Peanut Allergy: What to Eat and What to Avoid

Peanut Allergies 101 - everything you need to know to stay safe. Includes peanut vs tree nut allergies, a list of symptoms for peanut allergies, and what you need to know to avoid peanut allergy reactions. 

The peanut allergy is one of the most common allergies in children, with upwards of 0.6% of all children having this allergy. Typically, after diagnoses as a child, you will have the peanut allergy for the rest of your life, with only about 20% of people outgrowing it by 18.

Peanut allergies are one of the most severe allergies out there, with anaphylactic reactions common. If your child has suddenly developed a peanut allergy you do want to stress to them the importance of being safe and how somethings might be changing, but it is to keep them healthy.

This article walks you through all aspects of a peanut allergy, symptoms, what to avoid, what you can still enjoy, and how best to manage your peanut allergy.

What is a Peanut Allergy? 

Peanut allergies are one of the most common allergies in the world, making it included in the top 8 allergens. It is generally an allergy that is not outgrown as you age. If you become allergic to peanut as an adult, you will probably have this for the rest of your life. 

If you are an adult who has suddenly developed a peanut allergy, please be vigilant in your avoidance of this new allergen. Peanut allergies can jump in severity suddenly and catastrophically. A few years ago in the UK an 84-year-old woman suddenly had a dangerous anaphylactic reaction to peanut butter and almost died. She is now 92 and avoids peanuts.

An allergy occurs when the body is exposed to the peanut protein and develops a strong IgE antibody response. This is the bodies own antibodies working to protect the body from something it sees as a threat, in this case a peanut protein. The body responds by triggering the immune system that has different effects on the body (see symptom list below) that can range from mild to life-threatening. 

Symptoms of a Peanut Allergy 

Most children and adults will develop an allergic reaction either immediately, a few minutes, and as long as a few hours after consuming a peanut or peanut derivative. Remember, some people are so allergic to certain foods that even touching the food or smelling the food can cause a reaction. 

A list of probable reactions includes:

• swelling, itching, or irritation of the mouth, lips, tongue, or throat 
• Asthma attacks 
• eczema on the skin
• hives, itching rash of the skin
• nasal congestion
• headaches
• difficulty breathing
• cramping and/or pain of the stomach or bowels 
• nausea
• vomiting
• diarrhea
• anaphylactic reaction 

Anaphylactic Reaction to Peanuts

For some people, a life threatening reaction known as an anaphylactic reaction may occur after consuming, touching, or smelling peanuts or peanut by-products. If this happens, please call 911 or your local emergency number immediately. Signs and symptoms of this include

• Swelling or tightening of the throat
• Difficulty breathing
• Chest pain or tightness
• Trouble swallowing
• Dizziness or fainting
• Change of normal coloring of the skin
  • for light skin, check for signs of dark blue tints in the mucous membranes (inner lips, gums, around the eyes, and nail beds)
  • for medium skin, check for signs of a gray-green tint in the mucous membranes
  • for dark skin, check for signs of gray or white tint in the mucous membranes  

How to Manage Peanut Allergies 

The best way to manage your peanut allergy is to avoid any and all forms of peanuts and peanut by-products. 

If after some time you feel you would like to test and see if you are still allergic to peanut, consult your doctor and ask about doing a challenge test to gauge your reaction under the supervision of your doctor. 

Being Your Own Allergy Advocate

When I was a child back in the 1990s, the word allergy was not as prevalent as today, and people really didn’t understand what it meant. I had relatives asking if they could just scrape off the nuts on the dessert and that would be fine, right? For seemingly the millionth time, my parents would explain that wasn’t and would offer me a safe to eat treat instead.

Even in grad school I encountered people who honestly didn’t believe that their eating of a bag of trail mix in the back of the classroom would cause me to have an anaphylactic reaction. There were several nights I would leave class early to go home and take medicine or even ended up in the hospital a few times thanks to the lack of concern people have about allergies.

Therefore, it is so important for you to be your own allergy advocate. Teach your kids if they have allergies to stick up for themselves and say something.

And if you are certain something is wrong, don’t give up! My former primary care physician was unconvinced I had developed a new allergy in my late 20s. He was ready to prescribe an anti-acid medication, assuming I was eating too much fast food. However, I was adamant in my knowing that something was wrong and went to a new allergy specialist. I had my blood checked and my IgE levels were off the charts! We did an elimination diet and saw immediate improvements in my health. Be your own advocate at the doctor’s office, and make sure you take someone with you to help navigate if you need.

Peanut Allergy Safety in School and Work

If your child has a peanut allergy, make sure to let both the school and their individual teachers know of their allergy. Any medication they might need, including an EpiPen if the reaction is severe, needs to be kept at the school in case of emergencies.

In elementary school, when they have assigned seating, it is easier to maintain a clean workspace for your child. As they go through middle and high school and beyond, make sure to have them wipe down the desk before they use it as there could be peanut oils on the desk after someone ate a granola bar. Some children may even benefit from a peanut free school if one is in your area. Finally, some allergies are so severe that homeschooling or online learning might be your best option. Talk with your doctor to determine what would be best for your child. 

In a work environment, you should inform your coworkers of your allergy and ask them to not eat peanuts around you or your workspace. Making sure to wipe down surfaces is again important. 

How to Read a Food Label with a Peanut Allergy

Learning how to read food labels is one of the most important things you can do after developing a peanut allergy. Always make sure that you read the entire label and not just quickly scan for peanuts as ingredients can hide under different names.

Sometimes companies will place advisory statements on their label to say things such as, “May Contain” or “Produced in the same facility as…”. These are not required by law but are placed there at the discretion of the company. Talk with your doctor about if you should avoid these food labels as well.

In general, I tend to avoid any and all food products that list my own allergies on these advisory statements. You never know if one day cleaning the machines, an allergen was totally washed away or not. I err on the side of caution with my health and recommend you do the same.

What to Avoid with a Peanut Allergy

When looking at a food label, make sure that the ingredient list does not contain any of the following items. The list of foods to avoid with a peanut allergy are long, and while I’ve done my best to include them all here, I am sure there are more being made and discovered each day. If you know of a peanut allergy name that I’ve missed, write it in the comments below and I’ll be sure to add it to the list 

• Arachic oil
• Arachis
• Arachis hypogaea
• Artificial nuts
• Beer nuts
• Boiled peanuts
• Cold pressed, extruded or expelled peanut oil
• Crushed nuts, crushed peanuts
• Earth nuts
• Goober peas
• Ground nuts, ground peanuts
• Hydrolyzed peanut protein
• Mandelonas
• Mixed nuts
• Monkey nuts
• Nu nuts flavored nuts
• Nut pieces
• Nutmeat
• Peanuts, peanut butter, peanut butter chips, peanut butter morsels
• Peanut flour
• Peanut paste
• Peanut sauce, peanut syrup
• Spanish peanuts
• Virginia peanuts

 Peanuts are sometimes found in the following places:

• Artificial flavoring
• Baked goods
• Candy
• Chili
• Chocolate
• Crumb toppings
• Egg rolls
• Enchilada sauce
• Fried foods
• Flavoring
• Graham cracker crust
• Hydrolyzed plant protein
• Hydrolyzed vegetable protein
• Marzipan
• Mole sauce
• Natural flavoring
• Nougat
• Traditional foods: African, Asian, Chinese, Indian, Indonesian, Thai, Vietnamese, Mexican

 

What You Can Eat with a Peanut Allergy

After developing a new allergy, how you eat both at home and out and about is very likely going to change. Cooking at home is going to be the safest option for you and your family as you can ensure no allergens come into contact with the food and no cross contamination can occur. Make sure your diet is filled with simple whole foods, such as meats, grains, vegetables, fruits, beans, and lentils.

Living with allergies has gotten so much better in the past few years thanks to the requirements of labeling all food in grocery stores, as well as the sheer quantity of allergy free alternatives available in most stores.

Some of the best swaps for peanut allergies are seeds and soy nuts. Soy nuts are not actually a nut at all, but a type of bean! Soy nut butter has a taste and texture that is very similar to peanut butter and honestly tastes just as good! Maybe even better, since it’s safe and I know I won’t keel over after eating it. Sunflower seeds and sunflower seed butter is also a good peanut utter substitute.

Pumpkin seeds and roasted chickpeas can also serve as a quick snack that offers the same crunchy feel, salty taste, and has less fat which makes it even healthier! 

For a list of my favorite peanut alternatives, and when each will work best in what recipes, make sure you grab a download of my free Food Swap Guide! It’s filled with over 45 swaps and substitutions so you can keep making your favorite recipes with your allergies.

Eating Out with Peanut Allergies

Perhaps the biggest change to your life with a peanut allergy will come from the options available to you when dining out. No longer can you just go grab a quick bite to eat, nor will you be able to freely eat at a friend’s house.

Some places where peanuts are likely to be found are:

• Airplanes, airports, and other forms of transportation
• Bars (peanuts are a common bar food snack left in bowls on the counter)
• Breweries (same as bars)
• Restaurants (cooking oil for frying food in particular)

The best way to avoid (or at least try to avoid) getting sick at restaurants is to research ahead of time. Most restaurants post their menus online, which gives me a chance to figure out if this restaurant would be a safe option. Even if the menu says “peanut free” or “nut free” you still should research, because it is really difficult to ensure that a chef or kitchen will wipe off any surfaces, open new bags of ingredients, or even use a different set of gloves when preparing food.

For peanut allergies in particular, it is important to ask the restaurant what oil they use to fry their food. You also need to ask if there are any items that go into the fryer that contain peanuts as you don’t want to have the risk of cross contamination via the oil.

Some places, like Subway and other fast food restaurants or bakeries, offer cookies that are baked on site. If they have a peanut butter cookie, there is a risk of cross contamination from multiple batches of cookies being baked on the same trays. Always use caution when you are eating at any place that isn't your home!

Finally, since the peanut allergy can also be airborne, I suggest that if you have a severe peanut allergy, you avoid all restaurants that have a large percentage of peanuts on their menu.

To that effect, some places I have found to be generally safe include:

• Burger King
• Mc Donald’s
• Chipotle
• KFC
• Dominos Pizza
• Popeye’s
• Arby’s
• Del Taco
• El Pollo Loco
• In and Out
• Taco Bell

Other Hidden Sources of Peanuts Not In Food

Beyond food, there are places that peanuts can hide, making you sick even though you don’t eat peanuts anymore! While you won’t be eating these things, you should be aware that a reaction can occur from touching or smelling peanuts. These hidden peanut places include:

• Medications (make sure you talk to your doctor before stopping medications and ask about switching to a different medication!)
• Skincare
• Cleaning Products, especially wood cleaners
• Lotions
• Make-up

Make sure you check these places and use the list above to make sure that you and your family are safe from these hidden peanut sources!

Have other allergies? Check out these articles to learn more

Wheat Allergy: What to Eat and What to Avoid

Dairy Allergy: What to Eat and What to Avoid

Sun Butter Chocolate Cups (top 14 free candy)

Buckeye Brownies (top 14 free) 

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