Nut or seed allergy sufferer? Beware the perfect storm forecast for 2020!

Everyone’s going nuts for vegan and health food but is there an unexpected social impact lurking around the corner…

Hurricane Hazelnut and Storm Sesame are about to collide into a nut and seed weather bomb as 2020 sees two factors combine to form a perfect storm for nut and seed allergy sufferers. With the rapid rise in health and environmentally conscious diets and the ubiquitous, yet unhelpful, ‘may contain traces of nuts’ response – I believe we are about to see an increase in hospital cases due to allergic reactions.

The NHS estimates that a quarter of the UK population now suffer with allergies at some point in their lives and according to the Food Standards Agency around 65% of people are hospitalised due to food hypersensitivity (which includes allergic reactions) compared to only 35% through foodborne disease.

With anaphylaxis cases in children alone up 72% in 2019 compared to 2014 - and nuts and seeds now a common ingredient in many restaurants, cafes and consumer goods - it’s time for the UK Food Standards Agency to accelerate change (e.g. Natasha’s Law) before tragedy strikes!

As we started the year I cautioned a group of friends and family that in 2020 we’d see a perfect storm for nut and seed allergy sufferers which would lead to many being caught out – I just didn’t realise how right I would be and that for the first time in years I would find myself in an ambulance bound for A&E following my worst case of anaphylaxis. The culprit – a banana and oat smoothie. I’d asked at the counter when ordering and reminded the member of staff when they delivered it – both times I was assured there were no nuts. One sip later – I knew I’d been caught out and for anyone that knows the journey through anaphylaxis – a worrying, and uncomfortable path now lay ahead of me!

We are on the verge of a perfect storm for nut and seed allergy sufferers due to two factors:

Factor One: The exponential rise in health, vegan and vegetarian diets has led to nuts and seeds (and other allergens like soy) appearing on menus across the country – especially during the recent Veganuary trend in January. This is likely because nuts and seeds have significant health benefits and are also a good alternative to meat protein for those taking steps to reduce meat consumption. I fully support this change for both health and environmental benefits (reducing meat significantly helps to reduce our individual greenhouse gas and water footprint) – but we need to ensure the change happens responsibly and doesn’t shift an environmental burden to a social burden in the form of increased cases of anaphylaxis.

Factor Two: Many nut and seed allergy sufferers are downplaying the severity of their allergy due to restaurants and cafés giving convoluted answers to customers raising allergy concerns. In fact, many places are refusing to even serve allergy sufferers – something I have personally experienced on several occasions. With ‘may contain traces’ on so many ingredients, and law suits becoming more prevalent, it is hardly surprising that food and beverage retailers are nervous. The result is responses to customers such as ‘everything may contain traces of nuts’ or ‘we can’t guarantee that there aren’t nuts in any of our foods’ or even ‘we can’t serve you’. In these instances – many will downplay their allergy just to get served, to avoid the awkward conversation, or may just assume that a food wouldn’t typically contain nuts – so will take the chance.

There are over 150 million Europeans now suffering from chronic allergic diseases and the current prediction is that half of the entire EU population could be affected by 2025. With the above two factors combined and the increasingly unpredictable use of tree nuts, that historically were often confined to more luxury foods and restaurants, I believe we are about to experience a spike in anaphylaxis cases.

We are now in a market where allergy sufferers might pick up the almond milk by mistake when getting their coffee at work, inadvertently order a pizza with walnuts on it, a hot chocolate with peanut butter or even a pint of beer with hazelnuts in the ingredients – all situations I have never found myself in as a nut allergy sufferer until recent years. Unlike many other allergens (e.g. shellfish), contamination with nuts and seeds is more common because of their widespread use in everything from smoothies to toppings on pizza and the handling of raw fish is already covered by standard health and safety regulations.

So, whilst the medical world looks to find a way to desensitise allergy sufferers, or potentially even find a permanent fix, I think that we need to make three key changes in terms of prevention and treatment:

1.      The UK Food Standards Agency should align the handling, storage and use of nuts with the health and safety guidelines for raw meat – nuts should be treated like a raw meat and the associated risks from things like salmonella – wash all items after use, clearly label, use separate appliances/chopping boards etc. In fact, unlike raw meats, the risk from nuts does not decrease with cooking and therefore it is even more important to avoid contamination. This would mean consistent and enforced guidelines for all food and drink retailers and producers in the UK and in turn a clear understanding for those communicating to end consumers.

2.      It’s time to address the ‘may contain traces’ capture all excuse – whilst the intention of this label is positive, my view is that it is being misinterpreted and used as a capture all excuse to avoid accountability. Food packaging and restaurants should be provided with clear tiered guidance for whether something intentionally ‘contains nuts in the recipe’ and whether the food product or restaurant has achieved ‘responsible nut handling status’ or not – meaning consumers are reassured that nuts have been handled in line with the above proposed guidelines or that there have been infringements (this could align with the standard H&S 1-5 rating we’re all used to seeing in restaurant windows).  

3.      EpiPen’s should be included in all first aid kits as standard (especially for offices, schools and aeroplanes) with first aiders and nut allergy sufferers clear on the exact process to follow. My understanding from my recent conversation with the paramedic is that all cases of EpiPen use should be followed by calling an ambulance but preferably one should be on the phone to the ambulance whilst using it! Official UK guidance can be found here and for other adrenaline pens have a look here. In case anyone is nervous to use their EpiPen – it really doesn’t hurt – I had to recently check it had even gone in!

This perfect storm caused by the rapid rise in nut and seed use, combined with the lack of clarity provided to allergy sufferers when asking ‘does this contain nuts’, poses a big risk as we move into 2020.

With a 615% increase in UK hospital admissions for anaphylaxis in the 20 years to 2012 the management of nuts, seeds and other allergens needs to become part of our standard health and safety procedures, so vendors and sufferers alike know what they’re doing.

I call on the Food Standards Agency to use this exponential rise in the use of this major allergen as an opportunity to update its guidance and standards but also to work with the medical profession to identify innovative ways to mitigate or even reverse this growing risk to society.

In the meantime – I caution allergy sufferers to be more vigilant in this new world of health and vegan food and always carry your EpiPen!