Though uncommon, peanut contamination can occur in unpackaged baked goods
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Approximately one in 40 items purchased at bakeries in the New York and Miami metropolitan areas contained unintended peanut protein, according to a study published in Annals of Allergy, Asthma & Immunology.
Additional safety measures are therefore needed to protect people with peanut allergies from accidental exposure in unpackaged goods, Travis A. Miller, MD, medical director and CEO of The Allergy Station in Roseville, California, and colleagues wrote.
The researchers randomly selected 18 bakeries that sell products with peanut, including at grocery stories and local shops selling American, French, Cuban, Haitian, Chinese, Polish, Italian and Indian cuisines.
Next, the researchers purchased baked goods that did not intentionally include peanut, including chocolate, carrot, raisin and vanilla cakes and cupcakes; chocolate chip, butter, coconut and sugar cookies; blueberry, cornbread and cheese muffins; and cinnamon buns.
A week later, the researchers purchased the same items from the same bakeries for between-batch comparisons. All samples were at least 100 g and sold and packaged according to each bakery’s usual practice.
Samples then were taken to a central, clean peanut-free environment, where they were individually double-packed, weighed, labeled, cataloged and shipped overnight to the Food Allergy and Resource Program (FARRP) at University of Nebraska–Lincoln.
FARRP performed qualitative and quantitative analysis of the samples for peanut protein contamination using an enzyme-linked immunosorbent assay.
The 56 samples from New York and 99 samples from Miami that were tested included 77 cupcakes, 48 cookies and 29 muffins, with four of them (2.6%) testing positive for peanut protein. All four were from New York bakeries, representing 7.3% of the New York samples.
Three of those positive samples — including a chocolate cookie, chocolate cake and vanilla cake — were identified in the first round. When these products were retested, only the chocolate cake tested positive again.
Contamination levels in the four samples ranged from 1 ppm to 6,500 ppm, or 0.1 mg to 650 mg of peanut protein per 100 g of each sample.
This range also equals approximately 0.07 mg to 474.5 mg of peanut protein consumption per single eating episode, based on the 2003-2010 National Health and Nutrition Examination Survey single eating occasion consumption estimates, or 0.63 mg to 832 mg based on 90th percentile consumption estimates.
Although doses of peanut protein needed to elicit an allergic reaction vary between individuals, 50% of people with peanut allergies have eliciting doses ranging from 30 mg to 100 mg, with 1% having eliciting doses as low as 0.2 mg, the researchers wrote.
The levels of contamination found in these samples fall into that range, the researchers continued, which could trigger allergic reactions in most individuals with peanut allergies. Packaged foods are required to feature labeling indicating possible allergen contamination, but these samples were not packaged, making such labeling voluntary.
Based on their findings, the researchers called for additional measures to prevent unintended allergic reactions including risk assessment practices, modifications in food manufacturing and food-labeling requirements to ensure safe food choices.
Perspective
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The results of this study are both surprising and significant. I am not surprised that contamination was detected. Baked goods are the number one food that we warn our patients with peanut allergy to avoid, and I would not have been surprised if a higher proportion of products were found to be contaminated.
What is surprising, even shocking, is the level of peanut in the one cake, equal to three to four peanuts and enough to be deadly for many patients without immediate treatment.
Our advice has always been to avoid baked goods unless you know specifically how they were made. New public policies enacted to prevent these risks would be ideal, but it is difficult enough to manage cross-contamination in labeled foods, much less unlabeled foods.
Strict avoidance of high-risk foods will remain the standard of care. Ideally, research will lead to safe and effective treatments that would protect against these potential accidental exposures.
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