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Hidden Allergens in Foods - Peanuts
Peanuts are one of the most allergenic foods,62,63 and peanut allergy is one of the most common food
allergies.64 Peanuts are probably the most common cause of death by food anaphylaxis in the United States,
and about one third of peanut-sensitive patients have severe reactions to peanuts.65,66
Peanuts are added to a large variety of processed foods (Table XI). These include ice cream (as a flavoring), marinades, snack
foods, and biscuits. Peanuts can be used as a flavoring or a seasoning agent67 and may be labeled as such
(Table XII). Nuts may be used in the manufacture of vegetable burger patties.68 A fatal reaction to peanut
antigen in almond icing has been recorded.69 Peanut butter may also be used to "glue down" the ends of egg
rolls to keep them from coming apart.70 Some individuals do not know that peanut butter is commonly used in Oriental cooking.
Peanuts can be "deflavored," "reflavored," and pressed into other shapes such as almonds and walnuts.9,65 These
products retain the allergenicity of the peanut. Some patients with peanut allergy also react to sweet lupine seed
flour, which may be used, for example, to fortify a spaghetti-like pasta.71
Although uncommon, a peanut protein hydrolyzate may also be used in soft drinks as a foaming agent or in confections as a whipping
agent.67
Peanut oil has been considered to be devoid of allergenicity,72,73 and this was initially confirmed by double-blind crossover studies.74
However, peanut oil allergenicity is clearly process-related, because cold-pressed peanut oils may contain peanut allergen.75
Moneret-Vautrin et al.76,77 confirmed the allergenicity of peanut oil in milk formulas, and 11 of 45 brands of milk formulas in France
contained variable amounts of peanut oil.77 Residual peanut proteins arc believed to become more allergenic with heating.77
The oil is frequently used in the preparation of so-called "health foods." The oil can be used for many nonfood products, which may, on
contact, affect sensitive individuals. Like peanut oil, other vegetable oils such as soy, maize, sesame, and sunflower oils contain very low
quantities of protein.78,79
Individuals who are allergic to peanuts are said to not be allergic to nuts such as almonds, pecans, or walnuts; and these nuts can be
substituted for peanuts.9 This is contradicted by a recent study, which showed that 50% of individuals allergic to peanuts reported allergic
reactions to other nuts as well.70 These findings were not validated by further clinical investigation.
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TABLE XI References 66,70,72
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Foods that may contain peanut or peanut oil
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Baked goods
Baking mixes
Battered foods
Biscuits
Breakfast cereals
Candy
Cereal-based products
Chili
Chinese dishes
Cookies
Egg rolls
Ice cream
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Margarine
Marzipan
Milk formula
Pastry
Peanut butter
Satay sauce and dishes
Soups
Sweets
Thai dishes
Vegetable fat
Vegetable oil
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TABLE XII Reference 67
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Labels that may indicate the presence of peanut protein
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Ground-nut
Peanut
Peanut butter
Emulsifier (uncommon)
Flavoring
Oriental sauce
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References:
9. Koerner CB, Sampson HA. Diets and Nutrition. In: Metcalf DD, Sampson HA, Simon RA. eds. Food Allergy. Adverse reactions to foods and food additives. 1991; 333-353. Blackwell Scientific Publications. Boston.
62. Smith T. Allergy to peanuts [editorial]. BMJ 1990;300(6736):1354
63. Bush RK, Taylor SL, Nordlee JA. Peanut sensitivity. [Review] Allergy Proc 1989;10(4):261-264
64. Sampson HA. McCaskill CC. Food hypersensitivity and atopic dermatitis: Evaluation of 113 patients. J Pediatr 1985;107(5):669-675
65. Yunginger JW, Squillace DL, Jones RT, Helm RM. Fatal anaphylactic reactions induced by peanuts. Allergy Proc 1989;10(4):249-253
66. Settipane GA. Anaphylactic deaths in asthmatic patients. Allergy Proc 1989;10(4):271-274
67. Natarajan KR. Peanut protein ingredients: preparation, properties, and food uses. Advances in Food Research 1980;26:215-273
68. Donovan KL, Peters J. Vegetableburger allergy: all was nut as it appeared. BMJ 1990;300(6736):1378.
69. Evans S, Skea D, Dolovich J. Fatal reaction to peanut antigen in almond icing. CMAJ 1988;139(3):231-232
70. Loza C, Brostoff J. Peanut Allergy (Review). Clin Exp Allergy 1995;25:493-502
71. Hefle SL, Lemanske RF Jr, Bush RK. Adverse reaction to lupine-fortified pasta. J Allergy Clin Immunol 1994;94(2 Pt 1):167-172
72. Keating MU, Jones RT, Worley NJ, Shively CA, Yunginger JW. Immunoassay of peanut allergens in food-processing materials and finished foods. J Allergy Clin Immunol 1990;86:44-47
73. Nordlee JA, Taylor SL, Jones RT, Yunginger JW. Allergenicity of various peanut products as determined by RAST inhibition. J Allergy Clin Immunol 1981;68:376-382
74. Taylor SL, Busse WW, Sachs MI, Parker JL, Yunginger JW. Peanut oil is not allergenic to peanut sensitive individuals. J Allergy Clin Immunol 1981;68:372-375
75. Hoffman DR, Collins-Williams C. Cold-pressed peanut oils may contain peanut allergen. J. Clin Allergy Immunol 1994;93(4):801-802
76. Moneret-Vautrin DA, Hatahet R, Kanny G, Ait-Djafer Z. Allergenic peanut oil in milk formulas. Lancet 1991;338(8775):1149
77. Moneret-Vautrin DA, Hatahet R, Kanny G. Risks of milk formulas containing peanut oil contaminated with peanut allergens in infants with atopic dermatitis. Pediatr Allergy Immunol 1994;5:184-188
78. Tattrie NH, Yaguchi M. Protein content of various processed edible oils. J Inst Can Sci Technol Aliment 1973;6:289-290
79. Klurfeld DM, Kritchevsky D. Isolation and quantification of lectins from vegetable oils. Lipids 1987;22:667-668
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