Should We Be Worried About a Peanut Allergy Epidemic?
Near-death reactions to the nut are on the rise. Researchers are racing to figure out why.
According to the American College of Allergy, Asthma, and Immunology, peanut allergies are on the rise, more than tripling between 1997 and 2008.
That’s made the often deadly allergy one of the most common food allergies out there, affecting an estimated 2.5 percent of children in the U.S. At best, these allergies cause annoying symptoms like an itchy throat or runny nose. But at worst, peanut allergies can send a patient into life-threatening anaphylactic shock.
Experts say that peanut allergies are becoming, worrisomely, increasingly common. Matthew Greenhawt, chair of the American College of Allergy, Asthma and Immunology (ACAAI) Food Allergy Committee, says that research shows that peanuts are right behind milk and eggs as the most common food allergy. Greenhawt has been personally treating more children than previously who present symptoms of peanut reactions.
“We are seeing more peanut allergies—more food allergies overall—than we did 15 to 20 years ago,” he says.
There are a couple of theories for the rise in peanut allergies. Scott Sicherer, director of the Jaffe Food Allergy Institute, points to the “hygiene hypothesis,” or the idea that humans are a lot “cleaner” now than we were generations ago—fewer of us are living on farms and being exposed to livestock, we use antibacterial soap frequently, and our homes and streets aren’t as littered with garbage and sewage.
All of that makes for a better life, but that can come at the cost of our immune systems.
“Our immune system was designed to fight germs—with fewer germs the immune system can get misdirected and attack innocent proteins, like food,” Sicherer says.
Another possible reason? Peanut allergies have earned such a reputation for being life-threatening that parents aren’t giving children peanut-filled foods at all, making them even more susceptible to allergies.
Reenal Patel, a pediatric allergist with Allergy & Asthma Care New York, says that in her practice, she’s seen children who’ve developed allergies after not being properly weaned on peanuts—whether that’s because parents have heard peanut allergy horror stories and became too nervous to give their children peanuts, or perhaps they’ve reacted to restrictions from school lunch menus.
“With different socioeconomic backgrounds, schools might be contributing to [higher peanut allergy rates],” she says. “[Peanuts aren’t allowed] in certain schools, so if you’re in a lower socioeconomic situation, you’re not going to be buying peanuts for your children because they’re not going to be able to eat them Monday through Friday. So your child isn’t getting exposed to those foods during the school week, and may not get them until they’re older.”
In recent years, research like the Learning Early About Peanut (LEAP) study has shown that early exposure to peanuts might be a way to reduce the risk of children developing allergic reactions in the future, reducing the high rates we’re seeing.
The study, led by Professor Gideon Lack at King’s College London and published in the New England Journal of Medicine in 2015, suggested that an early introduction to peanuts could increase tolerance and cut down allergy risks. For the study, researchers looked at 640 children with severe eczema, an egg allergy, or both (all indicators of being at high risk for peanut allergy). The researchers randomly separated them into two groups—one that consumed peanuts, and one that avoided peanuts.
After five years, they found that in the group of children who completely avoided peanuts, 17 percent developed a peanut allergy. However, in the group of children who had been introduced to peanuts, only 3 percent later developed an allergy.
Those findings urged a panel of experts to publish new national guidelines last year on introducing infants by the time they’re six months of age to foods containing peanuts as a way to reduce the chances of them developing allergies, particularly if they are at high risk for peanut allergy.
It might scare parents to introduce their children to a food they could be allergic to, but Patel says that if a parent suspects their child has any allergy, peanut or otherwise, they should see a doctor who can really pin down what exactly what’s going on and the best way to proceed.
“It’s important for a lot of parents who are fearful that their child has a reaction to note down everything that [child may have] ingested, and see a board-certified allergist to get to the bottom of why this happened, and what we can do to help them understand that allergy a little better,” she said.
Overall, however, experts are hopeful that we’re closer than ever to curbing the rise in peanut allergy rates as well as possible treatment for these allergies.
Greenhawt pointed to the results of a small clinical trial that Australian researchers published in The Lancet last year, in which they examined long-term treatment for peanut allergies in children. The researchers took 48 children with peanut allergies, dividing them into two groups: One group was given a treatment that combined a probiotic with oral peanut immunotherapy (meaning they were given small but increasingly larger amounts of peanuts to eat each day), and the other group was given a placebo.
The results? At the end of the 18-month trial, two-thirds of the group that was given a treatment was desensitized to their allergies for up to four years.
While there’s still work to be done to ensure that something like that could work for a bigger sample size, Greenhawt says this research has indicated a major step forward in what we understand about peanut allergies and how we might solve them.
“I hold great hope that we’ll be able to cure this,” Greenhawt said. “We’re in a great space right now. Certainly when I started in the field in 2006, when we talked about a treatment or cure, it was a distant concept: something we had hoped for, but we didn’t have fantastic research showing we could really make a dent. In the last 12 years, we’ve shown that we can desensitize patients.”