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Peanut Allergy Diet Guide: What You Need to Know

For American children, peanut allergies are the third most common food allergy, and for American adults, it’s the second most common allergy. Peanut allergies are becoming more prevalent, although scientists aren’t sure why. It’s also more common for boys to have peanut allergies than girls, and African-American kids are more likely to have peanut allergies than other children. This type of food allergy is more often a lifelong affliction, with 80 percent of children continuing to be allergic to peanuts once they reach adulthood. Peanuts can hide in both food items and non-food items, and most of the deaths that are connected with peanut allergies happen due to ingestion and anaphylaxis.


Generally, someone with a peanut allergy will begin showing symptoms immediately after ingesting something containing peanuts. Symptoms could start within a couple of minutes or a couple of hours. Typical symptoms include:

  • Rash, hives, or eczema
  • Nausea, stomach pain, vomiting, or diarrhea
  • Wheezing, coughing, or runny nose
  • Swelling of the lips, tongue, or face
  • Anaphylaxis, which is a medical emergency that might affect multiple organ systems

Diagnosis and Treatment

An allergist will diagnose a peanut allergy after completing a full physical examination, allergy testing, and medical history. After diagnosis, the treatment plan will include elimination of all peanut products from the diet. Immunotherapy may also be used, which involves a process of desensitization to peanuts by eating very tiny amounts of peanut protein. Immunotherapy is still in the research phase, and it is not considered to be a safe treatment option for everyone.

How to Avoid Peanuts

Eliminating peanuts from the diet is crucial for avoiding allergic reactions. It’s also important to avoid all products that might be contaminated with peanuts, which could occur during the manufacturing process. These products include items such as cookies, cereal, crackers, and granola bars.

The Food Allergen Labeling and Consumer Protection Act requires that manufacturers list the presence of peanuts as a potential allergen on the ingredient label. If a product doesn’t indicate peanut-based ingredients on the label, consumers can call the manufacturer to be sure that it is peanut-free. The cross-contamination risk with foods manufactured in the same facility causes many people with peanut allergies to avoid potentially risky products. Those with peanut allergies must avoid any foods with these ingredients:

  • Peanuts or peanut butter
  • Peanut flour
  • Ground or mixed nuts
  • Imported foods with hydrolyzed plant or vegetable protein
  • Cold-pressed, expressed, or expelled peanut oil

Be careful with these foods, because they may contain peanuts:

  • Baked goods such as cake, cookies, cupcakes, and crackers
  • Chocolate and candy
  • Frozen desserts such as ice cream and other treats
  • Spaghetti sauce, soup, and chili
  • Marzipan and nougat
  • Granola and other cereals

There are also some hidden dangers:

  • Peanut oil is often used in Asian cuisines for sauteing and deep-frying.
  • Peanut oil (also called arachis oil) appears in topical products, medications, and cosmetics.
  • Heating peanut butter or other peanut products may release proteins into the air, causing a reaction.
  • Highly refined peanut oil is often safe, but cold-pressed peanut oil may contain peanut proteins.

Cross-Reactivity and Additional Allergies

Peanuts are technically a legume and not a nut. However, it’s common for children with a peanut allergy to also be allergic to tree nuts such as hazelnuts or almonds. Some kids also have an allergy to lentils, chickpeas, and soy. About 95 percent of those with a peanut allergy are able to consume other legumes. However, about 20 percent of people with a peanut allergy have an allergy to lupin, a type of bean found in some food products. Lupin is also prevalent in European baking.

People with a peanut allergy may feel the need to avoid certain foods out of fear of having a similar allergic reaction. But this could unnecessarily limit the diet and even lead to the development of more sensitivities. It’s important to always discuss concerns with a physician to get help and guidance.

Managing a Peanut Allergy at School

Kids tend to love peanut butter, and peanut butter and jelly sandwiches are a common staple of kids’ lunches. The threat of cross-contamination at the lunch table is an important concern, so schools are responding in various ways to keep kids safe. Some options include separate lunch tables or even banning peanut products entirely. Daily cleaning routines are crucial to prevent cross-contamination. One of the best ways to keep children with peanut allergies safe is to have open communication between school staff and parents. A school nurse can also be involved with keeping children safe at school.

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(703) 565-2503