Nut allergies are one of the UK’s most common food allergies. According to Anaphylaxis UK, around 1 in 50 children and 1 in 200 adults are allergic to nuts.
While many people develop nut allergies as children, they appear at any time of life, including our 50s, 60s, and beyond. And having one can make things like travelling and dining out tricky – especially in severe cases.
Below, we take a closer look at nut allergies, including symptoms of a reaction, before offering 10 tips for living with one.
What is a nut allergy?
Nut allergies occur when our bodies misidentify nuts as harmful substances. To fight them off, our immune systems release chemicals like histamine, which cause the symptoms of an allergic reaction.
There are two types of ‘nut’ allergies: peanut and tree nut. This separation accounts for the fact that peanuts aren’t actually nuts – they’re legumes. However, reactions in people with peanut and tree nut allergies are often similar.
Tree nuts include almonds, Brazil nuts, cashews, macadamia nuts, pecans, pistachios, shea nuts, and walnuts. People can be allergic to just one of these or multiple. Plus, the American Academy of Allergy, Asthma, and Immunology reports that 30% of people with peanut allergies are also allergic to tree nuts.
What are the symptoms of an allergic reaction to nuts?
For some people, the symptoms of an allergic reaction to nuts can be mild. But, for others, inhaling or swallowing even trace amounts can be life-threatening. Reactions often occur within minutes of exposure, but can sometimes take hours to appear.
Some common symptoms include…
- Skin reactions – including itchiness, rashes, hives, redness, tenderness, and swelling of the extremities
- Breathing difficulties – caused by throat swelling
- Digestive issues – such as nausea, stomach cramps, vomiting, and diarrhoea
- Eye, nose, throat, and mouth symptoms – like sneezing, a sore throat, a runny nose, itchy or watery eyes, and itchy or tingling sensations around the mouth or throat
- Eosinophilic oesophagitis (EoE) – a condition of the gullet which can involve vomiting, chest pain, and difficulty swallowing
- Anaphylaxis – a life-threatening allergic reaction that comes on very quickly after exposure (usually within minutes). Symptoms include facial swelling, difficulty breathing and feeling tired, confused, or dizzy.
Head over to the NHS website to learn more about anaphylaxis.
Allergic reactions to nuts can be treated with medication. For example, antihistamines are prescribed for mild reactions, while epinephrine auto-injectors (like EpiPens) are used to treat anaphylaxis.
However, there’s currently no cure for peanut or tree nut allergies – and the best way to stay safe is to avoid them. Sometimes, this can be easier said than done but, below, we’ve pulled together some tips that may help.
10 tips for living with a nut allergy
1. Read every label, every time
Reading food labels carefully is one of the most important things you can do to avoid consuming nuts.
However, one thing people might overlook is that you need to check a product’s label every time you buy it, even if you’ve purchased it before. This is because manufacturers can change ingredients or how they prepare food.
It’s also important to check the labels of items you assume won’t contain nuts because they’re occasionally used in ways you might not guess. For example, ground nuts are sometimes used to thicken sauces and soups.
By UK law, manufacturers must highlight peanuts and tree nuts (along with 12 other common allergens) in ingredient lists. This can be done by placing the names in bold, capital letters, or underlining them.
Also, try to look out for ‘May contain traces of…’ labelling, which manufacturers use to show that allergens may be unintentionally present – for example, nut-free products may be made in the same factories as nut products. This can be phrased in many ways, such as ‘Not suitable for nut allergy suffers’ or ‘Packed in an environment where nuts may be present’.
For more advice on reading food labels, check out this information from Allergy UK.
Bonus tip: Remember to look outside the kitchen for possible nut exposure. Non-food items like shampoos, lotions, pet food, and even garden compost can contain them.
2. Familiarise yourself with alternative names for nuts
While steps should always be taken to highlight nuts on product labels, it can be worth familiarising yourself with alternative names just in case.
For example, peanuts may be called groundnuts, monkey nuts, or their Latin name, Arachis hypogaea. In the U.S., they’re sometimes referred to as goobers or pindars.
Manufacturers may also use Latin names for tree nuts, particularly in products like cosmetics and toiletries. The Allergy UK website has a list of these.
3. Learn about cross-contamination
Unfortunately, when living with a severe peanut or tree nut allergy, it’s not enough to avoid the nuts themselves because even traces can trigger an allergic reaction.
Cross-contamination occurs when traces of allergens find their way into other food. This can happen during the preparation process, and serving and storage stages. One example of cross-contamination could be a knife used for peanut butter not being cleaned properly before being used for something else.
If you have a nut allergy or live with someone who does, it’s essential to learn about cross-contamination. This can help you avoid it when cooking at home and remember to ask restaurants how they prepare their food.
Check out this article from FARE to find out more about cross-contamination and how to prevent it.
4. Call restaurants ahead of time
Eating out is one of the most tricky scenarios to navigate if you have a nut allergy. However, sharing a meal with loved ones at a restaurant is one of life’s simple pleasures, and you shouldn’t miss out because of your allergy.
Clear communication is key to preventing exposure when dining out. That’s why the NHS recommends calling restaurants in advance and talking to staff about whether they can serve you and which dishes are suitable. This can alleviate some pressure of trying to sort it all out when you arrive. If possible, try calling during quiet periods (for example, between lunch and dinner rushes), when staff aren’t so busy.
When talking to restaurant staff, it’s important to ask questions, such as ‘Have the staff been trained properly to manage allergens?’ ‘How is the food handled?’ and ‘Is there any chance of cross-contamination from ingredients or cooking equipment?’
It’s also key to make sure they understand exactly what will happen if you’re exposed to nuts. This is especially true since a U.S. study found that more than 1 in 10 restaurant managers incorrectly believe that a person with food allergies can safely eat small amounts of that food.
When you arrive at the restaurant, reconfirm everything you discussed over the phone. General advice is: if you have doubts about how a restaurant prepares its food or whether or not they understand the consequences of your nut allergy, it’s not worth eating there.
Check out this information from the Food Standards Agency for more questions to ask and further advice on eating out with an allergy.
5. Carry chef cards
As mentioned in the previous section, clear communication is key to avoiding exposure to nuts. So, when eating out, many people also carry chef cards to give to kitchen staff.
Chef cards generally contain information about what ingredients you’re allergic to, and a reminder of the severity of the consequences if you’re exposed. By giving restaurant staff a card with all this written information, we can help to reduce the risk of miscommunications and further stress the importance of the situation.
You can download templates for chef cards from the Food Standards Agency here.
6. Prepare for language barriers when travelling
When travelling abroad, language barriers can make communicating your allergies a challenge. So, before you set off, try learning some allergy-related phrases – such as ‘I have a nut allergy’ or ‘may contain traces of nuts’.
You could also order allergy translation cards, which include information about what you’re allergic to and emergency messages in given languages, in case you have a reaction.
Head over to Allergy UK to learn more about allergy translation cards and order some of your own. You can also download their food allergies and travel factsheet for more advice.
7. Fly in the morning
Like eating out, flying with a nut allergy can be stressful. However, it’s possible to minimise your risk of exposure.
For example, it’s worth researching different airlines to learn about their allergy policies and read any customer reviews from people with allergies. For example, do they offer allergy-free meals? If not, are passengers with allergies allowed to bring their own food? Are people allowed to wipe down their seats and the surrounding areas?
This document from FARE has some helpful information about the best and worst airlines for people with food allergies.
Also, one handy tip that Anaphylaxis UK recommends is to fly first thing in the morning. Planes are typically cleaned overnight, so getting the first flight of the day can limit your chances of encountering contaminated surfaces.
8. Wear medical alert jewellery
Medical alert jewellery contains any information (such as allergies and medication) that someone looking after you in an emergency needs to know to keep you safe and treat you.
It can be particularly helpful for those with severe nut allergies. Your jewellery can inform first responders what allergen you’ve reacted to if you’re unconscious or unable to speak.
On her blog, Ruth Holroyd, who’s worn a medical alert bracelet for over 20 years because of anaphylaxis, reveals that it helps give her peace of mind and lessens her anxiety about having a reaction. You can also purchase medical alert jewellery in necklace form.
You can find out more in our article; What is a medical ID and why might you benefit from one?
9. Do anxiety-relieving activities
Whether we have a food allergy ourselves or look after someone who does, it can have a significant negative impact on our mental health.
This research found that 62% of patients reported allergy-related mental health concerns. This includes anxiety experienced after a reaction, as well as general anxiety caused by the fear of having one. So, if you’re feeling anxious about your allergies, you’re certainly not alone.
To help combat these feelings, Anaphylaxis UK recommends activities like yoga, mindfulness, and deep breathing exercises. Research also suggests that cognitive behavioural therapy (CBT) could reduce the psychological impact of food allergies.
To find out more about the mental health challenges of living with serious allergies, take a look at Anaphylaxis UK’s interview with Dr Chrissie Jones below.
10. Communicate clearly with everyone around you
Sometimes, speaking up about your allergies to the people around you – whether friends, family, colleagues, or people you’re travelling with.
For example, you might feel embarrassed to ask people not to eat something around you, or too shy to tell someone about your allergies in the first place.
However, try not to be afraid to remind people of how dangerous exposure can be. Nine times out of 10, those around you will be glad you said something, and that they can help you stay safe and feel comfortable.
It’s also a good idea to make sure that people you spend lots of time with know what to do if you have a reaction. For example, if you have a severe case, you could show your friends, family, and colleagues how to use your epinephrine auto-injector.
For more help talking to people around you about your allergies, check out this advice from FARE.
Final thoughts…
Living with peanut or tree nut allergies (or looking after someone who does) can be tricky, especially when travelling or dining out. However, hopefully, these tips can help you navigate some of the challenges of daily life.
For more tips for living with allergies, why not visit the Allergy UK and Anaphylaxis UK websites? These two charities have a wealth of information. And, for more general health content, check out our health section.
Do you have a nut allergy? If so, do you have any tips for living with it? We’d love to hear from you in the comments below.
