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May 13, 2016

Making labels matter: a peanut threshold study

“MAY CONTAIN NUTS”… “PRODUCED IN A FACILITY THAT CONTAINS PEANUTS.” Labels like these are everywhere – but what do they really mean? There are minimal guidelines around how these labels are used by food manufacturers and little research has been done to support them.

To get serious about food allergy labels, Dr. Susan Waserman and Dr. Manel Jordana are running a peanut threshold study. Working with the Allergy, Genes and Environment Network (AllerGen), Dr. Waserman is researching the highest amount of peanut that can be consumed before it triggers an allergic reaction.

Using a Double Blind Placebo Control Food Challenge (DBPFC) technique, subjects are given cookies that contain different levels of peanut protein at various times in a controlled environment. By examining the reaction patterns to the various dosages, Dr. Waserman will be able to identify a threshold dose that can be applied to the majority of those who have peanut allergies.

“Ultimately, if we can determine a threshold level for 90 percent of the population, we can begin to bring serious meaning food labels,” says Waserman. A threshold dose is an amount below which most peanut allergic individuals will not react.

This threshold dose can be used to inform the food industry about food allergy prevention and management. It can also help develop proper food safety standards and food allergy labels. Dr. Waserman says “patients, healthcare professionals and the food industry will benefit, as food labels would only list peanuts if the amount exceeds the recognized threshold.”

According to experts, peanut allergies have quadrupled over the past 14 years and now affect roughly 1.5 million children in Canada. Allergic reactions to peanuts account for the majority of near fatal food allergic reactions. The current treatment and prevention strategy is the complete avoidance of peanuts. Despite avoidance, the majority of those who have an allergy to peanuts will accidentally ingest some variation of peanut.

The research is still relatively fresh, but a proper understanding of risk and an open dialogue about threshold doses can help reduce anxiety for patients and their families. “Though peanut allergies will never by risk-free,” explains Dr. Waserman, “a standardized measure of tolerance can open the door of opportunity for those who have an allergy.”

Currently, Dr. Waserman and AllerGen are only applying this methodology to peanuts, however, the theory also holds significant potential for all types of allergies. “Peanuts are only the beginning,” says Dr. Waserman. “Given the appropriate findings, we hope to use this method to develop threshold dosages for other common types of allergies.”

Dr. Susan Waserman is an immunologist in the Division of Clinical Immunology and Allergy at Hamilton Health Sciences and is an associate professor for the Department of Medicine at McMaster University.