Tackling Peanut Allergies: Breakthroughs in Awareness, Prevention and Treatment

Peanut allergies are a concern for healthcare professionals, parents, school staff, and foodservice experts alike. Whether concerns manifest themselves during early infant feeding, in cafeterias or in the homes of allergic individuals, there’s actually a lot of good news to be had. According to Matt Greenhawt, MD, director of the food challenge and research unit at Children’s Hospital Colorado and member of the National Peanut Board’s Food Allergy Education Advisory Council, “In the past three years, there have been tremendous breakthroughs in food allergy research, including increased awareness and understanding of food allergy hallmarked by a comprehensive review from the National Academies of Science, publication of a groundbreaking study that showed the potential to prevent the development of peanut allergies as well as adoption of new early feeding policies in multiple countries to support these findings, and the initiation and completion of two pivotal phase III trials for two treatments for peanut allergy which both showed strong efficacy and safety.  The evolution of our knowledge in such a short time is simply remarkable.”

 

Awareness

The public is far more aware of food allergies now than ever before. That’s good news for those dealing with food allergies on a day-to-day basis. Free-from products, those that do not contain many common allergens, gives people with food allergies more options for safer foods to enjoy. Many restaurants now offer options for those with food allergies or celiac disease to help ensure that they avoid accidentally eating the offending food when dining out. Many states have laws requiring food allergy training in foodservice establishments, epinephrine in schools, and protect “good Samaritans” who provide emergency assistance to anyone experiencing anaphylaxis.

Eleanor Garrow-Holding, president of Food Allergy Anaphylaxis Connection Team (FAACT) and member of the NPB Food Allergy Advisory Council,  said, “As an advocate for food allergy families, I’ve seen a significant increase in awareness of food allergies across the country in the past 5 years. While there continues to be room for improvement, I’ve seen improvements in school education and schools recognizing the importance on educating staff, along with improvements in food establishments and staff being educated and aware on how to manage food allergy in the restaurant setting.” In fact, many resources now exist to help schools, including the School Nutrition Association’s Food Allergy Resource Center and NPB’s PeanutAllergyFacts.org websites. Garrow-Holding went on to say, “There have been improvements with colleges and universities being educated on how to manage food allergies and food service personnel in dining halls being trained on cross-contact, cleaning measures, etc. There have also been improvements in specialty food products for families, as well as food manufacturers understanding the severity and putting best practices in place on behalf of the food allergy community. Food allergy awareness has come a long way in the past 14 years since we started this journey.”

There remain opportunities, however, to address common myths and misperceptions about food allergies. For instance, consumer research commissioned by the National Peanut Board has shown that parents and caregivers believe peanut allergies to be 40 times more common than they actually are and most people are surprised to learn that less than 1% of the U.S. population has a peanut allergy[1].

 

Early Introduction

Thanks to the groundbreaking Learning Early About Peanut allergy (LEAP) study in 2015, we now have definitive guidelines supporting the early introduction of peanut foods to infants to help prevent peanut allergies. In fact, the 2017 NIAID Addendum Guidelines for the Prevention of Peanut Allergies in the United States give detailed instructions for how to assess risk for food allergies and when and how infants should begin to eat peanut foods. Pediatrician and chair of the NPB Food Allergy Education Advisory Council Dr. JJ Levenstein said, “Having the NIAID Guidelines and solid research supporting early introduction in order to prevent peanut allergy is thrilling. For the first time, we have a way to empower parents to actually prevent their child from developing this life-threatening condition.” Infants at high risk for developing peanut allergies – those with severe eczema or existing egg allergy – should be evaluated by their healthcare provider before peanut food introduction. According to the guidelines, unless already allergic, all infants should begin eating peanut foods by around 6 months.

More research is needed to understand how early introduction of other foods impacts the development of those allergies. As with all health concerns, parents should consult with their healthcare provider with any specific questions they have about their child’s health.

 

Treatments

Those with existing food allergies can also share in the excitement as options for treating food allergies are on the horizon. Currently, there are no FDA-approved treatments for food allergies and strict avoidance is the only path. However, researchers are making strides in immunotherapy, particularly with regard to peanut allergies, using oral and epicutaneous exposure. In fact, at the recent American Academy of Allergy, Asthma, and Immunology meeting, researchers presented very promising results. According to Aimmune, maker of one peanut allergy treatment option, a petition to FDA will be made for a new treatment by the end of 2018. If approved, this would be the first commercially available option for desensitization for peanut allergic individuals. “It’s exciting to see so much research producing options for those who have food allergies. Recent advancements in oral immunotherapy research mean that options for desensitization or increasing tolerance and safety are on the horizon for those who suffer with peanut allergy every day,” said Dr. Levenstein.

While the issues of food allergies are not yet resolved and there is still work to do, it is a time of positive change. Through consistent investments in research, education, and outreach, the National Peanut Board is proud to be part of the solution. Learn more about NPB’s commitment here.

 

[1] Guidelines for the diagnosis and management of food allergy in the United States: Report of the NIAID-Sponsored Expert Panel. Available at http://www.jacionline.org/article/S0091-6749%2810%2901566-6/fulltext. Accessed March 15, 2018.