Peanut allergy is a common allergy among children. Approximately 0.6% of American children have a peanut allergy. Peanuts are a common allergen reported to cause fatal and near-fatal allergic reactions. It is important to know the symptoms of a severe allergic reaction called anaphylaxis.
Peanut allergy is usually life-long once acquired. Studies show that about 20% of peanut allergic children will outgrow their peanut allergy.
Children with a peanut allergy must avoid peanut in all forms. This includes all peanut products. Children with a peanut allergy also must avoid anything containing traces of peanut ingredients in it.
How to Read a Label for Peanut
Always read the entire ingredient label to look for the names of peanut. Peanut ingredients may be within the list of the ingredients. Or peanut could be listed in a “Contains: Peanuts” statement beneath the list of ingredients. This is required by the federal Food Allergen Labeling and Consumer Protection Act (FALCPA). Learn more about the U.S. food allergen labeling law.
FALCPA requires that all packaged foods regulated by the FDA must list "peanut" clearly on the ingredient label if it contains peanut. Advisory statements such as “may contain peanut” or “made in a facility with peanut” are voluntary. Advisory statements are not required by any federal labeling law. Discuss with your doctor if you may eat products with these labels or if you should avoid them.
Highly refined peanut oil will not be labeled as a major allergen on an ingredient statement. There are clinical studies showing that highly refined oils can be safely eaten by food allergic individuals. This is because highly refined oils contain extremely small levels of allergenic protein.
However, people with peanut allergy need to avoid any expeller pressed, extruded or cold pressed peanut oil. These types of oil do contain peanut protein and must be listed on the label as an allergen.
Did you know that arachis, hypogaeic acid and mandelonas all contain peanut? The FDA food allergen label law requires foods to state if they contain a top 8 allergen such as peanut. But, there are many foods and products that are not covered by the law, so it is still important to know how to read a label for peanut ingredients. Products exempt from plain English labeling rules: (1) Foods that are not regulated by the FDA. (2) Cosmetics and personal care items. (3) Prescription and over-the-counter medications. (4) Toys, crafts and pet food. Download and print our Peanut Allergy Avoidance List and Travel Cards to carry with you and share.
The following ingredients found on a label indicate the presence of peanut protein. All labels should be read carefully before consuming a product, even if it has been used safely in the past.
Cold pressed, extruded or expelled peanut oil
Crushed nuts, crushed peanuts
Ground nuts, ground peanuts
Hydrolyzed peanut protein
Nu nuts flavored nuts
Peanuts, peanut butter, peanut butter chips, peanut butter morsels
Peanut sauce, peanut syrup
PEANUT IS SOMETIMES FOUND IN
Ethnic foods: African, Asian, Chinese, Indian, Indonesian, Thai, Vietnamese, Mexican
Graham cracker crust
Hydrolyzed plant protein
Hydrolyzed vegetable protein
However, if the product is an FDA regulated food, the word "Peanut" must appear on the label.
MAY NOT BE SAFE
Lupine is a legume that cross-reacts with peanut at a high rate and should be avoided by peanut allergic patients. It does not fall under the labeling requirements of FALCPA. Lupine is also known as lupinus albus and can be found in seed or flour form.
MAY BE SAFE, BUT ASK YOUR ALLERGIST
Peanuts and soybean are in the legume family which includes beans and lentils. Five percent of children allergic to peanuts may react to other legumes. Many years ago, it was common to recommend avoidance of legumes, including soy, because of a peanut allergy; but this practice has been proven unnecessary. Ask your allergist what is best for your child.
Some allergy experts advise those allergic to peanuts to avoid all tree nuts. Ask your allergist what is best for your child.
FALCPA does not require peanut oil to be labeled as an allergen. Studies show highly refined oils can be safely eaten by those with food allergies. Highly refined oils contain extremely small levels of allergenic protein. However, peanut oil that is expeller pressed, extruded or cold pressed does contain peanut protein and must be clearly listed on an ingredient label as "peanut". These types of peanut oil should be avoided by those with peanut allergy.
Cross Reactivity: Do You Need to Avoid Foods Related to Peanuts?
Cross-reactivity occurs when the proteins in one food are similar to the proteins in another. When that happens, the body's immune system sees them as the same.
Birch and Grass Pollen
Peanut contains proteins that cross-react with birch (a type of tree) or grass pollen. Some (but not all) individuals with these pollen allergies may have oral allergy syndrome (OAS) to peanut. And, for those who do have OAS, they may experience symptoms with some, but not all, foods cross-reactive to a particular pollen to which they are allergic.
Soy and Beans
Peanuts are in the legume family, which includes different beans, including soybeans and lentils. A common question that comes up for people with an allergy to peanut is whether they can eat soy-based foods or other beans. More than half of peanut-allergic individuals will have a positive skin test or blood allergy test to another legume. But, it turns out that 95% of them can tolerate and eat the cross-reactive legumes. Many years ago, it was common to recommend avoidance of legumes, including soy, because of a peanut allergy. This practice has been proven unnecessary. One possible exception is lupine/lupin.
Lupin, Lupine, Lupini Warning
"Lupinus albus" is known as lupin, lupine or lupini and can be found in bean, seed or flour form. Studies show that people who are allergic to peanuts appear to have a greater chance of being allergic to lupin. Lupin is a common food ingredient in Europe and it is relatively new to the U.S. market. It is likely to become more popular, particularly in gluten-free foods. For people allergic to peanut, eating lupin could cause an allergic reaction on the first exposure. The FDA is actively monitoring complaints of lupin allergies by U.S. consumers. Find out more: Allergies to a Legume Called Lupin: What You Need to Know
Peanuts are legumes and are not botanically related to tree nuts (almonds, walnuts, cashews, etc.). However, about 35% of peanut-allergic toddlers in the U.S. have or will develop a tree nut allergy. Doctors often recommend that young children avoid tree nuts if they are allergic to peanuts. This is because it is fairly common to be “co-allergic” to tree nuts if a child is peanut allergic.
Another reason for peanut allergic individuals to avoid tree nuts is due to safety concerns. Young children may have a hard time distinguishing a tree nut from a peanut. Also, there is the potential of cross-contamination or cross-contact of tree nut products with peanut.
However, the larger issue is that allergy to tree nuts is common in peanut allergic individuals. Your doctor should check for a tree nut allergy if your child has a peanut allergy. The doctor can then make recommendations that are just for your child about whether you need to avoid tree nuts.
Your doctor also can make recommendations just for your child regarding seeds, such as sesame seed. There are a few individuals who are allergic to both peanut and seeds. This is likely due to highly allergic individuals developing another food allergy, rather than cross-reactivity.
Nutrition for a Peanut-Free Diet
Peanuts are a good source of protein in a child's diet. Peanuts also provide a source of niacin, magnesium, vitamins E and B6, manganese, pantothenic acid, chromium, folacin, copper and biotin. Your child can get vitamins and nutrients by consuming a variety of foods from other food groups.
WHEN AVOIDING PEANUT
|SUGGESTED ALTERNATE SOURCES
(if not allergic)
|Protein, Vitamins, Minerals
||Increase other protein foods such as meat, fish, poultry, eggs,
dairy (if safe for your child);
fruit, vegetables, and enriched grains
Peanut Substitutions in Recipes
It is very easy to replace nuts in a recipe. There are many seeds and seed products available including sunflower butter and pumpkin seed butter. Roasted chickpeas can replace nut snacks.
Learn more about PEANUT SUBSTITUTES.
Over 1,200 peanut-free recipes are available in KFA's Safe Eats™ Recipes. Search for Peanut-Free Recipes
Early Introduction to Prevent Peanut Allergy
In 2015, the Learning Early About Peanut Allergy (LEAP) study found that introducing peanut early to infants may prevent peanut allergy. The study showed that the group of at-risk infants who ate 2 grams of peanut three times a week had significantly less allergy to peanuts at 5 years of age compared with infants who avoided peanut.
Based on this study and others, an expert panel of doctors, scientists and public health experts created new guidelines on how to introduce peanut to infants. The National Institute of Allergy and Infectious Diseases released new guidelines in January 2017.
Download our handout Preventing Peanut Allergy: Introduce Peanut Foods Early to Your Baby.
Medical review July 2015.