Peanut allergy : symptoms, which foods to avoid ?
- Peanut allergy
- Causes and risk factors
- Frequency in children
- What foods should be avoided?
- Crossed allergies
- You may be interested:
Peanut allergy is the second most common childhood allergy after egg allergy. It is increasing and can be severe. An update on your symptoms and treatments with Dr. Julien Cottet, allergist.
Photo Karolina Grabowska in Pexels
Contrary to what one might think, peanuts are part of the legume family (peas, soybeans, beans, lupins, chickpeas...) and not of the oilseed family (hazelnuts, walnuts, pistachios...).
The former grow in the soil and have a flexible and permeable membrane, while the latter grow on trees and have a hard and waterproof membrane, they are called "nuts".
Causes and risk factors
"Peanut allergy often develops as a result of early contact sensitization of the very young baby or even the unborn child," explains Dr. Cottet.
This awareness can be done:
- By consuming infant formulas containing peanut oil,
- Administering oily vitamin solutions,
- During breastfeeding if the mother consumes peanuts or peanut products in large quantities.
- In the uterus also through the mother's feeding
- By applying a skin cream containing peanut oil.
Finally, "atopic dermatitis is the first risk factor for peanut allergy," the allergist adds. In fact, it is observed that almost 34% of the children with atopic dermatitis have a food allergy associated, mainly to eggs, milk and peanuts.
Frequency in children
"The prevalence of peanut allergy is not known in France, but the increase in frequency is very real," explains Dr. Cottet. It seems that the number of children with peanut allergies has doubled in the last ten years.
The prevalence of this allergy is 1.3% in England and 0.4% in the United States.
"Food allergy to peanuts is the second most common food allergy in children after eggs," says the specialist.
Symptoms occur immediately after ingesting even very small amounts of peanuts. "A patient with peanut allergy can be allergic to different peanut proteins," explains Dr. Cottet: PR10, LTP, storage protein
The symptoms can be very mild:
- Oral Diet Syndrome: with a tingling sensation in the mouth and swelling of the lips.
- Isolated hives: especially for the PR10 profile.
But they can also be more serious:
- Cough, asthma, breathing problems,
- Discomfort, loss of consciousness,
- Tachycardia, blood pressure is dropping,
They can even be dead, for subjects with LTP or storage protein profiles, where the peanuts cannot be eaten either raw or cooked.
"On the other hand, cooked peanuts cannot cause reactions in patients with a PR10 profile," says the allergist.
True allergy, known as IgE-mediated, does not cause chronic symptoms such as abdominal pain or diarrhea.
Only an allergist can diagnose a peanut allergy. "The consultation always begins with a careful interrogation with the classification of the reaction according to Ring and Messmer and the search for non-allergic aggravating co-factors, such as concomitant alcohol, non-steroidal anti-inflammatory drugs, aspirin or physical exertion or fatigue," explains Dr. Cottet.
Only in a second step are skin tests performed, using raw and cooked native peanuts.
- A blood test can be proposed to determine the molecular profile, but it does not allow the diagnosis "a positive blood test does not mean 'allergic', and on the contrary a negative blood test does not exclude it" insists the specialist.
- If there is any doubt about the diagnosis, an oral provocation test in a specialized hospital environment is suggested, with a search for the triggering dose.
The only possible treatment for peanut allergy is an oral desensitization called immunotherapy, but this is very controversial.
"It consists of creating a 'low dose' addiction, to tolerate small doses and have a less restrictive diet avoiding total exclusion," explains Dr. Cottet.
But recent studies have shown that the quality of life of patients under addiction protocols is affected, with significant side effects.
On the other hand, it is essential to have the various treatments for allergy symptoms at hand.
For example, a person who has had severe symptoms of peanut allergy should carry an emergency kit that includes a bronchodilator, an antihistamine and a self-injectable adrenaline syringe at all times.
What foods should be avoided?
Foods containing peanuts are..:
- Peanut oil
- Peanut and peanut butter
- The peanut flour
- Mandelona nut (processed peanuts)
- Peanut Vegetable Protein
- Hydrolyzed peanut vegetable protein
- Commercial trail mixes
- Satay Sauce
The foods that can contain them are..:
- Dessert cream, dried fruit cheeses, müesli yoghurt, dairy products with cereals
- Ice cream, frozen desserts
- Cereal bars
- Cakes, filled chocolates, pralines, ice cream, nougat, frangipane cake, galette des rois, cereal bar, chocolate bars with oil fruits...
- Breakfast cereals, cakes, cookies, cakes in the form of industrial products, snack cookies...
- Breads made with lupine flour and special cereal breads
- Ready meals
- Ice decorations based on "hazelnut" powder.
- Almond paste
- Thai or Asian dishes, such as spring rolls, spring rolls ...
Cross-allergies to peanuts can be:
Vegetables from the same family: peas, lentils, soybeans, beans...
Nuts: almond, pistachio, cashew, hazelnut, etc.
"But cross allergies are not at all systematic, so there is no reason to avoid other legumes and nuts if they are tolerated" insists the specialist.
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