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Nut and Peanut Allergy

Updated on February 18, 2018

The Basics

Nut allergies affect one to two per cent of the population worldwide. Prevalence of this allergy is thought to be rising, especially in children. Awareness of nut allergies have been increasing in recent years as nut allergies, along with seafood, produce the most serious allergic reactions even in minute amounts.

Frequently, this allergy first occurs during childhood. Researches hypothesize that nut allergies develop when children are given foods containing nut proteins before their gastrointestinal tract or immune systems are fully mature. In contrast to other food allergies like milk and eggs, nut allergies are usually not outgrown. Experts recommend that children with a family history of food allergies should not eat peanuts or tree nuts, such as pecans or walnuts, until after age three. Similarly, pregnant women with a history or family history of food allergies should avoid peanuts or tree nuts.

As this allergy commonly occurs in children, educating friends, relatives and acquaintances is essential. Furthermore, since nut allergies tend to produce serious allergic reactions, even adults may need the assistance of friends and family for emergency treatment. If you or your child has a nut allergy, educate friends and family to recognize the signs of an allergic reaction and how to use an emergency epinephrine kit.

Strategies to Avoid Nuts

  • Read labels, do not eat foods that do not have labels.
  • Avoid bulk bin foods as they may have come into contact with nut products.
  • Don't eat baked goods from bakeries where food may be cross contaminated with nuts during baking or in the display.
  • Thoroughly clean counter tops, cutlery or dishes after contact with nuts before using, the nut residue can produce a reaction.
  • Avoid all nuts as they are commonly contaminated with other nut material during production.
  • Exercise safe restaurant, fast food, and traveling techniques.
  • Air borne nut material from cooking, opening sealed nut butters or from others eating nuts can cause asthma in susceptible individuals.
  • Pure peanut oil is generally safe, however, cold pressed peanut oil may be contaminated with peanut protein.
  • Be weary of foods at deli counters that serve bar-be-que foods, bar-be-que sauce generally contains peanut oil and may unknowingly contaminate other foods.
  • Asian, Chinese, Thai, Mediterranean, Indian, and African foods often contain nuts and should be eaten cautiously.
  • Check animal food labels and be careful when visiting places that have animals. Some animal, bird feed contain nuts.
  • Many cosmetics, sunscreen, shampoos, shaving cream, and health care products may contain nuts or nut oils.
  • Notify your pharmacist of your nut allergy. Some medications, such as the hormone replacement therapy medication Prometrium, contain nuts.

Alert For Kids

As far a food allergies go, peanut and nut allergies are real cause for alert in the daily lives of children and their parents. From peanut butter sandwiches in the lunchroom, cookies at holiday parties, flavors in ice creams, candy packs and birthday celebrations, kids are literally surrounded. Unfortunately, anything from skin rash to a life threatening anaphylactic reaction is possible. Each potential exposure risk must be taken seriously.

The point for parents, and children themselves as they grow older, is to scrupulously screen for any potential source of peanuts or nuts. Teach children at an early age tell adults and other kids about their allergy, and train your child to always ask about nuts or peanuts before eating any food at a party or classroom event. If your child is invited to a friend's home or party, talk with the host parents in advance to review the allergy precautions and emergency procedures. While this is a serious matter, it is important to keep discussions you have with your child about the allergy calm, direct and in a matter-of-fact tone. Knowledge, assertiveness training and skill building will benefit children with allergies far more than anxiety and fear.

Teachers, daycare staff, parents of your child's close friends and relatives should be all told of the allergy, educated about potentials for exposure and instructed on what to do in case of emergency. Fellow classroom parents should be asked to avoid adding nuts, peanuts or peanut butter to any potluck items being prepared for class parties. (This may be addressed in a letter distributed to all parents by the school or classroom teacher.) At very least, ask that food containing nuts or peanuts be clearly labeled and that the teacher is informed.

Young, school age friends may not be able to manage an impulse to 'have fun' with regards to your child's allergy. Without malicious intent, even good friends may find it 'funny' to tease a classmate by threatening to touch him or her with a little peanut butter. Young children are unable to grasp the potential for serious harm from something as 'benign' to them as peanut butter. Should teasing occur, it is important to talk directly to the parents of the children involved. Request that their child be given direct, clear instructions about the danger of their actions. (It is best to remain calm and nonjudgmental, but also direct about the critical need for the child's cooperation.) It is also important to make the teacher and school administrators aware of teasing, and request closer supervision and cooperation where appropriate.

An emergency anaphylactix kit should be kept at school or your child's day care facility. Be sure your child carries an emergency kit when attending a party, or visiting friends or family without you.

Label Reading

Nuts, particularly peanuts, are one of the most common allergenic foods. Allergic reactions to peanuts is thought to be one of the most common causing of anaphylaxis-related deaths in the US. Careful reading of labels and ingredient lists on food packages is essential to avoiding nut proteins. Obvious sources of this allergen, whole nuts, are small by comparison to the foods that contain nut additives. Reading the ingredient list is the key to avoiding this allergen.

For those with severe food allergies, even trace amounts can produce an allergic reaction. Avoiding foods that may be cross contaminated is prudent. Cross contamination occurs when nut parts or dust accidentally get on a nut free food during manufacturing. This usually results from using the same equipment that has not been fully cleaned. Therefore, the presence of nuts will not be listed on the label.

Even with commonly used brands, it is very important to read all labels carefully prior to buying or eating a food. Food manufacturers frequently change suppliers and ingredients. It is equally important to read labels when changing brands. Different brands of the same type of food may contain different ingredients.

Review the list of common foods containing nut protein and help take the guess work out of label reading. Keep this list handy, you never know when you will need to read a food label. Remember, although nut oils theoretically should not contain nut proteins, this is highly dependent on the processing and may be contaminated.

Common Foods and Ingredients Containing Nut Protein

Foods that may contain nuts or be cross contaminated
nut butters
beer nuts
nut oil
brazil nuts
nut paste
egg rolls
peanut butter
ice cream
peanut flour
peanut syrup
ground nuts
cold pressed peanut oil
pie crusts
extruded peanut oil
baked goods
hickory nuts
peanut butter chips
baking mixes
macadamia nuts
peanut biter
battered foods
mixed nuts
loramine wax
bulk bin foods
nu nuts ("new nuts")
artificial flavored nuts
milk formula
bar-be-que sauce
pine nuts
dessert toppings
frozen desserts
graham cracker crusts
black walnuts
hydrolyzed plant protein
hydrolyzed vegetable protein
oriental sauce
vegetable fat
vegetable oil


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    • cecileportilla profile image

      Cecile Portilla 4 years ago from West Orange, New Jersey

      Hi yourbodyweight:

      Thanks for pointing out that medications, cosmetics, shampoos and other hygiene products many contain nut allergens. Very informative hub! Voted up!