The Amish Have Lower Rates of Allergies & Asthma. Can We Benefit Too?

Unlike some other health myths about the Amish, this is a claim that evidence suggests is true. The BBC takes a look at this phenomenon – and wonders if we non-Amish can enjoy the same benefits:

The Amish have gripped the imaginations of Hollywood scriptwriters, documentary makers and sociologists for decades.

But in the past 10 years, their way of life has become of increasing interest to the medical world too, as they seem to defy one particularly concerning modern trend.

While rates of immune-related conditions which begin in childhood, such as asthma, eczema and allergies, have soared since the 1960s, this has not been the case for the Amish.

Here is a study showing that asthma is 4-6 times lower among the Amish than a comparison group (Hutterites) and another showing evidence of lower levels of asthma and allergies.

What is at the root of this?

The authors of the first study linked above compared Amish and another similar group, Hutterites.

In a nutshell, Hutterites, who use much higher levels of technology in farming, likewise do not spend nearly as much time around animals as the Amish – who practice largely horse-drawn agriculture, and live in close proximity to animals:

To try and understand why the Amish have lower rates of certain immune conditions, a group of scientists spent time back in 2012 with an Amish community in the state of Indiana, and with another farming community known as the Hutterites, in South Dakota. In both cases, they took blood samples from 30 children and studied their immune systems in detail.

There are many similarities between the two groups. Like the Amish, the Hutterites also live off the land, have European ancestry, have minimal exposure to air pollution and follow a diet which is low in processed foods. However, their rates of asthma and childhood allergies are between four and six times higher than among the Amish.

One difference between the two communities is that while the Hutterites have fully embraced industrialised farming technologies, the Amish have not, meaning that from a young age, they live in close contact with animals and the plethora of microbes that they carry.

More:

“If you look at an aerial drone photographs of Amish settlements, and compare them with Hutterite communities, the Amish are living on the farm with the animals, whereas the Hutterites live in little hamlets, and the farm could be a few miles away,” says Fergus Shanahan, professor emeritus of medicine at University College Cork, Ireland.

And when they looked at the microscopic level, it was clear that Amish children had significantly greater exposure to microbes – which essentially strengthened their immune systems:

In 2016, a team of scientists from the US and Germany published a now-landmark study concluding that Amish children have a lower risk of allergies because of the way their environments shape their immune systems. In particular, the researchers found that the Amish children in their study had more finely tuned so-called regulatory T cells than those from Hutterite backgrounds. These cells help to dampen down unusual immune responses.

When the researchers scanned dust samples collected from the homes of Amish and Hutterite children for signs of bacteria, they found clear evidence that Amish children were being exposed to more microbes, likely from the animals that they lived among.

In a nutshell, getting dirty – and specifically animal “dirt” –  is not the bad thing that some may believe in a world of antibacterial gels and antimicrobial soaps. Rather, as the Amish example shows, it can lead to a stronger immune system.

Can pets do the same thing for the rest of us?

The vast majority of Americans are not farming nowadays. Simply put, people in modern society have nothing like the exposure to animals that Amish farm families do. But we do have one source of animal contact that might benefit us – our pets:

Since the Amish study was first published, the potentially protective effect of interacting with animals during childhood has been the subject of much fascination, with the New York Times even publishing an article asking whether pets are the new “probiotic”.

So what’s going on? Perhaps unsurprisingly, given the tactile nature of humans and our fondness for stroking and fondling our pets, when we live with animals, microbes from their fur and paws have been shown to end up on our skin – at least temporarily.

The idea is that this could be beneficial in similar ways to how the Amish benefit from exposure to farm animals.

Some believe that our pets’ microbes could be naturally incorporated into our “microbiomes”. Not all agree with this, though more study may be warranted.

There are other theories as to how pets might be helping us:

Gilbert believes that pets are playing a different, yet equally vital role. His theory is that because our distant ancestors domesticated various species, our immune systems have evolved to be stimulated by the microbes that they carry. These microbes do not reside with us permanently, but our immune cells recognise the familiar signals as they pass through, which then keeps the immune system developing in the right way.

“Over many millennia, the human immune system got used to seeing dog, horse and cow bacteria,” says Gilbert. “And so when it sees those things, it triggers beneficial immune development. It knows what to do,” he says.

Here’s another way pets might be helping us:

Studies have also shown that humans who live in the same household as a pet end up with gut microbiomes which are more like each other, and Gilbert suggests that the animal is likely acting as a vehicle to help transfer human microbes between its owners.

At the same time, regular exposure to the pet’s own microbes will also be stimulating their immune systems to stay more active and better manage the bacterial populations in their own gut and skin microbiomes, keeping pathogens out and stimulating the growth of useful bacteria.

Regardless of the mechanism, it does seem that exposure to animals, especially from a young age, can lead to lesser likelihood of being diagnosed with allergies later on.

And pets can be beneficial in this way throughout our lifetimes – for example, having a dog means you’re going outside more often for walks, and being exposed to a wider variety of microbes.

The science is fascinating, and it looks like more study would be beneficial, but the basic idea seems pretty clear – exposure to animals can be a beneficial thing to our immune systems – and we don’t have to be Amish to get that exposure.

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