Risk Management Strategies

There will always be risks for the nut-allergy sufferer. A recent news story highlighted the case of a man stealing a Christmas kiss at the office party and being hospitalised with anaphylactic shock. His colleague had been snacking on nuts and had passed the nut protein into his mouth. There have also been incidents of youngsters having reactions from coming into contact with items accidentally smeared with peanut butter by other youngsters. However we can't live in a bubble or wrap allergy-sufferers up in cotton wool so a sensible risk management plan must be introduced to keep risks at an acceptable level.

At Home

Deciding on a policy for at home can be tricky. With very young allergy-sufferers it may be best to create a nut free zone to avoid all risks, although as nut allergy rarely goes away even little toddlers have to learn that there are certain foods that they mustn't touch.

Personally, we choose to have no nut products or items with trace warnings in the house as it makes life at home simpler and more relaxed (although shopping takes twice as long and can be very frustrating). Inevitably things do slip through the net, but very rarely reach the mouth of our little no-nutter as every product is double-checked before being prepared.

With an older child it may be more practical to have different food for that child as this simulates the situation in the real world (although you may feel a little uncomfortable tucking into a chicken satay when they're around) and this does introduce the possibility of cross-contamination issues in your own kitchen.

Shopping

A weekly shopping trip may take twice as long when catering for a nut-allergy sufferer. Labels need to be checked to ensure minimal risk of contact with nut protein.

The bad news is that there is no standard labelling practice used by all food manufacturers and there is no legal requirement to put trace warnings on products. (although if it is an actual ingredient it does need to be listed as such).

Avoid foods containing the following nuts: almonds, brazil nuts, cashew nuts, chestnuts, cob nuts, filberts, ground nuts, hazelnuts, macadamias, peanuts, pecans, pine nuts, pistachios, walnuts.

And avoid products containing the following nut mixtures: frangipani, marzipan, nut oils, pesto sauce, praline.

Fortunately many manufacturers are responding to the needs of allergy-sufferers by putting specific allergy information on their products, but it can sometimes be difficult to work out how big the risk of contamination is.

Labels reading 'this product has been produced in a factory which handles nuts', do not demonstrate how significant the risk is.

The safest path is to avoid any food labelled with nut warnings and to buy food that has allergy information on it and no nut warning (although this is not foolproof, so it would be prudent to also read the ingredients). If food has no clear allergy labelling it may have been contaminated with nuts at some time in the production process. If in doubt contact the manufacturer.

Check all packaging for nut warnings, on multipacks only the outer (or inner) sleeve may bear a warning.

Several companies follow voluntary guidelines and place 'may contain' statements next to the ingredients, but they may be found elsewhere on the packaging. Scrutinise all packaging.

Also check ingredients where there is no warning. Many people don't realise that Mars Bars and Milky Way Bars have nuts listed in their ingredients.

Another problem is that products sometimes stop being nut-free if their production process/line is changed, so it is necessary to check all products every shopping trip to check food is still OK to buy. A recent example of a change in nutfree status involves the Twix bar which is no longer safe due to a change in production.

Several food manufacturers now produce lists of products that are nut-free, however these are also subject to change and all items should still be checked before purchase.

Also, check ingredients on cosmetics and toiletries as these may contain nut oils.

We are currently contacting food manufacturers and retailers to investigate their policy regarding nut allergy labelling and will publish the details shortly.

For specific information on food retailer/manufacturer policies go to our guides page.

Eating Out

This is a difficult one. Some restaurants are better than others and some don't have a clue. I have been into several pubs and been greeted with a dazed look when asking whether the food contains nuts. The worst response has to be the waitress glibly responding 'I don't think so' without consulting anybody on the matter, and then expecting you to decide whether to take a chance or not. If you firmly explain that the consequences of eating nuts could be fatal staff tend to be a little more co-operative.

However never rely on staff to interpret your needs correctly and check everything you are given. And always carry emergency medication.

Cross-contamination is a major problem in restaurants. A lot of restaurants are now putting warnings such as ' we cannot guarantee that any of our standard menu items are free from nuts' to cover themselves. However, when probed further some of these establishments may actually be able to cater for allergy-sufferers through alternative arrangements (such as cooking food in a separate area).

Chinese, Indian and other oriental restaurants are not recommended due to the vast quantities of nuts and nut oils used in these foods. Spicy food may also mask initial symptoms of allergy.

The key is to always inform staff/managers that you/your child have a nut allergy and to work out whether it is a safe place to eat. It's often worth giving restaurants a ring before visiting to check on their policy and save a wasted journey.

We are currently contacting restaurant chains to investigate their policy regarding catering for diners with nut allergy and will publish the details shortly. For more information on restaurant policies go to our guides page.