Nuts: An example of a common food allergy

Nuts

Nuts can cause serious reactions, sometimes even fatal. Those with a nut allergy often react to several types of nuts. Even if they do not belong to the same plant family. However, nut allergy can also be milder and be related to birch pollen allergy. This is called oral allergy syndrome, with complaints around the mouth in particular. In the Netherlands, hazelnut and walnut are the number one allergens. Cashew nut allergy is becoming increasingly common in children. The reaction is comparable to a peanut allergy:

• nut oil;
• nut paste;

Examples of ingredients and products that (may) contain nuts:

• nut oil; 
• nut spreads; 
• muesli (bread, bars);
• cruesli;
• almond paste;
• marzipan;
• broth (powder/blocks);
• biscuits;
• pastry;
• cake;
• ice cream;
• filled chocolate;
• chocolates;
• candy bars;
• crackers;
• luxury breads;
• pudding powders;
• nut cheese; 
• pesto;
• sauces;
• soups;
• salads;
• snacks;
• sweets (e.g. nougat); 
• soy drinks
• soya drinks;
• soya desserts;
• surrogate coffee;
• salty snacks;
• vegetarian meat replacements;
• ready meals;
• oriental dishes;
• gianduja.

In oral allergy syndrome (OAS), symptoms occur in the mouth and throat: usually within minutes; * small blisters:

• swelling;
• redness;
• itching;
• Tingling of mouth, itching.

Anaphylaxis, severe generalised reactions in the whole body, manifested as:

• initial tingling in mouth, throat, cheeks or tongue;
• local hives (urticaria);
• Then reactions in many organs;
• often with predominant severe asthma;
• finally, a drop in blood pressure;
• shock.

Points of attention: 

• Often nuts are used in muesli;
• Nut oil can be found in vegetable oil;
• Some types of margarine contain nut oil;
• Nut flavourings may contain nut oil, e.g. (bitter) almond oil;
• Do not specify synthetic/natural identical nut flavouring (does not contain nuts);
• Do not specify here: peanut (this is not a nut);
• Do not specify coconut, chestnut, palm and nutmeg;
• Do not enter pine nuts, sunflower seeds or sesame seeds here.

Nuts must be specified by their species (i.e. almond, hazelnut, walnut, cashew, pecan, brazil nut, pistachio nut or macadamia nut) in the ingredients statement.