Ask the allergist is a regular feature in our newsletters where Dr. Julia Upton answers your questions!
Dr. Julia Upton is a Canadian allergist who is on staff at Toronto’s SickKids Hospital in the Immunology and Allergy Department. She is an Assistant Professor in the Department of Paediatrics at the University of Toronto and is the Section Chair of Food Allergy and Anaphylaxis with the CSACI. Dr. Upton is also a member of our Healthcare Advisory Board.
Please note: Dr. Upton is answering as an individual allergist and her answers do not constitute an official position of her affiliated organizations. Her responses are for informational purposes only and do not constitute specific medical advice, recommendations, diagnosis, or treatment. Please talk to your doctor about any concerns or questions you may have regarding your own health or the health of your child.
As plant-based alternatives are becoming more common, this month we’re featuring a previous article on pea protein allergy with some new additions.
What is pea protein allergy?
This is a timely question with the desire for many people to eat plant proteins.
People can be allergic to any food. Pea protein allergy is where a person is allergic to peas, which is a legume. Peanut is also a legume.
What’s the cross-reactivity risk for those with peanut allergy?
On allergy skin testing and blood testing there is cross-reactivity with other legumes such as lentils and peanuts. However, this cross-reactivity does not mean that a reaction will happen when peas are eaten.
How do you know if you should avoid products with pea protein?
If you have eaten pea protein previously with no allergic reaction then you are very unlikely to have a reaction. You may be able to review foods you eat routinely and see that you have already eaten pea protein. There may also be differences in allergic reactions to regular pea rather than concentrated pea protein.
Pea is not a priority allergen so the labelling on certain types of products is not straight forward like it is for the priority allergens. If pea protein is an ingredient in a product it must be labelled, similar to other ingredients. However, if pea protein is a component of an ingredient, it may not be required to be labelled. For example, if pepperoni has pea protein as an ingredient, then the pepperoni product sold on its own would have pea protein listed in the ingredient list. However, if that pepperoni is used on a frozen pizza, then the pepperoni would be included by name in the list of ingredients, but it’s not required to provide all the sub-ingredients of the pepperoni unless one or more of these is a priority allergen. In this situation, pea protein would not be required to be listed in the ingredient list of the frozen pizza.
According to Health Canada, consumers with a known allergy to pea protein should read labels carefully and avoid any product that contains pea or pea derivatives as an ingredient. They should also be cautious about products which contain prepared meats as ingredients and should inquire with the manufacturer to ensure there is no pea protein present before consuming these products.
Are plant-based burgers safe for someone with a peanut allergy?
Plant-based burgers may be made of pea protein, a highly concentrated ingredient from peas. Most people with peanut allergy can eat other legumes like peas and green beans. However, pea protein may have a different allergic risk than regular pea.
Who is at most risk of having a reaction? Is it just people with peanut allergy?
Anyone can be allergic to any food. However, people with other legume allergies are at higher risk.
If a person gets slight tingling by eating peas, should they stay away from pea proteins?
Mouth tingling can be a sign of a food allergy. Sometimes a reaction in the mouth is part of pollen food syndrome (pollen food syndrome is an allergy to a food due to a cross reaction from pollen). This symptom would need to be discussed with a physician.
How do you test for pea protein? Is there a substance available that allergists can use for testing?
The evaluation for pea allergy would include reviewing the foods suspected to cause a reaction as well as reviewing labels of foods that do not cause an allergic reaction. Skin prick testing can be performed with a commercially available allergy extract, or by using actual peas. Blood tests are also available for pea allergy.
None of these tests tell us for sure if someone will react when they eat the food. If someone has had symptoms of allergic reactions to eating peas and has positive tests then we would usually say they are allergic. The tests alone are not enough to label someone as allergic. Some people may need an oral food challenge to know for sure if they are allergic or not.
Sometimes it is helpful to test the actual food that a person reacted to because pea protein can be very concentrated in a food. Taking a picture of the label or knowing the exact food can be very helpful to identify the allergen.
Do you have a question you’d like to ask Dr. Upton in the months to come? If so, send it along to us at firstname.lastname@example.org. Please note: Dr. Upton answers questions on general topics, please talk to your doctor if you have questions about your own health or the health of your child.Tags: ask the allergist, dr upton