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NEW ORLEANS, Mar 20 (Reuters Health) - About 1 in 7 people who are allergic to peanuts or tree nuts have experienced a reaction after eating at a restaurant or getting take-out food, researchers said on Monday at the American Academy of Allergy, Asthma, and Immunology meeting here.
Nearly 20% of the allergic episodes were related to Asian restaurants, 14% were related to ice cream shops, and 13% were related to bakery/donut shops.
And those who are allergic may have an extra incentive to skip the dessert. Of the various parts of a meal, desserts accounted for more than 40% of the allergic reactions, reported Dr. Scott H. Sicherer, from Mount Sinai School of Medicine in New York, and colleagues.
The researchers randomly selected 129 people enrolled in the National Peanut and Tree Nut Allergy Registry and asked them about their experiences dining out.
"Eating out is a common issue for people with these allergies," Sicherer told Reuters Health. "For Asian food, nuts are often used in cooking and because the utensils and cooking equipment from different foods are often shared it becomes a high-risk food for allergic individuals," he stated.
Desserts are also high risk because of the frequent use of nuts and because "the nuts are often in hidden forms, like sauces," Sicherer said. "Ice cream is a particularly high-risk food because of cross-contamination issues," he added. Even though a food has not been prepared with nuts, it can become "cross-contaminated" if utensils used in nut-filled dishes are used to serve the food.
Although this may happen to people allergic to other foods such as fish, milk or egg, the researchers focused on nut allergies "because we have a giant registry of people with these allergies and because it is a severe allergy that affects 1.1% of the population," Sicherer explained. Such reactions can be potentially life threatening, causing swelling of the lips and throat, breathing difficulty and in the most severe cases, collapse of the circulatory system.
Sicherer noted that "one of the problems was that patients did not uniformly notify the restaurants about their allergies." For example, "sometimes the allergic person would ask if the food has nuts in it and the person serving the food would say no, but they may not have specifically said 'I'm allergic to nuts. If I eat nuts I'm going to die. Does this have nuts in it?'" he said.
"Physicians should instruct their patients to be very clear in identifying themselves as allergic and to communicate with the person who actually knows how the food is prepared," Sicherer said. In addition, allergic individuals should wear a medic alert bracelet and carry the appropriate medications with them in case an accident does occur, he added.
"Restaurants and food establishments have to understand the seriousness of food allergy and be educated about all of the places where the food can get cross-contaminated," Sicherer stressed. Perhaps one day there will be signs in restaurants, similar to the Heimlich maneuver signs for choking, that will raise awareness about nut allergies, he concluded.
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