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Peanut Free

Peanuts, also called ground nuts or monkey nuts, are a common cause of food allergies especially in the USA where the consumption of peanuts is high. 

An adverse reaction to peanuts is a true food allergic response involving an over-reaction of the immune system and production of IgE antibodies. The symptoms of peanut allergy can vary from mild to very severe, life-threatening reactions. Indeed, peanuts along with tree nuts have been identified as the most likely food to provoke the extreme form of severe food allergy reaction, anaphylaxis. The potential severity of peanut allergy requires extra care and alertness from those affected by the condition and lay people around them. The wide usage of processed peanut products in foods means that the issue of peanut allergy is also of great significance to the food processing industry which has the responsibility of ensuring that its products are labelled so as to alert purchasers to the presence of potential allergens products.

How common is peanut allergy?
Peanuts are a common cause of food allergy, caused when the immune system reacts to the protein found in peanuts. 

It usually develops in early childhood but, occasionally, can appear in later life. Peanut allergy tends to be persistent and only approximately 1 in 5 children outgrow their allergy, usually by the age of 5 .

Peanut Allergy

Who is at risk of peanut allergy?
Infants with eczema and/or egg allergy are more likely to develop a peanut allergy . It is important to know that peanuts are a legume and from a different family of plants to tree nuts (almonds, Brazil nuts, cashews, hazel nuts, macadamia, pecan, pistachios and walnuts). A peanut allergy does not automatically mean an allergy to tree nuts although it is not uncommon to be allergic to both peanuts and some tree nuts.

An allergy to peanuts does also increase the likelihood of an allergy to sesame and lupin. Advice on whether it is safe to have sesame, lupin or tree nuts in the diet should be sought from your GP/allergy specialist.

Prevention of peanut allergy
New research has shown that the risk of developing peanut allergy can be reduced in infants at high risk of this allergy (i.e. those with significant eczema and/or egg allergy) by introducing food containing peanut into infants’ diets within the first 12 months of life.

Early introduction is thought to help the immune system tolerate peanut protein. Infants with no eczema or known food allergy can be given food containing peanut from the time that solid food is introduced, at around 6 months, when baby is developmentally ready, but not before 4 months. This should be in the form of smooth peanut butter or peanut snacks suitable for babies (never use crunchy peanut butter or whole peanuts due to the risk of choking). If they have been diagnosed with a food allergy or eczema it is important to discuss introducing peanuts with your GP, Dietitian, Pediatrician or Health Visitor. (Delaying the introduction of peanut can increase the risk of developing a peanut allergy) so ensure you speak to your health professional as soon as possible.

It is safe for pregnant and breastfeeding women to consume peanuts unless they are allergic themselves.

What are the signs and symptoms of an allergic reaction to peanut?
Signs and symptoms usually occur within minutes of contact with peanuts, but can also occur up to one hour later. Most allergic reactions are mild but they can also be moderate or severe. Anaphylaxis (pronounced ana-fil-laxis) is the most severe form of allergic reaction which can be life threatening.

Mild to moderate symptoms include:

Itchy mouth, tongue and throat
Swelling of lips, around the eyes or face
Red raised itchy rash (often called nettle rash, hives or urticaria)
Vomiting, nausea, abdominal pain and diarrhea
Runny nose and sneezing
Any one or more of the following symptoms are a sign of a severe allergic reaction (anaphylaxis) and should be treated as a medical emergency.

Severe symptoms of anaphylaxis include:

Swelling of the tongue and/or throat
Difficulty in swallowing or speaking
Change in voice (hoarse voice)
Wheeze (whistling noise) or persistent cough
Difficult or noisy breathing
Dizziness, collapse, loss of consciousness (due to a drop in blood pressure)
Pale, floppy, sudden sleepiness in babies.

Severity of reactions

It is commonly misunderstood that food allergic reactions become more severe each time they happen, but this is not the case. Reactions are unpredictable and there is no reliable way of knowing how an individual may react. There are several reasons why an allergic reaction may be more severe, including how much peanut allergen has been eaten and other factors such as uncontrolled asthma, exercise, and infection. Some people do seem predisposed to more severe reactions with a previous anaphylactic reaction increasing the risk of a further one.

It is important to seek advice from a Healthcare professional if a peanut allergy is suspected. In the first instance, this will usually be your GP. They may arrange for allergy testing to be carried out or refer you to a specialist allergy service for skin prick testing and/or specific IgE blood testing to peanut. These tests help to confirm if food allergy is likely and rule out other possible causes. Allergy tests cannot predict how mild or severe an allergic reaction will be, or when an allergic reaction is likely to happen. Alternative types of allergy testing other than those recommended by a Healthcare professional are not advised as these may be from an unreliable source with no value in diagnosing allergy and could lead to removing food from the diet that does not actually need to be avoided. 

If you have had cause for concern over peanut allergy and have been avoiding peanuts, it is important not to reintroduce peanuts back into the diet without medical advice.

More about peanuts
Peanuts are grown in areas of the world with warm climates such as America, Asia and Africa. They are grown from seed and grow under the ground. Different varieties of peanut are produced for different uses (for example, peanuts to be used in peanut butter and peanuts in the shell for roasting). Peanuts are from a family of plants called legumes, the same family as garden peas, lentils, soya beans and chick peas. Most people will be able to eat other types of legumes without any problems and it is rare for people with a peanut allergy to react to other legumes.

One member of the legume family that can affect people with peanut allergy is lupin as these seeds share similar proteins with peanuts. Lupin flour and seeds can be used in bread, pastry and pasta. It is often used in wheat and gluten-free food. Lupin is more commonly used in other European countries, Brazil and the Middle East.

Sesame allergy may affect up to a quarter of those with peanut allergy. It is very important to be aware of this and seek medical advice from an allergy specialist if you or your child has ever had a severe reaction to peanut as allergy testing to these other foods may also be needed.

Living with a peanut allergy
As there is currently no cure for peanut allergy, the complete avoidance of peanuts and foods which contain peanuts is important. Peanuts are widely used in a variety of foods and are a common ingredient in different types of cooking like Asian and Indian cuisine. They can also be found in foods like muesli and cereals and cereal bars. It is important to carefully check the ingredients list on food items (specifically those produced outside of the EU as they are not required to include peanut as a highlighted food allergen). Avoid foods which contain peanut and could be listed under any of the following names:

Arachis hypogaea
Beer nuts
Chinese nuts
Goober nut/pea
Monkey nuts