Breaking the Peanut Allergy Misconception: Five Eye-Opening Insights

Peanuts are a nutritious, delicious, and a­ffordable food. Yet, for foodservice professionals, accommodating requests to eliminate peanuts can pose a dilemma. Balancing the safety of diners with the practicality of policies becomes paramount. By exploring these five evidence-based insights, we unravel the misconceptions surrounding peanut allergies, paving the way for a more informed and effective approach to allergen management.

1. Only a small percentage of the population has a peanut allergy. Though it’s increasingly in the news, the fact is less than 1% of Americans have a peanut allergy, and overall food allergies only affect about 5% of children and 4% of teens and adults [1].
2. Research shows that casual contact presents an extremely low risk for anaphylaxis. Smelling or touching peanuts or peanut butter does not cause anaphylaxis. Research does not support skin contact or airborne peanut butter exposure as a source of anaphylaxis, though hay fever-type reactions may occur [1]. Most instances of anaphylaxis are the result of accidental ingestion of peanut proteins or exposure through the eyes or mouth. A study of 30 peanut-allergic children who smelled peanut butter for 10 minutes resulted in zero reactions. Skin contact in this study also resulted in zero life-threatening reactions; redness and irritation occurred for some where the peanut butter touched the skin [2]. Further research found that washing hands with soap and water and using common household cleaners on surfaces can remove peanut proteins to mitigate cross-contact [3]. More recently, allergists documented their practice of placing peanut butter in close proximity to peanut-allergic patients to show them that just being near peanut foods doesn’t cause anaphylaxis. Similarly, they applied peanut butter to the skin of allergic patients. In their article, the clinicians reported that none of their patients has experienced a systemic reaction and only one had a hive at the site of application [4].
3. There is no such thing as a peanut oil allergy when it comes to highly refined peanut oil. Allergic reactions are caused by proteins in peanuts, which are removed in highly refined peanut oils. It's important to distinguish between refined and unrefined peanut oils. Refined oils are safe for people with peanut allergies and are frequently used for frying, while unrefined oils contain proteins that can cause allergic reactions. The refining process involves removing peanut proteins from the oil, making refined peanut oil non-allergenic according to the FDA.
4. Experts do not recommend banning peanuts in dining establishments. In a study of 567 food allergy reactions in a Canadian pediatric cohort, 4.9% of reactions occurred in “peanut-free” schools compared to 3% in schools that allow peanut foods. Authors warned about a false sense of security when foods are banned [5]. According to a study of schools in Massachusetts, schools with policies that restricted peanut foods from being brought from home, served in the school cafeteria or in the classroom did not reduce the use of epinephrine to treat food allergy reactions compared to schools that did not have peanut-free policies [6]. Best practices for managing food allergies in foodservice include using basic food safety techniques, separating allergens, clearly labeling allergens and avoiding cross contact in kitchens and serving areas. Most importantly, allergic diners should be encouraged to notify staff of their allergy and be prepared in case of accidental ingestion.
5. Peanuts are not tree nuts. Peanuts do not grow in trees and are legumes, not nuts. This means individuals allergic to tree nuts, like almonds or cashews, may not necessarily be allergic to peanuts, and vice versa. This highlights the importance of accurate diagnosis and understanding the specific allergens an individual may be sensitive to, as well as the importance of accurate food labeling.

What to do:

Focus on Training – all foodservice staff (or anyone who provides oversight, care and services for a food-allergic student or diner) should be trained in identifying symptoms of a reaction and how to respond.

• FARECheck is an enhanced training and review program in food handling and safety practices to help keep food-allergic individuals safe and included when dining out. It was developed by FARE, the largest private funder of food allergy research.
• The National Restaurant Association offers an online, on-demand training in food allergen handling called ServSafe Allergen®. This quick and affordable resource helps foodservice staff learn to keep allergic diners safer in the foodservice environment.
• Because dining out is one of the vulnerable areas of exposure for the food allergic, the National Peanut Board offers presentations and trainings for large foodservice operators to help educate them about strategies for meeting patron and student needs without unnecessarily eliminating foods from their menus.

Learn more about managing peanuts and other potential allergens at PeanutAllergyFacts.org.

Additional Resources

1. Food Allergen Labeling and Consumer Protection Act of 2004 (FALCPA) | FDA
2. Publication: USDA ARS
3. Peanut allergy – Symptoms and causes – Mayo Clinic

References

1. NIAID. Guidelines for the Diagnosis and Management of Food Allergies in the U.S. Available at http://www.jacionline.org/article/S0091-6749%2810%2901566-6/pdf
2. Simonte S., M. S. (2003). Relevance of casual contact with peanut butter in children with peanut allergy. J Allergy Clin Immunology, 180-182. Available at https://pubmed.ncbi.nlm.nih.gov/12847496/
3. Perry, Tamara T et al. “Distribution of peanut allergen in the environment.” The Journal of allergy and clinical immunology vol. 113,5 (2004): 973-6. doi:10.1016/j.jaci.2004.02.035
4. Dinakar C., S. J. (2016). The transforming power of proximity food challenges. Annals of Allergy, Asthma & Immunol, 135-137. doi:10.1016/j.anai.2016.06.015
5. AACI. Accidental exposure (AE) to peanut in a large cohort of Canadian children with peanut allergy. Available at https://aacijournal.biomedcentral.com/articles/10.1186/1710-1492-10-S1-A32
6. JACI. Impact of School Peanut-Free Policies on Epinephrine Administration. Available at http://www.jacionline.org/article/S0091-6749(17)30472-4/abstract