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How to live with peanut and tree nut allergies? – Part 3

What are treenuts and what is treenut allergy?

Tree nuts include:
• macadamia nuts
• brazil nuts
• cashews
• almonds
• walnuts
• pecans
• pistachios
• chestnuts
• beechnuts
• hazelnuts
• pine nuts (pignoli or pinon)
• gingko nuts
• hickory nuts
– Tree nut allergies also tend to be severe.
– These allergies are strongly associated with anaphylaxis.
– Walnuts and cashews are the two tree nuts that cause the most allergic reactions.
– At least 90 percent of children diagnosed with tree nut allergies will have them for life.

Cross-Reactivity Among Tree Nuts:

• Most people with tree nut allergies are not allergic to all tree nuts.
• There is high cross-reactivity among various families of tree nuts.
• About 12 percent of people who are allergic to one tree nut are allergic to another tree nut.
• The strongest probability of cross-reactivity is between walnut and pecan and between cashew and pistachio.
• Hence, people who are allergic to one type of tree nut are generally advised to avoid all tree nuts as a precautionary measure.

Tree Nut Allergy Symptoms

• anaphylaxis
• severe breathing difficulties
• cardiac arrythmia
• hives
• Welts
• asthma
• skin reactions
Tree nut allergies are especially likely to cause anaphylaxis; people with tree nut allergies will be prescribed injectible epinephrine.

Foods Commonly Containing Tree Nuts:
Foods always or almost always containing tree nuts include:
• Nutella
• Marzipan
• Pesto (unless specially prepared without pine nuts)
• Baklava
• Pralines
• Nut liqueurs (Frangelico, Amaretto, and Nocello)
• Nougat
• Turrón
• Gianduja

Foods that commonly contain tree nuts include:
• Macaroons
• Granola bars
• Trail mix
• Cereal
• Fudge
• Caponata
• Ice cream
• Divinity
• Candy bars
• Baked goods

Eating Out with Tree Nut Allergies:
• While tree nuts are not as prevalent as many other allergens, the risk of anaphylaxis makes them dangerous to eat out.
• This is because at restaurants there is a chance of cross-contamination.
• So call ahead and discuss your diet with a manager or the chef.
• The riskiest cuisine for nut allergies is Greek; several common dishes use walnuts.
• Cashews are used in Chinese cuisine, while almonds feature in Mediterranean food.
• Pesto, with pine nuts, is likely to appear on Italian menus.
• And many higher-end restaurants make vinaigrette dressings using tree nut oils.
• Japanese and Latin American are likely among the safer ethnic cuisines.

Tree Nut Allergies and Anaphylaxis:
• Peanut allergies are popularly considered the most severe allergies.
• It’s true that both peanut and shellfish allergies cause far more cases of anaphylaxis than tree nut allergies.
• Both of those allergies are much more common.
• The fact is that there is strong evidence that severe reactions are far more likely to occur in people with tree nut allergies, especially cashew allergies, than with peanut allergies.
• Hence, it’s essential that anyone with a tree nut allergy learn the symptoms of anaphylactic shock.
• It is always best in the interest of the patient to carry an injectible epinephrine at all times.

Living with Tree Nut Allergies:
• Management of tree nut allergies depends on strict avoidance of tree nuts.
• For young children, this can depend on the collaboration of a wide variety of interested adults.
• They include parents, caregivers, school teachers and administrators, and parents of close friends.
• There are some places, however, where it may be especially difficult to avoid tree nuts.
• These include parties (where bowls of mixed nuts may be served) and bars.
• Nut allergies are a well-recognized cause of severe allergic symptoms.
• So families dealing with tree nut allergies are likely to find some systems in place for dealing with severe allergies in many institutions.

The Peanut Allergy Answer Book Food Allergies and Food Intolerance Allergies: Fight Them with the Blood Type Diet

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