Latest From ACAAI: Peanut Allergy Guidelines Coming Soon



Peanut2Many parents continue to have questions about when and how to introduce of peanut into their children’s diet – and soon-to-be-released guidelines from a National Institute of Allergy & Infectious Diseases (NIAID) expert panel are expected to clarify matters.

During the American College of Allergy, Asthma & Immunology (ACAAI) Annual Scientific Meeting Nov. 10-14, several presentations addressed introduction of peanut during early childhood.

“The first step is determining if your child is at high-risk for peanut allergy,” says Amal Assa’ad, MD, associate director of the Division of Allergy and Immunology at Cincinnati Children’s Hospital, chair of the ACAAI Food Allergy Committee and a member of the NIAID expert panel.

Infants are considered high-risk of developing peanut allergy if there’s severe eczema and/or egg allergy. The guidelines recommend introduction of peanut-containing foods at 4-6 months for high-risk infants, after an allergist has determined it is safe to do so, according to ACAAI.

“Before introducing peanut-containing foods to a high-risk infant, the infant should be seen by a primary care provider who will determine if referral to an allergist for testing and/or in-office introduction is needed,” Dr. Assa’ad says.

Parents should not give whole peanuts to infants due to choking risk, and peanut should only be introduced when the child is in good health.

“The guidelines are an important step toward changing how people view food allergy prevention, particularly for peanut allergy,” says Matthew Greenhawt, MD, assistant professor of pediatric allergy at Children’s Hospital Colorado, incoming ACAAI Food Allergy Committee Chair and also a member of the NIAID expert panel. “They also offer a way for parents to introduce peanut-containing foods to reduce the risk of developing peanut allergy.”

Among other research studies presented at ACAAI:

Living With Food Allergies at College

A greater community of support is needed for college students with food allergies, says Ruchi Gupta, MD, MPH, associate professor of pediatrics at Northwestern Medicine in Chicago.

“While many colleges offer support for students with food allergy in the dining hall, the same support doesn’t carry over to organized sports, dormitories or social events,” says Dr. Gupta, who spearheaded a study on the topic. “That leaves students feeling vulnerable and scrambling to inform all the various departments of their needs.”

In addition to cafeteria workers, fellow students, professors, librarians and residence hall directors need food allergy information. “Giving a student support from peers, staff and the college itself is critical in providing a safe and positive environment,” Dr. Gupta says.

Also at ACAAI’s annual meeting, David Stukus, MD, presented on how allergists can help ease the college transition for students with food allergies.”

“College students must know how and when to use epinephrine auto-injectors, how to read food labels and what to communicate to food handlers,” Dr. Stukus says. “They must also have epinephrine available at all times in case of an accidental ingestion leading to a severe allergic reaction.” Here’s more advice for students with food allergies transitioning to a college environment.

Stuck In a Food Desert?

Children who live in a “food desert” – an urban area where lack of nearby supermarkets limit access to affordable or good-quality fresh food – are 53 percent more likely to develop asthma than those who live closer to markets, according to a study presented at ACAAI.

Food deserts are areas that lack access to affordable fruits, vegetables, whole grains, low fat milk and other food that make up a full and healthy diet, according to the Centers for Disease Control and Prevention (CDC).

A nutritious, well-rounded diet helps develop a healthy immune system, and asthma is primarily an immune system disease. It’s especially important for children with still-developing lungs and airways. Also, healthy food helps reduce overall inflammation that can lead to the development of asthma.

Smoking and Asthma

Teenagers with asthma are almost twice as likely to smoke as teens who don’t have asthma, according to a study presented at ACAAI.

“The researchers discovered that curiosity about cigarette smoking is the main reason why kids with asthma start smoking,” says Bradley Chipps, MD, an allergist/immunologist and pediatric pulmonologist with Capital Allergy and Respiratory Disease Center in Sacramento, California. “They then develop a greater dependence to nicotine compared to kids the same age who don’t have asthma.”

Most of the teens with asthma knew that smoking was particularly bad for their lungs. Despite this, they “didn’t consider smoking to be a problem,” Dr. Chipps says. In many cases, the teens suggested smoking relieved anxiety and stress.

Smoking is unhealthy for everyone but it’s especially harmful for people with asthma. In fact, tobacco smoke is one of the most common asthma triggers.

When inhaled, tobacco smoke irritates the airways and causes the lungs to produce more mucus. It also weakens tiny hairs called cilia that sweep away mucus out of the airways; instead the mucus settles in the airways, causing asthma symptoms.