what is anaphylaxis
Frequently asked questions about food allergy
In this section we aim to answer some frequently asked questions about food allergy, these include:-
Q1: Are children with nut allergy at risk from conkers?
Q2: Should people with nut allergy avoid coconut?
Q3: Should people with nut allergy avoid nutmeg?
Q4: Do vegetable oils pose a risk for people with allergies?
Q5: I have a child with peanut allergy. Could his young brother develop it?
Q6: Can you have a reaction from touching or inhaling allergens?
Q7: I have a child with peanut allergy. Should he avoid other legumes such as peas and lentils?
Q9: Should I take “may contain” warnings seriously?
Q1: Are children with nut allergy at risk from conkers?
A1: A few schools have banned conkers because they are worried they will endanger pupils with nut allergy. However, we can find no credible reports suggesting that conkers pose any risk to people with nut allergy.
We have heard a few anecdotal reports from people saying they have skin reactions to conkers when they handle them. Clearly if this happens, they should be avoided. No one should be eating them as they are poisonous in their own right.
Q2: Should people with nut allergy avoid coconut?
A2: The coconut is a member of the palm family and only distantly related to the tree nut. However, because of its name, people with nut allergy often feel they must avoid it at all costs. The coconut does not appear on Europe’s list of tree nuts that must always been labelled on food packages, but in the U.S. coconut is classed as a tree nut for labelling purposes.
The key question is whether coconut is likely to trigger allergic symptoms in people with tree nut allergy. We believe this is highly unlikely for most people with tree nut allergy. The botanical distance between coconuts and tree nuts would suggest that most people with tree nut allergy can tolerate coconut. There are bound to be exceptions to this, but if you are allergic to nuts and have never had a reaction to coconut it is likely that coconut poses no greater risk than many other foods. Check this with your allergist.
Q3: Should people with nut allergy avoid nutmeg?
A3: Because of its name, many people with nut allergy believe that nutmeg must be avoided at all costs. It is possible that they are being over-cautious because there is no hard evidence to suggest that people with nut allergy are particularly at risk from nutmeg, and the incidence of nutmeg allergy is thought to be rare. However, not enough research has been carried out to be certain about how much of a problem it is. Nutmeg is the kernel of an apricot-like fruit and there is just the possibility that there might be cross-reactivity with almond, which is also a fruit kernel. If you are allergic to nuts and have never had a reaction to nutmeg it is likely that nutmeg poses no greater risk than many other foods. However, it would be sensible to be cautious, particularly if you are allergic to almonds or other fruit kernels such as apricot.
Q4: Do vegetable oils pose a risk for people with allergies?
A4: The most common oils used in the UK are derived from rapeseed, sunflower seed, soya, maize, palm, coconut and palm kernel. Where they appear in pre-packed food, these oils are likely to have been refined and it is believed that this process removes any detectable traces of proteins. It is the protein in a food that triggers allergic reactions. Although it is impossible to be 100 per cent certain, it is highly unlikely that these oils, when refined, will cause allergic reactions. However, to be absolutely certain about this, research would have to be undertaken on each oil. Some speciality oils (e.g. sesame, hazelnut and walnut) contain unrefined oil and do present a risk.
Q5: I have a child with peanut allergy. Could his young brother develop it?
A5: The tendency to be allergic runs in families. Because there is allergy in your family, there is a high chance that the younger sibling will also be susceptible to allergies. This will not necessarily be peanut allergy and will not necessarily be severe. If you do have a sibling with peanut allergy, then there is a seven per cent risk of the other child developing peanut allergy, compared with a 1-2 per cent risk in a child in the general population.
Q6: Can you have a reaction from touching or inhaling allergens?
A6: Some reassurance can be gained from a 2003 American study (reference below). Researchers observed 30 children with severe peanut allergy while they were being exposed to peanut butter through touch and smell. Accidental contact was simulated by pressing a dab of peanut butter on the child's back for one minute, and by holding a dish containing three ounces of peanut butter one foot from the child's nose for 10 minutes.
The results:
- None of the children experienced anaphylaxis.
- There were no reactions to inhalation.
- During the touch challenge, however, one-third of the children had a mild reaction, such as redness, itching, or a single hive limited to the site of contact. Medication was not needed to treat these reactions.
Researchers concluded that at least 90 per cent of similarly allergic children would not experience a severe reaction to similar exposures.
It’s important to add that the researchers advised strongly that no changes in general avoidance measures should be taken based upon these results. They added that the study looked at peanut butter but not peanut in other forms. Furthermore, the Campaign knows of a very small number of cases where touch or smell caused moderately severe reactions. Be guided by your GP or consultant.
Reference: Simonte SJ, Ma S, Mofidi S, Sicherer SH (2003). Relevance of casual contact with peanut butter in children with peanut allergy. J Allergy Clin Immunol;112(1):180
Q7: I have a child with peanut allergy. Should he avoid other legumes such as peas and lentils?
A7: In our experience, the number of people with peanut allergy who react to other legumes (such as peas, beans and lentils) is relatively small and this is supported by research from the USA (see below). Care is needed, but most people find they can tolerate these other legumes without problems. If in doubt, raise this with your allergy specialist.
Reference: Sicherer SH (2001). Clinical implications of cross-reactive food allergens. J Allergy Clin Immunol.;108(6):881-90.
Q8: Are food companies legally obliged to use “may contain” warnings if there’s a risk of cross-contamination?
A8: The use of "may contain" warnings is voluntary and not directly covered by the food labelling laws. Nevertheless industry is well aware that the General Product Safety Regulations place a requirement on suppliers to communicate any risk associated with their product to the consumer.
Q9: Should I take “may contain” warnings seriously?
A9: “May contain” warnings are infuriating because they limit choice and make shopping complicated, but often these warnings are there for a good reason because of the risks of cross-contamination during the production chain. Our advice to people is clear: Don’t ignore these warnings. You may eat a product numerous times without having a reaction but the next time you may not be so lucky. Cross-contamination can be intermittent.
