What to watch for with peanut allergies

A food allergy occurs when the body’s immune system sees a certain food as harmful and reacts by causing symptoms. This is an allergic reaction. Foods that cause allergic reactions are allergens.

Two Categories of Food Allergies

  • Shortness of breath, trouble breathing, wheezing
  • Lupin (or lupine)—which is becoming a common flour substitute in gluten-free food.

    A study showed a strong possibility of cross-reaction between peanuts and this legume, unlike other legumes.

  • Sunflower seeds (which are often produced on equipment shared with peanuts)
  • Glazes and marinades
  • Enchilada sauce
  • Peanut flour
  • Arachis oil (another name for peanut oil)
  • Beer nuts
  • Pancakes
  • Marzipan
  • Alternative nut butters, such as soy nut butter or sunflower seed butter, are sometimes produced on equipment shared with other tree nuts and, in some cases, peanuts. Contact the manufacturer before eating these products.
  • Specialty pizzas
  • Cold-pressed, expelled or extruded peanut oil*
  • Ground nuts
  • Mixed nuts
  • Artificial nuts
  • Candy (including chocolate candy)
  • Chili
  • Skin rash, itching, hives
  • Feeling love something terrible is about to happen
  • African, Asian (especially Chinese, Indian, Indonesian, Thai and Vietnamese), and Mexican restaurant food—even if you order a peanut-free dish, there is high risk of cross-contact
  • Swelling of the lips, tongue or throat
  • Sweets such as pudding, cookies, baked goods, pies and boiling chocolate
  • Peanut butter
  • Stomach pain, vomiting, diarrhea
  • Nut pieces
  • Mandelonas (peanuts soaked in almond flavoring)
  • Monkey nuts
  • Nut meat
  • Ice creams
  • Nougat
  • Immunoglobulin E (IgE) mediated.

    Symptoms result from the body’s immune system making antibodies called Immunoglobulin E (IgE) antibodies. These IgE antibodies react with a certain food.

  • Egg rolls
  • Sauces such as chili sauce, boiling sauce, pesto, gravy, mole sauce and salad dressing
  • Pet food
  • Peanut protein hydrolysate
  • Non-IgE mediated. Other parts of the body’s immune system react to a certain food. This reaction causes symptoms, but does not involve an IgE antibody. Someone can own both IgE mediated and non-IgE mediated food allergies.
  • Goobers
  • Vegetarian food products, especially those advertised as meat substitutes

How to Read a Label for Tree Nuts

Always read the entire ingredient label to glance for the names of the tree nut(s) you need to avoid.

Tree nut ingredients may be within the list of the ingredients. Or tree nuts could be listed in a “Contains” statement beneath the list of ingredients. Examples are «Contains Walnut» or «Contains Almond». This is required by the federal Food Allergen Labeling and Consumer Protection Act (FALCPA). Study more about the U.S. food allergen labeling law.

FALCPA requires that every packaged foods regulated by the FDA must list the common names of tree nuts clearly on the ingredient label if it contains tree nuts. Advisory statements such as “may contain hazelnuts” or “made in a facility with tree nuts” are voluntary.

Advisory statements are not required by any federal labeling law. Discuss with your doctor if you may eat products with these labels or if you should avoid them.

What to watch for with peanut allergies

Did you know that marzipan, mortadella and  mandelonas every contain tree nuts? The FDA food allergen label law requires foods to state if they contain a top 8 allergen such as tree nuts. But, there are numerous foods and products that are not covered by the law, so it is still significant to know how to read a label for tree nut ingredients. Products exempt from plain English labeling rules: (1) Foods that are not regulated by the FDA. (2) Cosmetics and personal care items.

(3) Prescription and over-the-counter medications. (4) Toys, crafts and pet food.

CONTAIN TREE NUTS

The following ingredients found on a label indicate the presence of tree nuts. Every labels should be read carefully before consuming a product, even if it has been used safely in the past.

COMMON TREE NUT NAMES (FDA LIST)

Almond
Beechnut
Brazil nut
Bush nut
Butternut
Cashew
Chestnut
Coconut*
Filbert
Ginko nut
Hazelnut
Hickory nut
Lichee nut
Macadamia nut
Nangai nut
Pecan
Pine nut
Pistachio
Shea nut
Walnut

COMPLETE LIST OF TREE NUT NAMES (BOTANICAL NAMES AND DERIVATIVES)

Almond
Almond paste
Anacardium nuts
Anacardium occidentale (Anacardiaceae) [botanical name, Cashew]
Artificial nuts
Beech nut
Brazil nut
Bertholletia excelsa (Lecythidaceae) [botanical name, Brazil nut]
Bush nut
Butternut
Butyrospermum Parkii [botanical name, Shea nut]
Canarium ovatum Engl.

in A. DC. (Burseraceae) [botanical name, Pili nut]
Caponata
Carya illinoensis (Juglandaceae) [botanical name, Pecan]
Carya spp. (Juglandaceae) [botanical name, Hickory nut]
Cashew
Castanea pumila (Fagaceae) [botanical name, Chinquapin]
Castanea spp. (Fagaceae) [botanical name, Chestnut (Chinese, American, European, Seguin)]
Chestnut (Chinese, American, European, Seguin)
Chinquapin
Coconut*
Cocos nucifera L. (Arecaceae (alt.

Palmae)) [botanical name, Coconut]
Corylus spp. (Betulaceae) [botanical name, Filbert/hazelnut]
Filbert
Fagus spp. (Fagaceae) [botanical name, beech nut]
Gianduja
Ginko nut
Ginkgo biloba L. (Ginkgoaceae) [botanical name, Ginko nut]
Hazelnut
Heartnut
Hickory nut
Indian nut
Juglans cinerea (Juglandaceae) [botanical name, Butternut]
Juglans spp. (Juglandaceae) [botanical name, Walnut, Butternut, Heartnut]
Karite (shea nut)
Lichee nut
Litchi chinensis Sonn.

Sapindaceae [botanical name, Lichee nut]
Lychee nut
Macadamia nut
Macadamia spp. (Proteaceae) [botanical name, Macadamia nut/Bush nut]
Mandelonas
Marzipan
Mashuga nuts
Nangai nuts
Natural nut extract (for example, almond extract)
Nougat
Nu-Nuts®
Nut butters (e.g., Almond butter, Hazelnut butter, Brazil nut butter, Macadamia nut butter, Pistachio nut butter, Shea nut butter, Karike butter, as well as other nut butters)
Nut meal
Nutella ®
Nutmeat
Nut oil (e.g., Walnut oil as well as other nut oils)
Nut paste
Nut pieces
Pecan
Pigñolia
Pili nut
Pine nut
Pine nut (Indian, piñon, pinyon, pigndi, pigñolia, pignon nuts)
Pinon nut
Piñon or Piñon nut
Pinus spp.

(Pineaceae) [botanical name, Pine nut/piñon nut]
Pistachio
Pistacia vera L. (Anacardiaceae) [botanical name, Pistachio]
Pralines
Prunus dulcis (Rosaceae) [bontanical name, almond]
Shea nut
Sheanut
Vitellaria paradoxa C.F. Gaertn. (Sapotaceae) [botanical name, Shea nut]
Walnut (English, Persian, Black, Japanese, California)

TREE NUTS ARE SOMETIMES FOUND IN

Artificial flavoring
Baked goods
Mortadella
Natural flavoring
Nougat
Pesto

However, if the product is an FDA regulated food, the common tree nut name must appear on the label.

Tree Nut Substitutions

It is extremely simple to replace nuts in a recipe.

There are numerous seeds and seed products available including sunflower butter and pumpkin seed butter. Roasted chickpeas can replace nut snacks. Pretzels can substitute for pecans in pecan pie.

Learn more about  NUT SUBSTITUTES.

Cross Reactivity: Do You Need to Avoid Other Foods?

Cross-reactivity occurs when the proteins in one food are similar to the proteins in another. When that happens, the body’s immune system sees them as the same.

Tree nuts are in a diverse plant family than peanuts.

Peanuts are legumes and are not related to tree nuts (almonds, walnuts, cashews, etc.). However, about 35% of peanut-allergic toddlers in the U.S. own or will develop a tree nut allergy. Doctors often recommend that young children avoid tree nuts if they are allergic to peanuts. This is because it is fairly common to be «co-allergic» to tree nuts if a kid is allergic to peanuts.

There is a high degree of cross-reactivity between cashew and pistachio and between walnut and pecan. Most people who are allergic to one tree nut are not allergic to every tree nuts. But some doctors will advise their patients to avoid every tree nuts if allergic to one or more tree nuts.

Check with your doctor to discover out if you need to avoid every tree nuts.

Nutrition for a Nut-Free Diet

Tree nuts are a excellent source of protein, vitamins and minerals in a child’s diet. However, if your kid needs to avoid nuts of any type, they should not be at nutritional risk since there are numerous other sources of protein to eat instead.

NUTRIENTS LOST
WHEN AVOIDING TREE NUTS
SUGGESTED ALTERNATE SOURCES
(if not allergic)
Protein, Vitamins, Minerals Increase other protein foods such as meat, legumes,  fish, poultry, eggs, dairy
(if safe for your child);
fruit, vegetables, and enriched grains

IgE Mediated Food Allergies

The IgE mediated food allergies most common in infants and children are eggs, milk, peanuts, tree nuts, soy and wheat.

The allergic reaction can involve the skin, mouth, eyes, lungs, heart, gut and brain. Some of the symptoms can include:

  1. Skin rash, itching, hives
  2. Shortness of breath, trouble breathing, wheezing
  3. Stomach pain, vomiting, diarrhea
  4. Swelling of the lips, tongue or throat
  5. Feeling love something terrible is about to happen

Sometimes allergy symptoms are mild. Other times they can be severe. Take every allergic symptoms seriously.

Mild and severe symptoms can lead to a serious allergic reaction called anaphylaxis (anna-fih-LACK-sis). This reaction generally involves more than one part of the body and can get worse quick. Anaphylaxis must be treated correct away to provide the best chance for improvement and prevent serious, potentially life-threatening complications.

Treat anaphylaxis with epinephrine. This medicine is safe and comes in an easy-to-use device called an auto-injector. You can’t rely on antihistamines to treat anaphylaxis.

The symptoms of an anaphylactic reaction happen shortly after contact with an allergen. In some individuals, there may be a delay of two to three hours before symptoms first appear.

Cross-Reactivity and Oral Allergy Syndrome

Having an IgE mediated allergy to one food can mean your kid is allergic to similar foods. For example, if your kid is allergic to shrimp, he or she may be allergic to other types of shellfish, such as crab or crayfish. Or if your kid is allergic to cow’s milk, he or she may also be allergic to goat’s and sheep’s milk.

The reaction between diverse foods is called cross-reactivity. This happens when proteins in one food are similar to the proteins in another food.

Cross-reactivity also can happen between latex and certain foods. For example, a kid who has an allergy to latex may also own an allergy to bananas, avocados, kiwis or chestnuts.

Some people who own allergies to pollens, such as ragweed and grasses, may also be allergic to some foods. Proteins in the pollens are love the proteins in some fruits and vegetables. So, if your kid is allergic to ragweed, he or she may own an allergic reaction to melons and bananas.

That’s because the protein in ragweed looks love the proteins in melons and bananas. This condition is oral allergy syndrome.

Symptoms of an oral allergy syndrome include an itchy mouth, throat or tongue. Symptoms can be more severe and may include hives, shortness of breath and vomiting. Reactions generally happen only when someone eats raw food. In rare cases, reactions can be life-threatening and need epinephrine.

*Coconut

The FDA lists coconut as a tree nut. In fact, coconut is a seed of a drupaceous fruit. Most people allergic to tree nuts can safely eat coconut. Coconut allergy is reasonably rare.

If you are allergic to tree nuts, talk to your allergist before adding coconut to or eliminating coconut from your diet.

Non-IgE Mediated Food Allergies

Most symptoms of non-IgE mediated food allergies involve the digestive tract. Symptoms may be vomiting and diarrhea. The symptoms can take longer to develop and may final longer than IgE mediated allergy symptoms. Sometimes, a reaction to a food allergen occurs up 3 days after eating the food allergen.

When an allergic reaction occurs with this type of allergy, epinephrine is generally not needed.

In general, the best way to treat these allergies is to stay away from the food that causes the reaction. Under are examples of conditions related to non-IgE mediated food allergies.

Not every children who react to a certain food own an allergy. They may own food intolerance. Examples are lactose intolerance, gluten intolerance, sulfite sensitivity or dye sensitivity. Staying away from these foods is the best way to avoid a reaction.

Your child’s doctor may propose other steps to prevent a reaction. If your kid has any food allergy symptoms, see your child’s doctor or allergist. Only a doctor can properly diagnose whether your kid has an IgE- or non-IgE food allergy. Both can be present in some children.

Eosinophilic Esophagitis (EoE)

Eosinophilic (ee-uh-sin-uh-fil-ik) esophagitis is an inflamed esophagus. The esophagus is a tube from the throat to the stomach. An allergy to a food can cause this condition.

With EoE, swallowing food can be hard and painful. Symptoms in infants and toddlers are irritability, problems with eating and poor weight acquire.

Older children may own reflux, vomiting, stomach pain, chest pain and a feeling love food is “stuck” in their throat. The symptoms can happen days or even weeks after eating a food allergen.

EoE is treated by special diets that remove the foods that are causing the condition. Medication may also be used to reduce inflammation.

Food Protein-Induced Enterocolitis Syndrome (FPIES)

FPIES is another type of food allergy. It most often affects young infants. Symptoms generally don’t appear for two or more hours. Symptoms include vomiting, which starts about 2 hours or later after eating the food causing the condition.

This condition can also cause diarrhea and failure to acquire weight or height. Once the baby stops eating the food causing the allergy, the symptoms go away. Rarely, severe vomiting and diarrhea can happen which can lead to dehydration and even shock. Shock occurs when the body is not getting enough blood flow. Emergency treatment for severe symptoms must happen correct away at a hospital. The foods most likely to cause a reaction are dairy, soy, rice, oat, barley, green beans, peas, sweet potatoes, squash and poultry.

Allergic Proctocolitis

Allergic proctocolitis is an allergy to formula or breast milk.

This condition inflames the lower part of the intestine. It affects infants in their first year of life and generally ends by age 1 year.

The symptoms include blood-streaked, watery and mucus-filled stools. Infants may also develop green stools, diarrhea, vomiting, anemia (low blood count) and fussiness. When properly diagnosed, symptoms resolve once the offending food(s) are removed from the diet.

Medical review December 2014.

To prevent a reaction, it is extremely significant that you avoid peanut and peanut products. Always read food labels to identify peanut ingredients.

If you are allergic to peanuts, you own a 25 to 40 percent higher chance of also being allergic to tree nuts.1 Also, peanuts and tree nuts often touch one another during manufacturing and serving processes.

Discuss with your allergist whether you need to also avoid tree nuts.

Peanuts are one of the eight major allergens that must be listed on packaged foods sold in the U.S., as required by federal law.

Avoid foods that contain peanuts or any of these ingredients:

  1. Artificial nuts
  2. Ground nuts
  3. Peanut flour
  4. Mixed nuts
  5. Nut pieces
  6. Cold-pressed, expelled or extruded peanut oil*
  7. Mandelonas (peanuts soaked in almond flavoring)
  8. Lupin (or lupine)—which is becoming a common flour substitute in gluten-free food. A study showed a strong possibility of cross-reaction between peanuts and this legume, unlike other legumes.
  9. Monkey nuts
  10. Nut meat
  11. Goobers
  12. Peanut butter
  13. Arachis oil (another name for peanut oil)
  14. Beer nuts
  15. Peanut protein hydrolysate

*Highly refined peanut oil is not required to be labeled as an allergen.

Studies show that most people with peanut allergy can safely eat this helpful of peanut oil. If you are allergic to peanuts, enquire your doctor whether you should avoid peanut oil.

But avoid cold-pressed, expelled or extruded peanut oil—sometimes called gourmet oils. These ingredients are diverse and are not safe to eat if you own a peanut allergy.

Other Possible Sources of Peanut

Peanuts can be found in surprising places.

While allergens are not always present in these food and products, you can’t be too careful.

Remember to read food labels and enquire questions about ingredients before eating a food that you own not prepared yourself.

  1. Alternative nut butters, such as soy nut butter or sunflower seed butter, are sometimes produced on equipment shared with other tree nuts and, in some cases, peanuts. Contact the manufacturer before eating these products.
  2. Glazes and marinades
  3. Sweets such as pudding, cookies, baked goods, pies and boiling chocolate
  4. Pancakes
  5. Specialty pizzas
  6. Chili
  7. Marzipan
  8. Ice creams
  9. Pet food
  10. Sauces such as chili sauce, boiling sauce, pesto, gravy, mole sauce and salad dressing
  11. Enchilada sauce
  12. Nougat
  13. Candy (including chocolate candy)
  14. African, Asian (especially Chinese, Indian, Indonesian, Thai and Vietnamese), and Mexican restaurant food—even if you order a peanut-free dish, there is high risk of cross-contact
  15. Egg rolls
  16. Sunflower seeds (which are often produced on equipment shared with peanuts)
  17. Vegetarian food products, especially those advertised as meat substitutes

Also, peanut hulls (shells) can sometimes be found in compost, which can be used as lawn fertilizer.

Before you hire a contractor, enquire whether they use peanut hulls in their compost so you can make an informed decision.


1 Sicherer SH, Munoz-Furlong A, Burks AW, Sampson HA. Prevalence of peanut and tree nut allergy in the US sure by a random digit dial telephone survey. J Allergy Clin Immunol 1999; 103(4):559-62; see also Sicherer SH, Munoz-Furlong A, Sampson HA. Prevalence of peanut and tree nut allergy in the United States sure by means of a random digit dial telephone survey: a 5-year follow-up study.

J Allergy Clin Immunol 2003; 112(6):1203-7.
2 Sicherer SH, Munoz-Furlong A, Godbold JH, Sampson HA. US prevalence of self-reported peanut, tree nut, and sesame allergy: 11-year follow-up. J Allergy Clin Immunol 2010; 125(6):1322-6. [LINK to ADVANCING A CURE>FARE Research Grants>Selected Completed Studies > Sicherer, Prevalence of Peanut and Tree Nut Allergy in the United States]

Tree Nut Allergy

Tree nut allergy is the second most common allergy in infants and young children. Approximately 0.4- 0.5% of American children own a tree nut allergy.

Tree nuts are a common allergen reported to cause fatal and near-fatal allergic reactions.

Tree nut allergy is generally life-long once acquired. Approximately 9% of children allergic to tree nuts may outgrow their allergy.

Children with a tree nut allergy must avoid that tree nut and every products containing that type of tree nut. Children with a tree nut allergy also must avoid anything containing traces of ingredients containing that tree nut. There is a potential of tree nut products having cross-contact other tree nuts and with peanuts. For this reason, your child’s doctor may advise you to avoid every tree nuts and peanuts.

Nut-Free Recipes

Over 1100 nut-free recipes are available in KFA’s Safe Eats™ Recipes.

Search for Nut-Free Recipes

Medical review February 2015.

How to Read a Label for Tree Nuts

Always read the entire ingredient label to glance for the names of the tree nut(s) you need to avoid. Tree nut ingredients may be within the list of the ingredients. Or tree nuts could be listed in a “Contains” statement beneath the list of ingredients. Examples are «Contains Walnut» or «Contains Almond».

This is required by the federal Food Allergen Labeling and Consumer Protection Act (FALCPA). Study more about the U.S. food allergen labeling law.

FALCPA requires that every packaged foods regulated by the FDA must list the common names of tree nuts clearly on the ingredient label if it contains tree nuts. Advisory statements such as “may contain hazelnuts” or “made in a facility with tree nuts” are voluntary. Advisory statements are not required by any federal labeling law. Discuss with your doctor if you may eat products with these labels or if you should avoid them.

Did you know that marzipan, mortadella and  mandelonas every contain tree nuts? The FDA food allergen label law requires foods to state if they contain a top 8 allergen such as tree nuts. But, there are numerous foods and products that are not covered by the law, so it is still significant to know how to read a label for tree nut ingredients. Products exempt from plain English labeling rules: (1) Foods that are not regulated by the FDA. (2) Cosmetics and personal care items. (3) Prescription and over-the-counter medications. (4) Toys, crafts and pet food.

CONTAIN TREE NUTS

The following ingredients found on a label indicate the presence of tree nuts.

Every labels should be read carefully before consuming a product, even if it has been used safely in the past.

COMMON TREE NUT NAMES (FDA LIST)

Almond
Beechnut
Brazil nut
Bush nut
Butternut
Cashew
Chestnut
Coconut*
Filbert
Ginko nut
Hazelnut
Hickory nut
Lichee nut
Macadamia nut
Nangai nut
Pecan
Pine nut
Pistachio
Shea nut
Walnut

COMPLETE LIST OF TREE NUT NAMES (BOTANICAL NAMES AND DERIVATIVES)

Almond
Almond paste
Anacardium nuts
Anacardium occidentale (Anacardiaceae) [botanical name, Cashew]
Artificial nuts
Beech nut
Brazil nut
Bertholletia excelsa (Lecythidaceae) [botanical name, Brazil nut]
Bush nut
Butternut
Butyrospermum Parkii [botanical name, Shea nut]
Canarium ovatum Engl.

in A. DC. (Burseraceae) [botanical name, Pili nut]
Caponata
Carya illinoensis (Juglandaceae) [botanical name, Pecan]
Carya spp. (Juglandaceae) [botanical name, Hickory nut]
Cashew
Castanea pumila (Fagaceae) [botanical name, Chinquapin]
Castanea spp. (Fagaceae) [botanical name, Chestnut (Chinese, American, European, Seguin)]
Chestnut (Chinese, American, European, Seguin)
Chinquapin
Coconut*
Cocos nucifera L. (Arecaceae (alt. Palmae)) [botanical name, Coconut]
Corylus spp. (Betulaceae) [botanical name, Filbert/hazelnut]
Filbert
Fagus spp. (Fagaceae) [botanical name, beech nut]
Gianduja
Ginko nut
Ginkgo biloba L.

(Ginkgoaceae) [botanical name, Ginko nut]
Hazelnut
Heartnut
Hickory nut
Indian nut
Juglans cinerea (Juglandaceae) [botanical name, Butternut]
Juglans spp. (Juglandaceae) [botanical name, Walnut, Butternut, Heartnut]
Karite (shea nut)
Lichee nut
Litchi chinensis Sonn. Sapindaceae [botanical name, Lichee nut]
Lychee nut
Macadamia nut
Macadamia spp. (Proteaceae) [botanical name, Macadamia nut/Bush nut]
Mandelonas
Marzipan
Mashuga nuts
Nangai nuts
Natural nut extract (for example, almond extract)
Nougat
Nu-Nuts®
Nut butters (e.g., Almond butter, Hazelnut butter, Brazil nut butter, Macadamia nut butter, Pistachio nut butter, Shea nut butter, Karike butter, as well as other nut butters)
Nut meal
Nutella ®
Nutmeat
Nut oil (e.g., Walnut oil as well as other nut oils)
Nut paste
Nut pieces
Pecan
Pigñolia
Pili nut
Pine nut
Pine nut (Indian, piñon, pinyon, pigndi, pigñolia, pignon nuts)
Pinon nut
Piñon or Piñon nut
Pinus spp.

(Pineaceae) [botanical name, Pine nut/piñon nut]
Pistachio
Pistacia vera L. (Anacardiaceae) [botanical name, Pistachio]
Pralines
Prunus dulcis (Rosaceae) [bontanical name, almond]
Shea nut
Sheanut
Vitellaria paradoxa C.F. Gaertn. (Sapotaceae) [botanical name, Shea nut]
Walnut (English, Persian, Black, Japanese, California)

TREE NUTS ARE SOMETIMES FOUND IN

Artificial flavoring
Baked goods
Mortadella
Natural flavoring
Nougat
Pesto

However, if the product is an FDA regulated food, the common tree nut name must appear on the label.

Tree Nut Substitutions

It is extremely simple to replace nuts in a recipe.

There are numerous seeds and seed products available including sunflower butter and pumpkin seed butter. Roasted chickpeas can replace nut snacks. Pretzels can substitute for pecans in pecan pie.

Learn more about  NUT SUBSTITUTES.

Cross Reactivity: Do You Need to Avoid Other Foods?

Cross-reactivity occurs when the proteins in one food are similar to the proteins in another. When that happens, the body’s immune system sees them as the same.

Tree nuts are in a diverse plant family than peanuts. Peanuts are legumes and are not related to tree nuts (almonds, walnuts, cashews, etc.).

However, about 35% of peanut-allergic toddlers in the U.S. own or will develop a tree nut allergy. Doctors often recommend that young children avoid tree nuts if they are allergic to peanuts. This is because it is fairly common to be «co-allergic» to tree nuts if a kid is allergic to peanuts.

There is a high degree of cross-reactivity between cashew and pistachio and between walnut and pecan. Most people who are allergic to one tree nut are not allergic to every tree nuts.

What to watch for with peanut allergies

But some doctors will advise their patients to avoid every tree nuts if allergic to one or more tree nuts. Check with your doctor to discover out if you need to avoid every tree nuts.

Nutrition for a Nut-Free Diet

Tree nuts are a excellent source of protein, vitamins and minerals in a child’s diet. However, if your kid needs to avoid nuts of any type, they should not be at nutritional risk since there are numerous other sources of protein to eat instead.

NUTRIENTS LOST
WHEN AVOIDING TREE NUTS
SUGGESTED ALTERNATE SOURCES
(if not allergic)
Protein, Vitamins, Minerals Increase other protein foods such as meat, legumes,  fish, poultry, eggs, dairy
(if safe for your child);
fruit, vegetables, and enriched grains

IgE Mediated Food Allergies

The IgE mediated food allergies most common in infants and children are eggs, milk, peanuts, tree nuts, soy and wheat.

What to watch for with peanut allergies

The allergic reaction can involve the skin, mouth, eyes, lungs, heart, gut and brain. Some of the symptoms can include:

  1. Skin rash, itching, hives
  2. Shortness of breath, trouble breathing, wheezing
  3. Stomach pain, vomiting, diarrhea
  4. Swelling of the lips, tongue or throat
  5. Feeling love something terrible is about to happen

Sometimes allergy symptoms are mild. Other times they can be severe. Take every allergic symptoms seriously. Mild and severe symptoms can lead to a serious allergic reaction called anaphylaxis (anna-fih-LACK-sis). This reaction generally involves more than one part of the body and can get worse quick.

What to watch for with peanut allergies

Anaphylaxis must be treated correct away to provide the best chance for improvement and prevent serious, potentially life-threatening complications.

Treat anaphylaxis with epinephrine. This medicine is safe and comes in an easy-to-use device called an auto-injector. You can’t rely on antihistamines to treat anaphylaxis. The symptoms of an anaphylactic reaction happen shortly after contact with an allergen. In some individuals, there may be a delay of two to three hours before symptoms first appear.

Cross-Reactivity and Oral Allergy Syndrome

Having an IgE mediated allergy to one food can mean your kid is allergic to similar foods.

For example, if your kid is allergic to shrimp, he or she may be allergic to other types of shellfish, such as crab or crayfish. Or if your kid is allergic to cow’s milk, he or she may also be allergic to goat’s and sheep’s milk. The reaction between diverse foods is called cross-reactivity. This happens when proteins in one food are similar to the proteins in another food.

Cross-reactivity also can happen between latex and certain foods.

For example, a kid who has an allergy to latex may also own an allergy to bananas, avocados, kiwis or chestnuts.

Some people who own allergies to pollens, such as ragweed and grasses, may also be allergic to some foods.

What to watch for with peanut allergies

Proteins in the pollens are love the proteins in some fruits and vegetables. So, if your kid is allergic to ragweed, he or she may own an allergic reaction to melons and bananas. That’s because the protein in ragweed looks love the proteins in melons and bananas. This condition is oral allergy syndrome.

Symptoms of an oral allergy syndrome include an itchy mouth, throat or tongue. Symptoms can be more severe and may include hives, shortness of breath and vomiting. Reactions generally happen only when someone eats raw food. In rare cases, reactions can be life-threatening and need epinephrine.

*Coconut

The FDA lists coconut as a tree nut.

What to watch for with peanut allergies

In fact, coconut is a seed of a drupaceous fruit. Most people allergic to tree nuts can safely eat coconut. Coconut allergy is reasonably rare. If you are allergic to tree nuts, talk to your allergist before adding coconut to or eliminating coconut from your diet.

Non-IgE Mediated Food Allergies

Most symptoms of non-IgE mediated food allergies involve the digestive tract. Symptoms may be vomiting and diarrhea. The symptoms can take longer to develop and may final longer than IgE mediated allergy symptoms.

Sometimes, a reaction to a food allergen occurs up 3 days after eating the food allergen.

When an allergic reaction occurs with this type of allergy, epinephrine is generally not needed. In general, the best way to treat these allergies is to stay away from the food that causes the reaction. Under are examples of conditions related to non-IgE mediated food allergies.

Not every children who react to a certain food own an allergy. They may own food intolerance. Examples are lactose intolerance, gluten intolerance, sulfite sensitivity or dye sensitivity.

What to watch for with peanut allergies

Staying away from these foods is the best way to avoid a reaction. Your child’s doctor may propose other steps to prevent a reaction. If your kid has any food allergy symptoms, see your child’s doctor or allergist. Only a doctor can properly diagnose whether your kid has an IgE- or non-IgE food allergy. Both can be present in some children.

Eosinophilic Esophagitis (EoE)

Eosinophilic (ee-uh-sin-uh-fil-ik) esophagitis is an inflamed esophagus. The esophagus is a tube from the throat to the stomach. An allergy to a food can cause this condition.

With EoE, swallowing food can be hard and painful.

Symptoms in infants and toddlers are irritability, problems with eating and poor weight acquire. Older children may own reflux, vomiting, stomach pain, chest pain and a feeling love food is “stuck” in their throat. The symptoms can happen days or even weeks after eating a food allergen.

EoE is treated by special diets that remove the foods that are causing the condition. Medication may also be used to reduce inflammation.

Food Protein-Induced Enterocolitis Syndrome (FPIES)

FPIES is another type of food allergy.

It most often affects young infants. Symptoms generally don’t appear for two or more hours. Symptoms include vomiting, which starts about 2 hours or later after eating the food causing the condition. This condition can also cause diarrhea and failure to acquire weight or height. Once the baby stops eating the food causing the allergy, the symptoms go away. Rarely, severe vomiting and diarrhea can happen which can lead to dehydration and even shock.

Shock occurs when the body is not getting enough blood flow. Emergency treatment for severe symptoms must happen correct away at a hospital. The foods most likely to cause a reaction are dairy, soy, rice, oat, barley, green beans, peas, sweet potatoes, squash and poultry.

Allergic Proctocolitis

Allergic proctocolitis is an allergy to formula or breast milk. This condition inflames the lower part of the intestine. It affects infants in their first year of life and generally ends by age 1 year.

The symptoms include blood-streaked, watery and mucus-filled stools.

Infants may also develop green stools, diarrhea, vomiting, anemia (low blood count) and fussiness. When properly diagnosed, symptoms resolve once the offending food(s) are removed from the diet.

Medical review December 2014.

To prevent a reaction, it is extremely significant that you avoid peanut and peanut products. Always read food labels to identify peanut ingredients.

If you are allergic to peanuts, you own a 25 to 40 percent higher chance of also being allergic to tree nuts.1 Also, peanuts and tree nuts often touch one another during manufacturing and serving processes. Discuss with your allergist whether you need to also avoid tree nuts.

Peanuts are one of the eight major allergens that must be listed on packaged foods sold in the U.S., as required by federal law.

Avoid foods that contain peanuts or any of these ingredients:

  1. Artificial nuts
  2. Ground nuts
  3. Peanut flour
  4. Mixed nuts
  5. Nut pieces
  6. Cold-pressed, expelled or extruded peanut oil*
  7. Mandelonas (peanuts soaked in almond flavoring)
  8. Lupin (or lupine)—which is becoming a common flour substitute in gluten-free food.

    A study showed a strong possibility of cross-reaction between peanuts and this legume, unlike other legumes.

  9. Monkey nuts
  10. Nut meat
  11. Goobers
  12. Peanut butter
  13. Arachis oil (another name for peanut oil)
  14. Beer nuts
  15. Peanut protein hydrolysate

*Highly refined peanut oil is not required to be labeled as an allergen. Studies show that most people with peanut allergy can safely eat this helpful of peanut oil.

If you are allergic to peanuts, enquire your doctor whether you should avoid peanut oil.

But avoid cold-pressed, expelled or extruded peanut oil—sometimes called gourmet oils.

What to watch for with peanut allergies

These ingredients are diverse and are not safe to eat if you own a peanut allergy.

Other Possible Sources of Peanut

Peanuts can be found in surprising places. While allergens are not always present in these food and products, you can’t be too careful.

Remember to read food labels and enquire questions about ingredients before eating a food that you own not prepared yourself.

  1. Alternative nut butters, such as soy nut butter or sunflower seed butter, are sometimes produced on equipment shared with other tree nuts and, in some cases, peanuts.

    Contact the manufacturer before eating these products.

  2. Glazes and marinades
  3. Sweets such as pudding, cookies, baked goods, pies and boiling chocolate
  4. Pancakes
  5. Specialty pizzas
  6. Chili
  7. Marzipan
  8. Ice creams
  9. Pet food
  10. Sauces such as chili sauce, boiling sauce, pesto, gravy, mole sauce and salad dressing
  11. Enchilada sauce
  12. Nougat
  13. Candy (including chocolate candy)
  14. African, Asian (especially Chinese, Indian, Indonesian, Thai and Vietnamese), and Mexican restaurant food—even if you order a peanut-free dish, there is high risk of cross-contact
  15. Egg rolls
  16. Sunflower seeds (which are often produced on equipment shared with peanuts)
  17. Vegetarian food products, especially those advertised as meat substitutes

Also, peanut hulls (shells) can sometimes be found in compost, which can be used as lawn fertilizer.

Before you hire a contractor, enquire whether they use peanut hulls in their compost so you can make an informed decision.


1 Sicherer SH, Munoz-Furlong A, Burks AW, Sampson HA. Prevalence of peanut and tree nut allergy in the US sure by a random digit dial telephone survey. J Allergy Clin Immunol 1999; 103(4):559-62; see also Sicherer SH, Munoz-Furlong A, Sampson HA. Prevalence of peanut and tree nut allergy in the United States sure by means of a random digit dial telephone survey: a 5-year follow-up study. J Allergy Clin Immunol 2003; 112(6):1203-7.
2 Sicherer SH, Munoz-Furlong A, Godbold JH, Sampson HA. US prevalence of self-reported peanut, tree nut, and sesame allergy: 11-year follow-up.

J Allergy Clin Immunol 2010; 125(6):1322-6. [LINK to ADVANCING A CURE>FARE Research Grants>Selected Completed Studies > Sicherer, Prevalence of Peanut and Tree Nut Allergy in the United States]

Tree Nut Allergy

Tree nut allergy is the second most common allergy in infants and young children. Approximately 0.4- 0.5% of American children own a tree nut allergy. Tree nuts are a common allergen reported to cause fatal and near-fatal allergic reactions.

Tree nut allergy is generally life-long once acquired. Approximately 9% of children allergic to tree nuts may outgrow their allergy.

Children with a tree nut allergy must avoid that tree nut and every products containing that type of tree nut.

Children with a tree nut allergy also must avoid anything containing traces of ingredients containing that tree nut. There is a potential of tree nut products having cross-contact other tree nuts and with peanuts. For this reason, your child’s doctor may advise you to avoid every tree nuts and peanuts.

Nut-Free Recipes

Over 1100 nut-free recipes are available in KFA’s Safe Eats™ Recipes. Search for Nut-Free Recipes

Medical review February 2015.


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