Two-year-old Libby was unconscious – her lips red and swollen, face puffy, skin mottled, wheezing, with streaming eyes. Consultant allergy specialist Dr Elana Levine had seen the reaction many times before. Anaphylactic shock, an extreme allergic reaction – probably due to peanuts, she thought.
In these cases the airways swell dramatically, restricting breathing, and blood pressure plummets to dangerously low levels.
Dr Levine knew if she didn’t act fast the little girl would die. Roughly 20 people suffer fatal anaphylaxis in Britain every year.
The rise in popularity of meat free burgers could leave vulnerable people at risk of suffering an anaphylactic reaction due to the growth in the use of pea protein
The doctor immediately administered a life-saving shot of the hormone noradrenaline.
But something seemed unusual. Not least that, as far as her distraught parents knew, their child Libby hadn’t consumed nuts. The reaction seemed to have resulted from a spoonful of apparently nut-free yogurt.
After carrying out further tests, Dr Levine, who is based at Humber River Hospital in Ontario, Canada, discovered the culprit was not nuts after all, but an ingredient Libby’s parents had never heard of: pea protein.
The powdered protein extract from yellow peas – which are grown for use by the food industry – is finding its way into an increasing number of ready-made foods.
Protein shakes and snack bars that claim to help muscles recover after exercise may contain it. More recently, brands have begun packing it into vegan meat-substitute products such as burgers and sausages, as the popularity for plant-based diets continues to climb.
Marks & Spencer lists pea protein as one of the main ingredients in a ‘plant-based’ Christmas stuffing sandwich, and it has even made its way into a high-protein houmous being sold at Waitrose. Dairy-free ice creams from Halo Top and Ben & Jerry’s also contain it.
Protein shakes and snack bars that claim to help muscles recover after exercise may contain pea protein
And experts warn that a new, potentially deadly allergic reaction – linked to peanut allergy – has developed as a result.
Peas, like peanuts, are legumes – and share some of the same proteins, hence the reason some of those allergic to peanuts are also sensitive to pea protein.
Worryingly, according to UK food safety law, manufacturers do not have to flag-up pea as a potential allergen on product labels, making the hazard well and truly hidden.
And experts say this loophole could leave at least 12,000 allergic Britons at serious risk…
Fake meats brim with danger
In the past couple of years, Dr Levine has seen at least five cases similar to Libby’s in her clinic alone.
‘In several, the reaction was severe,’ she says. ‘One ten-year-old with a history of food allergies was eating a home-made pizza thought to be free of all allergens, but within minutes had difficulty swallowing and her face was swollen.’ The ingredients listed vegan pepperoni – which contained pea protein.
The only way to confirm an allergy to it is to undergo skin prick tests. A specialist measures the body’s reaction when a tiny amount of a suspected allergen is injected into the top layer of the skin.
Dr Levine conducted this test with those she believed to be suffering pea protein allergy, and results confirmed her theory. The problem occurs due to a phenomenon called ‘cross reactivity’, according to Dr Isabel Skypala, a consultant allergy dietician at the Royal Brompton Hospital in London.
‘Allergies to one food make you more likely to have problems with other similar ones – as in peanuts and pea protein,’ she says.
Roughly 250,000 children suffer from peanut allergies in the UK, as well as thousands of adults. It is commonly known among peanut allergy sufferers that many of them – roughly a third – are also allergic to tree-nuts, such as walnuts and Brazil nuts. But five per cent of peanut allergy patients also react to other legumes, such as peas, meaning roughly 12,000 people could be at risk of pea protein allergy. The high quantity of pea protein in some products is a big problem
‘The issue is that pea protein is not just an additive, it is the main ingredient,’ says Dr Levine.
The higher the quantity, the higher the chance of a reaction. In vegan products that ‘copy’ meat, manufacturers need to use high levels of the protein to replicate the amount normally supplied by the animal.
In the ‘bleeding’ Beyond Meat burger, for example, now available in Tesco, pea protein accounts for roughly a fifth of the ingredients.
There’s a similar quantity in the company’s vegan sausages, also available in British supermarkets.
Pea protein is also used to enhance the so-called energy-boosting effects of popular snack bars.
In Pulsin bars it is the fourth highest out of 17 total ingredients.
Worryingly, unlike other allergens such as eggs, peanuts, and gluten, the Food Standards Agency does not require manufacturers to flag the ingredient on a label.
Only a handful of brands choose to do so.
Lynne Regent, of Anaphylaxis UK, says: ‘A vegan sandwich or burger made with pea protein will not have it listed in bold as a potential allergen, as the existing 14 allergens are.’
Peas not the only hazard
Alarmingly, allergy experts say pea protein isn’t the only hazard in some products with ‘healthy’ plant-based credentials. Dr Skypala says: ‘With many ingredients it may be unclear whether a reaction is due to an allergen present in an added ingredient.
‘Other hidden allergens include flavourings such as mustard and celery as well things that add texture, such as a type of flour made from legumes, called lupin.’
Allergic reactions to these are currently rare, but as more allergic people come into contact with them, cases are expected to increase.
‘Food processing can also alter the structure of the proteins in many of these other hidden allergens,’ adds Dr Skypala. ‘This makes the proteins more likely to cause a severe reaction.’ So should peanut allergy patients avoid fake meat and plant-based snacks altogether?
Not necessarily, says Lynne Regent. ‘Not all products contain pea protein’ she says. ‘But if you have a peanut allergy, it’s very important to read the full list of ingredients to look out for it.’