British Society for Allergy and Immunology Abstracts From the 2024 Annual Conference



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Nutmeg Vs. Tree Nuts: What's The Difference?

Despite its name, nutmeg is not a nut but a seed. Some people may have an allergic reaction to nutmeg and other seeds.

Nutmeg is used to season dishes and is available to buy as a ground spice or in its whole form. It can be found in baked goods, entrees, and desserts. Certain cuisines, such as Moroccan and Indian cuisines, feature nutmeg in their dishes. It's also sometimes used in beverages, like cider.

People with tree nut allergies may wonder if it's safe for them to eat nutmeg. The answer is yes. Despite its name, nutmeg isn't a nut. It's really a seed.

If you have a nut allergy, you may be able to eat nutmeg without any risk of an allergic reaction. However, if you have a seed allergy, you may need to avoid nutmeg since it's technically from a seed. But just because you're allergic to one type of seed doesn't mean you're allergic to all of them.

Peanut and tree nut allergies affect millions of Americans. They're most common in children, but adults can also develop these allergies. Allergies to seeds such as nutmeg are much rarer.

Researchers don't know exactly how many Americans have a seed allergy. They do know that the most common seed allergy is a sesame seed allergy. Sesame seed allergies are so common in Canada that Canadian nutrition labels are required to declare if the product contains even traces of sesame seeds.

Understanding food allergies

A food allergy is an allergy to a protein present in a particular food. You may be allergic to more than one type of food protein. In that case, you would be allergic to multiple foods. It's not uncommon for a person to be allergic to several foods in the same category. These categories might include:

If you've been diagnosed with a nut allergy, you don't have to avoid seeds such as nutmeg. Also, if you've been diagnosed with an allergy to seeds, you don't have to avoid nuts.

If you have a severe seed allergy, you'll likely know very quickly after eating a seed. An anaphylactic reaction often occurs within minutes. A less severe reaction, however, may take hours or days to develop. Your symptoms may not be as obvious as some other allergic reactions.

In that case, the best way to know if your symptoms are the result of a nutmeg allergy is to be tested. An allergist is a specialist who can test and diagnose you if you're allergic to a food. Your primary doctor or allergist may order both a skin test and a blood test. They may also want to perform an oral food challenge in their office to further identify your reaction to a particular allergen. This involves feeding you small doses of the suspected allergen.

When purchasing products

If you have an allergy to nutmeg or any other seed, you must be vigilant about looking for them in foods, oils, and beauty products. Strict avoidance is the best policy.

When grocery shopping

When you're grocery shopping, read labels carefully. Look for seed oils and extracts in the ingredients list. Research alternative names for the seeds you're allergic to, and search labels for all name variations.

When dining out

When you're dining out, talk with your server or the restaurant's cook. Whole seeds are easy to spot, but seed extracts and ground seeds may be harder to detect. You must rely on the restaurant's staff to prepare food that's safe for you to eat.

If you have a severe allergy, always carry an epinephrine auto-injector (EpiPen) with you in the event you accidentally eat a food that contains some of the allergen.

Food allergies, including seed and nutmeg allergies, do not have a cure. Instead of trying to cure a food allergy, your doctor will encourage you to focus on avoiding a possible allergic reaction.

If you have an allergic reaction to nutmeg, you may need treatment. The type of treatment you receive depends on the severity of the reaction. An anaphylactic response requires immediate medical treatment with epinephrine. A less severe reaction may require treatment with antihistamines, steroids, or asthma medications. These medications are available over-the-counter (OTC) or through a prescription with your doctor.

Make sure to speak with your doctor about the proper use of both prescription and over the counter medications to treat allergies.

If you have a history of allergic reactions, your doctor may suggest you carry medication with you at all times. If you've had an anaphylactic response in the past, your doctor may also request that you wear an emergency medical bracelet. The bracelet will help emergency responders know how to treat you if you lose consciousness or are unable to give yourself an epinephrine injection.


Is Nutmeg A Nut? This Brown Ball Has Much Spicier Origins

Looking at nutmeg, brown ball that it is with a telltale title to boot, you might find yourself wondering: is nutmeg a nut? As is often the way with kitchen staples, there's sometimes confusion over where nutmeg comes from and what it actually is. The good news for people with nut allergies is that no, nutmeg is not a nut, it's something a whole lot spicier.

Nutmeg comes from the tropical evergreen tree Myristica fragrans that's indigenous to the Maluku Islands of Indonesia, formerly known as the Spice Islands. The tree is very popular as the producer of nutmeg and its sister spice mace, which isn't used in mace spray (that actually uses chloroacetophenone to achieve peak devastation). M. Fragrans grows yellowish-brown fruits about the size of a ping pong ball with a thick fleshy exterior. Tucked inside is a shiny seed wrapped in a thin red coat of aril. That shiny red aril is what becomes mace, while the brown ball inside becomes nutmeg.  This scarlet get-up is crucial to M. Fragrans' dispersal technique as birds feast on the aril before regurgitating the seed along with a helping hand of digestive slime. This unique set up for a successful growing tree is what made the initial propagation of these trees tricky, and has influenced the range where they can grow. Is nutmeg a nut? No, it's a seed. You'll find it stuffed inside the fleshy fruit of the Myristica fragrans tree wrapped in a shiny red coating of aril. Image credit: anilkumart / Shutterstock.Com Nutmeg was jostled about by the battle of the spices that played out as European colonialists competed for flavors. Eventually it was moved out to Malaysia and Mauritius to level the monopoly, explains the University of Oxford, and is now grown across the tropics. As for nutmeg as a spice, it's long had a place in cooking as a way of enriching flavor (mashed potatoes have never been the same), but research has found that its medicinal uses endure in its area of origin. Its applications extend to the treatment of diarrhea, mouth sores, and insomnia.  A nutmeg "high" has been investigated in research, with some claiming that when ingested in large quantities it can cause hallucinogenic effects (coupled with tachycardia, hypertension, and delirium – yikes). It's thought to be brought on by myristicin that causes a rush of norepinephrine, writes Inverse, and people have been reportedly using it in this way since the 1500s. It was perhaps inevitable, then, that the spice would journey for centuries only to wind up as a #NutmegChallenge TikTok trend. It eventually got banned after nutmeg intoxication reportedly led to some users experiencing seizures, serving as a timely reminder to nutmeg responsibly. The looks-like-a-nut, sounds-like-a-nut, not-a-nut spice might not pose a threat to certain allergy groups, but that doesn't mean it won't give your central nervous system a kick.

What To Know About Nut Allergies

Nut allergies are among the most common food allergies, and they include reactions to almonds, walnuts, and pecans. An allergy to peanuts, however, is not technically a nut allergy.

Many of the 1.2% of people in the United States who are allergic to peanuts may mistakenly believe that they have a nut allergy, but peanuts are not actually nuts — they are legumes, similar to black beans and lentils.

However, according to the American College of Allergy, Asthma & Immunology, 25–40% of people with peanut allergies are also allergic to at least one tree nut.

In this article, we look at the symptoms, causes, and treatment of nut allergies.

If a person has a nut allergy, their body will react badly to eating tree nuts. A person may be allergic to one type of nut or multiple types, though doctors usually recommend that people with one nut allergy also avoid other nuts. Tree nuts include:

  • almonds
  • walnuts
  • pecans
  • pistachiosmacadamia nuts
  • cashews
  • hazelnuts
  • Brazil nuts
  • pine nuts
  • lychee nuts
  • acorns
  • Nut allergies are widespread and may be becoming more common, especially in children. According to Food Allergy Research & Education, hospitalizations for nut allergies in children tripled between the late 1990s and the mid-2000s.

    Nut allergy symptoms usually develop rapidly after a person eats or has exposure to nuts.

    Symptoms can range from a mild runny nose to the life threatening symptoms of anaphylaxis, which include throat swelling, shortness of breath, and shock.

    The same person can have different nut allergy symptoms at different points in time.

    People with a nut allergy may experience the following symptoms after exposure to some or all types of nut:

  • coughing
  • stomach pain
  • nausea
  • sneezing
  • diarrhea
  • itching, particularly around the face and mouth
  • puffy or runny eyes
  • swelling lips
  • a gravelly throat
  • vomiting
  • trouble breathing
  • hives
  • difficulty swallowing
  • feeling faint
  • Anaphylaxis can be fatal without prompt treatment. People with severe nut allergy symptoms should speak with a healthcare professional about getting a prescription for an EpiPen — an auto-injector with epinephrine. This device will give them ready access to the treatment that they need.

    Nutrition resources

    For more science-backed resources on nutrition, visit our dedicated hub.

    All nut allergy symptoms are due to the immune system's response to nut protein, but there can be differences in the antibodies that the immune system creates as part of this reaction.

    The most common type of nut allergy, and the one most likely to lead to dangerous reactions such as anaphylaxis, occurs as a result of the activation of immunoglobulin E (IgE) in the body. Different components of the immune system are responsible for most other reactions, which tend to develop more slowly.

    The third type of allergic reaction has an association with a combination of IgE and other immune system elements.

    Some people with food allergies, for example, those who are allergic to milk, outgrow them over time. Peanut allergies are more common in children than adults, affecting 2.5% of children but only 1.2% of the total population of the U.S. However, in general, allergies to peanuts and tree nuts tend to be lifelong conditions.

    People who are allergic to nuts should avoid eating all tree nuts, even if a healthcare professional has only diagnosed them as being allergic to one type. Experts advise people with tree nut allergies to avoid peanuts as well.

    Nutmeg may resemble a nut, but it is not one, so it should be safe for people with nut allergies to consume.

    The Food and Drug Administration (FDA) consider coconut to be a tree nut, but it is officially a fruit. Individuals who are allergic to nuts should check with a healthcare professional before adding coconut to their diet or using products containing coconut.

    Nuts have many different uses, and they can crop up in a wide variety of foods, beverages, and nonedible products. To avoid nut allergy symptoms, people with allergies should exercise caution when consuming or using:

  • baked goods
  • desserts
  • sauces
  • Asian, African, and Indian cuisine
  • salads
  • prepared soups and chili
  • packaged mixes
  • soaps
  • skin lotions
  • hair care products
  • some alcoholic drinks
  • As with other allergic reactions, nut allergy symptoms occur as a result of the immune system responding to the proteins in nuts as though they were harmful substances.

    Scientists do not know exactly why some people's bodies react this way to nut proteins, but as food allergies tend to run in families, genetics seem to be a factor. Individuals with other allergies, such as hay fever, are also more likely to develop nut allergies.

    The basic treatment plan for people with nut allergies involves:

  • avoiding all tree nuts and peanuts, as well as products that contain them and products that have undergone processing in the same facilities as these foods
  • recognizing nut allergy symptoms and taking prompt action if they develop
  • taking antihistamines to address mild symptoms, such as itching or swelling, if they arise
  • people with severe allergies should carry an auto-injector, such as an EpiPen, so that they can treat anaphylaxis immediately should it occur
  • if a child has nut allergies, parents or caregivers should make sure that teachers, care providers, coaches, and parents of the child's friends understand the severity of the child's condition
  • People with nut allergies need to be vigilant about reading labels to make sure that nothing that they eat contains nuts or could have become contaminated with nuts during the production process.

    "Nut-proofing" a household can reduce the risk of accidental exposure and onset of nut allergy symptoms. Cleaning surfaces with cleaning sprays or sanitizing wipes can remove peanut residue. Washing the hands with running water and soap after handling nuts can also reduce the risk of contamination.

    Researchers are currently exploring a variety of techniques to help people with peanut allergies build up their tolerance to peanut exposure.

    Nut allergies are one of the most common food allergies in the United States, and nut allergy symptoms can range from bothersome to life threatening.

    Avoiding foods and products comprising nuts is the best way to prevent reactions. However, because tree nuts and peanuts are present in so many foods and products, and cross-contamination can develop in facilities where manufacturers process nuts, people need to be vigilant to avoid accidental exposure.






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