How modern lifestyle changes are disrupting our immune systems

In addition to a steep increase in prevalence, in recent decades, we have seen an evolution in the ways our immune system misbehaves: eosinophilic esophagitis, mast cell disorders, and early onset colon cancer, among many others. This data alone should remind us that we are an ever-evolving species. With our rapidly changing lifestyle over the last century, it shouldn't be surprising that we are seeing some sort of physiologic hangover.

As one of the handful of lifestyle medicine-trained allergy immunology physicians, I find myself increasingly talking about the entirety of the exposome- the summation of all of the things we are exposed to in our lives. Everything from viral infections, early traumatic events, the food we eat, and the air pollution we inhale is a potential culprit for us to point a finger at when looking for a reason for all of this suffering.

In reality, a mixture of these variables extoll their effects on susceptible individuals flipping the epigenetic switches and putting chinks in our armor-disrupting the delicate balance that exists at the interface between outside and inside: our epithelial barriers. As our understanding evolves through the work of scientists like Dr. Cezmi A Akdis, the hygiene hypothesis has evolved into the epithelial barrier hypothesis: the theory that disruptions in our skin, respiratory and gastrointestinal tracts are at the root cause of many of our diseases of modernity: allergies, asthma, inflammatory bowel, and Alzheimer's to name a few. We see shifts in our microbiome and the inflammatory cascade when the barrier is broken. We are still seeking to understand how best to prevent, repair and rebalance.

In the meantime, how can we approach this paradigm shift as we discuss our patient conversations? How can we minimize the insults and reinforce our defenses as we go about our busy modern lives?

For our skin:

For our respiratory tract:

For our gut:

At the core, though, we must remember to do the best we can with our knowledge and bandwidth. When in doubt, keep it super simple, start small, and let things snowball over time. Last but not least, I always return to the idea of progress over perfection because the reality is that stress has its own physiologic can of worms to contend with– more of it is rarely helpful.

Kara Wada is a board-certified academic adult and pediatric allergy, immunology, and lifestyle medicine physician, Sjogren's patient, certified life coach, TEDx speaker, and Dr. Midwest 2023. She can be reached at Dr. Kara Wada and on Instagram, YouTube, Facebook, and LinkedIn. She is a national expert, sought-after speaker, advisor, and host of the Becoming Immune Confident Podcast. She is CEO and founder, The Crunchy Allergist and the Virtual Sjogren's Summit, and serves as the director of clinical content for Aila Health.

Tagged as: Allergies & Immunology

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