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   Peanut Allergy

Receiving a diagnosis of a peanut allergy can be frightening, especially with the prevalence of peanut butter in our society! Our son had a contact reaction to a peanut butter sandwich at the age of 9 months. He didn’t even eat anything – he just touched it. 

Research reported in the April 1999 JACI (Journal of Allergy & Clinical Immunology) estimated that 1% of the population, or close to 3 million Americans, is allergic to peanuts or tree nuts.  The JACI is the peer-reviewed scientific journal of the American Academy of Allergy, Asthma and Immunology (AAAAI). According to the Center for Disease Control (CDC) in 2007, approximately 3 million children under age 18 (3.9% of the population or almost 4 out of every 100) were reported to have a food or digestive allergy in the previous 12 months. From 1997 to 2007, the prevalence of reported food allergy increase 18% among children under age 18. Researchers aren’t currently certain why the prevalence has increased.

There is the thought that roasting peanuts, as we do in the USA makes them more highly allergenic versus boiling them as China does. There’s also the possibility that pregnant and nursing women who eat peanuts are passing the proteins on to their infants which increases the likelihood of the child developing a peanut allergy. Yet other research studies have found the opposite to be true! Lastly, there is the supposition that our too clean houses don’t challenge our immune systems to fight off parasites, and instead they turn on themselves viewing a peanut protein as the enemy. There is also a relatively new book, “The History of the Peanut Allergy Epidemic” by Heather Fraser that implicates vaccinations.

The main problem with a peanut allergy is the severity of the reaction. In fact, studies by Scott H. Sicherer, M.D., associate professor of pediatrics at the Mount Sinai School of Medicine and a researcher in the Jaffe Food Allergy Institute, suggest that 80% of people with a peanut allergy have had a reaction that involves a breathing problem or have experienced a reaction that affected multiple areas of their body. He further estimates that 100 to 150 people in the USA die each year from peanut allergies.

These types of statistics are frightening for those of us with peanut allergic children! The peanut allergy was once considered life long, yet research has determined that up to 20% will actually outgrow the allergy by school age. This is especially true if your child has few, if any, other food allergies; doesn’t have other allergic issues such as asthma or eczema; and has a low peanut IgE on a RAST blood test.

Peanut is in the legume family, along with peas, lima beans, lentils and soybeans to name just a few. Just because your child is allergic to peanuts does not mean an allergy to any of these other legumes will also be present. An allergy testing can be completed on each of these foods separately. Some children will test allergic to other foods in the legume family, yet be able to tolerate them. Apparently the proteins are so similar on an allergy testing that the body may react solely because of this.

My son is severely allergic to peanuts, and mildly allergic to soy, peas and green beans! He doesn’t tolerate eating anything in the legume botanical family. Other children may be able to tolerate eating one item and not another. An allergy testing is the only way to determine exactly what your child is allergic to. If your child has been eating green beans without issue, an allergist will probably not suggest ceasing to eat them because of a positive allergy test.

There has been work on a peanut vaccine, which has yet to be approved by the FDA. The July 2003 JACI reported on an important milestone in the development of a peanut vaccine for long-lasting protection against peanut induced anaphylaxis. Xiu-Min Li, MD from Mt. Sinai developed "genetically engineered" peanut proteins that no longer bind Immunoglobulin E (IgE), but retain T cell proliferation. It is the binding of the protein to IgE that can trigger severe reactions in sensitized individuals. Researchers found that injecting heat killed E coli containing the engineered proteins into mice was very effective in preventing a severe reaction to peanut. The engineered proteins may be used as a "peanut vaccine" which would safely elicit a protective immune response to peanut, without the fear of an allergic response.

Another finding published in March 2003 by Leung and Hugh A. Sampson, MD, FAAAAI, Mt. Sinai, found that treatment with Anti-IgE therapy may represent an effective long-term approach for management of food-induced anaphylaxis. Their study showed that treatment with an anti-IgE antibody raised the average level at which patients began reacting to peanuts from about a half a peanut, to almost nine peanuts.

There has been some exciting new research recently in regard to finding a cure for food allergies, especially to the peanut allergy. Dr. Wesley Burks, chief of Pediatric Allergy and Immunology at Duke Medical Center, is part of a potentially groundbreaking study aimed at finding out whether children with peanut allergies can be desensitized to peanuts and eventually cured of the allergy altogether.

The study has children ingesting tiny, precise amounts of peanut flour every day, and gradually increasing the dose every two weeks. Patients are becoming increasingly less sensitive as the study continues. This would NOT be a study to take on in your own home! Patients receiving the peanut flour are closely monitored for hours after each dose, and an abundance of emergency medical care provisions are available should a severe reaction ensue.

Dr. Burks said the therapy works by depleting the body of chemicals that cause allergic reactions. If successful, desensitization therapy should be able to help all different kinds of food allergies. He is currently predicting that there will be a viable treatment for peanut allergies within 5 years! Wouldn’t that be great!!

Clinical trials of the drug Xolair for peanut allergy were halted early in 2006 after two children experienced anaphylactic reactions. The children hadn’t yet been given the drug, but reacted to an oral challenge of peanuts to determine their level of tolerance. The establishment of tolerance levels was required in the enrollment process of the FDA (Food & Drug Administration). The manufacturer of Xolair, Genentech and two others companies, remain committed to continuing the trials, however oral challenges may not be included in the future.

Researchers at the Mt. Sinai School of Medicine in New York have been working with two Chinese herbal formulas – one to treat asthma and one to prevent anaphylaxis to peanuts. Participants in the asthma study had results from the Chinese herbs similar to the control group taking the corticosteroid Prednisone. The herb to prevent peanut anaphylaxis has only been studied on mice, yet the herbs completely blocked anaphylaxis for up to six months. Dr. Xiu-Min Li, a leader of the project, has applied to the FDA for human trials, which will hopefully begin soon.

Until a cure is found, the only “cure” for the peanut allergy is to stay away from all peanuts and peanut products.  Read labels of EVERY food that your child eats, and all foods in your house.  Re-read the labels each time you purchase a product, because manufacturing processes change continuously. Peanuts and peanut products show up in the most unsuspecting foods. 

Reading Labels

The Food Allergy Labeling Consumer Protection Act (FALCPA) was passed in 2004, requiring: labels to be marked such that a 7 year old could read and understand the ingredients, all allergens are declared even if they are in the spices or flavorings, and curtail the current widespread use of the ‘may contain statements.’ This act went into effect January 1, 2006.

For more information on this important law, please click here.

Peanuts can appear in foods, peanut oils in foods or personal care products. Read labels of any product that your peanut allergic child ingests or uses. Be mindful of the following:

  • Anything that says NUTS
  • Peanut oil –    there are some people who can tolerate peanut oil, and others who can’t.  Cold pressed peanut oil is usually not tolerated.
  • Peanut flour
  • Peanuts can show up in unsuspecting places, but they are especially prevalent in Chinese dishes, egg rolls, chocolates, candy bars, and pastries.  If you can’t read the ingredients – don’t eat it!
  • I have heard that some people use peanut butter in chili, or in thickening frosting for a cake or cupcakes.
  • Hydrolyzed plant or vegetable protein will probably be marked if it is from peanuts.  In Europe, the use of peanut protein is more prevalent so be careful if traveling! Lupine flour (used mainly in Europe) cross-reacts with peanuts.
  • Plain M&M’s® is a surprising food that has a label indicating “may include peanuts” or “processed in a plant containing peanuts”.
  • Chick-fil-A fries all of their chicken and other products in peanut oil.  The signs are very small, and may be missed. Some stores are converting to canola oil, but their website still indicates peanut oil is used.

our allergist should be able to provide you with a complete listing of ingredients that may indicate peanut protein.  There are always new products being created with newly processed ingredient names.  If you don’t know the exact nature of the ingredient, don’t eat it!

Allie the Allergic Elephant

 

Check out “Allie the Allergic Elephant: A Children’s Story of Peanut Allergies” for a heartwarming story of an elephant learning to live with peanut allergies. “Allie” teaches children (and adults) about allergic reactions, how peanuts hide in the most unsuspecting foods and helps everyone understand the severity of food allergies.

When your peanut-allergic child goes to school, having things in writing is a must! We have a 9x12 sign is perfect for your child’s classroom to let everyone know that the classroom is a Peanut-Free Zone! It can also be used in the cafeteria on the lunch table. Each year we place signs in my son’s classroom and in the hallway to ensure that every visitor, parent and child knows to keep peanuts away! 

 

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The sign is laminated on both sides to ensure durability.

Purchase a sign for just $8.95 plus shipping. 

If your child’s school library, gym and other locations are peanut free – make sure they are adequately marked with a sign!

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Purchase our School Information Pack for $18.85 and receive the following:

  • Two e-books - How to Send your Food Allergic Child to School and
    Food Allergic Children and Schools: Support for Teachers & Administrators
  • Classroom No Peanuts Sign for your child’s classroom or lunch table!

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