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Nutrition therapy in peanut allergy

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Summary

Background

The diagnosis “peanut allergy” is often frightening for affected persons and their families because it is perceived as life-threatening much more often than allergies to other foods. In order to be able to realistically assess risks, alleviate or dispel emerging concerns, and effectively counteract the feeling of being powerless over this diagnosis, good education, integration of affected families into existing structures, and their support in everyday life are needed.

Results and discussion

Effective disease management in (peanut) allergy is based on four pillars: (a) a confirmed diagnosis, (b) knowledge about the occurrence of peanut—especially in processed form, (c) situational risk assessment as a basis for individual avoidance strategies that promise the greatest possible safety, but at the same time do not restrict the quality of life more than necessary, and (d) learning to deal adequately with unforeseen incidents (emergency management) to avoid severe allergic reactions.

Conclusion

This requires close cooperation between pediatricians or allergists, allergy-experienced nutritionists or dieticians and ideally psychologists. Furthermore, the membership of a patient organization and the participation of affected persons and their environment in training measures (e.g. anaphylaxis training) is useful.

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References

  1. Roberts G, Ollert M, Aalberse R, Austin M, Custovic A, DunnGalvin A, et al. A new framework for the interpretation of IgE sensitization tests. Allergy. 2016;71:1540–51.

    Article  CAS  Google Scholar 

  2. Du Toit G, Roberts G, Sayre PH, Bahnson HT, Radulovic S, Santos AF, et al. Randomized trial of peanut consumption in infants at risk for peanut allergy. N Engl J Med. 2015;372:803–13.

    Article  CAS  Google Scholar 

  3. Worm M, Reese I, Ballmer-Weber B, Beyer K, Bischoff S, Claßen M, et al. Guidelines on the management of IgE-mediated food allergies. S2k-Guidelines of the DGAKI in collaboration with the AeDA, the BVKJ, the DAAB, DDG, the DGE, the DGVS, the German Society for Oto-Rhino-Laryngology, Head and Neck Surgery, the DGKJ, the GPA, the DGP, the GPGE, DKG, the ÖGAI, the VDOE and the AWMF. Allergo J Int. 2015;24:256–93.

    Article  Google Scholar 

  4. Venter C, Mazzocchi A, Maslin K, Agostoni C. Impact of elimination diets on nutrition and growth in children with multiple food allergies. Curr Opin Allergy Clin Immunol. 2017;17:220–6.

    Article  Google Scholar 

  5. Reese I. Karenz und Toleranz – ein Balanceakt bei Nahrungsmittelallergien. Pädiatr Allergol. 2018;1:29–31.

    Google Scholar 

  6. Reese I. Ernährungstherapie bei Nahrungsmittelallergien [Dietary management of food allergies]. Bundesgesundheitsblatt Gesundheitsforschung Gesundheitsschutz. 2016;59:849–54.

    Article  Google Scholar 

  7. Eigenmann PA, Ebisawa M, Greenhawt M, Hourihane JOB, Perry TT, Remington BC, et al. Addressing risk management difficulties in children with food allergies. Pediatr Allergy Immunol. 2021; https://doi.org/10.1111/pai.13455.

    Article  PubMed  PubMed Central  Google Scholar 

  8. Grabenhenrich LB, Dolle S, Moneret-Vautrin A, Kohli A, Lange L, Spindler T, et al. Anaphylaxis in children and adolescents: the European Anaphylaxis Registry. J Allergy Clin Immunol. 2016;137:1128–1137.e1.

    Article  Google Scholar 

  9. Pouessel G, Balerdi M, Lejeune S, Deken V, Dubos F, Antoine M, et al. Recurrent food anaphylaxis and risk factors in children. Pediatr Allergy Immunol. 2020; https://doi.org/10.1111/pai.13429.

    Article  PubMed  Google Scholar 

  10. Maris I, Dölle-Bierke S, Renaudin JM, Lange L, Koehli A, Spindler T, et al. Peanut induced anaphylaxis in children and adolescents: data from the European Anaphylaxis Registry. Allergy. 2020; https://doi.org/10.1111/all.14683.

    Article  PubMed  Google Scholar 

  11. Arkwright PD, MacMahon J, Koplin J, Rajput S, Cross S, Fitzsimons R, et al. Severity and threshold of peanut reactivity during hospital-based open oral food challenges: an international multicenter survey. Pediatr Allergy Immunol. 2018;29:754–61.

    Article  Google Scholar 

  12. Acaster S, Gallop K, de Vries J, Ryan R, Vereda A, Knibb RC. Peanut allergy impact on productivity and quality of life (PAPRIQUA): Caregiver-reported psychosocial impact of peanut allergy on children. Clin Exp Allergy. 2020;50:1249–57.

    Article  Google Scholar 

  13. Reese I, Schäfer C, Werfel T, Worm M. Diätetik in der Allergologie. 5th ed. München-Deisenhofen: Dustri-Verlag Karl Feistle; 2017.

    Google Scholar 

  14. Amtsblatt. L304/18 Verordnung (EU) Nr. 1169/2011 des Europäischen Parlaments und des Rates vom 25. Oktober 2011 (betreffend die Information der Verbraucher über Lebensmittel)

  15. Verbraucherzentrale H. Verbraucherzentrale Hamburg: Allergisch und allein gelassen.. www.vzhh.de/themen/lebensmittel-ernaehrung/mogeleien-restaurants/allergisch-allein-gelassen. Accessed 20 Apr 2021

  16. Galenko L, Trendelenburg V, Bellach J, Schnadt S, Niggemann B, Beyer K. P18: Nachweis relevanter Mengen an Kuhmilchprotein in Backwaren vom Bäcker – trotz neuer gesetzlichen Reglung der Allergenkennzeichnung für lose Ware. P18 Deutscher Allergie Kongress 2016 Berlin. Allergo J Int. 2016;25:177.

    Google Scholar 

  17. Reese I, Holzhauser T, Schnadt S, Dölle S, Kleine-Tebbe J, Raithel M, et al. Allergen and allergy risk assessment, allergen management, and gaps in the European Food Information Regulation (FIR). Allergo J Int. 2015;24:180–4.

    Article  Google Scholar 

  18. Schnadt S, Reese I. Möglichkeiten und Grenzen der Allergeninformation. AL. 2016;39:402–8.

    Article  Google Scholar 

  19. Schnadt S, Pfaff S. „Versteckte Allergene“ in vorverpackten Lebensmitteln. Bundesgesundheitsblatt Gesundheitsforschung Gesundheitsschutz. 2016;59:878–88.

    Article  Google Scholar 

  20. Schryver SD, Clarke A, Vieille SL, Eisman H, Morris J, Lim R, et al. Food-induced anaphylaxis to a known food allergen in children often occurs despite adult supervision. Pediatr Allergy Immunol. 2017;28:715–7.

    Article  Google Scholar 

  21. Kansen HM, Le T‑M, Knulst AC, Gorissen DMW, van der Ent CK, Meijer Y, et al. Three-year follow-up after peanut food challenges: accidental reactions in allergic children and introduction failure in tolerant children. J Allergy Clin Immunol. 2020;145:705–707.e7.

    Article  Google Scholar 

  22. Cabanillas B, Jappe U, Novak N. Allergy to peanut, soybean, and other legumes: recent advances in allergen characterization, stability to processing and IgE cross-reactivity. Mol Nutr Food Res. 2018; https://doi.org/10.1002/mnfr.201700446.

    Article  PubMed  Google Scholar 

  23. Chan ES, Greenhawt MJ, Fleischer DM, Caubet JC. Managing cross-reactivity in those with peanut allergy. J Allergy Clin Immunol Pract. 2019;7:381–6.

    Article  Google Scholar 

  24. Couch C, Franxman T, Greenhawt M. Characteristics of tree nut challenges in tree nut allergic and tree nut sensitized individuals. Ann Allergy Asthma Immunol. 2017;118:591–596.e3.

    Article  CAS  Google Scholar 

  25. Brough HA, Caubet JC, Mazon A, Haddad D, Bergmann MM, Wassenberg J, et al. Defining challenge-proven coexistent nut and sesame seed allergy: a prospective multicenter European study. J Allergy Clin Immunol. 2020;145:1231–9.

    Article  Google Scholar 

  26. Hourihane JO, Allen KJ, Shreffler WG, Dunngalvin G, Nordlee JA, Zurzolo GA, et al. Peanut Allergen Threshold Study (PATS): novel single-dose oral food challenge study to validate eliciting doses in children with peanut allergy. J Allergy Clin Immunol. 2017;139:1583–90.

    Article  CAS  Google Scholar 

  27. Dua S, Ruiz-Garcia M, Bond S, Durham SR, Kimber I, Mills C, et al. Effect of sleep deprivation and exercise on reaction threshold in adults with peanut allergy: A randomized controlled study. J Allergy Clin Immunol. 2019;144:1584–1594.e2.

    Article  Google Scholar 

  28. DunnGalvin A, Blumchen K, Timmermans F, Regent L, Schnadt S, Podestà M, et al. APPEAL-1: A multiple-country European survey assessing the psychosocial impact of peanut allergy. Allergy. 2020;75:2899–908.

    Article  Google Scholar 

  29. DunnGalvin A, Gallop K, Acaster S, Timmermans F, Regent L, Schnadt S, et al. APPEAL-2: A pan-European qualitative study to explore the burden of peanut-allergic children, teenagers and their caregivers. Clin Exp Allergy. 2020;50:1238–48.

    Article  Google Scholar 

  30. Reese I, Ahrens B, Ballmer-Weber B, Beyer K, Blümchen K, Doelle-Birke S, et al. Is the concept of “peanut-free schools” useful in the routine management of peanut-allergic children at risk of anaphylaxis? Position paper of the Food Allergy Working Group of the DGAKI. Allergo J Int. 2020;29:169–73.

    Article  Google Scholar 

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Authors and Affiliations

  1. Ernährungsberatung und -therapie Schwerpunkt Allergologie, Ansprenger Straße 19, 80803, Munich, Germany

    Imke Reese & Sabine Schnadt

  2. Deutscher Allergie- und Asthmabund e. V., Mönchengladbach, Germany

    Imke Reese & Sabine Schnadt

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  1. Imke Reese
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  2. Sabine Schnadt
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Correspondence to Imke Reese.

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Conflict of interest

I. Reese states to have received honoraria from the DAAB—outside the present work. S. Schnadt declares that she has no competing interests.

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Reese, I., Schnadt, S. Nutrition therapy in peanut allergy. Allergo J Int 30, 282–286 (2021). https://doi.org/10.1007/s40629-021-00176-4

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