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Peanut Allergy


Posted by kevvyg on Tuesday, November 25, 2014
Alcohol and Food AllergiesAs the season of family get togethers and office parties draws nearer, now is a great time to go over a few things regarding foods allergies and two things that commonly appear at these types of gatherings - alcohol and nuts. For people with food allergies, gatherings and meals can often be a hassle, and the frequency of holiday gatherings can greatly increase this. Nut allergies tend to be some of the most problematic, and with nuts in everything from Thanksgiving stuffing and pies to cookies and alcohol, some anxiety isn't without merit. Even though bowls of nuts sitting on a bar are largely a thing of the past, they can still make appearances at dinner parties. For adults though, what alcohols pose the most problems and which are safe?

This question can be a very difficult one to answer. Alcohol, though consumed like juice, food, or soda (though your liver hopes not with the same frequency!), isn't governed by the same regulations or even the same agency as these others. While foods and most beverages fall under the domain of the Food and Drug Administration (FDA), alcohol falls under the guidance and regulations of the Alcohol and Tobacco Tax and Trade Bureau, a subdivision of the Department of Treasury. This INCLUDES labeling rules and regulations. I TOTALLY Begged My Graphic Designer for a Graphic of 'Mega-Jumbo-Can-O-Caffeinated-Monkey-Juice' But THIS Is What I Got So while your mega-jumbo-can-o-caffeinated-monkey-juice will most certainly have a label listing the nutritional value and all the ingredients, alcohol is almost always devoid of the former (and often the latter as well). Though it is often easier to determine how many calories are in your alcoholic beverage of choice, finding the actual ingredients that make up that drink is another story entirely.

Many producers do list ingredients on their website or have at least become savvy enough to list some of the common allergens that are NOT in their products, particularly nuts or nut derivatives. Beyond visiting websites and doing your own investigative research, many people are left with only anecdotal evidence as to whether a type of drink can cause a reaction or not.

Distilled spirits (think whiskey, rum, etc.) have a list of standard requirements when it comes to labeling. These include
  • Name
  • Alcohol Content
  • Address of Distiller
  • Country of Origin
  • Net Contents (a metric measurement of volume)
  • Coloring Agents (colored with caramel, annatto, etc.)
  • Wood Treatment ("beechwood aged" ring a bell?)
  • Other Ingredients like Dyes, (Yellow #5), Saccharin, or Sulfites
  • Specific Type of Commodity (redistilled, blended, compounded, etc.)
  • Statement of Age
  • Distillation/Production Location
  • A Health Warning
Seems like a lot, right? Notice what's missing? Nutrition information and ingredients.

Nut Allergy & AlcoholAs of right now, major food allergens can voluntarily be listed for wines, distilled spirits, and malt beverages, but again, this is only voluntary. There has been a proposal to make this mandatory, and since 2006, nothing has been finalized... eight years later.

And, even if you do find a list of ingredients, this still may not cover a statement regarding the processing. Though some can tell you that there are no nuts in their products, many can't ensure their products were produced in a facility that is also nut-free. This touches on another problem, cross-contamination.

Any Type of Alcohol Can Potentially Contain Allergens and Finding What's In the Drink Is No Easy TaskBartenders and those mixing drinks work in fast paced environments and worrying about cross contaminating a drink is likely not high on the priority list when there are half a dozen orders rolling in at a time. A good general tip is to skip the garnish. One garnish in particular that can be troublesome for those with nut allergies is maraschino cherries. These are often processed or flavored with almond extract. If you know a favorite mix or type of drink that is safe for you and you order it with no garnish, you can dramatically reduce any risk. At that point ingredients should be coming straight from the bottle to your glass.

For reference purposes, here's a quick list of some common alcoholic beverages that contain nuts or nut extracts. Keep in mind, things can and do change, so contacting the producer is still your best bet.
  • Amaretto
  • Creme de noyaux
  • Creme de noix
  • Frangelico
  • Galliano
  • Kahana Royale
  • Nocello
  • Beefeater
  • Bombay Sapphire
  • Harp Lager
  • Phillips Dirty Squirrel
  • Southern Comfort
  • Eblana
  • Nocino

This list is by no means comprehensive, and there are MANY varieties of wines, beers, champagnes and other types of alcohol I excluded because they to be rather obvious choices to avoid (many had things like "Nut", "Cashew", or "Almond" in the actual name).

Be Safe This Holiday Season - Cheers!In general, I advise people to stick with what they know. For people with severe nut allergies being adventurous around the holidays can likely lead to some not-so-festive memories. Check producers websites whenever possible, and if you don't see the information you need listed, call or email them. Most producers would much prefer you contact them and err on the side of safety when consuming their products. Lastly, make sure you keep your auto injector (and a backup!) handy at all times.

Unfortunately, all we've covered today is nuts. If you are one of the rare people who has a wheat or gluten allergy, that's a whole other ball of wax. Be safe and enjoy the holidays responsibly!

Author: K. Gilmore

Posted by kevvyg on Wednesday, August 27, 2014
In the last two years, there has been an incredible amount of research into what is called the human microbiome - the wide variety of microorganisms that live on and in us. It is still a difficult concept for many of us to wrap our heads around, but research has shown that the cells of all the microbes on and inside of us actually outnumber the total cells that make up the human body and by a pretty wide margin. Only recently have we started to consider the larger roles these tiny cohabitants play in our lives and in our health. Last year I wrote a piece about fungi in the lungs and how the types and numbers of them found in those with asthma vs. control patients varied. More recently, a research piece published in the Proceedings of the National Academy of Sciences of the United States of America (PNAS) highlights the link between bacteria in the gut and food allergies.

Mice, Peanut Allergies & Gut Bacteria - Probiotic Solution to Food Sensitivities?Researchers started by examining the role gut bacteria play in food sensitivities and food allergies in two groups of mice. Playing on the "hygiene hypothesis" researchers put together one group of mice that were raised in a sterile environment. In the other group, the mice were given a large dose of antibiotics at just two weeks of age. After being given peanut extract, both groups were observed, and from here researchers began introduction specific groups of bacteria to see if they had any effect on the allergic response. Specifically, Bacteroides and Clostridia bacteria groups were the focus, two types that are commonly found in wild mice.

The results were very interesting. First, mice that were given antibiotics showed a high sensitivity to the peanut extract. Antibiotics given early in life have recently been shown to be linked to a myriad Clostridia Bacteria Introduced Into Gut Reduced Peanut Sensitivityof problems later on, including things like the development of allergies and asthma. Of the second group, the reaction to the peanut allergen was even more severe with some showing signs of anaphylaxis. While the introducing Bacteroides into the gut of mice had little effect, Clostridia was another story.

In both groups of mice, the introduction of Clostridia bacteria into the mice resulted in reduced allergic responses to the peanut allergen. This is extremely important for two reasons. First, it shows a link between specific gut bacteria and the development of allergies, again highlighting the link between the microbiome and the health of the animal. Second, these results point toward the potential of treating food allergies with the use of probiotics.

This study also refines the "hygiene theory" somewhat. While traditionally, it was suggested that a lack of exposure to germs and microbes early on could lead to the immune system overreacting to innocuous substances like dust mites, peanuts, or pollen, these results would suggest that a more sterile environment or perhaps even an overuse of antibiotics could lead to less diverse and less numerous gut bacteria, which would in turn be setting the stage for allergen sensitivity.

While the notion of treating allergies or food sensitivities with probiotics are still many years away, this latest research solidifies the link between gut bacteria and allergies. More importantly, it opens the door for potentially novel, new treatments of allergies, asthma and possibly other allergic diseases.

To read the abstract of this study.

Author: KevvyG

Posted by kevvyg on Thursday, August 21, 2014
Tree nut and peanut allergies are some of the most common as well as some of the most commonly discussed food allergies. Without fail, every year we hear at least a handful of stories about those who are severely allergic coming in contact with and ultimately dying from food allergies. The standard way most deal with food allergies is with allergy shots (or another type of desensitization procedure) or strict avoidance. Yet neither is fullproof. A team of researchers at the U.S. Department of Agriculture are approaching this problem by not changing the person dealing with allergies but instead by changing the food.

Allergy-Free Cashews? Maybe!Allergy-free peanuts? While it may seem a bit farfetched, this is just what they are working on. Started with a cashew extract (oil), researchers are treating the proteins found in the oil with heat and sodium sulfite. You may recognize sodium sulfite, as it's a preservative commonly found in a variety of foods. What this process does is change the molecular look of reaction-causing protein in the cashew, making it more difficult for immunoglobin (IgE - the antibody that kicks off your body's response, aka, allergic reaction) to recognize and bind with the protein.

Test results showed that when mixing unmodified and modified cashew proteins with the IgE of a nut allergic person, 50% fewer of the IgE molecules bonded with the altered proteins. This is important for a few reasons. Even though this isn't the first experiment to attempt this, it is the first that uses a compound generally regarded as safe (GRAS) to disrupt the protein structure of the allergen. It is also important because unlike other treatments, it is aimed at treating the food, not the person. Lastly, its success shows the potential for reducing or possibly even eliminating the binding of IgE to food allergens, the root of the allergic response.

For now results show a allergy-reduced nut, which isn't as helpful a non-allergenic one. However, these results at least point towards the possibility of this as a solution. What's up next for researchers? Modifying whole cashews then ensuring the cashews still taste they way they should! Until then, avoidance remains the best option for most dealing with severe food allergies.

To read the full abstract of the research.

For more information on food allergies.

Author: K. Gilmore

Posted by R. Power on Friday, May 23, 2014
Once in a while our customer service department receives calls asking what we suggest for traveling with allergies, most often, peanut allergies. As of now there is not much we can say aside from informing your airline of your allergies, wearing a mask and asking your doctor for any additional medical advice. But now we can tell our curious callers to fly with Swiss! Swiss Airlines has proudly earned ECARF (European Centre for Allergy Research Foundation) quality seal of approval in becoming the first allergy-minded airline on the globe!

Switzerland has a history of being a very innovative and efficient country, so it doesn’t surprise me that they would make such an impression with the airline industry as they have done with chocolate, banks and pharmaceuticals.

Here’s what their allergy-minded airline includes to minimize the presence of allergens within the cabin and lounge areas:
  • High efficiency air conditioning to filter out pollen, pet hair and dander and any airborne particulates on board.
  • Removal of air fresheners for flyers with chemical sensitivities.
  • Selection and use of hypoallergenic fabric for upholstered items.
  • In the lavatories they provide soap friendly for those with sensitive skin.
  • Your meal, snack and drink selections are free of glucose, lactose and a variety of other common allergens.
  • Swiss Airline cabin crew members are trained to respond, and are equipped with the histamine tablets in the case of allergic reactions and emergencies.
I think this is a great idea for an airline to specialize a plane for allergy prone travelers. Perhaps this will start a trend for other airlines, especially here in the U.S. If not, well, then twist my arm, I guess I'll have to book a flight to Switzerland to fly allergy-free. On second thought, how would I bring back my precious Swiss chocolate covered cheese snacks?

Author: R. Power

Just a reminder for those local to the Atlanta area, if you have peanut allergies but want to catch a game at Turner field Saturday as part of your Memorial Day Weekend, they do have a Peanut Free Section. Check out the Braves site for more details, and Have a Happy Memorial Day!

Posted by R. Power on Monday, February 10, 2014
Immunotheraphy Treatment Offers Hope for Peanut Allergy SufferersMothers with children who have peanut allergies can find hope for relief in recent allergy studies. In a study recently published in the Lancet, Dr. Andrew Clark and his team conducted clinical trials testing immunotherapy treatments for children with peanut allergies. A treatment group of children with this allergy were fed small yet increasing amounts of peanut flour for a 6 month period. After the treatment, over 80% of the children were able to safely eat the equivalent of 5 peanuts a day, which is at least 25 times the quantity of peanut protein they could tolerate before the experiment. "As kids take an increasing amount, their immune systems start to change," said Dr. Clark. "They can tolerate peanuts more robustly."

Immunotherapy has been a successful form of allergy relief for wasp-sting allergies and grass pollen. At its core, immunotherapy is a long, slow process of reintroducing tiny amounts of a particular allergen to patients. Over time, the amounts of the substance patients ingest or are exposed to increases with that hope of leading to a higher, long term tolerance of the allergen. With regard to peanut allergies, this has been the most successful study so far, and gives hope to parents who are constantly on the lookout for even trace amounts of peanuts that can send the severely allergic into anaphylactic shock. In the future this type of treatment could relieve much of the worry associated with trace amounts of allergens causing severe reactions and help lift many of the precautionary diet restrictions those with food allergies often have to impose.

While we wait for more research, long term test results, and potential FDA approval for this treatment, avoidance remains one of the best options for those dealing with food allergies. Though peanut butter might not be one the menu just yet, here are some Peanut/ nut substitute suggestions without the risk of allergic reactions.
  • Sunflower seed butter
  • Soy nut butter
  • Hummus
All of these substitutes are easily found in local grocery stores, generally near the peanut butters. If any of you readers have suggestions on sunflower seed butter or soy nut butter brands, let me know, I’d love to try!

Author: R. Power

Posted by Richard on Thursday, May 09, 2013
For all you peanut allergic individuals, have you ever wondered about eating at restaurants that use peanut oil for cooking. Five Guys and Chick-fil-A are probably the two most well known examples. They use peanut oil in their fryers.

Cooking oils used by most restaurants, especially the big commercial franchises that use peanut oil, use a highly processed, refined peanut oil. Why is this important? The refining process involves high heat, deodorization, bleaching, purification, and other methods of processing to strip away the peanut proteins that are responsible for the allergic reaction to peanuts and leaves a purified, refined oil.

The peanut oils to avoid are often the gourmet peanut oils. These types of oils may have things like "cold-pressed," "natural," "unrefined," "gourmet" or "aromatic" While the Cooking Oil Might be Safe, Five Guys Still Has Peanuts on the labeling of the bottle. Found in the cooking oil aisles at supermarkets or specialty stores, these oils often forego the refining process and retain allergic proteins.

There are research studies that back up these findings, and the FDA makes specific note of oils in Food Allergen Labeling and Consumer Protection Act of 2004 (FALCPA) [Paragraph 1-201.10(B)]. So, if you are craving those fries cooked in the peanut oil, chances are you can probably feel safe eating them. Now, the only reasons to avoid Five Guys might be the actual peanuts in their restaurants or your expanding waistline.

Always inquire about the oil before ordering, and discuss with your allergist if you have any questions or reservations.

For more information on FDA guidelines concerning food allergens or for a convenient way to let restaurant staff know about your food allergies, try our convenient food allergy cards.

Posted by kevvyg on Thursday, June 07, 2012
I've been waiting to see something along these lines for quite some time now. In the midst of this feisty election year, PeanutAllergy.com partnered with OpposingViews.com to run a poll. Should peanuts be banned from schools? While the breadth of the number of people polled is a relatively small sample, the results might be surprising to some.

With the "No" vote totaling 76.6%, most of those who responded are opposed to banning peanuts in school. This is interesting for a few reasons. First, food allergies in general but nut allergies in particular, have been trending sharply upward in recent years. In part because of better awareness surrounding food allergies, the number of cases of peanut allergies has been on the rise. Secondly, as more school districts and states across the nation are developing plans to keep Epi-Pens on hand, there has been a response to the growing number of severe allergic reaction cases by administrators, parents and legislators.

This is a sticky situation (sorry for the poor peanut butter pun) for several reasons. Peanuts have been a staple in the American diet for a very long time. On average, a typical American consumes over 3 lbs. of peanuts every year. Now this doesn't mean we're all sitting around at the ballpark, the local Five Guys, your nearest steakhouse or on airplanes just munching away. Peanut oil and the ever-favorite peanut butter is consumed and used in a variety of foods and for food preparation across the nation. Peanuts have traditionally been a low cost source of nutrients and protein, far cheaper than meat.

On the other side are the health risks for those who are allergic. Part of what makes the increase in food allergies so alarming is how severe they can be. Why have schools and state legislatures been pushing to enact laws that require schools to carry auto-injectors? Fatalities. Though the number of food allergy related deaths each year is small, typically a couple hundred, they are alarming, in large part because they are so preventable. And, for parents of children with severe food allergies, this no small matter, so much so that some parents have turned to home schooling or specially trained dogs to help their child avoid food they're allergic to.

There are also other issues in play with this debate, cost, effectiveness, and even concerns regarding civil liberties. The issue is a difficult one, but one where opinions can be very sharp and not in short supply. So where do you stand? Should they be banned in schools for allergy reasons? If not, what should schools and others do to help prevent these preventable deaths?

Author:

Posted by Jamie on Wednesday, March 30, 2011
We recently had a mother write to us for advice and help with food allergy questions. Recently, she found out that her 3 year-old is allergic to dairy protein (specifically Casein) and nuts. One problem is that milk and cheese are staples of his diet. Also, it is a vegetarian family, so these foods were an important source of protein.

She needs some advice on how to get around offering him dairy products, while meeting nutritional requirements and maintaining the boy’s interest in eating. She has tried rice milk, almond milk, and coconut milk without much success. The parents were advised against using soy milk and other soy products due to estrogen content.

Does anyone have a similar situation? Can you share your experiences with what foods you offer your child that might work? How did you explain to your child why they can’t have regular milk, ice cream, and cheese? Any words of wisdom or advice would be helpful and appreciated. Thanks in advance for your comments and posts.

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