Children affected by peanut allergy has doubled in the past 20 years. Interestingly, it is more common in the United
States than in Asian countries; although the consumption of peanuts over there is at least as high, if not higher than in
the United States. The difference is that in the United States, we mostly consume dry roasted peanuts. In Asia,
they are usually boiled or fried. Studies demonstrate that roasting peanuts results in the generation of new proteins
which have a higher allergic potential, perhaps explaining the higher incidence of peanut allergies in the USA
compared to Asian countries.
What are Peanuts?
Peanuts, along with peas, lentil, and beans are legumes. It is extremely rare for someone to have a cross-reactivity
between peanuts and other legumes and it is therefore safe to eat other legumes (perhaps to the dismay of
children!). While tree-nuts are not related to peanuts, about half of peanut allergic patients will also be allergic to
tree-nuts. Even if you are not allergic to tree-nuts, it is important to avoid them as there is a risk that trace amounts
of peanuts will be found on tree-nut products since most tree-nut processing plants also process peanuts.
Reading food labels is extremely important. As a rule of thumb, you should avoid anything with the word “nut” in
it. Studies demonstrate, however, that it is safe to eat foods cooked in peanut oil—unless this oil is cold processed
or labeled as gourmet peanut oil. It is therefore safe to eat foods cooked in peanut oil, unless it is cold processed,
expelled, extracted, or gourmet oil. But looking for the word “nut” is not always enough! Hidden sources of
peanuts include Asian dishes (such as egg rolls or dishes with Satay sauce, which is made with peanuts), nougat,
chocolate, baked goods such as cookies and cakes. While sunflower seeds do not cross-react with peanuts, they
are often processed on the same equipment used to manufacture peanuts, and generally should be avoided since
they could be contaminated with trace amounts of peanuts.
Avoid foods that contain:
- Artificial nuts
- Beer nuts
- Cold pressed peanut oil
- Expelled peanut oil
- Extruded peanut oil
- Gourmet peanut oil
- Ground nuts
- Mixed nuts
- No-Nuts flavored nuts
- Peanut butter
- Peanut flour
These foods may contain peanuts:
- Baking mixes
- Chinese food
- Egg rolls
- Hydrolyzed plant protein
- Hydrolyzed vegetable protein
- Indonesian food
- Mexican food
- Thai food
- Vietnamese food
Most peanut allergic individuals can consume peanut oil safely, unless it is cold pressed, expelled, extruded, or
gourmet peanut oil.
Nutmeg is safe to eat. Although the name of this spice would lead one to believe it is made from nuts, nutmeg is
actually made from the seed of the fruit that grows on a tropical evergreen called Myristica fragrans.
Is this For Life?
Peanut allergy appears to be a life long condition for the majority of people. However, it does go away in some, and
studies suggest that up to 20% of children outgrow their peanut allergy by age 6. Research is ongoing to determine
whether allergy shots or allergy drops (sublingual immunotherapy) may be of benefit for food allergies.
Make sure to check out the coping with food allergies page for school and traveling tips, and useful links including
sites that sell allergy safe foods, medic alert bracelets. There's even a link to a website that will translate food allergy
words in just about any language you can imagine!
updated 17 July 2013
Fleischer et al. The Natural Progression of Peanut Allergy: Resolution and the Possibility of Recurrence. J Allergy
Clin Immunol 2003;112:183-9.
Food Allergy: A Practice Parameter Annals of Allergy, Asthma, & Immunology 2006;96
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