Boiled peanuts could help children overcome nut allergies, Australian researchers find | Health

Boiled peanuts could provide a means to help children overcome peanut allergies, according to the results of a year-long Australian clinical trial.

In a trial of 70 children aged six to 18 with documented peanut allergies, 80% became able to eat the legumes without allergic reaction after being given increasing daily doses of boiled and roasted peanuts – a potential treatment known as oral immunotherapy.

However, those conducting the trial have cautioned parents against feeding boiled peanuts to their peanut-allergic children.

In the first part of the study, for 12 weeks children ingested doses of peanuts that had been boiled for 12 hours. For the next 20 weeks, the participants ate peanuts that had been boiled for two hours; this was followed by 20 weeks of ingesting roasted peanuts.

The initial doses in the clinical trial were supervised by medical practitioners for adverse reactions. Children were initially given 62.5mg of crushed boiled peanut powder, the equivalent of about one-16th of a boiled peanut, and upped their intake over time.

Of the 70 children, 56 – or 80% – were eventually able to ingest the target dose of 12 roasted peanuts daily without an allergic response.

“That gives a high level of protection against accidental exposure, which in our case was really the goal – taking away that anxiety and stress that comes with worrying about accidental exposures to peanuts,” said the study’s lead author, Associate Prof Luke Grzeskowiak of Flinders University and the South Australian Health and Medical Research Institute.

Peanut allergies are estimated to affect up to 3% of children in western countries.

One of the study’s co-authors, the paediatric immunologist Dr Billy Tao of Flinders University, has previously shown that boiling peanuts appears to reduce the allergenicity of the proteins they contain.

“Essentially, the protein begins to unfold in a way that the body … no longer reacts to it,” Grzeskowiak said. “So you get that reduction in the severity of allergic response to exposure to boiled peanut.”

Grzeskowiak emphasised that the trial’s results represented a potential treatment but not a cure.

“There’s the need to continue using or being exposed to peanuts to continue to have that tolerance.”

He added that of 45 children who were followed up six months after the trial concluded, 43 were still consuming peanuts regularly. “None of those children had reported experiencing severe allergic reactions … from either the treatment but also unintended exposure.”

Despite the success of the trial – which did not include children with a history of extremely severe reactions – Grzeskowiak discouraged people from feeding their peanut-allergic kids boiled peanuts at home.

“It’s really important that people are not embarking on immunotherapy without having an appropriate level of supervision. At this point, it’s part of experimental studies,” he said.

The researchers did not test the participants’ ability to tolerate peanuts weeks or months after stopping treatment.

“We’re aware that the use of boiled peanuts has been looked at for a long time,” said Jody Aiken, a senior health management educator at Allergy & Anaphylaxis Australia.

Experts have long suspected that the consumption of boiled peanuts in parts of Asia may contribute to lower rates of childhood peanut allergy there.

Commenting on the clinical trial, Aiken said the research was a first step in the right direction. “The authors are really clear that there needs to be further research done around using boiled peanuts as a treatment for peanut allergy,” she said.

“As an organisation we are really keen for there to be treatments, but we want those treatments to be safe and affordable,” Aiken added.

The clinical trial did not include a placebo component to compare against the effectiveness of boiled peanut consumption.

At present, no oral immunotherapies for food allergies are approved by Australia’s medicines regulator, the Therapeutic Goods Administration. In the UK and US, a peanut allergen powder called Palforzia has been approved for use.

The study was published in the journal Clinical & Experimental Allergy.

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