Randomised, double blind, crossover challenge study of allergenicity of peanut oils in subjects allergic to peanuts

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Abstract
Objective: To determine the in vivo allergenicity of two grades of peanut oil for a large group of subjects with proved allergy to peanuts. Design: Double blind, crossover food challenge with crude peanut oil and refined peanut oil. Setting: Dedicated clinical investigation unit in a university hospital. Subjects: 60 subjects allergic to peanuts; allergy was confirmed by challenge tests. Outcome measures: Allergic reaction to the tested peanut oils Results: None of the 60 subjects reacted to the refined oil; six (10%) reacted to the crude oil. Supervised peanut challenge caused considerably less severe reactions than subjects had reported previously. Conclusions: Crude peanut oil caused allergic reactions in 10% of allergic subjects studied and should continue to be avoided. Refined peanut oil did not pose a risk to any of the subjects. It would be reasonable to recommend a change in labelling to distinguish refined from crude peanut oil. Peanut (groundnut) allergy is the most common cause of deaths related to food allergy. Peanut oil is often suspected of causing reactions to meals in which a more obvious source of peanut cannot be found Refined peanut oil is odourless and flavourless and is commonly used in catering. Crude peanut oil, which is known to contain considerable amounts of protein is used only rarely, when a peanut flavour is deliberately required In vivo challenges of 60 subjects with proved peanut allergy showed no reaction to refined peanut oil, but six (10%) reacted to the crude peanut oil If refined peanut oil is used properly and is not reused after cooking peanuts, it seems to be safe for most people with peanut allergy; crude oil represents a risk The confusing use of the term groundnut oil should be stopped, and food labelling should distinguish between refined and crude oils