How to cope with a nut allergy at Christmas

How common are nut allergies?

In the UK and USA, the prevalence of nut allergies is increasing. According to Allergy UK, there are nearly 100,000 new cases each year. Peanut allergies among children in Western countries have doubled in the last 10 years. In addition, in the UK over the last 20 years there has been a 615% rise in hospital admissions for anaphylaxis - extreme allergic reactions that can result in death.

Christmas time can see a surge in hospital admissions for those with nut allergies. Nuts enjoy the spotlight in many of our festive recipes, and in others their presence can be hard to spot.

Adam Fox, consultant paediatric allergist at a leading London teaching hospital, describes how Christmas can be a chaotic time of family gatherings and social events. The abundance of food and party snacks puts people with nut allergies at risk and makes it hard for parents to always keep an eye on what their children are eating.

What happens when you have an allergic reaction to nuts?

Both peanuts and tree nuts - although peanuts are not strictly classed as a nut - can cause allergic reactions in some people. This happens when your body's immune system overreacts to a foreign substance which wouldn't cause you harm. Your immune system releases a substance called histamine, and this can trigger several symptoms of an allergic reaction.

What are nut allergy symptoms?

"Look out for classic food allergy symptoms such as hives/nettle rash (urticaria), swelling and an itchiness around the mouth immediately after eating," advises Fox. "In rare cases, people may experience difficulty breathing. This is an anaphylactic reaction and requires emergency medical attention."

Other signs and symptoms of an allergic reaction can include:

• Your mouth and lips tingling.

• Nausea.

• Colicky pains in your tummy (abdomen).

• A feeling of tightness around your throat.

Signs and symptoms of a more severe allergic reaction (anaphylaxis) can include:

• All of the above.

• Wheezing or difficulty breathing

• Swelling around your throat.

• A sense of impending doom.

• Dilation (opening up) of your blood vessels, which can cause skin redness, a quick heart rate, or low blood pressure which can cause you to feel faint.

What nuts do you eat at Christmas?

There are some obvious nutty festive food favourites, and some not so obvious uses of nuts at Christmas.

Roasted chestnuts and salted peanuts are popular party snacks often found on party tables. The amount of food and people at some gatherings can make it hard for parents of children with nut allergies to keep a watchful eye and to stop their children from grabbing nuts.

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Rocky road, hot chocolate, and other chocolate-based products may also contain nuts and it's worth always reading the label or to be wary of food provided by others. Walnuts also enjoy the spotlight over Christmas and can be found in many savoury and sweet dishes, including salads and cake.

Tips to help you avoid nuts at Christmas

Despite the abundance of food and people over Christmas time, there are some things you can plan for to make avoiding nuts a little easier:

Over Christmas and throughout the year, if you have been issued an adrenaline auto-injector (AAI) always have this ready for emergency use.

Eating out

Allergy UK has some useful tips to help you stay in control of what you're eating when dining out, both over Christmas and throughout the year.

Even food which doesn't have nuts listed in the ingredients may have been cooked in oil containing nuts or sesame seeds. Cross-contamination of food cooked in the same oil as nut-containing food can also cause an allergic reaction.