The U.S. Food and Drug Administration
estimates that 6% of children younger than 3 years old have some kind of food
allergy; among the most common is peanut allergy. Peanuts are actually legumes
(not nuts) that grow in the ground. However, the proteins in peanuts are
similar to those in tree nuts so people who are allergic to peanuts could also
be allergic to the nuts that grow on trees.
Tree nuts are the nuts of hard-shelled
fruit and include almonds, walnuts, pistachios, macadamias, Brazil nuts, hickory
nuts, pine nuts, pecans, and cashews. You should be tested for both types of
allergies to determine if you need to avoid both groups.
The
Allergic Response
Since the body erroneously
identifies the proteins in peanuts or tree nuts as hostile invaders, it mounts
an immune response by creating specific antibodies to those proteins. These
antibodies trigger the release of certain chemicals into the body such as
histamine. Allergic reactions differ from person to person, from mild to
severe. Some people outgrow certain food allergies as they get older but for
most people, peanut and tree nut allergies are for life.
Peanut reactions can be very severe,
even with minimal exposure to peanut protein. In general, most reactions to
food allergies last less than a day and may affect:
- Skin. Itchy, red, bumpy rashes (hives), eczema, or redness
and swelling around the mouth or face.
- Gastrointestinal system. Belly cramps, nausea, vomiting,
or diarrhea.
- Respiratory system. Runny or stuffy nose; itchy, watery eyes; sneezing to
the triggering of asthma with coughing and wheezing. In severe cases, anaphylaxis may occur; this sudden,
potentially life-threatening reaction causes airways to swell and blood
pressure drop. The person may have trouble breathing and could lose
consciousness.
- Cardiovascular system. Feeling lightheaded or faint,
can lose consciousness.
How
the Reactions are Triggered
Typically, an allergic reaction to
nuts occurs through ingesting nuts or peanuts or products containing them, or
from cross-contact from cooking/food prep—but it could occur from breathing in
airborne particles or handling them. Therefore, keep the offenders out of your
home and ask questions before visiting or dining at other people’s homes.
The obvious sources for peanuts and
tree nuts is peanut butter and nut butters extracts, and flours, but you might
be surprised to discover nuts used in a wide range of other products as
thickeners, emollients, and flavoring agents: baked goods, candy, frozen
desserts, cereals, soups and chili, breads, meatless burgers, sauces (such as
pesto and mole), and salad dressings, plus shampoos and soaps.
KidsHealth (www.kidshealth.org) has a great instruction sheet
regarding peanut/nut allergic reactions:
Taking
Precautions
·
Read every label and if you have any questions, call
the manufacturer to confirm the presence of absence of any nuts in the
manufacturing plant or process. Check the ingredient lists of international
foods which use nuts extensively in their recipes.
All
packaged food products sold in the U.S. that have tree nuts as an ingredient
must list the specific tree nut on the label. Some manufacturers use advisory
labels (“May contain …”) but this is voluntary and without specific guidelines.
However, the FDA—which just announced regulations for labeling gluten-free packaged
goods—is said to be developing a long-term strategy to help manufacturers use
these statements clearly and consistently; that way, consumers can be informed about
the potential presence of the eight major allergens (peanuts, tree nuts,
soybeans, milk, wheat, shellfish, eggs, fish).
·
Avoid them all? Food
Allergy Research & Education
notes that someone who is allergic to one type of tree nut has a higher chance
of being allergic to other types; therefore, many experts advise patients with a
tree nut allergy to avoid all nuts. Individuals may be advised to also avoid
peanuts (and vice versa) because of the higher likelihood of cross-contact with tree nuts during manufacturing
and processing.
·
Talk to school/camp. Schools and camps are well aware of
the dangers of nut allergies and the concerns parents have for their children’s
well-being. Separate dining tables or instructions to other parents about what
is allowed for lunch or snack are often offered. However, we recommend you
speak with your school administrator and school nurse about steps to create a
safe, allergen-free environment for your child.
·
Carry medication. As we noted in last month’s post
about wheat allergy, many families carry injectable
epinephrine for emergencies away from home. For people with milder reactions,
an oral antihistamine might be all you need. Consult your doctor!
As
with any food allergy, your best course of action is to research and become as
well-informed as possible. Be sure to let others know about your child’s
allergy to avoid any unpleasant situations or upsets.
Nearly four out of every 100 children in the U.S. have a food allergy, according to CDC data from 2007. Avoiding common food allergens, such as peanuts, eggs, tree nuts and fish, for the first few years of life was the prescription for prevention for many years, but in 2008 the American Academy of Pediatrics reversed these guidelines, noting little evidence existed to say the avoidance was preventing food allergies. Newer expert recommendations have even suggested introducing these foods early could play a role in preventing allergies. An idea known as the “dual-allergen exposure hypothesis,” which has to do with when and how children are exposed to allergens, could be a reason why.
