Updated September 02, 2014.

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The rate of peanut allergy has dramatically increased over the last 10 years, and now affects one to two percent of the population in the United States and other Westernized countries. Severe, life-threatening allergic reactions to peanuts are common in people with peanut allergy, and have resulted in dozens of deaths over the past 15 years. In other parts of the world, such as Korea, China and Israel, the rate of peanut allergy is much lower than that of Westernized countries.

Some researchers think that the lower rate of peanut allergy in these countries might have to do with how peanut is processed. In Westernized countries, peanuts are commonly dry roasted; in non-Westernized countries, however, peanuts are often boiled, fried or even pickled. These different forms of processing likely alter how a body reacts to the peanut allergen.

How Processing and Cooking Changes Peanut Allergy

There are 3 major peanut allergens that have been described, called Ara h 1, Ara h 2 and Ara h 3. People living in the United States (U.S.) with peanut allergy most commonly are allergic to Ara h 2, especially those people with the more severe forms of peanut allergy. It appears that the major peanut allergens are altered by how peanuts are processed when compared to raw peanuts. Roasting peanuts enhances how IgE antibodies react to Ara h 2, which could explain why people in the U.S. tend to have more common and more severe allergic reactions to peanuts. On the other hand, roasted peanuts are rarely eaten in Korea, where it is more common to eat pickled, boiled or fried peanuts, which seems to reduce the ability of Ara h 2 to act as an allergen.

For this reason, it's likely that peanut allergy, especially severe forms, tend to be more common in Westernized countries compared to Asian countries.

Is There Currently a Cure for Peanut Allergy?

Not really. There are a number of small studies focusing on the use of oral immunotherapy for the treatment of peanut allergy. These studies involve giving increasing amounts of peanut flour (often in gelatin capsules) to swallow on a daily basis, for a period of weeks to months. After this time period, an oral challenge to peanut is used to determine how much peanut the person could then tolerate without experiencing an allergic reaction. A few studies have shown that after children had undergone oral immunotherapy to peanut for many months, they could then eat a large amount of peanuts (approximately 20) without experiencing an allergic reaction. Unfortunately, almost all of these children experienced some form of allergic reaction during the course of the oral peanut immunotherapy.

In addition to the symptoms of anaphylaxis that have been reported to occur in the majority of children undergoing oral peanut immunotherapy, there are a growing number of reports of children developing eosinophilic esophagitis as a side effect of the oral immunotherapy. Therefore, as a result of the frequent, sometimes severe side effects of oral peanut immunotherapy, as well as the question of how long the benefit of the immunotherapy will last, it is not recommended for use outside of a clinical research setting. This therapy is not ready to be offered by community allergists, and should only be offered by major universities or allergy training centers, or as part of a research study.

Experts on food allergies have concluded, "peanut oral immunotherapy represents a promising, potentially disease-modifying therapeutic approach for the management of IgE-mediated peanut allergy. However, currently there is insufficient evidence in terms of long-term effectiveness, safety and cost-effectiveness of peanut oral immunotherapy to recommend its routine use in clinical practice."

Could Boiling Peanuts Lead to a Cure for Food Allergies?

Possibly. Past studies have shown that through extensive heating, certain foods such as milk and egg lose their ability to cause allergic reactions. Most people with milk and egg allergy tolerate these foods when they are extensively heated. When extensively heated egg and milk is frequently eaten by people with egg and milk allergy, their food allergy is more likely to be outgrown, and at an earlier age.

A recent study, performed on 4 children with peanut allergy, followed this same logic in an attempt to cure their peanut allergy. The children ate boiled peanuts in increasing amounts, everyday, over the course of many months. After a period of many months, some of the children were able to eat raw peanuts. As is the case with eating extensively heated milk and egg, eating boiled peanuts – with the decreased amount of Ara h 2 – may lead to the development of oral tolerance. While many more studies are needed, eating boiled peanuts may be the key to a cure for peanut allergy. 

If you suffer from peanut allergy, it is very important that you do not try eating boiled peanuts without speaking with your allergy physician first. The above mentioned study only included a small number of patients, and severe life-threatening allergic reactions may occur with eating boiled peanuts for people with peanut allergy.

 

Sources:

Turner PJ, et al. Loss of Allergenic Proteins During Boiling Explains Tolerance to Boiled Peanut in Peanut Allergy. J Allergy Clin Immunol. In Press.

Sampson HA. Peanut Oral Immunotherapy: Is It Ready for Clinical Practice. J Allergy Clin Immunol. 2013;1:15-21.

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