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Contributed by Fran Weiss, MS RDN CDN, Consultant Dietitian

Have you ever noticed the eye roll of a parent informed that their child’s classroom was nut-free and that they need to be mindful, sensitive, supportive and aware when bringing foods into the classroom? That parent obviously never had a child with a food allergy. Although they are separate allergies, tree nut and peanut allergies can coexist. Both tree nut and peanut allergies are major precipitators of anaphylactic reactions. These allergies are no joke!

Allergic Reactions

Signs of anaphylaxis include swelling, rapid pulse, wheezing, difficulty breathing, rash, rapid pulse, lightheadedness/dizziness, and loss of consciousness. Anaphylaxis is a medical emergency. Epinephrine injection should be given immediately and 911 called for emergency care.

In addition to potential life-threatening anaphylaxis, less severe allergic reactions to peanuts and tree nuts include itchy skin, itchy eyes, itchy ears, rashes, conjunctivitis, hives, swelling, eczema, runny nose, sneezing, tingling, dryness in the mouth and throat areas, diarrhea, stomach cramps, abdominal pain, and nausea. Medical advice and attention is indicated for anyone with any symptoms to assure appropriate monitoring should symptoms progress.

Risk Factors

Although there are many unknowns as to why some people develop allergies and others do not, the following risk factors are common.

  1. AGE – Tree nut and peanut allergies occur most commonly in infants, toddlers, and school age children. However, people at any age can develop allergic reactions to foods. Sometimes children outgrow food allergies as their digestive systems mature.
  2. ECZEMA – A link is sometimes seen between the skin condition known as atopic dermatitis (eczema) and food allergies.
  3. GENETICS – The risk of any food allergy increases if family members have food allergies.
  4. KNOWN ALLERGIES – Having another type of allergy (such as to mold or pollen) or being allergic to any food increases the likelihood of developing a food allergy to another food.
  5. HISTORY – A food allergy can resurface even after an allergy is believed to have been outgrown.

What Triggers An Allergic Reaction?

  1. DIRECT CONTACT – The most common cause of an allergic reaction is eating or touching any food containing tree nuts or peanuts.
  2. INDIRECT CONTACT (CROSS CONTAMINATION) – This can occur during food handling and processing. Processed foods run the risk of allergen contamination if prepared in factories that also prepare foods with tree nuts or peanuts. Eating at salad bars and ice cream parlors, purchasing fresh bakery products, using store coffee grinders, and purchasing foods from bulk containers are additional potential sources of allergens. Remember that manufacturers that produce specific food products free from peanuts or any one nut may process other nuts on the same equipment.
  3. INHALATION – Breathing in particles from tree nuts and peanuts can lead to allergic reactions. Peanut and tree nut flours as well as peanut and tree nut oils and extracts are common sources.

Are Peanuts Tree Nuts?

Peanuts are technically legumes and do not fall under the tree nut category. Because peanuts grow underground, they are not considered in the same class as tree nuts. Although possible, having an allergy to peanuts does not necessarily mean a higher incidence of an allergy to legumes (peas, beans, lentils, soybeans). However, there is a higher likelihood of allergic reactions to lupins (aka lupines) in individuals who experience peanut allergies. Sometimes a peanut allergy is an indicator for the need to also avoid seeds such as sunflower, flax, poppy, pumpkin, and sesame. Always check with your allergist with any allergy concerns. Peanut and tree nut allergies can coexist or can manifest as separate allergies. It is important to keep in mind that tree nuts and peanuts are often found together in nut mixes and during food processing.

What Is A Tree Nut?

Tree nuts include: almonds, beechnuts, brazil nuts, butternuts, cashews, chestnuts, chinquapins, filberts (aka hazelnuts), gingkoes, hickory nuts, lichee nuts, macadamia nuts, pecans, pili nuts, pine nuts (aka pignolia, pignoli, pinoli, pinon), pistachios, shea nuts, pecans, and walnuts.

Although it is possible to be allergic to only one tree nut, most people with nut allergies are allergic to several or more nuts. Nut allergies are sometimes based on the protein pattern found. Such pairs include almonds and hazelnuts, walnuts and pecans, cashews and pistachios. Being allergic to one of the nuts in such a pair puts one at risk for being allergic to the other nut. For example, a person allergic to pecans has a high likelihood of being allergic to walnuts. The risk of cross contact is high when multiple tree nuts are used during food production. For that reason, it may be recommended that a person who is allergic to any tree nut(s) avoid all tree nuts.

Common Foods That May Contain Tree Nuts

nut butters, nut flour, baklava, pesto, pralines, marzipan, nut liquors, nougat, nut flours, baking mixes, macaroons, mixed nuts, nut pieces, marinades, salad dressings, Nutella, granola bars, trail mixes, cereals, fudge, baked items, ice cream, candy bars, cookies, crackers, sauces, lunchmeat, energy bars, caponata, salad garnishes, breadings, almond extract, walnut extract, wintergreen extract; nut flavorings, cultural foods

Common Foods That May Contain Peanuts

peanut butter, peanut flour, peanut oil, beer nuts, nutmeats, mixed nuts, artificial nuts, goobers, beer nuts, nut pieces, artificial nuts, earth nuts, Cracker Jacks, monkey nuts, marzipan, enchilada sauce, peanut protein hydrolysate, egg rolls, salad garnishes, baking mixes, baked products, breadings, sauces, kernels, goober nuts, goober peas, arachis oil, arachide, mandelonas, valencias, cultural foods

Is Nutmeg A Tree Nut?

Despite its name, nutmeg is not a tree nut. Nutmeg is a spice derived from the nutmeg tree. Nutmeg is technically a seed. If you have a seed allergy, nutmeg should be avoided. Similarly, if you notice an allergic reaction associated with eating nutmeg, you many have an allergy to seeds.

Is Coconut A Tree Nut?

Botanically, coconut is a fruit. Most people with tree nut allergies do not experience allergic reactions to coconut. The FDA (US Food and Drug Administration) classifies coconut as a nut for labelling purposes. If coconut is not part of your current diet, it is best to check with your allergist prior to eating coconut and coconut products.

What To Do When Choosing Foods

Always read food labels. Manufacturing practices and ingredients can change at any time and without warning or change in taste or appearance of the food or drink item.

The best way to avoid triggering an allergic reaction is to avoid the allergen!

As common food allergens, tree nuts and peanuts are required by the FDA (US Food and Drug Administration ) to be listed on food labels. The Food Allergy Labeling and Consumer Protection Act (FALCPA) requires that manufacturers clearly indicate the specific nut(s) a product contains. If a label mentions a specific nut such as “contains almonds,” it is important to remember that another nut such as walnuts may be used in the same factory for other foods. Mention of the presence of any tree nuts or peanuts used on the same production lines or in the same factory is not required. Many companies voluntarily indicate possible tree nut and peanut cross contamination as precautionary allergens on their labels. Examples of such voluntary and unregulated labeling include “ may contain peanuts,” “may contain traces of peanuts,” “manufactured in a facility that also processes nuts,” and “manufactured in a facility that also processes peanuts.” Unless produced in a dedicated nut free or peanut free facility, products that do not list possible cross contaminants should be avoided by persons who have tree nut or peanut allergies. Sometimes prepackaged foods that include any of the eight major allergens (tree nuts, peanuts, milk, eggs, fish, crustacean shellfish, wheat, soybeans) are incorrectly labelled in the manufacturing process. The FDA recalls such products. There is no such worry for Enjoy Life Foods products as the majority of their products are manufactured in the bakery they opened in Jeffersonville, IN in 2016 – North America’s largest dedicated nut-free, allergy-friendly, and certified gluten-free bakery. Not all products are made in Jeffersonville, but they are always manufactured in a facility with validated allergen cleaning and testing processes.

Alcoholic beverages are not covered under FALCPA. If natural flavors or botanicals are listed as ingredients, you can contact the manufacturer to ask if those ingredients include nuts or nut flavors.

The following message that I received from a thoughtful and loving mother whose child has multiple food allergies summarizes this blog well:

“As the parent of a child with multiple food allergies, I am always looking for products with clear, simple ingredient lists. I also really appreciate clear alerts on packages when they have changed their ingredient lists in any way. Nut allergies can be challenging in bakeries because nut extracts are added to so many vanilla and chocolate cookies and cakes. When making similar items at home, I try to very explicitly point out why our home version is okay and the bakery versions are NOT. Being able to have Enjoy Life products in my bag in a pinch when we’re out also helps take the pressure and anxiety out of making an inadvertent error in the bakery.”

Fran Weiss, MS RDN CDN, is a nationally registered dietitian and active member of the Academy of Nutrition and Dietetics as well as a certified dietitian/nutritionist for the State of New York. She received her Master of Science degree in Nutrition and Food Science from Cornell University in 1976. Since then, Fran has dedicated over 40 years to helping people of all ages with their food and medical nutrition therapy needs. Fran thoughtfully uses her years of experience and enthusiasm for nutrition to bridge the gap between supermarket shopping and personal and community health awareness. Her dedication was nationally acknowledged in 2018 when she was selected as one of four National Retail Registered Dietitian finalists.