Talk:Peanut allergy

Wiki Education Foundation-supported course assignment

This article is or was the subject of a Wiki Education Foundation-supported course assignment. Further details are available on the course page. Student editor(s): Willwu22, MikeChristie94!, Nasztalos. Peer reviewers: Ben893, Bethany.ricker, Naveen Sivaranjan 8. 20:58, 19 January 2022 (UTC)

Removed horribly broken English part of article

I removed a part of the article that was borderline incoherent and clearly written by a semi-literate person. The passage was unsalvageable and its absence will not be missed.

new ref on death stats

Can we find the actual CDC numbers, instead of leaving up a reference to someone talking about them on a tv show?  :-) (the tv ref is also munged a bit) Asbruckman (talk) 02:42, 13 April 2008 (UTC)

I

I think that the comment about eating peanuts causing your kids to have peanut allergies should be removed until a reference can by found for this. Tom Hubbard 22:44, 11 October 2006 (UTC)

• Agreed. This strange claim shouldn't have been made without citations in the first place. I'm pulling it off. Glaucus 02:59, 13 October 2006 (UTC)
• Agreed. The claim has zero credibility without a sources and just works to discredit everything else. Danyak501 22:21, 27 October 2006 (UTC)

There are two links that are broken in this article: reference 17 and reference 22. I suggest removing or updating. ShinobiNoKami (talk) 17:39, 15 May 2010 (UTC)ShinobiNoKami

Blood Transfusion of Peanut Alergy

I work at a Blood Center and I saw a posting in one of the labs about an 80 year old woman having a severe alergic reaction to peanuts with out any prior peanut allergy. When investigated, it was discovered that one of the units of blood the woman had recently recieved was from a young woman with a peanut alergy. I'm not much in the mood for research or editing these articles, but it's still something that I think might be worth mention as it is information about peanut alergies. MCP 16:50, 20 September 2007 (CST)

Percentage of kids who outgrow allergies

In the article for "peanuts" here on wikipedia there is a section about peanut alergies, in that section the percentage is diffrent.

Acceleration

Article would benefit from a section discussing frequency of peanut allergy over time. This of course will be unavailable data for much of the world, but whatever can be located should be. Anecdotally it has been reported peanut allergy has increased a lot in the last ten years. This would be a good place to debunk the notion or document it. Tempshill 21:55, 2 November 2006 (UTC)

Anyone have any idea why peanut allergies are virtually unheard of outside the western world? Exploding Boy 08:36, 19 November 2006 (UTC)

roasting, not boiling

The article from Science News gives an indication of a likely reason: sensitivity is mediated by exposure while the immune system is still "programming" itself as to what is self vs other. Combine that with the recent (last 10-20 years) advice against exposure until 3 or 4 in certain countries (that now have rising rates of peanut allergies), and you have a setup that's perfect for making the problem worse. The mis-understanding may have been caused by some studies that (correctly, perhaps) indicated that heavily-at-risk children (genetic pre-disposition) benefit from avoiding it at a young age. Unfortunately that doesn't necessarily mean that all children benefit from avoiding exposure. jesup (talk) 01:28, 24 March 2009 (UTC)

¶ I would very much like to know why peanut allergy was virtually unheard of when I was young, was regarded as rare 45 years ago, and now seems to be a substantial population. What causes the allergy - and why do its numbers seem to grow exponentially? Sussmanbern (talk) 22:23, 27 October 2013 (UTC)

Deaths Section Misleading

As the article is currently written, the inclusion of one 'famous death' that isn't really a peanut-related death strikes me as misleading. It sort of implies that deaths from peanut allergies are over-reported/don't happen. It would be nice if we could put in some stats on how many people really do die from peanut allergy. Or failing that, just take the famous deaths section out.... What do you all think? Asbruckman 17:48, 5 June 2007 (UTC)

Increased risk of death for patients with both asthma and peanut allergy?

There is published research that looked at fatalities involving food allergies which indicates that patients with both asthma and peanut allergies were at greater risk. published article abstract of research I'm new to wiki ... Is this something we'd want to add? Allergy-mom 16:30, 18 July 2007 (UTC)

Yes, I think that sounds very relevant! Asbruckman (talk) 01:51, 17 September 2008 (UTC)

Exclusive to North America?

Someone was telling me that peanut allergies aren't found anywhere in the world other than North America. Is this true?

• This is not true. Peanut allergy does, however, seem to be a side affect of "westernized" societies.--Shogun 220 05:36, 11 January 2007 (UTC)

• • This IS true. UNICEF uses a peanut based food product for its famine relief programs, with no reported allergic reactions. Even the "allergy experts" claim that it is not the peanut that causes the reaction, that it is the way it is processed. The peanut allergy issue, along with many other allergy issues are a cultural psychosomatic issue based in America. There should be a peanut allergy myth section.

• • There are other developed countries besides America. I just talked to a guy today who is from england and is allergic to peanuts. There are certainly people outside of North America who are allergic to peanuts. I've heard it suggested that the reason for more allergies among developed nations is that allergies are the result of an over active immune system, and an over active immune systems are more likely to prevent cancer. people living in developed countries are more likely to live longer, and thus an overactive immune system is more of a benefit to them, and thus people who've lived in such cultures for long periods of time may have even developed the beneficial allergic reactions through natural selection. --nairbv —Preceding unsigned comment added by 69.65.110.19 (talk) 06:44, 18 April 2008 (UTC)

• • • That's complete nonsense. 65.41.92.123 (talk) 03:53, 15 May 2008 (UTC)

• Well, I don't have a reference on this, but my son's allergist told me that rice allergies are rare in the US but much more prevalent in Asia. I imagine peanuts are the same thing--higher incidence where the food is eaten more often. Asbruckman (talk) 02:04, 17 September 2008 (UTC)

I've always thought these allergies were somehow related to the use of GMOS, that would explain the high rate of peanut allergies in North America.69.248.21.130 (talk) 21:51, 26 November 2008 (UTC)

• • I'm afraid you've always thought wrong then; peanut allergies predate GMOs, and so far as I can find out no one is selling GMO peanuts, let alone doing so in the US. There are much better explanations for the prevalence in the US - combination of wider exposure (increased chances of an allergic person being exposed) and later initial exposure at the recommendation of well-meaning pediatricians. (See Science News, linked in Causes.) jesup (talk) 01:33, 24 March 2009 (UTC)

• • • I would not call this "complete nonsense" .... My logical explanation is simply that the US educate its population and physicians too well about the "incurability" and danger of peanut allergy, so any kids who breaks out in hives, automatically get skin prick tested for peanut allergy. If positive, you give him an epipen, and tells him to completely avoid peanut obsessively. Thus resulting in very high anti peanut IGE levels in these kids, and fulfilling the prophecy of a dangerous allergy. Whereas, in other countries, kids with the hives just scratches, and are given more peanuts.... Eventually, the parents complete the Rush immunotherapy on the child unknowingly, creating anti-IgE IgG antibodies.... and the child grow up eating peanuts without problems. I have a son with peanut allergy, and my gut feeling is - he can be desensitized easily with oral desensitization. But we have not gotten around to doing it. The second theory is - in third world countries, children are so overwhelmed with intestinal parasites, that the body doesn't seem to mind the peanut allergens.... Thus, the dirtier your child lives, the less likely he'll have asthma, seasonal allergies, and food allergy. My guess is - 90% of peanut allergy suffered, if left muching on m & ms and eating chinese food, will complete their own Rush oral immunotherapy and becomes "cured" of their allergy. <spahttp://www.babble.com/CS/blogs/strollerderby/archive/2008/12/18/death-by-peanut-epidemic-or-urban-myth.aspxn style="font-size: smaller;" class="autosigned">—Preceding unsigned comment added by 69.47.64.172 (talk) 02:16, 26 November 2009 (UTC)

^ This is dangerous talk. It may work for this person and their child but anyone affected by the allergy knows all too well that desensitation is not a viable option for many affected persons. Of course this comment comes from someone who has never and will never experience the reaction. This is not a "gut feeling" type of thing; Speak with your doctor. My point is - DO NOT TRY THIS AT HOME IF YOU CARE ABOUT YOUR CHILD. UselessToRemain (talk) 18:33, 27 July 2012 (UTC)

• • • If peanuts are cuasing a bio-chemical reaction, why can't they identify the chemical compound? Why would Epinephrine help resolve a poison? Why can't they present a double-blind study showing that peanuts secreted into someone's food will cause a reaction? Here is an article that should be posted:

http://www.babble.com/CS/blogs/strollerderby/archive/2008/12/18/death-by-peanut-epidemic-or-urban-myth.aspx

^ This is a good question regarding the chemical compound. Some scientific phenomena are not yet explained. Where is it said that the epinephrine is prescribed to resolve a poison? Epinephrine acts as a bronchodilator after a severe reaction, allowing the individual to regain the ability to breathe through the mouth. If the airways to from both the mouth and nose to the lungs are closed off, death can occur(especially in older individuals). Such a study might set a dangerous precedent. UselessToRemain (talk) 18:33, 27 July 2012 (UTC)

http://en.wikipedia.org/wiki/Peanut_allergy#Injected_peanut_desensitization < - This answers the question about the study better than I can. UselessToRemain (talk) 18:52, 27 July 2012 (UTC)

Leading Cause of Death

I think I heard somewhere that peanut allergies in teenagers is the leading cause of death from food allergy. Anyone got a reference? Asbruckman 18:58, 5 December 2006 (UTC)

I don't have a reference, but my allergist told me that one common reason is that they consume food made with peanut oil (which doesn't necessarily have protein in it when used to make, for example, potato chips, and the protein is what triggers allergies - I'm 90% sure of this) and they believe that they are not allergic to peanuts anymore. They then stop being careful because they think they don't have to be anymore, and when they later reacted to the nut protein in a whole nut they wouldn't have adrenaline at hand.

Another reason why there are accidental fatalities attributed to peanuts is cross-contamination. I have read about people who have died because they played with a basketball that had been previously handled by someone who had just eaten a peanut butter sandwich, and a girl who was killed because her boyfriend had eaten a peanut product and then kissed her.

I hope these are at least remotely helpful - maybe this can be useful fact confirmation-wise if someone else has heard of these stories. BlueStarz 06:59, 4 January 2007 (UTC)

Severity

Today's [The Gazette (Cedar Rapids)|Cedar Rapids Gazette] has an article about peanut-butter alternatives for school lunches because many local schools have banned all peanut products the the point kids aren't even allowed to bring them for lunch. Are there many peopel who are allergic to peanuts to the point where it would be dangerous to sit next to someone who was eating peanut butter? Ace of Sevens 15:28, 21 August 2007 (UTC)

Not sure about how many it is but this exists for sure. The severity of the danger would depend on the individual, ranging from minor annoyance to breathing restriction. When speaking of elementary age kids, it's probably best to use more caution than not. UselessToRemain (talk) 23:52, 27 July 2012 (UTC)

The "Allergies" Section of the Peanut article is better than this article

How about switching the two around? (while leaving some details in this article) —Preceding unsigned comment added by VTNC (talk • contribs) 07:51, 16 December 2007 (UTC)

Myth?

I came to this article after hearing one person explain to me that children who are exposed to peanuts through their mother while in the womb are more likely to contract a peanut allergy. This sounds fishy to me. I was hoping to find some research here on possible causes for the perceived increase in peanut allergy cases. Does anyone know if there is any credible research of that kind? --Thaddius (talk) 17:09, 6 March 2008 (UTC)

• I don't think there is research. Just simply observation that gluten hypersensitivity was associated with early infantile feeding of cereal. Then the rest of it is extrapolation. —Preceding unsigned comment added by 69.47.64.172 (talk) 12:11, 30 November 2009 (UTC)

comorbidity

I have had a peanut allergy since childhood and have also had much milder allergic reactions to peas. My allergist told me at one point that this occured because both foods come from the legume family. I would be curious to see data on rates of coincidence of the two. —Preceding unsigned comment added by 130.184.85.102 (talk) 05:40, 8 March 2008 (UTC)

Family Guy

Meg Griffin's death by peanuts: She's a FICTIONAL character. This should be notated somehow, or removed. Imogenne (talk) 16:38, 4 August 2008 (UTC)

Needs more information on mechanism

This article needs more information on what actually causes the allergy. A peanut is just a peanut. Which proteins or other substances are responsible for the reaction? -Rolypolyman (talk) 13:53, 10 September 2008 (UTC)

Possible references

From a discussion on my talk page [1] --Ronz (talk) 16:15, 10 January 2009 (UTC)

External links

• Allergy and Allergies Agency (UK)
• Allergy/Asthma Information Association (Canada)
• Allergy New Zealand
• Allergy UK
• Anaphylaxis Australia
• Anaphylaxis Campaign (UK)
• Food Allergy and Anaphylaxis Network (USA)
• Food Allergy Initiative (USA)
• Internet Symposium on Food Allergens
• Mayo Clinic (USA)
• World Allergy Organization

Books and articles

• The Complete Peanut Allergy Handbook, by Dr. Scott H. Sicherer, with Terry Malloy
• The Peanut Allergy Answer Book, by Dr. Michael C. Young
• The Sprouted Peanut Vaccine and Other Stories, by Billy Adam Gottlieb
• Peanut allergy: where do we stand?, by Dr. John Weisnagel
• Peanut allergy: an overview, by Saleh Al-Muhsen, Ann E. Clarke, and Rhoda S. Kagan

Much improved!

Hey, this article has gotten so much better! Very nice! Can we move it from 'starter class' to something higher on the scale? Asbruckman (talk) 01:48, 25 April 2009 (UTC)

Upgraded to C-class, although many of the refs are incomplete - lacking hyperlinks to the abstract at PubMed. Starting to repair. David notMD (talk) 18:11, 18 October 2017 (UTC)

Your input sought on References and External Links

Two editors have been discussing this, and could benefit from your input.

There's a proposal, modeled on the Wikipedia Cancer article, to add as General References, after the References, for readers to find more comprehensive information, the three main science books on the topic, at their publishers' sites:

• The Complete Peanut Allergy Handbook, by Dr. Scott H. Sicherer, with Terry Malloy
• The Peanut Allergy Answer Book, by Dr. Michael C. Young
• The Sprouted Peanut Vaccine and Other Stories, by Billy Adam Gottlieb

... and to have as the External Links the main international allergy organization and one major allergy group from each English-speaking country where one exists, so that readers can find local services:

• Allergy/Asthma Information Association (Canada)
• Allergy New Zealand
• Allergy UK
• Anaphylaxis Australia
• Food Allergy and Anaphylaxis Network (USA)
• World Allergy Organization

The full details of the discussion are at [2], under Peanut Allergy article, external links. Thanks for your input.Wikiabilly (talk) 04:56, 23 January 2009 (UTC)

Sorry I haven't commented sooner. In general, we want editors adding content, not external links. The References section is for - references used in the article. Since these are not references, they should not be indicated as such. See WP:EL and WP:NOTLINK. (More to follow.) --Ronz (talk) 19:25, 3 February 2009 (UTC)

Also, see WP:DR for ways to get other editors' opinions. --Ronz (talk) 19:26, 3 February 2009 (UTC)

If they're to be included at all, the proposed General References should be formatted in cite book format, without the promotional links, and included in a Further reading section. That would make it easy for editors to then use them as references in the future. --Ronz (talk) 19:51, 3 February 2009 (UTC)

No problem about the delay. Thanks for your input again. Citing the books as Further reading makes sense. I would include the links, however, so visitors can follow-up.

I appreciate your experience with the Wikipedia process.

In terms of the content of the article, important issues remain; many of these I've asked about and not received a reply.

• The proposed book links proposed are comprehensive, not selective (all 3 of 3 books out there), so there should be no room for CoI;
• The book and group links do something good for the public that the current random smattering of links does not: direct them to the only sources more completely informative than the WP Peanut Allergy article, and to their closest local service group;
• No rationale has been given for how the existing links got chosen, in terms of the research that went into them or the credentials of the author;
• Given my training and extensive study of this matter, I am in a position to verify that the proposed information is comprehensive and representative.

More about this on your talk page.24.68.79.46 (talk) 04:33, 12 February 2009 (UTC)

Recent articles about cures of the allergy via desensitization

This section should not turn into a "how-to" which might prompt people to try it on their own without medical supervision. See [3] for a recent summary of the research from CBS News. Edison (talk) 23:37, 8 September 2010 (UTC)

Routes of Exposure

I think some information about common beliefs and empirically gathered data is needed regarding routes of exposure. For example, there are those claim that systemic anaphylaxis can be triggered in allergic individuals by merely touching peanut products, smelling them, or being in the same vicinity. There is a lot of social interest in such claims because in some areas such as schools it has resulted in facility-wide bans on all peanut products, and these have draw criticism as overreaction.Legitimus (talk) 02:16, 2 November 2010 (UTC)

History

Recent TV show indicates peanut allergies were suspected as far back as the 1890s. AMCKen (talk) 01:52, 31 August 2011 (UTC)

Misconceptions about Peanut Allergies

As a person with a severe peanut allergy, I would like to see some information regarding the misconceptions held by society regarding peanut allergies, and the common mistake of grouping peanut allergies with nut allergies when they are so very different. What percentage of people with peanut allergies also have nut allergies, or vice versa? What items in the legume family have also been known to be allergens for people with peanut allergies?

Sandréna (talk) 14:40, 19 September 2011 (UTC)

Amusing

"Not to be confused with Peanut gallery." Hahaha, I mean, really?

No, but seriously.... really?! --Atommalac (talk) 15:59, 18 June 2012 (UTC)

Introduction

I'm attempting to re-organize the introductory paragraphs for the article. Feel free to let me know if there are any issues with the information. News Team Assemble!^[talk?] 02:57, 7 April 2014 (UTC)

Sublingual immunotherapy desensitization

I'm adding a section on "Sublingual immunotherapy desensitization" for review. News Team Assemble!^[talk?] 11:59, 16 April 2014 (UTC)

I wrote a section on "Epicutaneous immunotherapy desensitization" for review. I also removed tone, citation, and essay notices. Should the "Peanut butter alternatives" be removed? I think this section gets off topic. Let me know what you think. News Team Assemble!^[talk?] 03:56, 22 April 2014 (UTC)

I removed the "Peanut butter alternatives" section. I think it goes off topic as a reader. Please let me know if you think it should be reinserted. News Team Assemble!^[talk?] 04:39, 23 April 2014 (UTC)

Nuts?

The paragraph before the section 'Prevalence' uses the term "nuts" instead of peanuts. As peanuts are not actually a type of nut this is unclear, does it refer to nuts or to peanuts? If not to peanuts why is it in this article? 86.128.240.4 (talk) 23:18, 8 May 2014 (UTC)

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Research section - premature mention of hypoallergenic peanuts?

Anyone else feel that the mention of creating hypoallergenic peanuts by enzyme treatment is premature? There are no published clinical trials. There is one trial listed at www.clinicaltrials.gov as 'Completed' but does not show up as published. "Evaluation of Allergenicity of Hypoallergenic Peanut Product in Peanut Allergic Subjects" David notMD (talk) 01:33, 25 October 2017 (UTC)

Agree and removed. Doc James (talk · contribs · email) 02:10, 25 October 2017 (UTC)

Proposed Edits

Hello, we are a group of medical students editing this page as part of our class assignment. We have compiled a list of suggestions to improve this article and would appreciate community feedback before we proceed with these edits. Here is a list of our suggestions:

1. Society and culture: We propose that the following sentence is added “The high severity of peanut allergy reactions, as well as the increasing prevalence of peanut allergy in the Western world have led to widespread public attention. As a result, many school policies within North America have been implemented to completely ban the presence of all peanuts and tree-nuts in schools. However, it remains unclear whether the complete ban of peanuts and tree-nuts in schools is warranted, in comparison with the potential decrease in quality of life associated with food bans.

Suggest search for additional sources on this topic, MEDRS-quality if possible, but also global health or major media reports. --Zefr (talk) 18:47, 5 November 2017 (UTC)

@Zefr thank you for your feedback. I have added an additional source from the US Department of Health and Human Services. Willwu22 (talk) 18:05, 10 November 2017 (UTC)

While the CDC is often an excellent source, that long document seems unwieldy for the common online user to review (see WP:NOTJOURNAL #7-8), and seems not to discuss peanut allergy specifically. This is a briefer version and this NIH news release with its internal links may be helpful. Please remember to sign your comments with the pen icon above the edit box or 4 tildes. --Zefr (talk) 16:49, 9 November 2017 (UTC)

@Zefr that it a good point, the official CDC document is quite long and I have replaced it with the two (more condensed) sources that you suggested. Thank you for your suggestion!--Willwu22 (talk) 18:05, 10 November 2017 (UTC)

2. In the epidemiology section: “Peanut allergies in the Western world are more common among non-white, minority populations.”

This seems inconsistent with some sources, e.g., this, Table 3, which indicate higher incidence among whites. Suggest a more thorough review of literature, then include and discuss disparate research findings. --Zefr (talk) 18:47, 5 November 2017 (UTC)

@Zefr, thank you for this additional source. You are correct, this information conflicts with the source I referenced here. Because this point would require a more thorough review of literature, I will refrain from implementing this edit at this time. Bethany.ricker (talk) 17:13, 8 November 2017 (UTC)

3. In epidemiology, “In Western countries, the incidence of peanut allergy is between 1-3%. There has been a sudden increase in number of cases in the past 10-15 year period.

• This looks like it was a mistake in the PMID. I have alerted the group to revisit this. Thanks for noticing it @Zefr:JenOttawa (talk) 03:08, 6 November 2017 (UTC)

COMMENT: Now your #3 an #5 are the same citation. Fleischer is the first author on six or seven articles all with the same title (VERY ANNOYING), so if you mean to cite two different articles, make sure the PMIDs you use to create the citations are not identical. Otherwise, use the repeated use of a citation format. David notMD (talk) 20:48, 6 November 2017 (UTC)

COMMENT: Thanks for pointing out, it is supposed to be the same reference - we will make change! MikeChristie94! (talk) 23:36, 7 November 2017 (UTC)

4. We propose to add an “Outcomes” subsection under the “Treatment” section, as this subsection is recommended in Wikipedia’s suggested outline for articles on diseases, disorders, or syndromes.  This subsection would contain the following: “In terms of the natural history of one’s allergy to peanuts, this allergy tends to resolve in childhood less often than allergies to soy, milk, egg, and wheat. Accordingly, re-evaluation of peanut allergy is recommended on a yearly basis for young children with favourable previous test results, and every few years or longer for older children and adults."

Under Conclusions: this seems worth developing in discussion, " it cannot be determined how much of the increases in estimates are truly attributable to increases in clinical disease and how much are attributable to increased awareness by physicians, other health care providers, and parents" --Zefr (talk) 18:47, 5 November 2017 (UTC)

@Zefr, I am not sure we are speaking about the same topic. My proposed addition was in relation to the natural history of peanut allergy, i.e. whether someone with peanut allergy will ever “outgrow” it, which is a topic that falls under “outcomes of the disease”. There is evidence to suggest that allergies to soy, milk, egg, and wheat are more likely to resolve in childhood, whereas allergies to peanut resolve less often. This influences decisions surrounding the frequency with which a physician would want to re-evaluate the patient’s allergy. I was not referring to an increase in prevalence of peanut allergy, as I think you were suggesting. Please correct me if I am misunderstanding you. Nasztalos (talk) 17:36, 8 November 2017 (UTC)

As the topic is about Treatment/Outcomes, it seems appropriate that misdiagnosis be ruled out and discussed in the article. In the Branum-Lucaks report I cited above, it is stated that "data are based on parental or proxy reports of food allergy rather than clinical diagnoses, which could potentially result in inflated estimates because it has been demonstrated that perceived food allergy is often misunderstood and overestimated, compared with clinically diagnosed food allergy." Such information affects not only diagnosis and incidence rates, but long-term progress with the allergy and its associated outcomes. --Zefr (talk) 18:46, 8 November 2017 (UTC)

I agree that inflated/inaccurate prevalence and incidence rates (as well as long-term outcomes of the disease) could result from parental reporting of the allergies rather than reporting based on clinical diagnosis; however, I don't believe that this issue necessarily fits within "Prognosis" (see comments re section title below). Perhaps this topic could be added to "Epidemiology" in the future. - Nasztalos (talk) 17:08, 10 November 2017 (UTC)

The right placement for individuals becoming tolerant would be in a section titled Prognosis. See Egg allergy for example. David notMD (talk) 21:05, 8 November 2017 (UTC)

Thank you. I will include this addition in a section entitled "Prognosis", which will be placed underneath the "Treatment" section. -Nasztalos (talk) 16:50, 10 November 2017 (UTC)

5. "The “Timing of exposure” section lacks specifics describing its evidence. We propose the following change: There is evidence that consuming peanut proteins between 4-11 months of age decreases the risk of developing peanut allergies by the age of 5 years in high risk infants by 11-25%.

• A referencing error? Please add correct PMID JenOttawa (talk) 03:08, 6 November 2017 (UTC)

COMMENT: Definitely a mixup on our end, reference changed! MikeChristie94! (talk) 23:36, 7 November 2017 (UTC)

6. We propose adding a section on how peanuts are cooked may act as a risk factor for peanut allergy. “Boiling peanuts acts to decrease IgE-binding capacity as the boiling processes causes loss of Ara h2, Ara h6, or Ara h 7 proteins. Furthermore, the structural folding of these proteins are also altered contributing to the decreased IgE-binding capacity. Alternatively, roasting peanuts lead to increased IgE-binding capacity compared to raw peanuts. Some proposed mechanisms are increased effects of Ara H 2 on trypsin inhibition leading to decreased digestibility and increased Ara h 8 stability both contributing to increased allergenicity."

7. Under the section entitled “Diet During Pregnancy”: The reference for the first sentence, Reference #15 (Frazier AL, Camargo CA, Malspeis S, Willett WC, Young MC. Prospective Study of Peripregnancy Consumption of Peanuts or Tree Nuts by Mothers and the Risk of Peanut or Tree Nut Allergy in Their Offspring. JAMA Pediatr. 2014;168(2):156–162. doi:10.1001/jamapediatrics.2013.4139) is a primary source, and should be removed. In place of that first sentence, we propose the following sentences: “The Canadian Pediatric Society and Canadian Society of Allergy and Clinical Immunology issued a joint statement in 2013, reaffirmed in 2016, in which they acknowledged there is conflicting evidence on whether maternal diet during pregnancy has any effect on development of allergies due to a lack of good studies. However, they recommended no restrictions be placed on maternal diet during pregnancy on the basis of allergy development, due to the general risk of malnutrition as an unintended consequence.”

8. I would like to propose that there be a “risk factors” subheading added under the “causes” section of the page. I would like to include the following under the “risk factors” section” “Infants with eczema, or atopic dermatitis, are at a higher risk of developing peanut allergy or sensitivity due to cutaneous exposure to peanut proteins.” .”

COMMENT: Never heard of it. But a search on cutaneous exposure peanut allergy turned up several articles, including Brough HA 2015 PMID 25457149. If your proposed review ref adequately describes the nature of cutaneous exposure, specific to presence/consumption of peanut products in the house, go for it. David notMD (talk) 01:30, 9 November 2017 (UTC)

We appreciate your time and gladly accept any feedback. Thank you. See after references

References

Preliminary feedback while your comments are reviewed and sources checked: 1) there's likely a better source for your statements under #3 and #5. Please review WP:MEDRS for a systematic review, meta-analysis, or association review similar to the one under #7 (URL now provided; preferred); 2) note WP:REFPUNCT, source comes after punctuation. Will review further and respond. --Zefr (talk) 19:25, 4 November 2017 (UTC)

COMMENTS: First, remember to sign your Talk content by typing four ~ after the end. Looks like the refs got messed up. #3 is 1989 cancer ref. As Z pointed out, you have a ref number between a period and a quotation mark. In my opinion premature to discuss processing (your item #6) so I recommend not adding that. And it was not clear from the abstract alone that it covers boiling versus roasting. I am ambivalent about your proposed item #7, as it seems general to all food allergy, not peanuts. And the mention of general risk of malnutrition feels like a digression. David notMD (talk) 19:29, 4 November 2017 (UTC)

DON'T DELETE TALK CONTENT To the students: Once you have added something in Talk and someone else has followed, do not go back and delete/add/change what you wrote, as this will turn the subsequent comments into nonsense. It is OK to add new content at the bottom. Style is to add one more : that the last comment so that your content is indented more. (If no one has commented after your content was added you have a window of opportunity to amend or delete it.) And remember to sign with four of ~ David notMD (talk) 00:04, 8 November 2017 (UTC)

COMMENTS: I was hoping you could elaborate on what you mean by premature. There seems to be a fair amount of literature on roasting and boiling impact on the allergenicity of peanuts. Do you think it would be more appropriate to include this section if we further supplemented this information with a deeper explanation? Furthermore, although the impacts of roasting and boiling are not discussed in the abstract the paper has sections dedicated to this topic.Naveen Sivaranjan 8 (talk) 17:16, 8 November 2017 (UTC)

I do not have free access to the complete article. For that reason I mentioned that all I can see is the abstract. A search on peanut allergy boiling roasting yielded Zhang 2016, Prusak 2014, Maleki 2014, Blanc 2011, Mondoulet 2005, Maleki 2003 and Beyer 2001. However, none of those are clinical trials, which if any existed, would still be considered primary research. For medical articles Wikipedia strongly prefers secondary literature (reviews, etc.). Unless you can add that level of literature, I stand by premature. In comparison, Immunotherapy is described in the Research section, but the basis for inclusion is multiple clinical trials and subsequent reviews. David notMD (talk) 20:01, 8 November 2017 (UTC)

RE:#7 The source used (PMID 24497783) falls into the category of “authoritative review articles, in statements and practice guidelines issued by major professional medical or scientific societies” since it originates from the Canadian Pediatric Society and Canadian Society of Allergy and Clinical Immunology. And while systematic reviews and meta-analyses are preferred I thought it could be a strength of the Wikipedia article to include some summarized information from those Societies to help make those recommendations a bit more accessible. With regards to the generality of the proposed sentences, the source article’s content is meant to cover peanut allergy as one of many allergies discussed in the guidelines, so I thought it would still be relevant. If the second proposed sentence is too much of a diversion then it could be removed. Ben893 (talk) 17:53, 8 November 2017 (UTC)

Yeah, I took umbrage at the second sentence. David notMD (talk) 20:01, 8 November 2017 (UTC)

Okay, I will limit the addition to the first sentence proposed: “The Canadian Pediatric Society and Canadian Society of Allergy and Clinical Immunology issued a joint statement in 2013, reaffirmed in 2016, in which they acknowledged there is conflicting evidence on whether maternal diet during pregnancy has any effect on development of allergies due to a lack of good studies.” Thank you for the feedback. Ben893 (talk) 17:57, 10 November 2017 (UTC)

Now refs 3 and 8 (Wood 2016) are identical. David notMD (talk) 03:49, 9 November 2017 (UTC)

Thank you, I have changed the reference format accordingly!Bethany.ricker (talk) 17:09, 9 November 2017 (UTC)

The Christakis statement in Society and culture section

Anyone else not happy with the Christakis statement and citation (from 2008) in the Society and culture section? It got huge amounts of press back in 2008-09 (do a Google search on Christakis peanut allergy), but there does not appear to be follow up in the scientific literature, either by Christakis or anyone else. Just saying. David notMD (talk)

What is the objection to the statement, which seems true to the author and to reasoning? The LEAP project and NIAID recommendations are consistent with Christakis. --Zefr (talk) 17:55, 9 November 2017 (UTC)

Are we looking at the same content in the article? My read is that Christakis (2008) is saying that the hullaboo over peanut allergy is unwarranted. "Sociologist Nicholas Christakis has said that measures taken (especially in schools) to ensure allergic children are not exposed to peanut allergens are disproportional to the actual risk of such exposure. Christakis has also said that popular responses to the danger of peanut allergies 'bear many of the hallmarks of mass psychogenic illness.'" I do not agree that it is unwarranted, as according to Togias 2017 (PMID 28065802) "Peanut allergy is the leading cause of death related to food-induced anaphylaxis in the United States." The fact that the topic of peanut allergy in children is research-worthy, and that early & frequent exposure is being looked at as a means of promoting tolerance, does not justify Chritakis's dismissal of concern as hysteria. David notMD (talk) 20:03, 9 November 2017 (UTC)

I took the statement as the quote and cited BMJ source as it is. We could add a counterpoint review or an advisory qualifier to it in social/cultural context, but I am unaware of such a source. The NIAID panel report is a worthwhile reference, but it's more relevant under Diagnosis and Prevention, and seems off-topic to the main Christaki point that allergy fear is "disproportional to the actual risk of such exposure." --Zefr (talk) 20:24, 9 November 2017 (UTC)

The Christakis content feels like an orphan. This may need searching the literature on how an allergy known to trigger anaphylaxis has affected quality of life in the people with the allergy plus their family, and reactions by businesses (food companies, schools, airlines, restaurants, etc.) to avoid legal liability. Elaboration would address the charge of disproportionality. David notMD (talk) 20:53, 9 November 2017 (UTC)

Although the Cristakis content does bring up an important (and potentially valid) point, I don't think that a direct quote from a single primary source is suitable for Wikipedia standards. My proposed edit (#1 in the "Proposed Edits" heading above) may be a good replacement to the Cristakis statement: “The high severity of peanut allergy reactions, as well as the increasing prevalence of peanut allergy in the Western world have led to widespread public attention. As a result, many school policies within North America have been implemented to completely ban the presence of all peanuts and tree-nuts in schools. However, it remains unclear whether the complete ban of peanuts and tree-nuts in schools is warranted, in comparison with the potential decrease in quality of life associated with food bans." (with appropriate sourcing as shown in "Proposed Edits") --Willwu22 (talk) 17:15, 15 November 2017 (UTC)

@Willwu22: I raised the Cristakis-or-not question, but am not entirely happy with your proposed text. Of the three refs proposed (#1-3), only #1 mentions schools, and from my reading, none address your last sentence. At a minimum, I recommend deleting the last sentence. For Egg allergy, I created a referenced paragraph on quality of life issues. You are welcome to copy/paste all/parts of that if you wish, as long as in the Edit summary you state that it was copied from the Egg allergy article. David notMD (talk) 18:23, 15 November 2017 (UTC)

A fair point, I have condensed my proposed edit to address solely the fact that food allergies are perceived to be more prevalent than they actually are: "The high severity of peanut allergy reactions, as well as the increasing prevalence of peanut allergy in the Western world have led to widespread public attention. However, the perceived prevalence of food allergies in the public view is substantially higher than the actual prevalence of food allergies." [ref was added to article]

This would be to replace the Cristakis statement. @DavidnotMD feel free to add a statement on decreased quality of life from the egg allergy article after this, as I do believe that would be helpful in rounding out the Society and Culture section of this article. --Willwu22 (talk) 00:05, 16 November 2017 (UTC)

I will hold off adding the QOL material from egg allergy until after your course assignment is graded. Have not yet decided on removing the Cristakis content or not. David notMD (talk) 13:09, 16 November 2017 (UTC)

Deleted Christakis. Added the Quality of Life content. "Mass psychogenic illness" (Christakis) is about groups caught up in imaginary illness events. Over-reacting to a real health risk is not that, nor like that. David notMD (talk) 22:05, 25 November 2017 (UTC)

Why have image of ara h 3 protein?

In my opinion the addition of a protein structure image does not add to the value of the article. None of the other common food allergies have protein structures (please don't change that), and ara h 3 is only one of the many peanut proteins implicated in peanut allergy. Not even a major one (ara h 2, ara h 6). Just sayin'. I left a note at the inserter's Talk to see if willing to revert own addition. David notMD (talk) 12:17, 29 November 2017 (UTC)

Removed image. David notMD (talk) 12:14, 30 November 2017 (UTC):::

Why reverted?

I just wanted to sort of add that the "Causes" launches into some very technical stuff about proteins, immuno response, pathways, etc. which is sort of hard to understand. It also jumps back and talks about the developing world having little peanut allergy. I found the "Causes" section confusing Cdiesh (talk) 11:04, 30 July 2018 (UTC)

Unreferenced statements are not appropriate for medicine and health articles. That is why what you added was reverted. I agree the Cause section jumps between identifying the specific proteins - very technical - and softer information on differences in prevalence in different parts of the world. Needs to be improved. David notMD (talk) 12:58, 30 July 2018 (UTC)

Text

User:David notMD What text supports this in the refs provided?

"The declaration of the presence of trace amounts of allergens in foods is not mandatory in any country, except Brazil."

Ref says "FDA guidance for the food industry states that food allergen advisory statements, e.g., “may contain [allergen]” or “produced in a facility that also uses [allergen]” should not be used as a substitute for adhering to current good manufacturing practices and must be truthful and not misleading. FDA is considering ways to best manage the use of these types of statements by manufacturers to better inform consumers." https://www.fda.gov/food/buy-store-serve-safe-food/what-you-need-know-about-food-allergies

So there is some suggestions. So should we say "recommended but not mandatory"? Doc James (talk · contribs · email) 05:50, 11 May 2019 (UTC)

I will look at this. The absolute nature of the current wording ("not mandatory in any country, except Brazil.") may be difficult to confirm. The "may contain" wording is about situations in food factories where production lines can be switched from product to product - such as a granola bar with peanuts followed by one without - or just that allergenic foods ingredients may be in the same room even though processed on separate equipment. Question is about trace amounts of allergens in foods versus just the possibility of trace amounts. David notMD (talk) 12:08, 11 May 2019 (UTC)

Business trip came up. For the moment, comfortable with DJ's "recommended but not mandatory" revision. That link to a mention of FDA's guidance is dated Sept 2018, so very possible that FDA has not issued any newer ruling or guidance. David notMD (talk) 02:31, 12 May 2019 (UTC)

What is recommended are Good Manufacturing Practice. Voluntary additional / precautionary allergen labeling is "permitted" (although not in all countries) rather than "recommended" (nor regulated, with some exceptions). [4]

As far as I could find, Brazil is the only country in which precautionary allergen labeling is mandatory.(page 5).

Therefore, perhaps "voluntary but not mandatory" is more accurate. --BallenaBlanca 🐳 ♂ (Talk) 18:24, 12 May 2019 (UTC)

Here is the translated text from the above given reference. Please point out where it says Brazil is the only country to require trace allergen warnings. Anything less is speculation and requires Original Research to verify (I don't even see the word "trace" used.)

LEGAL BASE

• RDC No. 26 of July 2, 2015, which deals with the requirements for mandatory labeling of main foods that cause food allergies.
• RDC No. 259 of September 20, 2002, approving the technical regulation on the labeling of packaged food.
• Portaria SVS / MS nº 326, of July 30, 1997, that approves the technical regulation on conditions hygienic-sanitary and Good Manufacturing Practices for establishment producers / food industrializers.
• RDC No. 275 of October 21, 2002, which provides for the technical regulation of Procedures Operational Standards applied to food producing / food processing establishments and the Good Manufacturing Practices checklist in establishments producers / food industrializers.

4. MANDATORY LABELING OF MAIN FOODS ALLERGEN

• The RDC No. 26, of 2015, was developed with the objective of ensuring that consumers have access to correct, comprehensible and visible information about the presence of the main allergenic foods and products, laying down rules for labeling declarations relating to:

 Intentional presence of allergenic foods and their derivatives;

 Possibility of cross-contamination with allergenic foods or their derivatives; and

 Absence of allergenic foods and their derivatives.

This Resolution covers all food suppliers, ingredients, food additives and technologies that are packaged in the absence of consumers, intended solely for industrial purposes. This scope was necessary due to the current complexity of the food production chain and the responsibility of each actor to control allergenic and in the transmission of adequate information on the composition of their products. The main allergenic foods were defined according to their relevance to public health, taking into account existing scientific data and legal references, and include:

•  Wheat, rye, barley, oats and their hybridised strains;
•  Crustaceans;
•  Eggs;
•  Fish;
•  Peanut;
•  Soybean;
•  Milk of all species of mammalian animals;
•  Almond (Prunus dulcis, sin .: Prunus amygdalus, Amygdalus communis L.);
•  Hazelnuts (Corylus spp.);
•  Cashew nuts (Anacardium occidentale);
•  Brazil nut or Brazil nut (Bertholletia excelsa);

Mensch (talk) 22:21, 12 May 2019 (UTC)

Talking about cross-contamination is equivalent to talking about trace amounts:

4. MANDATORY LABELING OF MAIN FOODS ALLERGEN (...)  Possibility of cross-contamination with allergenic foods or their derivatives;--BallenaBlanca 🐳 ♂ (Talk) 22:39, 12 May 2019 (UTC)

• Cross-contamination is not the same thing as "trace amounts." Additionally Brazil doesn't even recognize Mollusk, Celery, Mustard, Sesame or Lupine as allergens while the EU requires labels for all those allergens. How realistic are "trace" labeling requirements if they don't even recognize entire classes of allergens? If the WHO made the statement that Brazil was the only nation with "trace" labeling requirements OR a peer-reviewed paper was published in a major medical publication making a similar claim, then the claim would have standing. When a claim is added to an article it isn't then the duty of every editor to try and prove or disprove the statement. It needs a clear, easy to understand reference supporting the claim. Mensch (talk) 02:08, 13 May 2019 (UTC)

The "same" is not, that's why I said "equivalent", because the presence of trace amounts is the result of cross-contamination: "and the negative impact on business that might result from exposure to trace amounts of food allergen present during cross-contamination during production."

Brazil requires to declare the possibility of cross contamination (which is equivalent to saying that there is a possibility of presence of trace amounts) from the 8 main allergens recommended by the World Health Organization Codex Alimentarius Commission and in addition, three others.

It remains true that it is the only country that requires the declaration of cross-contamination from, at least, the eight major food allergens (peanuts among them). The current text is the result of doing what we do in Wikipedia: paraphrasing. How do you propose to write it? Let's see more opinions. --BallenaBlanca 🐳 ♂ (Talk) 18:21, 13 May 2019 (UTC)

If it is a true statement then all you need is a scientific reference supporting that Brazil is the "only" country. But honestly it isn't a meaningful statement in any case. It is minutiae. As an example there is a doctor's office that performs 100 peanut allergy tests a month. Should I create a link to the website and claim he makes more tests than any other doctor in Sao Paulo? It might be true but it isn't really relevant to the article. Additionally the claim that Brazil is the only country to regulate trace amounts is made twice in the article. Lastly I would just say that cross-contamination implies contamination from a source that the manufacturer has no knowledge of. If the food maker doesn't know about a contamination how can he possibly label for it? Or are all food items just labeled that they contain all allergens (That Brazil recognizes) so they can comply with the law. I doubt it so I suspect this is just an erroneous interpretation of the law.Mensch (talk) 04:34, 14 May 2019 (UTC)

References

Infobox sufficience?

I added some stuff into the infobox of Peanut allergy, and I would like some feedback as to how well I had added in such content. Qwertyxp2000 (talk | contribs) 23:18, 5 January 2021 (UTC)

US-centric information

This article is very US-centric. There are numerous references to the United States and American organisations, including in the lead, and very few references to other countries. Much of the information is written from a US POV, with references to other countries used as comparisons to the US. I added {{Globalize}} to the top of the article, but my edit was reverted by User:Danbloch with the summary: "I don't see this. Please discuss on talk page, or possibly put the template in specific sections." It's not specific sections – it's almost the entire article, and I'm not sure what the disagreement is here. MClay1 (talk) 01:23, 11 April 2024 (UTC)

I still don't see this. The reference you call out in the lead is immediately followed by a one giving the rate for the Western World as a whole. After that there are few references to the US (there's one in "Desensitization through exposure") until near the end, primarily in the "Immunotherapy" and "Society and culture". Hopefully other editors will weigh in. Dan Bloch (talk) 02:09, 11 April 2024 (UTC)