People with nut allergies can find alternative foods with similar benefits


Q. I am allergic to nuts and every article I read says “add nuts they are good for you”. So what’s a person to do?

A. I understand your frustration. I eat nuts probably two or three times a day and if I couldn’t eat them I would feel like something was missing from my diet.

For people who have nut allergies, it is important to consult an allergist to learn more about the specifics of your allergy and whether there are any nuts that you could eat. If you absolutely can’t eat peanuts or any other type of nut, alternative foods can add some of the protein, healthy fats, nutrients and satiety that nuts contribute to the diet.

The research supporting nuts as an important component of the daily diet is strong. In a multicenter study in Spain, researchers assigned nearly 7,500 people at high risk of cardiovascular disease to either a low-fat diet or a Mediterranean diet supplemented with virgin olive oil or mixed nuts.

After about five years of follow-up, a Mediterranean diet supplemented with extra-virgin olive oil or nuts reduced the risk of a major cardiac event by about 30 percent compared with the control group. Other benefits have been seen among those who eat healthy sources of fat (olive oil or nuts), including a lower risk of dementia, diabetes and breast cancer.

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Learn more about your nut allergy

Nut allergy is one of the most common food allergies, affecting approximately 0.5 to 1% of the US population, according to the American Academy of Allergy, Asthma and Immunology (AAAAI). Tree nuts include almonds, Brazil nuts, cashews, hazelnuts, pecans, pistachios, and walnuts. Peanuts are actually legumes, but although they are different from tree nuts botanically, they are similar in terms of health outcomes.

People with nut allergies are often allergic to more than one type of nut, but an allergy to one type of nut or to peanuts does not necessarily mean that a person is allergic to all other nuts.

If you are among those who have been told they can’t eat nuts, I would advise further specific research. Nut allergy is often diagnosed in childhood and continues into adulthood, but about 10 percent of children outgrow it over time, according to the AAAAI.

And some people are very allergic to peanuts but not tree nuts, and vice versa, but they may not recognize it. Don’t risk experimenting on your own. It is important to have careful medical guidance.

If you find out that your nut allergy is limited and you can safely eat certain nuts, that’s good news. Most common nuts, along with peanuts, are similar in composition and are good sources of protein, healthy fats, fiber and many other phytochemicals.

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Try seeds if you are allergic to nuts

For those who know they definitely can’t eat peanuts or tree nuts, seeds are a great alternative. Seeds are nutrient packets that make young plants grow, and these same nutrients are good for humans.

We classify seeds somewhat arbitrarily; many of the plants we eat are technically seeds, such as grains, legumes, beans, and nuts. But when we talk about seeds, we mean pumpkin, sunflower, chia, poppy, sesame seeds and more. According to the AAAAI, people with a tree nut allergy can usually tolerate the seeds, as well as macadamia and pine nuts, which are also seeds.

We don’t have enough consumption of these seeds in our population to have a good, robust look at long-term health effects. But based on the composition and function of seeds, we would expect benefits similar to those of nuts. The seeds are high in protein, unsaturated fatty acids and fiber and contain a good combination of vitamins and minerals.

Sunflower seed oil is remarkably similar in flavor to peanut butter or other nut oils. Check the label to find one that has no added sugar. Adding seed oils to your diet is a fairly easy switch someone with nut allergies can make to get the extra protein, healthy fats, and nutrients they’re missing out on by not eating nuts.

Whether you can eat nuts or are limited to seeds, you don’t have to think of these great foods as just snacks. In the morning I usually eat oatmeal or yogurt with nuts. Nuts or seeds can be part of a lunch salad and replace cheese and animal products in our meals. In a stuffed pepper recipe, the nuts and seeds can even be used as a substitute for ground beef.

For breakfast or sprinkled on salads, dried chickpeas can be a crunchy alternative to nuts. Dried chickpeas are a legume and tend to contain more starch than most nuts. It’s not an ideal alternative, but as part of the mix it might be good to try them.

As another snack alternative, my two go-tos are apples and carrots. They are high in fiber and nutrients, satiating and add only a modest number of calories.

When I was writing the first edition of my book on nutritional epidemiology, I spent long hours just writing and gained about five pounds. For the second edition, I didn’t want to do it again and made sure I had plenty of carrots or apples for breakfast. That worked.

Many people snack on dried fruits, but they do not induce satiety like other foods. And dentists hate dried fruit because it’s sticky and keeps the sugar in contact with the teeth.

It is important to note that no food should be completely banned. It’s okay to have a favorite but less healthy food once in a while. But for everyday snacks, it’s helpful to declare to yourself what your snacks are and consciously have them available.

Walter Willett is a physician and professor of epidemiology and nutrition at the Harvard TH Chan School of Public Health.

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