Tree Nut Allergy: What to Eat and What to Avoid

Tree Nut Allergy: What to Eat and What to Avoid

The tree nut allergy is one of the top 8 food allergens in the world, affecting up to 1% of all people in the States. Tree nuts are a collection of similar nuts/seeds that trigger an allergic reaction in people. If you are allergic to one tree nut, you might not be allergic to them all, but I have found for me that I am allergic to all tree nuts and their biological counterparts.

The nuts of the Tree Nut allergy include: Almonds, Brazil nuts, cashews, hazelnuts, pecans, pistachios, and walnuts.

Even if you are not allergic to all of the tree nuts, I still would advise you to be careful when eating nuts as there is always the potential risk of cross contamination during the preparation and handling and transportation of the tree nuts.

Tree nuts are different from Peanuts, though about 25 to 40% of people who are allergic to peanuts are also allergic to tree nuts. This similar protein structure causes something known as cross-reactivity. Currently, the FDA also classifies a Coconut as a tree nut, despite them being a fruit and not a nut or seed. For more information, you can read my article all on the Peanut Allergy or the Coconut Allergy.

People who are allergic to tree nuts can usually eat seeds without worry of an allergy, such as sesame, sunflower, and pumpkin.

Macadamia nuts and Pine nuts are not actually nuts at all, but also seeds, and so the majority of tree nut allergic people can eat them. However, you should always use caution when eating them and chat with your doctor if you are unsure.

And for those wondering, yes, I am allergic to all of the tree nuts and their seed counterparts. Except for Sunflower seeds. I can still eat those, for now.

The tree nut allergy usually develops in childhood and most people will retain this allergy for the rest of their life. About 10% of people diagnosed in childhood will outgrow this allergy.

Extreme caution is to be used with a tree nut allergy as it can be a deadly allergy! Anaphylactic reaction is a common response to children and adults when exposed to tree nuts. I recommend that everyone with a tree nut allergy to get an EpiPen and carry it on their person at all times, just to be safe.

While it may seem overwhelming at times when living with a Tree Nut allergy, don’t worry! Living with a tree nut allergy is easier to manage than ever and you’ll be okay.

Being Your Own Allergy Advocate

When I was first diagnosed with my plethora of allergies back in the early 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 as pervasive as the word is today, there are still people who don’t really “get” allergies. For example, 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 urgent care 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 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.

tree nuts in glasses

Tree Nut Allergy Safety in School and Work

If your child has a tree nut 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 oils on the desk after someone ate a granola bar, for example.

The most dangerous moments for your child will be during school parties when parents bring in sweet treats to celebrate. You must teach your child that they can’t participate in these events no matter how good the cupcake (or whatever the treat is) looks because we don’t know if it’s safe.

Another dangerous moment is at the lunch table. While you might pack a safe lunch for your kid, there is no guarantee that they don’t swap foods to share with friends at the table. This is another thing you need to teach your kids not to do.

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

How to Read a Food Label with a Tree Nut Allergy

Learning how to read food labels is one of the most important things you can do after developing a tree nut allergy. Always make sure that you read the entire label and not just quickly scan for tree nut 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 suggest you do the same.

What to Avoid with a Tree Nut 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 is 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 an allergy name that I’ve missed, write it in the comments below and I’ll be sure to add it to the list!

Tree Nut Names

  • Almond
  • Beechnut
  • Brazil nut
  • Bush nut
  • Butternut
  • Cashew
  • Chestnut
  • Coconut
  • Filbert
  • Ginko nut
  • Hazelnut
  • Hickory nut
  • Lichee nut
  • Macadamia nut
  • Nangai nut
  • Pecan
  • Pine nut
  • Pistachio
  • Shea nut
  • Walnut

Tree Nuts also have a few variances on their names. You need to also watch out for:

  • Almond
  • Almond paste
  • Anacardium nuts
  • Anacardium occidentale (Anacardiaceae) [botanical name, Cashew]
  • Artificial nuts
  • Beech nut
  • Brazil nut
  • Bertholletia excelsa (Lecythidaceae) [botanical name, Brazil nut]
  • Bush nut
  • Butternut
  • Butyrospermum Parkii [botanical name, Shea nut]
  • Canarium ovatum Engl. in A. DC. (Burseraceae) [botanical name, Pili nut]
  • Caponata
  • Carya illinoensis (Juglandaceae) [botanical name, Pecan]
  • Carya spp. (Juglandaceae) [botanical name, Hickory nut]
  • Cashew
  • Castanea pumila (Fagaceae) [botanical name, Chinquapin]
  • Castanea spp. (Fagaceae) [botanical name, Chestnut (Chinese, American, European, Seguin)]
  • Chestnut (Chinese, American, European, Seguin)
  • Chinquapin
  • Coconut
  • Cocos nucifera L. (Arecaceae (alt. Palmae)) [botanical name, Coconut]
  • Corylus spp. (Betulaceae) [botanical name, Filbert/hazelnut]
  • Filbert
  • Fagus spp. (Fagaceae) [botanical name, beech nut]
  • Gianduja
  • Ginko nut
  • Ginkgo biloba L. (Ginkgoaceae) [botanical name, Ginko nut]
  • Hazelnut
  • Heartnut
  • Hickory nut
  • Indian nut
  • Juglans cinerea (Juglandaceae) [botanical name, Butternut]
  • Juglans spp. (Juglandaceae) [botanical name, Walnut, Butternut, Heartnut]
  • Karite (shea nut)
  • Lichee nut
  • Litchi chinensis Sonn. Sapindaceae [botanical name, Lichee nut]
  • Lychee nut
  • Macadamia nut
  • Macadamia spp. (Proteaceae) [botanical name, Macadamia nut/Bush nut]
  • Mandelonas
  • Marzipan
  • Mashuga nuts
  • Nangai nuts
  • Natural nut extract (for example, almond extract)
  • Nougat
  • Nu-Nuts®
  • Nut butters (e.g., Almond butter, Hazelnut butter, Brazil nut butter, Macadamia nut butter, Pistachio nut butter, Shea nut butter, Karike butter, as well as other nut butters)
  • Nut meal
  • Nutella ®
  • Nutmeat
  • Nut oil (e.g., Walnut oil as well as other nut oils), nut paste, nut pieces
  • Pecan
  • Pigñolia
  • Pili nut
  • Pine nut
  • Pine nut (Indian, piñon, pinyon, pigndi, pigñolia, pignon nuts)
  • Pinon nut
  • Piñon or Piñon nut
  • Pinus spp. (Pineaceae) [botanical name, Pine nut/piñon nut]
  • Pistachio
  • Pistacia vera L. (Anacardiaceae) [botanical name, Pistachio]
  • Pralines
  • Prunus dulcis (Rosaceae) [bontanical name, almond]
  • Shea nut
  • Sheanut
  • Vitellaria paradoxa C.F. Gaertn. (Sapotaceae) [botanical name, Shea nut]
  • Walnut (English, Persian, Black, Japanese, California)

Other Hidden Places for Tree Nut Allergies

Tree Nuts are often found in the following items

  • Artificial flavoring
  • Baked goods (especially almond extract!)
  • Body Care Items (especially skin care products like washes, exfoliators, moisturizers, lotions, creams, etc)
  • Candy (chocolate candy especially)
  • Cereals
  • Chili
  • Energy Balls / Energy Bars
  • Grain breads
  • Granola
  • Make Up
  • Mortadella
  • Natural flavoring
  • Nougat
  • Pesto
  • Salads and Salad Dressings
  • Veggie Burgers

What You Can Use with a Tree Nut Allergy

After developing or discovering your tree nut allergy, how you eat and how you live is very likely going to change. Cooking for home is one of the safest options for you and your family as you can ensure non allergens come into contact with your food, and thus, not cross contamination. 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.

For a list of my favorite tree nut 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 Tree Nut Allergies

While not the biggest change to your life with a tree nut allergy, there are some new considerations to make 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.

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 “allergy friendly” 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 tree nut allergies in general, you want to be wary of Vegan and Asian inspired cuisine as they both rely heavily on coconut to flavor things. Bakeries and baked goods are recommended to be avoided as the risk of almond extract or cross contamination is high.

When dining at a friend’s house, I will always ask if I can bring an option that is wheat allergy safe. Follow this link for an article that shares ideas for talking with your family and friends about your allergies.

Fast Food Options for Tree Nut Allergies

  • In-N-Out
  • Chipotle
  • Qdoba
  • Chick-fil-A
  • Burger King
  • Wendy’s
  • McDonald’s
  • Subway
  • Taco Bell
  • Arby’s
  • Most BBQ places

Have other allergies? Check out these articles to learn more

Note: All recipes on this blog are tree nut free and you are safe making and enjoying any one of them. 🙂

Peanut Allergy: What to Eat and What to Avoid

Coconut Allergy: What to Eat and What to Avoid

My Natural Skin Care Routine

Gluten Free and Vegan Chocolate Donuts

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