Nut Allergy 101

When you're allergic to peanuts or tree nuts, even a small amount can cause a severe allergic reaction. Find out what products are safest to eat, and which to avoid.
nut allergy

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Peanut allergy

Photo by: Chris Fertnig

Chris Fertnig

When you're allergic to peanuts or tree nuts, even a small amount can cause a severe allergic reaction. Peanuts aren't true nuts (they're a legume, just like beans and lentils), but their protein structure is similar to tree nuts and they're one of the most common food allergens. And because the protein structure is similar, folks allergic to peanuts are often allergic to tree nuts, such as almonds, walnuts, pecans, hazelnuts, macadamia nuts, filberts, pine nuts, pistachios, cashews and Brazil nuts.

Allergic reactions occur when the nut protein alerts the body's immune system to protect itself; it does so by releasing chemicals like histamine. These chemicals cause symptoms that vary from person to person, but typically include wheezing and coughing, problems breathing, anaphylaxis, throat tightness, stomach cramps, vomiting, diarrhea, itchy, watery and/or swollen eyes, hives and a drop in blood pressure. One person can actually react to the same food differently at different times.

The only way to deal with a nut allergy is to shun nuts entirely. Avoiding whole nuts, nut oils and nut butters is obvious, but peanuts and tree nuts are not always in evident places. You must know what to look for when reading food labels.

First, check labels every time you buy a product because manufacturers constantly revamp recipes and may add nuts to a new batch. After reading ingredient lists, look for these phrases:

• May contain nuts
• Produced on shared equipment with nuts or peanuts
• Produced in a facility that also processes nuts

These comments are required on labels due to the possibly of cross-contamination, meaning nuts might find their way into the food, even though it's not intentional or part of the ingredient list.

Next, be wary of high-risk foods (not all will contain nuts, so become label-savvy):

Baked goods: cookies, cakes, pastries, pie crusts
Candy: chocolate, nougat, marzipan

Ice cream and other frozen desserts: both grocery-store brands and ice cream shops (many times the same ice cream scoop is used for multiple flavors)

International cuisine (Asian, Thai, Indian): many dishes contain nuts
Soups, stews and chili: many are thickened with ground nuts
Pesto
Hot sauce
Gravy
Mexican mole sauce
Glazes and marinades
Pudding
Hot chocolate
Cereal and granola
Multi-grain breads
Energy bars
Honey
Italian ham: may contain pistachios
Vegetarian burgers
Salads and salad dressings
Hydrolyzed plant or vegetable protein

People with a severe nut allergy (meaning they have symptoms even when they handle or breathe in nuts) must also read labels on dog, cat and bird food, lotions and hair products.

When dining out, ask questions to be certain no sauce, dressing, gravy or any part of any dish contains nuts.

Even if you do your best to avoid nuts, there’s always the risk of exposure so be certain to carry an epinephrine auto-injector and know how to use it. Nut allergies can quickly become life-threatening so always be equipped.

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