Tree Nuts - Priority food allergens

2017
Cat.: H164-156/9-2017E-PDF 
ISBN: 978-0-660-09313-0 
Pub.: 170204

Allergic reactions are adverse reactions that occur when the body's immune system overreacts to a particular allergen. These reactions may be caused by food, insect stings, latex, medications and other substances. In Canada, the priority food allergens are peanuts, tree nuts (almonds, Brazil nuts, cashews, hazelnuts, macadamia nuts, pecans, pine nuts, pistachio nuts and walnuts), sesame seeds, milk, eggs, fish, crustaceans and molluscs, soy, wheat or triticale (a hybrid of wheat and rye grains), and mustard. Sulphites (a food additive), which do not cause true allergic reactions, are generally grouped with the priority allergens because sulphite-sensitive individuals may react to sulphites with allergy-like symptoms.

What are the symptoms of an allergic or allergic-type reaction?

When someone comes in contact with a food allergen or added sulphites, the symptoms of an allergic or allergic-type reaction may develop quickly and rapidly progress from mild to severe. The most severe form of an allergic reaction is called anaphylaxis. Symptoms can include breathing difficulties, a drop in blood pressure or shock, which may result in loss of consciousness and even death. A person experiencing an allergic reaction may have any combination of the following signs or symptoms:

• Skin: hives, swelling (face, lips, tongue), itching, warmth, redness;
• Respiratory: coughing, wheezing, shortness of breath, chest pain or tightness, throat tightness, hoarse voice, nasal congestion or hay fever-like symptoms (runny, itchy nose and watery eyes, sneezing), trouble swallowing;
• Gastrointestinal: nausea, pain or cramps, vomiting, diarrhea;
• Cardiovascular: paler than normal skin colour/blue skin colour, weak pulse, dizziness or light headedness, loss of consciousness, shock;
• Other: anxiety, sense of impending doom, headache, uterine cramps, metallic taste.

 Source: Anaphylaxis in Schools & Other Settings

How are severe allergic reactions treated?

Currently there is no cure for food allergies. The only option for managing the risk is to completely avoid the specific allergen. Appropriate emergency treatment for anaphylaxis (a severe allergic reaction) includes an injection of epinephrine, which is available in an auto-injector device. Epinephrine is the only medication that can stop an allergic reaction from progressing and must be administered as soon as symptoms of a severe allergic reaction appear. Antihistamines, if used, should be given AFTER epinephrine has been administered. The injection must be followed by further treatment and observation in a hospital emergency room. If your allergist has diagnosed you with a food allergy and prescribed epinephrine, carry it with you all the time and know how to use it. Follow the advice of your allergist on how to use an auto-injector device.

Frequently asked questions about tree nut allergies

Which tree nuts are included in Canada's list of priority food allergens?

The tree nuts included are almonds, Brazil nuts, cashews, hazelnuts, macadamia nuts, pecans, pine nuts (pignolias), pistachio nuts and walnuts. Peanuts are part of the legume family and are not considered a tree nut.

I have a tree nut allergy. How can I avoid a tree nut-related reaction?

• Read food labels.

Avoid all food and products that contain tree nuts and any product whose label carries a precautionary statement warning that the product might have tree nuts in it such as “may contain” tree nuts or similar wording. When provided by a manufacturer, precautionary statements are usually found after the list of ingredients or "Contains" statement if there is one.  By December 2021 any precautionary statements will have to appear in this location only.

If a tree nut is part of the product formulation, the specific tree nut(s) must be declared by their common name (almond, Brazil nut, etc.) in the list of ingredients or in a separate “contains” statement immediately following the list of ingredients.

• Avoid any products that do not have an ingredient list. 
• Read labels every time you shop. Manufacturers may occasionally change their recipes or use different ingredients for varieties of the same product.

Can a tree nut allergy be outgrown?

Some people with a tree nut allergy may outgrow it. Consult your allergist before reintroducing tree nut products.

Should I avoid peanuts if I have a tree nut allergy?

Peanut is part of the legume family and is not a tree nut; however, while peanuts and tree nuts are different, in some cases people with a tree nut allergy may also be allergic to peanuts. Consult your allergist before eating peanuts.

If I am allergic to one type of tree nut will I be allergic to all tree nuts?

Some people with a tree nut allergy may be allergic to more than one type of tree nut. Consult your allergist before eating any tree nuts that are not a regular part of your diet.

Should I avoid coconut and nutmeg if I have a tree nut allergy?

Coconut and nutmeg are not considered tree nuts for the purposes of food allergen labelling in Canada and are not usually restricted from the diet of someone allergic to tree nuts. A coconut is a seed of a fruit and nutmeg is obtained from the seeds of a tropical tree. However, some people allergic to tree nuts have also reacted to coconut and nutmeg. Consult your allergist before trying coconut- or nutmeg-containing products.

What do I do if I am not sure whether a product contains tree nuts or tree nut derivatives (e.g., nut butters, pralines…)?

If you have a tree nut allergy, do not eat, drink or use the product. Obtain ingredient information from the manufacturer.

Does product size affect the likelihood of an allergic reaction?

Product size does not affect the likelihood of a reaction; however, the same brand of product may be safe to consume for one product size but not another. This is because product formulation may vary between different product sizes of the same product or be produced in a different facility. Always read the ingredient lists carefully.

Other names for tree nuts

In the past, some products have used other names for tree nuts on their labels. These names are not permitted without the common name of the tree nut also appearing on the label, based on the enhanced labelling requirements for food allergens, gluten sources and added sulphites. However, if you have a tree nut allergy and see one of the following in the list of ingredients on a product you should not eat it.

• Anacardium nuts (another name for cashew nuts)
• Filberts (another name for hazelnuts)
• Nut meats (any nuts)
• Pignons
• Queensland nuts (another name for macadamia nuts)

Examples of foods and products that contain or often contain tree nuts

• Baked goods
• Granola bars
• Calisson (a marzipan-like candy made from almonds)
• Dishes such as almond chicken, pad thai, satay, chili and trout amandine
• Gianduja and giandula (chocolate blended with hazel nuts)
• Marzipan (almond paste)
• Tree nut oils (unrefined or partially refined tree nut oils, e.g., cold-pressed)
• Pralines
• Cocoa-based and/or nut-based spreads, e.g., almond paste-based spreads, chocolate nut spreads
• Nougat (sugar paste made with nuts), e.g., Torrone
• Dairy-free imitation cheese products made from tree nuts
• Mortadella (a type of Italian sausage which may be flavoured with pistachio nuts)
• Vegetarian dishes

Avoid food and products that do not have an ingredient list and read labels every time you shop.

Other possible sources of tree nuts

• Baking mixes, cereals, crackers and muesli
• Barbecue and pesto sauces
• Dressings and gravies
• Flavoured coffees
• Frozen desserts
• Liqueurs, e.g., amaretto, Frangelico
• Natural flavourings and extracts, e.g., pure almond extract
• Salads, e.g., Waldorf salad
• Snack foods, e.g., trail mix

Non-food sources of tree nuts

• Bean bags, kick sacks/hacky sacks
• Bird seed
• Cosmetics, hair care products, sun screens
• Massage oils
• Pet food

Note: These lists are not complete and may change. Food and food products purchased from other countries, through mail-order or the Internet, are not always produced using the same manufacturing and labelling standards as in Canada.

What can I do?

Be informed

Consult your allergist or physician in order to obtain the advice and support needed to help manage your condition. Contact your allergy association for further information.

If you or anyone you know has food allergies and would like to receive information about food being recalled due to improper allergen labelling, sign up for the Canadian Food Inspection Agency's (CFIA) e-mail “Food Recalls and Allergy Alerts” notification service available. When you sign up you will automatically receive timely food recall notifications.

Before eating

Allergists recommend that if you do not have your auto-injector device with you that you do not eat. If an ingredient list says a product “contains” or “may contain” tree nuts, do not eat it. If you do not recognize an ingredient, if there is no ingredient list available or if you don't understand the language written on the packaging, avoid the product.

Watch out for allergen cross-contamination!

Cross-contamination is the accidental transfer of an ingredient (food allergen) to a product that does not normally have that ingredient in it. Through cross-contamination, a food that should not contain the allergen could become dangerous to eat for those who are allergic.

Cross-contamination can happen:

• during food manufacturing through shared production and packaging equipment;
• at retail through shared equipment, e.g., through bulk display of food products, e.g., bins of baked goods, bulk nuts;
• during food preparation at home, daycares, schools or in restaurants through equipment, utensils and hands.

What is the Government of Canada doing about priority food allergens, gluten sources and added sulphites?

The Government of Canada is committed to providing Canadians with the information they need to make safe and healthy food choices. The Canadian Food Inspection Agency (CFIA) and Health Canada work closely with municipal, provincial and territorial partners and industry to meet this goal.

The CFIA enforces Canada's labelling laws and works with associations, distributors, food manufacturers and importers to ensure complete and appropriate labelling of all foods. The CFIA recommends that food companies establish effective allergen controls to prevent the occurrence of undeclared allergens and cross-contamination. The CFIA has developed guidelines and tools to aid them in developing these controls. When the CFIA becomes aware of a potential hazard associated with a food, such as undeclared allergens, Health Canada is asked to assess the situation. When a serious risk is identified, the food product is recalled from the marketplace and a public warning is issued. The CFIA has also published several advisories to industry and consumers regarding allergens in food.

Health Canada has worked with the medical community, consumer associations, and the food industry to enhance labelling regulations for food allergens, gluten sources and added sulphites in pre-packaged food sold in Canada. Health Canada has amended the Food and Drug Regulations to require that the most common foods and food ingredients that may cause life-threatening or severe allergic reactions are always clearly identified by their common names on food labels allowing consumers to easily recognize them and make safe and informed food decisions.

More information on the regulations that enhance the labelling of food allergens, gluten sources and added sulphites can be found on the Health Canada website.

If you come across a food that you think is improperly labelled, contact the CFIA and provide information about the product.

Report a food safety or labelling concern.

Where can I get more information?

For more information on:

• food allergies

visit Health Canada's website.

For information on:

• subscribing to the “Food Recalls and Allergy Alerts” e-mail notification service

visit the CFIA website or call 1-800-442-2342/TTY 1-800-465-7735 (8:00 a.m. to 8:00 p.m. Eastern time, Monday to Friday).

For information on this and other Government of Canada programs and services call

• 1-800-O-Canada (1-800-622-6232)
• TTY 1-800-465-7735

Below are some organizations that can provide additional allergy information:

• Allergy/Asthma Information Association
• Food Allergy Canada
• Allergies Québec (French only)
• Canadian Society of Allergy and Clinical Immunology (English only)