Peanuts: From regular snack to social outcast

PRINCETON (US) — New research on the public response to peanut allergies looks at how a rare, life-threatening condition can prompt far-reaching societal change.

Before 1980, peanut allergies were rarely mentioned in medical literature or the media, but starting around 1990, medical journals began discussing the seriousness of peanut allergies. And the 21st century described peanut allergies—in both medical journals and the mainstream media—as an epidemic.

For people with a peanut allergy, eating the legume can lead to anaphylactic shock and, if untreated, death. But the allergy is quite rare and it isn’t clear whether it is becoming more common, researchers say.

(Credit: Princeton Office of Communications)


But the increased focus on peanut allergies in the medical community, the media, and society in general combined to push for changes like peanut bans in schools.

“All of this was happening at about the same time to produce this big societal problem that is based on what is a small problem in terms of the population affected,” says Miranda Waggoner, a postdoctoral researcher in the Office of Population Research at Princeton University.

“One physician has written that the same number of people die each year from peanut allergies as from lightning strikes, yet the perception of peanut allergy risk has invaded the common social spaces we all inhabit—airlines, day cares, and schools.”

In 2002, Massachusetts became the first state to enact guidelines for the management of food allergies in schools, calling for “peanut-free” tables in the lunchroom under some circumstances. Many schools and day care centers have banned peanuts, and some baseball parks now offer peanut-free zones.

“This was part of a broader concern about food risks, changing perceptions of food production, as well as changes in the way we think about child risk,” Waggoner says.

“If you ask adults about peanut allergies when they were in school, most of them will say it wasn’t an issue. Peanut butter and jelly sandwiches were a staple, healthy snack. It’s the classic American kid snack. The fact that this sort of mundane food is under attack is really a potent moment for us as a society.”

A peanut panic?

As reported in the journal Social Science & Medicine, several factors make it difficult to assess the prevalence of peanut allergies or whether the problem is becoming more common. Before the 1990s, little data were collected on peanut allergies. And peanut allergy numbers are generally based on self-reporting, which leaves them open to interpretation and influence by increased media attention.

“There’s definitely increased awareness about it,” Waggoner says. “There’s more medical research being done. There’s more medical awareness, but what is contested is the prevalence, because it is based on self-reporting. We don’t have a good sense of long-term change over time.”

Experts now say about one percent of the American population has a reported peanut allergy. Another unknown is the cause of peanut allergies. Researchers are using genetic and molecular testing in the search for a cause.

One of eight culprits

Peter Conrad, a medical sociologist at Brandeis University, says the research offers important insights into the evolution of peanut allergies as a public problem.

“This paper helps us understand how a relatively rare disorder, peanut allergies, has become seen as a public risk and even as a childhood epidemic. While the individual risk is high, the risk on a population level is small. Sometimes the public’s response to a disorder may significantly outpace the actual public health risk potential.”

Along with continuing medical research into the causes and prevalence of peanut allergies, Waggoner says another important area for future research is why it is the peanut allergy that has sparked this level of public interest and resulting changes in society.

“While eight foods account for over 90 percent of food allergy reactions, including milk, eggs, peanuts, tree nuts, fish, shellfish, soy, and wheat, the peanut allergy has arguably received the largest share of medical and social attention.”

The research was supported in part by a grant from the National Institutes of Health.

Source: Princeton University