Nut Allergies

As the school year starts, alarm bells are once again ringing in cafeterias across the country. What are the risks of nut allergies, and why do they suddenly seem prevalent?

Allergic reactions are on the increase, and no one is sure why.

If you’re wondering how nut allergies have given rise to widespread concern when they were virtually unheard of a generation ago, you are not alone. The answer appears to be twofold.

First of all, awareness is heightened. Rather than blithely labeling a child as having a “weak stomach” or “sensitive skin,” we now can identify and address these symptoms as specific allergic responses. Second, and more troubling, is that allergies appear to be on a sharp increase. “We are becoming more allergic as a population,” states Anne Muñoz-Furlong, founder and CEO of the Food Allergy & Anaphylaxis Network (or FAAN). “Allergies in general are going up, and food allergies come under that umbrella.” Muñoz-Furlong cites a five-year study of nearly 5,000 children showing that reported reactions to peanuts doubled from 1997 to 2002. The results will be tracked again in 2007.

About 1 percent of the population is allergic to nuts.

Unlike allergies to milk, eggs and wheat, which are typically outgrown by a child’s 10th birthday, nut allergies tend to be lifelong. About 1.5 million Americans are allergic to tree nuts and another 1.5 million to peanuts. Note the distinction. Nuts such as almonds, cashews, pistachios and walnuts grow on trees. Peanuts grow underground and are part of the legume family; in fact, technically speaking they are not nuts. But that Planters guy with the monacle and the top hat? He’s nuts.

Reactions range from mild to life-threatening.

Skin irritation (hives), swollen lips, swollen tongue and gastrointestinal distress are common symptoms of an allergic reaction. These reactions are usually treated with antihistamines.

Far more dangerous is an anaphylactic reaction, marked by a severe shock to the respiratory system. Children who have a nut allergy in addition to asthma are at increased risk for a traumatic reaction. Says Muñoz-Furlong, “The highest risk group, according to our fatality work, is a teenager aged 10 to 19 with a peanut allergy and asthma.”

Beyond ingesting nuts, inhaling the fumes of roasted peanuts, boiled peanuts or cold-pressed nut oil can be dangerous. Cooking aerosolizes protein, which is the source of allergic reaction in foods.

To be safe, nursing mothers should avoid nuts.

Food proteins ingested by a nursing mother will make their way to her breast milk, and therefore to her baby. Women who are breastfeeding and have any family history of allergies are cautioned against eating nuts.

The only sure way to diagnose an allergy is to eat that nut.

Skin tests, skin-prick tests and blood tests (or RAST) can be helpful diagnostic tools, but they are known to have false positives and therefore are not 100 percent reliable. Precautionary guidelines set by the American Academy of Pediatrics say that children with a family history of allergies should not have nuts before their third birthday. If there are allergies of any sort in your family history, consult a pediatrician or allergist before introducing nuts to the child’s diet. When risk appears to be high, the patient might first try nuts in the safe and controlled environment of the doctor’s office. It’s a better method, for sure, than testing your child’s reaction with a jar of Jiffy in one hand and a telephone in the other.

Extensive resources regarding nut allergies (including allergy handbooks and information regarding food labels) may be ordered through the FAAN site or by calling the organization at (800) 929-4040.

Confused by health myths and misinformation? Each week, Rich Maloof talks to leading health experts to bring you the latest word on a wide range of health topics.

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