Recently a blog post entitled Food Allergies: Don’t Tear Down the Scaffolding caught my eye. Widely shared in online food allergy circles, the post made an impassioned plea for treating food allergy parents with kindness. I wanted to share it too but the post was published at Robyn O’Brien’s website. I’m a food allergy mom, but I won’t share that post or anything else from Robyn O’Brien, and I’ll tell you why.
O’Brien is the author of the book The Unhealthy Truth and a longtime food allergy advocate. As the food allergy community continues to expand, O’Brien has reached a kind of elder statesman status, even though she has a long and dangerous history of spreading misinformation, fear and pseudoscience.
The essential thrust of her book and her organization Allergy Kids is the argument that our worrisome food allergy epidemic has been caused by that most dreaded thing of all — “toxins.” Not unlike the Food Babe, O’Brien uses “toxins” as a catchall for everything she wants parents to fear — chemicals, pesticides, GMOs, vaccines, sugar…even processed food. O’Brien has perpetuated so many myths about food allergies that it’s hard to know where to begin. Recently, in a piece about what causes peanut allergies, she offers “some will talk about peanut oil used in vaccines.” That dangerous little aside lends legitimacy to an argument that has zero basis in fact. Peanut oil isn’t used in vaccines.
“Scaffolding” is a reference to O’Brien’s keynote address to a food allergy blogger conference in which she called on food allergy families to be the scaffolding and support we so desperately need. Lianne Mandelbaum, author of The No Nut Traveler blog and the “Scaffolding” posts on O’Brien’s site, argues that food allergy families should offer support and avoid publicly criticizing each other’s treatment choices. But in a community plagued by fear and pseudoscience, support isn’t always what we need.
We shouldn’t support dangerous recommendations from groups like Moms Across America who tell parents they can cure their child’s food allergy with an organic diet. We shouldn’t stay silent when alternative medicine practitioners tell parents they can cure a food allergy with homeopathy. We shouldn’t support anti-vaxxers who say vaccines contain peanut oil. These ideas are wrong and harmful to all of us in the food allergy community, and they don’t deserve our support.
As if to prove my point, the post directly preceding that viral “Scaffolding” post is a piece by O’Brien herself entitled The Myth: GMOs Foods Are Rigorously Screened for Allergic Potential. The post appears to be filled with science but ultimately there’s nothing there. The evidence for O’Brien’s claims amounts to a discredited study of transgenic peas, the case of StarLink corn where no allergic reactions were ever proven and the transgenic soy modified with Brazil nut protein that was never brought to market.
O’Brien argues that a review by “independent scientists” proves that genetically modified foods have “‘greater potential to increase novel proteins into the food supply’ and increase allergic reactions.” What the paper actually says is quite different. Dr. Jonathan Bernstein, an allergist, and his co-authors, argue that “the practice of allergy risk assessment for genetically modified foods and novel proteins has generally worked well but should be improved as our knowledge of food allergy increases.” This isn’t a sweeping condemnation of GMOs and their increased allergy risk. It’s an argument for vigilance and continued best practices in a field where the science is rapidly evolving.
The full passage from which she pulled her quote is far more balanced:
Although theoretically any plant-breeding technique can modify (increase or decrease) the allergenicity of foods, biotechnology has a greater potential to introduce novel proteins into the food supply, and thus has been subjected to closer scrutiny by regulators. Expert bodies have developed a decision tree for assessment of food allergy risks from such foods. All aspects of current food allergy assessments, both clinical and laboratory tools, have technical challenges that must be addressed if such tools are brought into a regulatory context. However, our challenge scientifically is how to assess novel proteins that have little or no exposure in the general population and thus no readily available tools for the prediction of exposures. The experiences with StarLink corn and in occupational cohorts exposed to grain dusts suggest that the development of methods to be used for postmarket consumer and occupational health surveillance may be useful. Thus, the current FAO/WHO decision tree for assessment of food allergy risks may require revision to include evaluation of appropriate diagnostic tests in these susceptible population groups, and to address technical challenges in assessing proteins newly introduced into the diet.
If you’re unfamiliar with StarLink Corn, in 1999 the EPA approved a type of genetically modified corn for use in animal feed only because tests indicated a slower rate of digestion. Some scientists feared that could increase allergenicity, so the EPA only approved the corn for animals. Despite the restriction, StarLink corn did end up in the larger food supply. Although it’s often cited as an example of the system failing, the StarLink case doesn’t prove anything about the allergenicity of genetically modified foods. The CDC found no allergic reactions that it could pinpoint on StarLink corn, and the corn was withdrawn from the market out of an abundance of caution. According to Anastasia Bodnar, PhD, plant geneticist and Policy Director for Biology Fortified, Inc., “I think it’s unlikely the EPA would do something like that again.”
Of course, anyone with a true allergy to corn must avoid corn in all forms: organic, conventional or transgenic. You can soak it in a vat of glyphosate or barter for it with artisanal corn whisperers – it’s still corn and an allergen to the corn-allergic. But O’Brien says that “GM food can unexpectedly cause an allergic reaction” in non-allergic patients too. Scary, if true, but she’s referring to a study comparing wild soy and GM soy in just 49 patients. Out of those 49, only one patient experienced an allergic reaction to GM soy only and it was just in a skin prick test. O’Brien can’t reasonably conclude that one skin prick test in one patient proves anything at all.
O’Brien also argues that the allergen screening process isn’t rigorous because you can’t screen for “unknown allergens.” What O’Brien fails to mention is we introduce new foods to the American marketplace that aren’t transgenic all the time and we don’t conduct any allergen testing on those foods at all. For example, kiwis were introduced to the American diet in the 1960s without any allergen screening and, yes, some people did develop a kiwi allergy.
Although O’Brien keeps referencing “unknown allergens,” it’s not as though there are all sorts of new proteins being used for genetic modification. In a piece for Grist, Nathanael Johnson recounts an email exchange with Steve Taylor, allergenicity and GM crop expert at the University of Nebraska: “There just aren’t many new proteins in GE food— you are adding just a couple. It’s much riskier to introduce a new food from another country, each of which contains hundreds of new proteins, Taylor wrote, and yet we subject new foods to less safety testing.”
When transgenic crops are created and tested, scientists are very precise about the genes they select and compare with for testing. Ultimately, when that gene is screened for allergenicity, scientists aren’t just checking that the protein isn’t from a nut or an egg white. The new gene is cross-checked against a massive database of allergens. That database contains thousands of allergens and is expanded every year based on input from experts around the world. Can scientists account for every possible allergen in existence? No, but the risk is relatively low, particularly in comparison to imported foods or foods bred by other methods that aren’t subjected to the same kind of rigorous scrutiny.
O’Brien also argues that scientists aren’t testing the right protein – that is, the protein in the end product – because the breeding process itself changes the protein. “So even though the amino acid sequences of the GM plant and GM E. coli proteins may be identical, their functions and allergenic potential can be quite different.” Here she relies on a study of transgenic peas from 2005, but that study has been widely disputed. She also points to the StarLink corn case, even though the CDC ultimately determined the transgenic corn wasn’t linked to any incidents of allergic reactions.
To bolster her post, O’Brien prominently highlights a quote from the American Academy of Environmental Medicine positing a clear link between genetically modified food and adverse human health effects. Of course, no evidence is offered to support that quote. Also, according to a piece at Science Based Medicine, AAEM is not recognized by the American Board of Medical Specialties and is listed as a questionable organization on Quackwatch.
Finally, O’Brien says that the lack of human trials is inadequate, insisting that genetically modified foods should be tested on large numbers of human volunteers or in post-commercial monitoring in which consumers are notified that they’ve eaten a GMO and subsequently told to report illness or side effects (mass nocebo effect, anyone?).
Aside from the ethical and practical issues with human trials of genetically modified foods, I’m unclear on what exactly O’Brien is asking for. Does she want to test GM soy on people who are soy allergic? If so, you don’t need a trial. People with a soy allergy will react to GM soy too. Would these volunteers have no food allergy? If the volunteers aren’t food allergic, what exactly are you looking to prove that isn’t better explored with blood samples from allergic patients?
Finally, O’Brien says the regulatory process is obviously flawed, because regulations didn’t stop the soy modified with a Brazil nut protein or the transgenic peas. And yet, the rigorous testing that informed the decision-making on those products is actually part of the regulatory process. The onus is on industry to prove that their product isn’t allergenic.
I know that O’Brien has been a longtime advocate for food allergy families, but I hope the community will begin to push beyond platitudes about “scaffolding” and look more closely at her unscientific claims. Unfounded fears about GMOs and “toxins” won’t get us any closer to understanding food allergies. The last thing we need is misinformation and fear. Our support for each other should be grounded in science.
Further reading: Can GMO Corn Cause Allergies?