Different forms of processing may alter the body’s reaction to the peanut allergen, and some research has focused on whether allergic reactions could vary depending on the way that peanuts are prepared.
How Processing and Cooking Changes Peanut Allergy
Severe, life-threatening allergic reactions to peanuts have resulted in dozens of deaths over the past 15 years. The rate of peanut allergies has dramatically increased in the 21st century and now affects approximately one percent of the population in the United States and other Westernized countries.
Preparation Methods
In other parts of the world, such as Korea, China, and Israel, the rate of peanut allergy is much lower than that of Westernized countries.
In Westernized countries, peanuts are commonly dry-roasted; in non-Westernized countries, however, peanuts are often boiled, fried, or pickled. Some researchers suggest that the lower rate of peanut allergy in these countries might have to do with how peanut is processed.
Peanut Allergens
Allergens are components that trigger an allergic reaction. Three major peanut allergens have been identified—Ara h 1, Ara h 2, and Ara h 3. People living in the US with peanut allergy most commonly are allergic to Ara h 2, especially those with the more severe forms of peanut allergy.
The major peanut allergens are altered by peanut processing.
Roasting peanuts enhances the reaction of IgE antibodies to Ara h 2, which could explain why people in the US tend to have more common and more severe allergic reactions to peanuts. Roasted peanuts are rarely eaten in Korea, where it is more common to eat pickled, boiled, or fried peanuts—processes that seem to reduce the ability of Ara h 2 to act as an allergen.
This is one potential explanation for why peanut allergies, especially severe forms, tend to be more common in Westernized countries than Asian countries.
Is There Currently a Cure for Peanut Allergy?
There is no cure for peanut allergies. Palforzia is a type of oral immunotherapy that is approved for use in treating peanut allergies. It contains precise amounts of peanut protein and is given to children age 4-17 years of age every day to help decrease their sensitivity to small amount of peanuts over time. People who take Palforzia must maintain a peanut-free diet and be under supervision of healthcare professional while on this form of oral immunotherapy.
If you or your child experience severe reactions, it’s important that you talk to your healthcare provider about whether you should have an EpiPen, and that you learn how to use it.
There are a number of small studies focusing on the use of oral immunotherapy for the treatment of peanut allergy. In one study, for example, participants were given increasing amounts of peanut flour (often in gelatin capsules) to swallow on a daily basis, for a period of weeks to months. After this time period, an oral challenge to peanut was used to determine how much peanut the person could then tolerate without experiencing an allergic reaction.
Reported results of immunotherapy for treating peanut allergy:
A few studies have shown that after children had undergone oral immunotherapy to peanut for many months, they could eat a large number of peanuts (approximately 20) without experiencing an allergic reaction. It’s important to note that almost all of these children experienced some form of allergic reaction during the course of the oral peanut immunotherapy. There are a growing number of reports of children developing eosinophilic esophagitis as a side effect of oral immunotherapy.
If you are interested in immunotherapy, you can contact your allergist to weigh your risks and benefits.
Peanut allergy immunotherapy is a treatment, not a cure, for peanut allergy. It is designed to reduce the frequency and severity of allergic reactions after accidental exposure to peanuts. If you receive immunotherapy for your peanut allergy, you should still avoid peanuts and talk to your healthcare provider about using an EpiPen in the event of anaphylaxis.
Could Boiling Peanuts Lead to a Cure for Food Allergies?
The idea behind boiling peanuts is based on principles of immunotherapy, as well as experience associated with other food allergies.
Past studies have shown that through extensive heating, allergens in certain foods, such as milk and egg, are altered. Most people with milk and egg allergies tolerate these foods when they are extensively heated. And, some people with milk or egg allergies who frequently eat these products in their heated form outgrow their allergies.
A recent study was performed on four children with peanut allergies who ate boiled peanuts in increasing amounts every day over the course of months. After months of this exposure, some of the children were able to eat raw peanuts. Experts suggest that sustained and frequent exposure to low amounts of Ara h 2 may lead to the development of oral tolerance.
While these results are not definitive in terms of directing any type of treatment for peanut allergy, the information adds to the scientific knowledge about peanut allergies.
If you have been diagnosed with a peanut allergy, you can talk to your healthcare provider about whether you qualify to take Palforzia or to participate in any research trials.
