to know more (from Estonia)
OutOfHere
Those are good, but I don't see playing in dirt in the list.
santiagobasulto
> Strengthen immunity by increasing contact with natural environments
fred69
Further to the Hygiene Hypothesis based approach, add exposure to cattle. They are another common factor during evolution and have a microbial footprint unlike common pets. Over years there have been a number of studies on this, sorry to not have a list of URLs. Take your kids -- and yourselves -- to visit farms and petting zoos.
And my anecdotal input: grew up on a livestock farm, also spending a lot of time in woods and river. No allergy problems at all. Moved to a city and had annoyance-level problems ever since. Decades of observation lead me to suspect particulates (engine soot, tire dust, etc.) as significant antagonists beyond the more commonly cited biological villains. Any chemical with a big-enough stretch of molecule to match what an immune cell is using as its search key.
thrance
Welp. I had a carpet floor in my bedroom as a kid, but that didn't prevent me from developing the badest allergy to dust mites as a teen. It recently got so bad that I started a hyposensitization treatment. Hopefully in 3-5 years it'll get better.
crossroadsguy
I was about to ask whether it worked then I finished reading your comment.
This reinvigorated phase of allergies in my late 30s is so much hell. I just wish I am able to get some kind of safer “cure”. Safer than those steroid based nasal sprays (which not always work) and those oral antihistamine. I sometimes think whether there has been not enough research in this field because it’s not fatal? Or maybe not too many people are badly enough affected by this?
forinti
I couldn't breathe through my nose most days until I got that treatment in my late teens/early twenties. It made my life a lot better. I can remember the day I was walking down the street and could smell everything.
I still get some bad episodes, especially in winter, and I keep a distance from dust, but most days I'm fine.
adammarples
And did you play outside in rural areas or were you raised in a city?
thrance
I grew up in some kind of village turned suburb, in France. I remember there being a field a few 100 meters away from home. So kinda rural?
jetrink
> Strengthen immunity by increasing contact with natural environments
My mom is a family and children's photographer. She likes to photograph kids in their backyards or in local parks, sitting in the grass. She often encounters small children who are unnerved by the feeling of grass as they have never touched it before. Also, parents will ask if their child could sit on a blanket, because the ground is dirty. I'm really curious how this attitude started. It is so alien to me.
ainiriand
Basically put a dog into your home and you are covered.
robohoe
Your assumption is partially correct. I have two dogs and now a baby. So now I have three babies.
null
readthenotes1
Didn't help me.
apwell23
my wife couldn't breastfeed because there was no milk production. That's the top recommendation?
Now what will happen to my son?
SamBam
The point isn't to make people feel guilty. Just do the rest and it will probably be fine.
Honestly, I worry that in the US there was a reaction against the "breast is best" movement because of the worry that people were being made to feel guilty if they couldn't produce milk. I understand the sentiment, but there should be a way to communicate facts while still recognizing that not everyone can do it.
jeroenhd
Your wife lost the genetic lottery. That doesn't mean you did anything wrong, or could've done anything better. When faced with the choice between "a higher chance of allergies" and "starving your son to death", you did the right thing if your son survived.
I think society as a whole would benefit from (government supported, modern takes on) wet nursing facilities so that every parent has access to natural breast milk, but the unfortunate fact is that today many parents simply don't.
Advice like this is aimed more at mothers who do have milk production but are considering formula because of the incredible drain breastfeeding puts on the body. Formula may still be the better option (what good is breastfeeding when the mother suffers so bad that it impacts the parents' ability to take care of their child?), but for those lucky enough not to suffer too much from breastfeeding, knowing the health benefits may change their minds, or decrease or delay the use of formula for just a little longer.
As for what will happen to your son: who knows, it's all probabilities. You can't connect a specific allergy to a decision. Some breastfed kids get allergies, some formula kids grow up without any. All these statistics state is that probabilities are a bit more favourable across millions of babies when more of them are breastfed. He'll probably be fine, and if he won't be, it's not your fault or anyone else's.
multjoy
He’ll probably be fine if you follow the rest of the steps?
t-3
It's probably not a big deal, but if you're really concerned, you can always hire a wet nurse or buy milk.
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a99c43f2d565504
Torille
For me this link results in a 503
I've read the gist of this article in my local news org feed. What it basically comes down to is that Finnish scientists noticed that Russian children who grew up in rural areas usually had way less asthma cases than Finnish city children, and thus began to research why this was the case. They hypothesized that early (first 10000 days) exposure to micro-organisms might play a key role in training the immune system not to over-react to (harmless) micro-organisms later on in life, and thus "train" the immune system better. Their hypothesis now seems to have been validated.
Basically this comes down to the hunch I had for quite a long time: Isolating children into an almost clinical environment is not a great way to boost the immune system. This might explain why there are so many people with allergies. People living too cleanly and not getting exposed to (benevolent) micro-organisms so that their immune system prepares them when exposed to later in life. I think that's one of the reasons that kids that are around pets early in life usually have lower risk of developing allergies later on.
The reasoning went like this: We've spent most of our evolution in caves digging in dirt, and now (relatively) recently we have been transported into an environment where we can pretty much have the cleanest settings. What do you think this will do to our immune system?