Rotten (2018–2019): Season 1, Episode 2 - The Peanut Problem - full transcript

[Pulsing music]

[narrator] Around the world,
food allergies are surging

to near-epidemic levels.

[man] A molecule of peanut protein,

a molecule of shellfish protein
could cause a reaction.

Any meal could be my last, I guess!

[narrator] Victims are often children,

and even their parents
can be powerless to help.

We had to take him
to Lurie Children's Hospital.

His face was swollen.

His eyes were turning
a different, dark color of red.



[narrator]
Restaurants have become battlegrounds.

[Ming Tsai] We bend over backwards
to ensure our food is safe.

Bend over backwards,
because it's life and death.

[narrator] Food allergies are no myth.
And they can kill.

He had only eaten a mouthful
of the meal that he'd ordered.

We had done what we had done
to prevent this happening.

[narrator] Science is just beginning
to understand

why some people react
to seemingly harmless foods...

We evolved to protect the body
by promoting their active expulsion.

[narrator] ...and is racing
towards finding a cure.

[woman] Getting your immune system
to know that this is OK:

that in itself would be incredible.

[sizzling]

[tense orchestral music]



[man] I'll be glad
when you take over.

-Do you know how to pull up peanuts?
-You've shown me.

[man] I don't know about you.

[woman] Peanuts are
a very interesting crop to grow.

[man] That better?

Mine is better than yours.

Luck. Beginner's luck.

[woman] I'm learning.

They are actually a legume.

They're nitrogen fixing,

which is a really incredible trait
within a crop rotation, because...

They don't need fertilizer.

You don't fertilize peanuts.
They make their own.

[narrator] Peanuts are in trouble.

In only a few years, they have seen
their reputation transformed.

For more than a century, peanuts have been
the classic American snack.

Cheap, nutritious, and everywhere.

There's a little crop canopy,
a small, bushy-type crop canopy

above ground,

but the peanuts form
and develop underground.

See this bloom here, this yellow bloom?

This little bloom turns into a peg
which goes into the ground,

that eventually becomes a peanut.

[narrator] Peanuts are the keystone
of agriculture in southwest Georgia.

Two out of every five peanuts in the US
are grown in Georgia.

The Cox family farms 280 acres of them:

more than one million pounds of peanuts
every year.

[Casey] My dad is the fifth generation
of his family to farm.

And I decided when I was in college

that I wanted to come back
to southwest Georgia

and eventually take over
our farming operation.

It's something that really matters to me,
and is really special to me.

I feel like it is an honor and a privilege

to have the opportunity
to come back to this farm.

So I just try to spend as much time
as I can with my dad,

listening to him and learning from him,

and eventually,
probably within the next few years,

he'll be ready to retire,

and I'll take more of an ownership
and leadership role in the farm.

I know I have a lot to learn,
and it's gonna take me a while.

My father has been so innovative
and progressive as a farmer,

and I want to continue that tradition
and legacy of innovation

and new opportunities,

and see what happens in my generation.

[narrator] But the next generation
of this peanut dynasty

will likely face challenges
that the last five never imagined.

The future of this essential harvest
is now in question,

all because of a sweeping surge
in food allergies.

Thirty years ago, it did not exist.

Or if it did, it was not discussed.

It really is something that my generation
is the first to deal with.

The first thing people think of
with peanut production,

people that I've talked to...

The first thing was the allergy.

It's interesting to hear theories

but there's not much information
about where it came from.

So, I'm hoping that the research
and science that is going on

can come up with a solution
and come up with other ways

to maybe prevent this from happening
in the future.

I'm allergic to peanuts, pecans,

pistachios, chestnuts,

walnuts, Brazil nuts...

I was deathly allergic to wheat,
rye, oats, and barley, growing up.

Abbie broke out in hives
and the reaction lasted four days

which, when you are on a cruise boat,
is really unnerving.

When she was three and a half,

we had an emergency landing on a flight
because of exposure to peanut dust.

I started to have a secondary reaction,

which is when...

it caused me to stop breathing,
and I wasn't able to talk.

[narrator] Something in our world
is changing.

Our bodies are rejecting the food we eat.

Even the experts don't really know why.

When I started looking at food allergy
it was shocking

that we knew so little
about food allergies.

This was 12 years ago. We didn't even know
how many kids had food allergies.

Those numbers were not being collected.

[narrator] Chicago pediatrician
Ruchi Gupta has spent the last decade

tracking this worldwide trend:

a surge in food allergies,
especially among children.

It was just starting to get noticed.

You started hearing it more and more,

but we didn't understand
the extent of the problem.

I have eggs, peanuts, tree nuts,

fin fish, shellfish,
sesame seeds, and legumes.

We surveyed 40,000 kids
across the United States,

and what we found was that 8% of children
in the United States have a food allergy.

That's about 1 in 13 kids.

Six million in the US.

[narrator] It amounts to a nearly 50%
increase in the last two decades alone.

There are eight key food allergens

that trigger more than 90%
of all food allergic reactions:

shellfish, tree nut,

egg, milk,

fin fish, soy,

wheat,

and the most prevalent of all
among children:

the peanut.

[sinister guitar music]

[Gupta] Peanut allergy is the most common
of all food allergens,

so it impacts about one in four kids
with a food allergy.

It's such a pervasive staple.

When children go to school,

they don't take a lunchbox of shellfish.

They take a peanut butter sandwich.

Peanut oil, peanut butter,
peanuts themselves,

they are in almost everything.

[Ruchi Gupta] Now, the reason peanuts
get the most attention:

not only are they the most common,

but kids who have a peanut allergy tend
to experience severe reactions more often.

-Haven't grown out of them?
-Nope.

Have you had any reactions
in the past year?

I actually had two allergic reactions
over the summer.

I started throwing up.
My stomach started condensing.

I got hives,
little red bumps all over my skin.

And my throat started closing up.
They had to put me on oxygen.

[narrator] In Gupta's research, more than
half of kids with peanut allergies

have experienced
a life-threatening attack.

The crisis is global.

Most countries that keep count
have seen children's food allergies surge.

In Britain,

the odds that a person with a food allergy
will be hospitalized by the condition

have jumped to three times
what they were 20 years ago.

Nearly two million Brits
are at risk at every meal.

I was meant to be going to a party
with my friends.

I went to my friend's house to get ready,
have something to eat.

My friend suggested
we went for an Indian takeaway.

So, yeah, I liked Indian,
so that was fine.

We all said what we wanted.

I think we all ordered something like
chicken korma or chicken tikka masala.

[narrator] Among the most popular takeout
foods in England are Indian curries,

many of which call for almonds
or almond powder.

But almonds are expensive.

Some restaurants
use cheaper peanuts instead.

I said, "Oh, I have
a peanut allergy, by the way,

so there can't be any peanuts in my meal."

And the guy behind the counter was like,

"There's no peanuts in a chicken
korma, so it will be fine for you."

I just had, like, a small part
of the sauce on a fork.

My lips started to swell
and get a bit red.

I was getting very hot.

And my lip tingling
just got worse and worse.

And my throat started to feel,
like, very swollen

and, like, tight.

And I came out in hives,
all over my arms, all over my legs.

Only, you know, like,
"Wait. I can't actually breathe here."

[sinister guitar music]

[narrator] Peanut proteins
had entered Ruby's bloodstream.

There, they were detected by
a defense system called Immunoglobulin E,

or IgE.

[Ruchi Gupta] You can have an IgE
specific to something.

That's why some people are
only allergic to cat dander,

or some are only allergic to peanuts.

It's almost like a watchdog.

It's sitting out there, watching

and thinking of the peanut,
or any food specific,

as an invader.

It's coming in to hurt the body,

and that's why the immune system
is a little bit messed up,

because it should not be attacking
these natural things in our environment.

But it does.

[narrator] The worst outcome
is anaphylaxis:

a swift, violent attempt by the body
to eject an invader.

Anaphylaxis is a term used to describe

kind of a severe allergic reaction
that's rapid in onset.

A lot of times you'll hear,
"I feel my throat closing,"

or "tightening" or "itching."

Lungs are a big one.

You get wheezing, difficulty breathing,
tightening of the chest.

It can impact your gut.
This is very common.

So you'll have vomiting,
often profuse vomiting.

It results in suppression of heart rate,

drop in blood pressure, and bronchospasm.

Bronchospasm is the one
that's particularly dangerous.

It's difficulty of breathing.

[narrator] Ruby's mom got a call.

Ruby's friend's dad explained
that Ruby had had a reaction

to a curry that she'd had.

He said, "She just wants
to go to hospital."

I said, "Fine. Just take her straight away
and I will meet you there."

[soft music]

I walked in and I was looking for her,

and all I saw was this girl
stood in front of me,

which I felt so sorry for.

She was absolutely covered
in these purple hives,

which looked extremely painful.

And when she turned around,
I realized it was my daughter.

We both started crying, and I was like,

just grabbed her and said,
"It will be fine, it will be fine."

We got in to see the doctor

and he knew how serious it was.

The only way we know how to deal with it,
other than avoiding exposure to allergens,

is by reversing that reaction
by using epinephrine.

[narrator] Epinephrine,
also known as adrenaline,

is a hormone easily administered
through an auto-injector.

It's powerful stuff,
and each use requires hospitalization.

[Ruby Scott] After he used the EpiPen,

I just laid down for a bit
in the treatment room,

and my symptoms started to go.

It actually relaxes the muscles
around your lungs,

so it's easier to breathe.

And that's life-saving,
under these conditions.

I had the hives for about
three or four days afterwards.

And I just felt very weak.

[Marianne Scott] We had been told
that each time she has one,

they get worse.

And you just dread
what might happen next time.

[narrator] Trading Standards
is the UK agency

that monitors restaurant conditions.

Once Ruby had recovered,
Marianne Scott called the agency

to report what had happened.

Maybe the restaurant wasn't aware
that there was peanuts in.

So we wanted to make it aware,

so this didn't ever happen again
to someone.

I was adamant there was peanuts in it,

and I wanted them to see if there was
peanuts being used in their meals.

[narrator] The restaurant
where Ruby had ordered was Jaipur Spice.

A Trading Standards officer went in,
made a test purchase,

specified that they had to have
a meal that was nut-free,

were assured that the meal was nut-free.

The meal was full of peanut.
Enough peanut to kill.

[narrator] Jaipur Spice
was issued a warning.

They had informed the owner,

and told them
what had happened to my daughter,

and how they could
prevent it happening to anybody else.

[narrator] Food allergies have made
the dinner table a high-risk environment.

And it's chefs who are forced to navigate
that minefield every day and every night.

I don't remember...

I don't remember it ever being a thing,
you know, 20 years ago.

Someone...

I know people have been
deathly allergic to peanuts forever.

I just don't remember it being...

as part of a service as it is these days.

There weren't nearly as many allergies,
20 years ago, so there's that.

It was rare when you got
a peanut allergy or soy allergy,

so there didn't seem to be a need.

[narrator] But today's restaurant world
has been radically changed by allergies.

Ming Tsai was one of the first chefs
to embrace clientele with this condition.

I've probably witnessed
20 crying mothers in my restaurant,

at Blue Ginger, because it's older,

and I've spent time at the table and I go
over and say, "Is everything alright?"

She's like, "My son has
never been out to a restaurant."

He's 12, he's 13, he's 11, he's 8.
"Look how happy he is."

[staccato music]

I can't think of a more fundamental thing
of a restaurant,

of the baseline you have to do,

which is clean water to drink
and safe food to eat.

Everything else: the music, awesome,
but if music isn't playing, it's OK.

Buy a CD player.
That's not gonna kill someone.

But if you don't know what's in your food,
get out of the business. Today.

There's, like, certain things
you stay away from,

and certain kinds of restaurants
you stay away from.

You can tell immediately if the waiter
or waitress has been trained.

We always get down
to the exact food she wants,

because it doesn't matter
what the restaurant does.

It matters if that macaroni is safe.

Sometimes they will start
to talk about peanuts,

and I have to say,
"No, my kids aren't allergic to peanuts.

They're only allergic to tree nuts.

They come back to the table
and they say, "You should be OK."

It should be, like,
"You will be OK. You are OK. It's safe."

[Ming Tsai] We have, on a Saturday night,
15 allergen tables a night.

I mean, a lot.

Enough that it could, if you didn't have
a system, ruin your service.

And now, you ruin service
for 85, 150 other people.

[narrator] When he opened his first
restaurant, Ming created a food bible,

showing a complete list of the ingredients
that go into every item on the menu.

I took an Excel spreadsheet,
which is just boxes,

and it's just the eight allergens
that are key:

soy, wheat, dairy, shellfish, peanuts,
tree nuts, eggs, and fish.

Those are the eight ones
that are up top in a box,

and then we just highlight
that this dish has four of those eight.

So it's crystal clear when you look
in the beef and potatoes,

there are four allergens, the common ones.

Literally, everyone thinks
this is a hard thing to do.

It's just a spreadsheet.

We got it. It's a shorty.
"Severe shellfish allergy."

We gotta use clean tongs, clean spoons.

Alright. Here it is, you guys...

[Ming Tsai] So the sous-chef pulls
the ticket, the waiter will highlight it.

I initial it,

so we have a check and balance
that I physically checked it.

Even on a Saturday night, I have to.
This is life and death.

OK, guys, we've got a smashed cucumber.
Egg, soy, and gluten allergy.

So, no white soy.

[Sam Mason] The wait staff
is the first line of defense.

They are the liaison
between you and this human being

whose face will swell up if they...
you know, if they eat a crustacean.

[woman] At any one time, I probably
have 25 to 30 people in my section.

It matters.

Everything that I'm doing,
I have to stop, pay attention,

ring in the allergy correctly,
double-check correctly with the chefs.

[narrator] Sara frequently deals
with anxious parents

ordering for allergic children.

[Sara] The mom's concern was apparent.

She was, like, nervous,

and did not really trust
what was going on here.

So in order to gain her trust,

I talked to her about my knowledge
and what I knew

about the allergy that she conveyed to me.

And I took a picture of the product
and ingredients, and brought it to her.

So I started to show her the ingredients
and products we were using,

just in an effort to make her
feel more comfortable.

I already know and am confident
in what we do here,

and that we were going
to protect her child and not hurt her.

But I wanted her to know.

I feel like having a food allergy

would be the most expensive way
to eat out, ever.

I would give every waiter
that didn't kill me an extra 50 bucks!

"For you. Thank you for not killing me."

[narrator] The costs fall on kitchens
more often than customers,

but some chefs see it as an investment.

[Ming Tsai] Everybody's money is good:

people with allergies
and without allergies.

If I have a food allergy
and I'm going out to dinner with friends--

The four top--

We're going to go to the restaurant
I feel safest at,

that hopefully has delicious food.

Allergy people talk to each other a lot.

And if you get it,
the word of mouth gets out there.

And the amount of repeat business you get
from an allergen table is incredible.

[chef] We've a shrimp
and a chicken, Table 1.

The other shumai is Table 3.

[narrator] In an industry
of hairline profit margins

there are very real costs
to accommodating food allergies.

Consider the impact of the prep cook
on the bottom line.

[Sam Mason] If he's by himself
and he has to run downstairs

to make a small amount of...
let's say it's a dressing for a salad...

no other cold app or salad
is getting plated while he's gone.

So that person, in five minutes,

probably could have picked up
15 other plates,

and those plates are still empty.

You know, when turn times are so fast
and you're a very busy restaurant,

that translates to money.

That is... That's American currency
that's not coming your way.

[chef] Chicken dumpling for Table 312.
Safe for shellfish.

[narrator] And there's also the cost
of allergy claims,

that are occasionally bogus.

If one of the Kardashians
is gluten-intolerant,

there's a good chance
you might get a group of people

who are, all of a sudden,
gluten-intolerant as well!

That's just the way it's going to be.

It's a dairy allergy or a wheat allergy.

Then we see them eating a cookie
with dessert.

"We thought you had a wheat allergy."
"Oh, no, I'm just on a diet."

Well, that is so different than,
"You can die from eating something."

[Sam Mason] There was a lady at Tailor
once, and I remember this vividly.

She was allergic to large-chopped nuts.

I guess that's not really a nut allergy.

It was the size of the nuts
that she was "allergic" to, quote-unquote.

Which is just absurd.

And that is just so unfair,

because what that does is,
it pisses off chefs,

and they're like, "You know what?"

At one point they're gonna be, like,
"Forget it. It's another fake one."

But that one is going to be real,
and someone is going to get hurt.

[narrator] In Yorkshire,

three weeks after Ruby Scott's close call
with the peanut-laced curry,

another local, 38-year-old Paul Wilson,

stopped into the pub for a pint.

And he just started drinking in here.

And just chatting away.
A very popular gentleman.

He liked it in here because of the music.

We played '60s and '70s music
on the jukebox.

[man] He used to always
go next-door for a pizza.

-But obviously, this time...
-[Paul] He decided to go for an Indian.

[narrator] Wilson went to the nearby
Indian Garden restaurant

and ordered a nut-free curry.

Then Brad took him home.

Simple as that. That's how it was.

Then I was just chatting away to him
on the way home,

you know, just general chit-chat.

And I waited while he got in the house,
put the lights on,

and then I drove off.

He had barely started to eat the meal

when he must have realized he was
developing a severe allergic reaction.

People manage their allergies
in different ways.

His way of managing it was to go
to the toilet and make himself sick.

[man] The ambulance service
received a 999 call

from Mr. Wilson's flatmate,

above the Oak Tree pub, in Helperby,

where he worked in the restaurant.

When the police officers arrived there was
an Indian takeaway meal on the table.

It was set out.
There was some cutlery there.

There was a fork on the plate,

as if someone had had a mouthful
from that meal.

There was a massive reaction to it
from Paul,

and the reaction was so severe,

he collapsed and died
on his bathroom floor.

Paul Wilson developed an allergy
as a child,

when he ate a chocolate bar
that contained peanuts.

He went himself
into the catering industry,

became a chef, and worked in hospitality.

So he was acutely aware
of the dangers of allergies,

and the need to handle food safely.

[narrator] The two restaurants that had
sickened Ruby Scott and Paul Wilson

were both owned by the same man:

Mohammed Zaman.

Police began an investigation
into Wilson's death and Zaman's kitchens.

[tense music]

They sent samples
from Paul Wilson's final meal

to a laboratory for testing.

[man]
We received in sealed evidence bags,

the food that Paul Wilson had purchased
that day, on the day of his death,

and also, from the pathologist,

Mr. Wilson's stomach contents.

We take a certain... a small weight
of the sample that we've prepared,

and that's shaken with a solution
to extract the peanut protein

from the solid food.

Extracts from the food
are pipetted into tiny test tubes.

They are then incubated
for the reaction to occur,

and the color that's produced during
that reaction is read in a plate reader.

The sauce of the chicken tikka masala
contained very high amounts of peanut.

In fact, 19% of the sauce of
the chicken tikka masala was peanut.

He may have simply licked a spoon,
which he had used to...

take the meal from its containers
onto a plate.

There was certainly enough peanut
in the sauce of the tikka masala

for a teaspoonful of it
to cause his death.

[narrator] Next,
investigators shifted their focus

to the Indian Garden restaurant.

[Andrew Palmer] The CCTV showed
a male come into the restaurant

who I understood to be Paul Wilson.

He stood at the counter,
appeared to order a meal.

The order was written down
on an order slip that went to the kitchen.

And that order slip had written on it
clearly, "No nuts."

We retrieved from the bin
at Paul Wilson's house

the lid of the container,
that also read "no nuts."

[Andrew Palmer] While we were
in the restaurant, Mr. Zaman arrived.

I do remember feeling
sort of slightly uncomfortable

by some of the things that he was saying.

He just seemed to contradict himself.

Personally speaking, it didn't seem
like a truthful account.

[narrator] Zaman ran
a minor restaurant empire.

As his business grew, so did his debts.

It would appear that Mr. Zaman borrowed
a lot of money against the restaurants.

So that's what we put forward
as a potential motivation

for changing from almond to peanut.

He had a meeting
with one of his suppliers,

and he asked the supplier
if there was a cheaper alternative

to serving almond in his curries.

[Andrew Palmer] When Mr. Zaman swapped
from almond to peanut,

they warned him of the potential
allergy risks to his customers.

Mr. Zaman claimed
that he didn't get that warning.

[narrator] Zaman ignored
both his supplier and Trading Standards.

And just three weeks after his food
put Ruby Scott in the hospital,

a meal from Zaman's restaurant
killed Paul Wilson.

Marianne learned the news while continuing
conversations with the inspectors.

I think it was the third time
when they came,

and they explained to us
that somebody else had...

eaten one of the curries
and had a reaction.

And at the time I was, like,

"Well, I'm really...

I can't believe that this
is still happening at this time,

but maybe somebody will
do something about it

now that it's happened to somebody else."

And it was then that I was informed
that the person had died.

And it shocked me,

because it could have been my daughter.

And I was just grateful that it wasn't.

[ominous music]

[Richard Wright] There were
no changes to the menus.

The menus did not reveal
that there was peanut in the dishes.

And there was no evidence
of any staff training being put in place.

If you had done things right,
this should never have happened.

If you had taken steps,
this should never have happened.

If you had trained your staff,
this should never have happened.

And the saddest thing is that
the things that needed to be done

to keep Paul Wilson alive
and to protect customers,

they were tiny steps.

It wasn't just a case
of someone making a mistake.

It was a case of a catalog of mistakes

that had gone on for a long time,

and it's amazing how someone
hadn't already died

from eating a meal
from one of those restaurants.

[narrator] And so,

the Crown Prosecution Service
decided to pursue criminal charges.

We were saying that the negligence
of Mr. Zaman was so bad, so gross,

that it amounted to a criminal offense.

There was no prospect

that Paul Wilson was going to get
a safe meal from that kitchen.

So many opportunities to put things right
had been missed,

that it was almost inevitable
that this accident was going to happen.

[narrator] It would be the first ever
prosecution of a restaurateur

in a food allergy case.

There was some caution
around whether this should proceed.

There were no guidelines
for an offense of this type.

We were in uncharted waters.

[narrator] The case against Mohammed Zaman
went to trial in 2016.

[Richard Wright] Mr. Zaman was very keen
to blame everybody and anybody he could,

other than himself.

He claimed he had removed
all peanut from his kitchens

and instructed all of his staff
to change their ways.

But the fact that Paul Wilson died
demonstrated that could not have happened.

I think he had told himself so many lies

that he convinced himself
he was correct, and in the right.

And he wasn't.

[narrator] After a day of deliberating,
the jury found Mohammed Zaman guilty

of gross negligence manslaughter.

[Richard Wright] The total sentence
was six years imprisonment.

Six years for the offense of manslaughter.

It's a sentence which
sends out a message, I think,

to other restaurants and takeaways,

that they have a duty of care
for their customers.

People can say, "Oh, it wasn't fair.
It wasn't him that did it."

But when you put yourself out there,
and buy these restaurants and takeaways,

you are responsible
for what goes on in them.

These people knew what they were doing.

You've got...

a responsibility.

You've got a duty of care.

[Paul] Yeah.

[narrator] The death of Paul Wilson
is not unique.

Nearly half of food allergy deaths

are caused by food from restaurants
or other food services.

But doctors are still struggling with
the core questions: why? And why now?

[Ruslan Medzhitov]
We want to understand what makes

one organism hypersensitive,

hyperreactive,

versus another organism
that would be normally reactive.

And that is not clear
and not obvious at all.

Such a dramatic and quick increase
in incidence

indicates there is something changing
about our environment.

We all know genetics is part of it.

But then what is this environmental piece
that may be pushing us towards allergies?

We really have to look
at how things have changed.

[narrator] One leading theory
points to the population of microbes

that live in our guts: our microbiome.

That population ain't what it used to be.

Infants at birth
or in the first year of life,

are getting antibiotics
much more commonly.

What does that do?

It kind of wipes out your gut bacteria,
your normal flora.

We're kind of going
into a more clean state.

Microbes come from playing in the dirt.

Now there's fewer animals,
and people are having fewer children.

You know,
it's the whole microbiome spectrum.

So it's hard to pinpoint which
environmental piece is causing this,

but something, and maybe it's
most commonly, most probably,

a combination
of multiple environmental triggers

that are changing the microbiome.

[narrator] This lack of bacteria
may be confusing our immune system,

and so may the absence
of much larger attackers.

Parasitic worms have been living
with humans for centuries.

And as we became more clean,

we have gotten rid of parasitic worms
as part of us.

Has that caused our immune system
to take off in a different direction?

[narrator] It seems to specialists
that modern medicine and sanitation

have changed an ancient balance
inside our bodies.

Profound changes have also affected
the food we grow and eat.

[Ruslan] The whole process
of plant domestication and agriculture

made foods much more eatable.

But as we went one step further
with industrial food production,

there was a further reduction
in some of these substances

that normally come with food,

including non-nutrient substances,

that may not be toxic

but they are just normally part of food,
and we evolved to eat it.

If we eliminate that completely,

just like if we eliminate
all the microbes from the body,

I think we cannot function normally.

I think that, in terms of what foods
we should have him avoid,

for sure we should have him avoid milk.

I mean, the regular milk test
was positive.

The baked milk test,
the casein was positive.

We should probably do another blood test.
I just think we need more information.

Now he's avoiding milk...

[narrator] Most people with allergies
learn the hard way.

I asked my fiancée and my babysitter
to give him formula,

which was a cow milk protein,
and they did.

And that day we actually had to take him
to Lurie Children's Hospital ER

in Chicago.

And his eyes were completely swollen shut,

he didn't have much energy,
his face was swollen

and his eyes were turning a different,
dark color of red underneath his eyes,

and he was really sick.

[narrator] Food allergies
can be a moving target.

Many people diagnosed as children
will outgrow their allergies,

but will continue avoiding the foods
because they are unaware.

Food allergies affect 4% of adults,

but a full 30% believe
they have an allergy.

The way we currently diagnose it is,
you have to have a reaction to a food,

and then we test your blood
or do a skin prick test.

So if both of those...

If you had an allergic reaction
when you ate a peanut

and your peanut-specific IgE is positive
or your skin prick test is positive,

then we label it as a food allergy.

[narrator] The skin prick is
the best-known test for food allergies.

Tiny amounts of potential allergens
are poked under the skin

to provoke small but detectable reactions.

An alternate method
tests a patient's blood,

to see which immunoglobulins are present.

I'm sorry, Leo. I'm so sorry.

[narrator] But even after years
of refinement, neither tool delivers.

[nurse] You are so brave.

[Ruchi Gupta] Unfortunately, the testing
we have for food allergy is not ideal.

So the only way we have right now
to truly know,

is to eat the food and see what happens.

[narrator] It's called the food challenge,
and it tests the limits of the body.

You sit in a room
at the allergist's office,

and you eat the food
that you're allergic to.

Start with small quantities
and increase it over time.

And if you do not react,

then hopefully, you have
completely outgrown that food

and can introduce it into your diet.

[soft music]

[sizzles]

If you don't have a family
or a friend that has it,

you're actually not aware
of how life-threatening,

and what a pain in the rear
food allergies can be.

[narrator] One year
after opening Blue Ginger

and working to accommodate
allergic customers,

Ming Tsai went from proprietor
to allergy dad.

It was the very unfunny joke from upstairs
to give me a child

that has allergies to soy, wheat, dairy,
shellfish, peanuts, tree nuts, eggs.

Seven of the eight.

I'm like, "Oh, my God."

And we went to our pediatrician
and he basically said,

"Well, don't eat the foods. Good luck."

We're like, "Don't eat those foods?
Good luck?"

"Yeah, I can't do anything. Sorry."

[narrator] Ming and his wife kept
their son David away from dangerous foods

until he was four.

But one night
a babysitter forgot the warnings.

[Ming Tsai] David asked for some milk.

Now milk, to David, is his rice milk.

She serves him regular milk.

And he's like,
"I'm having problems breathing."

And that's...

You cannot be more scared as a parent,
when you hear that.

First you wish it was you, not your child.

But we're just so grateful we had...
we were prepared. We had the EpiPen.

But there's never been
a scarier moment in my life than,

"I can't breathe, Dad."

[Ruchi Gupta] I was doing research
on food allergies.

And my own daughter was diagnosed
with food allergies about nine years ago.

Something that I pretty much
spent most of my time studying

now became a reality in my own world.

Until you experience it,
you don't understand it completely.

Although you would never wish it,

it has informed so much
of the research we do.

Riya, do you have your lunchbox?

Oh, yeah.

[Ruchi] What are you taking today?

Today, I have the grilled cheese
that you made me.

OK.

And a nut-free chocolate bar.

I really started to fully understand
the impact it has

on every aspect of a child's life,
every single day.

You have your epinephrine?

Yeah.

For Natalie and for my family,
there's the physical health.

But honestly, I'm equally concerned
about her emotional health.

She never went to the grocery store,
didn't fly, didn't go to people's houses.

At some schools now, they have
separate tables for the allergy kids,

or they will have no peanut products,
or whatever, in their home.

A blue cafeteria tray
is what they thought of,

to distinguish the food allergy kids.

There were hand wipes for everybody
going into her classroom.

I mean, it was...

really restrictive at every turn.

When they go out into the real world

and they're wondering when
they're at their workplace or university,

"Why isn't this table nut-free?"

It's not going to be.

At a ballpark, in a movie theater,
on a date or whatever.

That's just not the reality.

[narrator] And avoidance
might even be a cause of the problem.

One of the remarkable developments
in food allergy medicine

has been a radical reinterpretation
of early exposure.

In the year 2000,
the American Academy of Pediatrics

recommended against feeding peanuts
and peanut butter to children under three.

We were just starting to see this increase
and we didn't know what to do.

So let's just avoid it, right?

We don't want
these kids anaphylaxing.

[narrator] But then, in 2008,

a study demonstrated an extremely
low prevalence of peanut allergy

in Israel.

[atmospheric guitar music]

[narrator] That result was tied to Bamba,

a peanut-based snack
widely eaten by small children.

[Gupta] If you actually introduce peanut
to an infant from 4 to 11 months,

they may actually significantly decrease
their chances of developing it

by almost 80% in those high-risk kids.

So now the AAP changed their guidelines
to say: "Introduce it to your child."

[narrator] This same concept,
"Just eat the food,"

is now being tested
in several new medical treatments.

All of them involve introducing
the food protein to the individual.

Starting with small amounts,
until their immune system recognizes it

and can tolerate
larger and greater amounts.

So I started out with Mini Oreos.
I had, like, three Mini Oreos.

And then the next week...
Two weeks later, I had nine.

This is my morning dose,

which is 10,000 milligrams
of just plain peanuts.

Fifty milligrams of wheat
was my original tolerance level.

Now I'm up to...

I got up to the point
where I could eat eight grams,

which is 8,000 milligrams.

So it was from 50 to 8,000.

So she got cleared to eat things
that might have cross-contact

the day before her birthday,
like, almost two years ago.

And what have you done since then?

Well, I've had a lot of things.

I've had Chinese.

Indian. I like Indian.

And then the thing just goes on and on,

to the point where I had
Sprinkles cupcakes,

like, the things a kid wants, basically,

that I grew up not being able to eat.

All the tests still show
that I'm allergic,

and just because
I'm eating peanuts every day

and I'm able to do it, most days,

doesn't mean that I'm not allergic.

It's most days that I'm OK.

Sometimes I do have reactions
for a variety of reasons.

And you know, it's not a cure, not yet.

It began in 2012 and since then,
my life has just completely changed.

Yeah, it's
a completely different life, now.

We are hoping some of these treatments
start coming to market in the next year.

Can't promise a cure, you know,

but good treatments coming our way
in the next five to ten years

are highly likely.

[narrator] That's encouraging
for allergy sufferers,

and good news for peanut farmers, too.

Now here's what you do.

Take it like this...

And then...

No, I'm serious.

Then look at the ground,

and any insects on there,
they'll be on the ground.

See? Right there.

[Glenn] That could
either be a corn earworm,

or some kind of army worm.

Always look for white mold
right here, Casey.

-In the middle.
-Yeah, in the middle.

[Casey] When you grow a crop,
when you're a farmer,

the last thing you want is for someone
to be afraid of what you produce.

You know how hard we work
to get this crop.

From day one,
how expensive to grow.

To put everything into your crop,

and then all you hear is negative reports
on it, it's kind of disheartening.

[Casey]
I really hope that in the next few years,

continued science and research
will encourage people

to not do an all-out ban of peanuts.

We don't want anyone to have
a negative experience with peanuts,

because it is our livelihood.

[narrator] In fact, peanut farmers,
including Casey and Glenn,

have started funding
food allergy research.

Their alliance, the National Peanut Board,

has already contributed
nearly $22 million.

No one wants to see money taken out
of the bottom line,

but in this case it's a good thing.

We have plans for the future.
She's the future for us.

And we'll do whatever we need to,
to make it work.

[tense music]