Can You Identify That Nut?


More than 3 million people in the United States report being allergic to peanuts, tree nuts, or both. For those with nut allergies, knowing which is which when faced with an assortment can be critical. Unfortunately, new research presented at the 2010 Annual Scientific Meeting of the American College of Allergy, Asthma and Immunology indicates that only about half of the people with a nut allergy can visually identify those they are allergic to.

Peanut and Tree Nut Allergy Leading Cause of Food-Related Anaphylaxis

The study, conducted by Todd Hostetler MD of the Ohio State University, involved 1,005 adults and children, some with food allergies and some without, who were shown a tray with 10 different nuts in 19 various forms – whole (without the shell), in the shell, slivered, and crushed. The participants had to complete a worksheet identifying each nut. Only 21 of the participants (1.9%) were able to identify all 19.

Among the adults, most were able to accurately identify 8 or 9 out of the 19. Peanuts were the most easily recognizable, whether or not they were inside the shell. Hazelnuts and pecans were the least recognized.

If the adult had a nut allergy, he or she was able to identify slightly more – 13 out of 19.


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Children under 18 were only able to identify between 4 to 6 of the different nut varieties, but thankfully, 73.3% of parents of allergic children were able to name all of the nuts that affected the child.

The study is important, says Dr. Hostetler, because over a five-year period, 55% of the participants with peanut allergy had reactions after accidently eating the wrong nut. Peanuts and tree nuts are the leading cause of death from food-induced anaphylaxis.

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Clinicians should include information on how to recognize different nuts, in their different forms, as part of the education upon diagnosis of a peanut or tree nut allergy.

Source reference:
Hostetler T, et al "THe ability of adults and children to visually identify peanuts and tree nuts" ACAAI 2010; Abstract 48.