Peanut Allergies 101

by pblovers

Peanut Allergies

According to the National Institute of Allergy and Infectious Diseases (NIAID), about 0.6 percent of the American population has a peanut allergy. More children are allergic to milk and eggs than to peanuts and more adults are allergic to shellfish than are allergic to peanuts.

For an allergic individual, strictly avoiding the consumption of the offending food is the only sure way to avoid an allergic reaction. The real danger for a person with a peanut allergy is accidental consumption of peanut products by mouth or by being rubbed into mucous membranes like the eyes. Mild reactions may occur if peanuts come into contact with the skin. There is no evidence to suggest that skin contact or airborne exposure can cause an anaphylactic reaction.

Refined peanut oil does not contain the peanut protein and does not pose a risk to people with peanut allergies. The vast majority of peanut oil available to consumers and foodservice is highly refined oil and presents no risk. There is a specialty market for unrefined peanut oil, which may also be called ‘gourmet’, ‘aromatic’ or ‘cold pressed’. These unrefined peanut oils may contain peanut proteins, so they should be avoided.

Peanut Allergy Treatments

It is critical for a person with a food allergy to be diagnosed by a board-certified allergist and to work with that doctor to develop a treatment plan in case of accidental consumption. Epinephrine is the approved treatment for anaphylaxis and should be administered without delay. Individuals should seek medical assistance when a reaction occurs, including calling 911 any time epinephrine is administered.
The most promising strategy to reduce an existing allergy is oral immunotherapy, which is when a doctor administers a gradual amount of peanut protein in a controlled environment. This has been shown to increase tolerance to peanuts.

Peanut Allergy Prevention

In 2017, the National Institute of Allergy and Infectious Disease (NIAID) released recommendations about the early introduction of peanut foods to prevent peanut allergy.(1) The new guidelines recommend introducing peanut foods to infants between 4-6 months of age, depending on their risk for developing an allergy. This is based on research that showed that early introduction significantly reduced peanut allergy among children at high risk due to severe eczema or egg allergy.(2) Since 2008, the American Academy of Pediatrics has said waiting to reduce “high-risk” proteins past 4-6 months of age does not prevent food allergies.(3)

In spite of the evidence, some parents are still anxious about introducing peanut protein to their children, particularly those with a family history of food allergies.(4) Yet it’s important to remember that 98 percent or more of children are not allergic to peanuts. The potential benefits of early introduction to prevent peanut allergy far outweigh the risks.

1 Togias A, Cooper SF, Acebal ML, Assa’ad A, Baker J, Beck, LA, et al. Addendum guidelines for the prevention of peanut allergy in the United States: Report of the National Institute of Allergy and Infectious Diseases-sponsored expert panel. Ann Allergy Asthma Immunol. 2017:1-8.
2 Toit, G.D., Roberts, G., Sayre, P.H., Bahnson, H.T.. Radulovic, S., Santos, A.F., Lack, G. (2015). Randomized Trial of Peanut Consumption in Infants at Risk for Peanut Allergy. New England Journal of Medicine, 372(9), 803-813.
3 Thygarajan, A. & Burks, A.W. (2008). American Academy of Pediatrics recommendations on the Effects of Early Nutritional Interventions on the Development of Atopic Disease. Current Opinion in Pediatrics, 20(6), 698-702.
4 Bégin, P., Graham, F., Killer, K., Paradis, J., Paradis, L., & Roches, A.D. (2016). Introduction of peanuts in younger siblings of children with peanut allergy: A prospective, double-blinded assessment of risk, of diagnostic tests, and an analysis of patient preferences. Allergy.