The Amish and Asthma: The Facts Behind the Headlines

B.S. Dietetics, Dietitian, Health Professional

You’ve probably seen the headlines all over the internet and news media outlets, proclaiming “The Amish don’t get asthma.” Having two girls with asthma, the news story piqued my interest, to say the least. So I did a little digging to let you know the real story behind the media blitz.

Amish vs. Hutterite

The “Innate Immunity and Asthma Risk in Amish and Hutterite Farm Children” study was published in The New England Journal of Medicine in August 2016. The study sought to compare the risks of the development of asthma in Amish and Hutterite children. Both populations have similar genetic backgrounds and lifestyles. Their children are vaccinated, breastfeed as infants, fed similar diets, and are not exposed to tobacco smoke or indoor pets. However, the Amish and Hutterites differ with regard to their farming practices. Amish farms use traditional farming practices and live in closer proximity to their animals. In contrast, the Hutterites use more industrialized farming practices, which translates to their children having less contact with farm animals.

What group developed asthma?Current statistics place the average asthma incidence in U.S. children at 8.6 percent. Though this study has statistically small numbers, as the headlines suggest, of the 30 Amish children studied**, zero developed the condition.** In comparison, 20 percent (or six of the 30) Hutterite children developed asthma.

When researchers compared the homes of the two populations, they found that Amish children were exposed to a far more microbe rich environment, specifically a chemical from bacteria called endotoxin. Endotoxin plays a critical role in the control and activation of the innate immune response. In fact, a 2005 review of studies on endotoxin, published in the Annals of Asthma Allergy and Immunology, noted that exposure to endotoxin may reduce the incidence of allergic diseases for that very reason.

As you might expect, the Amish children had lab values that showed a greater innate immunity. Even more interesting, researchers took the dust from the Amish and Hutterite homes and used it in mouse model studies. The mouse models showed similar results to what was found in the children. Mice that were exposed to the Amish dust developed a protective effect against asthma, while those exposed to the Hutterite dust did not.

What does this mean for the future of asthma prevention?

While this specific study is too small and limited to make gross generalizations on the subject, it does begin to peel back the layers of asthma and other allergic conditions. We do not yet know exactly which bacterial endotoxins were present in the Amish dust or whether these results would translate to other ethnic populations. Further studies are needed.

Remember that some environmental exposures, like mice urine or cockroaches, actually increase the risk of asthma — so don’t stop cleaning just yet. In children who already have asthma, the exposure to germs is likely to do more harm than good. That being said, if your children do not have asthma, it may be wise not to over-sanitize their environment. It’s not necessary to use a million antibacterial products — basic hand washing with regular soap adequately kills germs without creating resistant strains.

For now, I am going to let my kids be kids — and play in the dirt.

See More Helpful Articles:
New Research Fights Pediatric Asthma Epidemic
6 Tips for Asthmatics to Manage Spring Allergies
5 Triggers That Could Be Wreaking Havoc On Your Asthma
The Cost of Asthma: Are you financially burdened?

Jennifer has a bachelor's degree in dietetics as well as graduate work in public health and nutrition. She has worked with families dealing with digestive disease, asthma, and food allergies for the past 12 years. Jennifer also serves the Board of Directors for Pediatric Adolescent Gastroesophageal Reflux Association (PAGER).