With food the centerpiece of many holiday traditions, this time of year can be a stressful one for those suffering from food allergies.
Among the fastest-growing food afflictions worldwide are peanut allergies, which now affect an estimated 1 percent to 3 percent of children in most westernized nations.
Dr. Vincent Tubiolo, a Santa Barbara allergist, recently spoke with Noozhawk about the rise in peanut allergies and medical efforts to combat the serious reactions, which can be fatal in some cases.
“We don’t know exactly why children develop allergy to nuts,” he said.
In some cases, Tubiolo said, genetically predisposed individuals become exposed to peanuts during a susceptible time in their lives and their immune response causes an allergy.
One in 50 elementary school-age children has some form of a peanut allergy, and those with strong reactions can die without immediate treatment for anaphylaxis, he said.
The recommended treatment is an injectable dose of epinephrine, also known as adrenaline.
Although the immune system normally protects people from germs, in people with food allergies, the immune system mistakenly responds to food as if it were harmful, according to the Centers for Disease Control and Prevention.
A 2013 CDC study determined that food allergies among children increased approximately 50 percent between 1997 and 2011, to more than 3 million.
Eight foods or food groups account for 90 percent of serious allergic reactions in the United States: milk, eggs, fish, crustacean shellfish, wheat, soy, peanuts and tree nuts.
Peanuts are technically legumes in the same family as beans, peas and lentils, while tree nuts include almonds, cashews, hazelnuts, pecans, pistachios, walnuts and other nuts.
The proteins in peanuts are similar to tree nuts, however, which means people who are allergic to peanuts typically must avoid tree nuts, as well.
According to the CDC, there is no cure for peanut or tree nut allergies.
Reactions in people with food allergies can vary widely. It all depends on the individual — and sometimes the same person can react differently at different times.
Some reactions can be very mild and involve only one system of the body, such as hives on the skin. Other reactions can be more severe, such as anaphylaxis after ingesting nuts, which can be fatal in children and some adults.
Although there is no cure for a peanut allergy, Tubiolo said new research indicates that early introduction of peanuts in young children with high risk for peanut allergy (kids who already have have eczema and are allergic to eggs) can dramatically decrease their subsequent risk of developing a peanut allergy.
A 2015 study reported in February in the New England Journal of Medicine demonstrated that high-risk infants eating a snack with peanuts prevented the allergy from developing.
Tubiolo said there is also information about how peanuts are prepared and how they may be more likely to cause allergy. Roasted peanuts are far more likely to cause allergy than boiled peanuts, which are more popular in China, for example.
Recent studies also show the possibility of desensitizing reactions by feeding children small amounts of peanuts. By gradually increasing the amount, some people can then safely eat a few peanuts, Tubiolo said.
There is no way, however, to induce tolerance, he warned.
“What this means is that once people are desensitized they must continue to eat the peanuts regularly to stay protected, otherwise they will regain their ability to react,” he said.
Studies are also currently underway testing a patch on the arm that may help people become desensitized to a peanut allergy.
However, the main way to deal with a peanut allergy is “strict avoidance,” Tubiolo said.
This requires careful observation of all food. Even small amounts of cross-contamination at a restaurant could be life threatening, Tubiolo said as one example.
Careful food handling is a large part of school food services. Barbara Keyani, spokeswoman for the Santa Barbara Unified School District, said food service is peanut-free on all elementary school campuses.
In junior high and high schools, almonds are included in the schools’ homemade granola.
Keyani said the district has a point-of-sale computer system in the elementary and secondary schools that has space to note individual students’ food accommodations, such as nut allergies.
When a parent notifies food service staff of a meal accommodation need, the information is added into the system.
“If a child has a food item on his/her tray that they should not have, (the point of service system) flags staff when the student goes through the checkout line, and that particular food item is removed from the child’s tray,” Keyani said.
“The district nurse is also notified of the information on the meal accommodation form.”
— Noozhawk staff writer Joshua Molina can be reached at jmolina@noozhawk.com. Follow Noozhawk on Twitter: @noozhawk, @NoozhawkNews and @NoozhawkBiz. Connect with Noozhawk on Facebook.
