The Scoop on Peanut Butter

Let’s face it.  We Americans have a major peanut butter dilemma on our hands.  You either love it, or you die from it.  It’s about that simple.  

Peanut butter is as American as apple pie.  The average American eats over 3 pounds of the stuff each year while the rest of the planet finds it about as exciting as American football.  To grow up in the United States means to eat peanut butter, typically plastered with jelly between two pieces of white bread,  a tradition that hasn’t changed for generations. Regardless of your camp, creamy or crunchy, the National Peanut Board estimates the sticky stuff is consumed in nine out of 10 U.S. households.   Peanut butter is a regular ingredient in the American diet.

Unless it tries to kill you.

Peanut allergy has been on the rise in recent years with some studies showing a near doubling in those effected from 0.6% to as high as 1.4% of the American population.  The cause for this rise in the allergy rate is not perfectly clear. Unlike other true nut allergies, a peanut allergy causes a type 1 hypersensitivity reaction of the immune system, the most serious type of allergy reaction.  Technically speaking, the peanut is innocent;  the immune system is to blame here.

Let me explain.

Hundreds if not thousands of times throughout the day, our bodies are introduced to foreign materials  be it foods, germs, chemicals, pollens, dusts, minerals, etc. Our immune system is tasked with sifting through all of these things and carefully identifying only those invaders (antigens) that could harm us.   When a potentially harmful antigen is found, a flurry of activity occurs and the body creates highly specialized proteins called  immunoglobulins, to “remember” the invader should it try to attack the system again in the future.  These immunoglobulins go on to circulate throughout the body long term, floating silently and harmlessly through the blood stream; sentries keeping watch for their target invaders.  

The Deadly Peanut

For most of us, this immunoglobulin system is dialed in perfectly, protecting us from a barrage of viruses, toxins, bacteria, protozoa and even parasites every day.   But for those unfortunate 1.4% of Americans trying peanut butter for the second time, these immunoglobulins can prove deadly.   When first eating peanuts, a specific peanut protein has a small chance of getting mislabeled by the immune system as an antigen causing the immunoglobulin “memory” to be created.   Once reintroduced, the peanut protein is recognized by the sentry immunoglobulins, sparking a chain reaction that causes cells throughout the body to release powerful inflammatory chemicals, namely histamines, leukotrienes, and prostaglandins.  For those not fluent in immunology, this translates to itching, swelling, dry skin, sneezing, asthma, and even abdominal pain.  For the most unfortunate,  rapid drops in blood pressure, anaphylaxis, or cardiac arrest.

So what are we parents to do?

In taking care of a lot of young families with newborns and infants, this is a question I hear often.  Young parents have enough to worry about already, let alone serving up an American tradition that could result in catastrophe.   Traditional wisdom and expert theory led us to believe that children should wait until they are at least 1 year old before trying peanut butter, a practice still commonly employed throughout the US. But as is often the case, our ‘best guess’ on medical issues is often incorrect.

Let’s look at the facts.

In digging further into the science of this peanut conundrum, we find a surprising result.  Recent studies have shown that introducing peanut butter earlier to our children actually reduces their risk for an allergy, especially those kiddos with high allergy risk.   The American Academy of Pediatrics recently released a statement  recommending the introduction peanut butter at 4 months of life and no later than 6 months of life for those with extreme allergies.  It would appear the immune system of an early infant is far less reactive to peanuts.

Dr. Neal’s recommendation:

I recommend for all infants I treat, and my own children for that matter, to start introducing creamy peanut butter as soon as 4 months of age and no later than 6 months of age to reduce their chances of an allergy.   I also encourage pregnant women to eat peanut butter throughout their pregnancy.

The full scoop: