Tree Nut Allergy

nut

It is estimated that 1%-2% of the United States population is allergic to tree nuts, peanuts, or both. In general, tree nut allergy has been considered a lifelong allergy. However, a recent article in The Journal of Allergy & Clinical Immunology suggests that approximately 9% of children with an allergy to tree nuts will outgrow their allergy, including children who have previously experienced a severe allergic reaction.

Tree nuts include cashews, almonds, walnuts, hazelnuts, macadamia nuts, pecans, pistachios, Brazil nut, beechnuts, chestnuts, filbert, and hickory nuts. Pine nuts are edible seeds of pine trees and are not, strictly speaking, tree nuts. However, because of their high allergenic potential, they are included in this discussion.

How to read a label for a tree nut-free diet

Be sure to avoid foods that contain any of the following ingredients:

  • almonds
  • brazil nuts
  • cashews
  • chestnuts
  • filberts
  • hazelnuts
  • gianduja (a creamy mixture of chocolate and chopped toasted nuts found in premium or imported chocolate)
  • hickory nuts
  • macadamia nuts
  • marzipan/almond paste
  • nougat
  • Nu-Nuts® artificial nuts
  • nut butters, i.e. cashew butter, almond butter
  • nut oil
  • nut paste, i.e. almond paste
  • pecans
  • pine nuts (pignolia, pinion)
  • pistachios
  • walnuts

Helpful facts about tree nuts

Nu-Nuts® artificial nuts are peanuts that have been de-flavored and re-flavored with a nut like pecan or walnut.

Filberts are hazelnuts.

Avoid natural extracts such as pure almond extract, and natural wintergreen extract (for the filbert/hazelnut allergic).

Use imitation or artificially flavored extracts.

Ethnic foods, commercially prepared baked goods, and candy can be cross-contaminated with nuts since nuts are frequently used in these types of foods.

Tree nuts are being added to an increasing variety of foods such as barbecue sauces, cereals, crackers, and ice creams.

Tree nuts may belong to different food families which are unrelated to each other.

Walnut : walnut, pecan

Mango : pistachio, cashews

Legythis : brazil nut

Beech : beechnut, chestnut

Birch : hazelnut, fibert, hickory nut

Pulm : almond

Macadamia
Interestingly, tree nuts are not related to peanuts. Therefore, some people who are peanut allergic can eat tree nuts, and tree nut allergic people can sometimes eat peanuts. However, it is important to note that some allergic individuals may be allergic to both peanut and tree nuts. In addition, you can be allergic to some but not all tree nuts. Almonds seem to cause the least problems of all common tree nuts.

What may contain tree nut?

  • chocolate, candies, cookies, desserts, sweets, almond paste, donuts, sundaes, cereal, milkshakes, granola bars, trail mixes, pesto sauce, European chocolates, muesli

– suntan lotion, shampoo, nut shells, bath oils

– popcorn and specialty cheese spreads

– gianduja (chocolate and chopped toasted nuts)

– specialty coffees, liqueurs

– small animal food e.g., hamster, gerbil

What contains walnut / pecan?

  • pecan pie, walnut containing muffins
  • Crosse & Blackwell Worcestershire sauce
  • AIM herbal fiber blend, pesto sauce, pralines, walnut oil, “Turtles” chocolates

What contains hazelnut / filbert?

Nutella, nougat, Toblerone chocolate bars, hazelnut liqueur, Frangelico liqueur, hazelnut coffee

What contains pistachio / cashew?

Cashew butter, pistachio ice cream, chicken with cashews

What contains almonds?

Marzipan, almond mocha, almond paste, almond guy ding, trout almandine, pure almond extract (artificial is okay), amaretto

What about seeds, tropical oils, exotic nuts?

Foods such as water chestnut, coconut, and nutmeg do not need to be avoided by nut allergic people, unless they are also allergic to these foods. Palm oil and tropical oils do not need to be avoided. Seeds, e.g., sesame, sunflower, poppy, mustard, safflower, canola, do not need to be avoided unless you are allergic to these as well.

Are nut oils safe?

Most tree nut oils probably contain enough allergenic protein to cause allergic reactions. These are cold pressed (unprocessed, extruded or expelled) oils and are not safe for nut allergic people.

Follow Us