Food Allergy

Nuts About Allergies: A Foodservice Guide to Tree Nut Allergies

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Trust20 Contributors • 14 minute read
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Does the idea of juggling food allergies in your establishment make you feel a little, well…nutty?

If so, you’re not alone. While it can be tough to remember the details of different allergies, it is an essential part of running a safe food business.

A tree nut allergy, in particular, can be life-threatening. And since about 1.2% of the US population suffers from this condition, you need to know how to cater to your customers safely and effectively.

Not sure where to start? Then this post is for you. We'll cover everything from identifying tree nuts to preventing cross-contamination in this post.

Here’s what we’ll go over:

What is a Tree Nut Allergy?

Recognizing and Responding to a Tree Nut Emergency

Tree Nut Allergies: How to Keep Your Kitchen (and Your Customers) Safe

What is a Tree Nut Allergy?

First things first–what is a tree nut allergy? Essentially, it's a food allergy in which your immune system overreacts to certain proteins found in tree nuts. That overreaction triggers an immune defense response that can be quite dangerous.

The proteins that cause tree nut allergies are called allergens. When a person with a tree nut allergy consumes these allergens, their immune system creates specific IgE antibodies that bind to the allergens. This binding causes the immune system to release chemicals like histamine, which leads to the symptoms associated with an allergic reaction.

Now, let's discuss the difference between tree nut and peanut allergies. While both are types of food allergies, they involve different types of nuts. 

That leads us right to our next section.

What Tree Nut Allergies Are Most Common?

Again, tree nuts aren’t the same as peanuts–so what should you watch out for?

First up, almonds. Almonds are used in all sorts of baked goods, from cookies to cakes. But they can also appear in almond milk, almond flour, and almond paste. Watch out for those sneaky almonds!

Beechnuts are another sneaky one. They're often used in chewing gum and can even appear in some teas. Black walnut hull extract is a common flavoring in baked goods, while Brazil nuts and cashews can be found in trail mix or as a snack on their own.

Butternuts, also known as white walnuts, are not to be confused with squash. They can be found in pesto or used in baking. Chestnuts are a popular holiday treat and can be found in stuffing or roasted as a snack.

Filberts, or hazelnuts, are commonly used in desserts like Nutella or pralines. They can also show up in coffee flavorings or used to make nut butter. Macadamia nuts are a popular snack, while pine nuts are often used in Italian dishes like pesto or as a topping for salads.

Other tree nuts and related products to watch out for include:

  • Artificial nuts (which may include traces of actual nuts)

  • Chinquapin nut

  • Coconut (most people allergic to tree nuts won’t also have a coconut allergy, but they can)

  • Gianduja 

  • Hickory nut

  • Lychee nut

  • Nangai nut

  • Nut butters (e.g., cashew butter)

  • Nut distillates/alcoholic extracts

  • Nut meal, meat, milk, oil, or paste

  • Pecan

  • Pesto

  • Pine nut 

  • Pistachio

  • Praline

  • Shea nut

  • Walnut

Are There Alternatives to Tree Nuts?

Unfortunately, some people may have a severe allergic reaction to even trace amounts of tree nuts. Just touching or inhaling the dust of a tree nut can cause an allergic reaction in some individuals. That is why it's important to be aware of the allergen risks in food products and to label them accordingly.

So, what are some alternatives to tree nuts? There are several substitutes that you can use in your recipes to achieve a similar flavor and texture.

For example, sunflower seeds or pumpkin seeds can be used instead of nuts in a salad or granola mix. Soy or rice milk can replace almond milk in recipes such as smoothies or baked goods. Chickpeas and edamame can work in many cases, too.

Recognizing and Responding to a Tree Nut Emergency 

We’ll talk in more detail about how to prevent an allergic reaction to tree nuts below, but it’s equally important to be aware of what to do if a reaction occurs within your establishment.

The “good” news, if you can call it that, is that allergies to tree nuts typically start in childhood (unfortunately, they rarely go away in adulthood, as is the case with many other allergies).1 This might be viewed as a good thing because the grown adults you serve will likely know that they have a tree nut allergy and will be able to communicate that to you ahead of time.

With that said, accidental exposure (or unknown allergies) can still and do often occur. 

Common signs of a tree nut allergic reaction include:

  • Hives, itching, or swelling of the lips, face, and tongue

  • Nausea, vomiting, diarrhea, or stomach cramps

  • Shortness of breath, wheezing, or coughing

  • Dizziness, lightheadedness, or fainting.2

In severe cases, an allergic reaction can also lead to anaphylaxis, a severe and potentially life-threatening response that can cause a drop in blood pressure, loss of consciousness, and trouble breathing.

These symptoms can occur within seconds or minutes after exposure to the allergen or even hours later. If you think a customer might be having an allergic reaction, here are some steps to take:

  • Call for emergency medical assistance by dialing 911 immediately.

  • Ask the customer if they have their epinephrine auto-injector with them, and if so, assist them in using it. Epinephrine is the only medication that can reverse the symptoms of anaphylaxis, and it's important to administer it as soon as possible.

  • Remove any traces of nuts from the food the customer ate if possible. If the customer has not already ingested the food, do not serve it to them.

  • Do not attempt to give the customer anything to eat or drink since this could make their symptoms worse. However, try to retrace the steps. Think of what foods or drinks the customer has already consumed or may have come into contact with so you can communicate this information to emergency responders.

  • Stay with the customer until the emergency medical team arrives to provide additional assistance. Reassure them and keep them calm.

Even if the customer takes an antihistamine and begins to show signs of recovery after an allergic reaction, it’s a good idea to encourage them to seek medical assistance. Up to 20% of people who have a reaction can experience a second wave of symptoms after the initial treatment, so they might not be out of the woods quite yet.3

Tree Nut Allergies: How to Keep Your Kitchen (and Your Customers) Safe

As a foodservice professional, here are some things you can do to keep your kitchen and customers safe from the ever-present threat of tree nut allergies.

1. Be Mindful of the Many Foods That Can Trigger a Reaction

So, what foods do we need to be mindful of when it comes to tree nut allergies? The list is longer than you think.

Besides the obvious culprits, like walnuts or almond butter, many less obvious sources of tree nuts can be easily overlooked.

For example, did you know that marzipan, a popular ingredient in many desserts, is made from almonds? Or that pesto sauce often contains pine nuts?

These are just a few examples, but the truth is that tree nuts can be found in many different types of dishes, from salads to Asian stir-fries. Because of this, we need to approach every meal cautiously and be aware of the risks involved.

2. Label Menus Clearly

Do your best to ensure your menus are labeled as clearly as possible. It's not enough to think that your customers will figure it out on their own or ask their server.

Make it easy for them by clearly indicating which dishes contain tree nuts or have been prepared in an environment where cross-contamination is possible.

3. Ask Customers About Dietary Restrictions

Always ask your customers about their dietary restrictions. A simple question like "Do you have any food allergies we should be aware of?" can save someone's life. Then, ensure your service staff informs the back of house team about all food allergies. This way, everyone is aware and can take the necessary precautions.

Make sure your team is trained on the menu items that contain these allergens. Knowledge is power! And speaking of power, consider having the manager talk to the table if a guest has food allergies. This personal touch shows that you care about their safety and well-being and will do everything you can to keep them safe.

Despite all best efforts, there’s always a potential for exposure to an allergen due to inadvertent cross-contamination. Because of this, customers should always be cautioned when there is a risk of exposure. It may seem like a small step, but it can be the difference between life and death for someone with a tree nut allergy.

4. Take Steps to Eliminate Cross-Contamination

Cross-contamination happens when a food item comes into contact with an allergen, like a tree nut, and then transfers that allergen onto another food item. It is a significant risk for people with tree nut allergies, as even a small amount of nut residue can cause a severe reaction.

Here are some hands-on examples of how to prevent cross-contamination:

  • Keep tree nuts separate: Store tree nuts in a separate area away from other foods to avoid accidental contact.

  • Clean and sanitize: Thoroughly clean and sanitize all equipment, utensils, and work surfaces before and after preparing food items that contain tree nuts.

  • Train your staff: Make sure all team members understand the severity of tree nut allergies and how to prevent cross-contamination. Train them to read ingredient labels and to know which dishes contain tree nuts.

  • Use dedicated equipment: Use separate equipment, such as cutting boards, knives, and mixing bowls, designated for tree nuts.

5. Remember That Tree Nuts Can Also Be Found in Soaps and Non-Food Products 

Tree nuts are a common allergen and can be found in a variety of foods, including cakes, granola bars, and pesto sauce. But they can also be lurking in non-food products, too, like soaps, shampoos, and lotions.4

For instance, almond oil is a popular ingredient in hand lotion due to its moisturizing properties, while macadamia nut oil is commonly found in soap since it’s an emollient. Carefully review all of the non-food products used in your establishment to make sure they're nut-free. Those products may include hand soaps in the bathroom, lotions for staff use, and even cleaning products for the kitchen.

6. Train All Team Members to Recognize Signs of Allergic Reactions 

One crucial step in ensuring customer safety is to train ALL team members on recognizing the signs of allergic reactions, especially those caused by tree nuts.5 That includes front-of-house staff, cooks, and anyone involved in food preparation and service.

You don't want to leave anyone out–every team member is an important part of the safety net you are building for your customers. 

7. If “Natural Flavors” or “Botanicals” Are Listed, Call the Supplier to Verify 

Pay close attention to labeling and ingredient lists. Specifically, if you see the terms "natural flavors" or "botanicals" on a label, you should call the supplier to verify what is included in that ingredient.

Why? Unfortunately, these terms can be used to hide the presence of potential allergens, such as nuts. Natural flavors can be derived from a wide range of sources, some of which may include nuts or nut-based oils. Similarly, botanicals can refer to any number of plant-based ingredients, some of which may be derived from trees or other nut-bearing plants.

Calling the supplier can help you get a better understanding of what exactly is included in the product and make an informed decision about whether or not it is safe for your customers with nut allergies to consume. This simple step can help you avoid a potential disaster and keep your customers healthy and happy. 

8. Be Careful With Imported Products

Speaking of labels and suppliers, be extra careful with any imported products.

And as much as possible, try to source locally or within your country to avoid confusion with labeling requirements. The labeling regulations for tree nuts can vary depending on the country of origin.

Some countries may use different names for the same nut, or may not even mention tree nuts on the label. Though the FDA in the United States mandates this, tree nut labeling is not a requirement in all countries. As you might expect, this can be a huge problem for people with tree nut allergies who rely on labels to determine whether a food item is safe for them to eat. 

9. Check Everything

If you want to keep your customers with tree nut allergies safe, you need to check everything! And we mean everything–not, just the obvious culprits, but also those sneaky tree-nut-containing ingredients hiding in unexpected places.6

Did you know that even alcoholic beverages can contain tree nuts? That delicious amaretto you add to your cocktails could be sending your nut-allergic patrons straight to the hospital.

But that's not all–hot cocoa mix, teas, sauces, flavorings, coffees, salad dressings, smoke flavorings–all of these seemingly innocuous ingredients can contain traces of tree nuts. 

So, even if your main dish is nut-free, a seemingly harmless side or accompaniment could be putting your customers at risk.

10. Sanitize Often

As you now know, allergens can be deadly serious for some people. And unfortunately, they can cling to surfaces like sponges and towels, waiting to contaminate the next unsuspecting dish.

Use disposable methods like paper towels or disinfecting wipes to sanitize whenever possible. Not only will this save time and make your life easier, but it will also help ensure you're not accidentally spreading allergens around your kitchen.

11. Encourage Good Hygiene Practices Among Team Members

One of the best ways to keep your customers safe is by encouraging good hygiene practices among your staff. That may seem like basic common sense, but you'd be surprised how many foodservice establishments forget the importance of proper handwashing and cleanliness. 

Make sure that all of your team members are trained on proper handwashing techniques. That includes washing hands with soap and warm water for at least 20 seconds and making sure to scrub under fingernails and between fingers. It's also a good idea to have hand sanitizer readily available for staff, especially during busy times when hand washing may be less convenient. 

12. Keep Surfaces and Equipment Clear

Of course, it's not just about hand hygiene–ensuring that all surfaces and utensils are regularly cleaned and sanitized is also crucial for preventing cross-contamination. That includes cutting boards, knives, and even the handles of equipment such as blenders or mixers. 

13. Consider Designating Parts of the Kitchen for Allergen-Free Prep

If you cater to a crowd that has tree nut allergies–which, frankly, pretty much everyone does–it's essential to have a plan in place to keep them safe. One approach is to designate parts of your kitchen for allergen-free prep. That can help minimize the risk of cross-contamination.

What does this mean exactly?

Let's say you have a salad bar where customers can choose their own toppings. You could designate an area of the kitchen where all the ingredients for this salad bar are prepped and stored. This way, you can ensure no cross-contamination with tree nuts.

In addition to designated areas, you could have your staff change gloves and use color-coded cutting boards when preparing allergen-free foods. That may seem like a small step, but it can make a big difference in keeping your customers safe.

14. Put Up Food Allergy Awareness Posters in the Staff Area

Putting up food allergy awareness posters in the staff area is a great way to keep the risk of allergies at the forefront of every team member’s mind. These posters can remind staff members to take extra precautions when preparing food for customers with allergies.

For example, they can remind staff to clean surfaces and utensils thoroughly to avoid cross-contamination. They can also remind staff to check ingredient lists carefully and to let customers know if a dish contains tree nuts or has come into contact with them.

15. Know When to Say No

So, what should you do when a customer with a tree nut allergy walks through your doors?

While some customers may ask you to eliminate tree nuts from their meals entirely, there are times when it might not be possible. 

Maybe your kitchen uses nuts in many dishes, or perhaps there's a trace amount of nuts in an ingredient you can't avoid. Whatever the case, you don't want to risk a customer's health just to cater to their wants.

That's where the alternative options come in. Instead of telling the customer, "Sorry, we can't accommodate your request at all," you need to figure out how to serve them safely. 

For example, you could recommend a dish that doesn't contain nuts or modify an existing dish to meet their needs. It's not impossible to make adjustments in most cases, but it requires creativity and a willingness to provide options that cater to everyone.

And if it is impossible? Don’t be afraid to say so. A customer might be annoyed, and the entire party will likely leave, but it’s better to make someone disgruntled than to make them sick. Of course, this should be done with as much grace and tact as possible. In most cases, the customer will appreciate the heads-up.

At the end of the day, taking the time to cater to customers with allergies can be good for business. When you go above and beyond to ensure safe dining experiences for your customers, you build trust and loyalty. Plus, you create a positive reputation for your business as a safe haven for those with allergies.

Final Thoughts

Did you know that some states require by law that establishments have at least one manager certified or trained specifically in allergy awareness (Illinois, Massachusetts, and Rhode Island are a few examples)? 

Whether or not you live in one of these states, the truth is that it’s up to us as foodservice professionals to make sure that our customers with tree nut allergies can dine safely. 

With the prevalence of tree nut allergies on the rise, it's a no-brainer that allergen awareness needs to be a top priority in any food establishment.

So, whether you're a restaurant chef or a cafeteria manager, it's time to brush up on your allergy knowledge, train your staff, and implement Trust20's comprehensive food safety and allergy awareness products.

Don't let a customer's tree nut allergy ruin their dining experience! Take action today and show your commitment to food safety and customer satisfaction.

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Sources

  1. Kuźmiński et al: Tree nut allergy

  2. FDA: Food Allergies: What You Need to Know

  3. Cleveland Clinic: Anaphylaxis: Causes, Symptoms, Diagnosis & Treatment

  4. FARE: Tree Nut Allergy

  5. American College of Allergy, Asthma, and Immunology: Tree Nut | Causes, Symptoms & Treatment

  6. Food Allergy Canada: Tree nuts