Malaysians love nuts. We put nuts in many of our food, such as cakes and chocolates. Our dishes also include nuts in Kuah kacang eaten with nasi impit and our beloved Nasi Lemak. We also use kacang in our traditional desserts such as Bubur Kacang, Kuih Kacang Hijau and Biskut Mazola. The list is almost endless. Thus, have you ever wondered how hard it is for those Malaysians who are allergic to nuts to avoid these tasty Malaysian dishes? The answer is very hard. Malaysians have low to moderate awareness towards allergies. According to a study, more than half of food handlers in Penang have low to moderate food allergy knowledge. Only a small number of them have excellent food allergy knowledge (1). This is worrisome because nut allergy is a serious problem. 

Nuts allergy, an allergy that is said to be very dangerous and could cause fatal problems, has been increasing year after year. Over the past two decades, it has been reported that the prevalence of peanut allergy in the United States has increased 3.5 times, from 0.4% in 1997 to 0.8% in 2002 and 1.4% in 2008 (2). A study done in Malaysia reported that 12% of the respondents are allergic to nuts (3). These are the reported and recorded cases; what about those who go unnoticed? There would be more than just these numbers.
 

What are Nut Allergies?

First, you need to understand how nut allergy occurs for you to substitute nuts with other types of food that still could give benefits to your body. Nuts are a delicious snack eaten in various ways, such as raw, roasted and even salted. For other people, when one consumes nuts, it will benefit their health. Nuts have been proven to help maintain cholesterol levels and improve heart well-being. However, for some, nuts could be the enemy and killer. Nuts contain components that could cause allergic reactions after food ingestion. 

According to the Ministry of Health Malaysia, when a person with a nut allergy consumes nuts, the immune system reacts to several proteins in peanuts and mistakes them as an invader. Antibodies are created, and the body turns into defence mode. These antibodies release substances into the bloodstream that can cause nut allergy symptoms (4). 

Symptoms of Nuts Allergy

Nut allergy needs to be taken seriously because it is a life-threatening condition that requires medical attention if the case arises. The allergy reaction usually occurs minutes after exposure. It is important to know your allergies to prevent anything dangerous from occurring. Some of the symptoms that could be observed are (5)

• Skin swelling and redness

• Itching around the mouth

• Constricted feel on the throat

• Shortness of breath

The worst of all allergic reactions is anaphylaxis. Anaphylaxis is when the body defends itself by overreacting to a trigger. This condition needs to be treated with an epinephrine auto-injector, which must follow up with a trip to the emergency ward. Some of the signs and symptoms of anaphylaxis are: (6)

• Constriction to airway

• Throat swelling

• Severe drop in blood pressure

• Dizziness and loss of conscious 

How to Help Reduce the Symptom Onset?

Nuts allergy for those who have it is a lifetime enemy. There is nothing that we can do to treat the allergy. However, people with nut allergies can take a few medications to reduce the symptom of nut allergy. For mild symptoms, an antihistamine is used to help reduce the symptom, while for the worst symptom, an epinephrine auto-injector needs to be taken into action (7). 

For the worst symptom, every minute matters. Epinephrine injection needs to be done as soon as the symptom occurs. Epinephrine has to be the first line of defence instead of antihistamine in the worst-case scenario. Acting late could end one's life so having a bad allergic reaction is a matter of life and death (8).

Avoiding Nuts could develop Nut Allergies.

Whiile there is nothing much we can do to help adults with nut allergies, we could help the future generation from facing the allergy problem. Mothers need to let their children explore all the dirt and germ for the children's bodies to create important antibodies. 

Since the COVID-19 pandemic, many people have been extra cautious and use products loaded with antibacterial. While using these products could help protect yourself and your family, it might also cause harm in the long run. People nowadays are too careful not to let their bodies explore what's good and bad for them. For example, babies not exposed to bacteria and allergens in food could not learn how to acknowledge good and bad. Their bodies became confused, and they ended up attacking the wrong enemy. This is why everything needs to be in moderation. Let your children eat everything and play with the dirt. Just know that this is a part of the growing-up process. 

One study links avoiding nuts early on to causing nut allergies later in life. The study concludes that it is good to introduce nuts to young children, even infants aged four months to 11 months. Children exposed to nuts at a young age will have an increased tolerance towards protein in nuts compared to those who avoided nuts (9). Thus, you should just let your children eat nuts from an early age. Let their body do the work! 

Written by: Alia Adrina Asri

BSc (Hons) Nutrition

Love Earth Nutritionist