The Washington Post

If I’m allergic to nuts, what other foods should I eat that have similar benefits?

- WALTER WILLETT Walter Willett is a physician and professor of epidemiolo­gy and nutrition at the Harvard T.H. Chan School of Public Health.

Q. I’m allergic to nuts, and every article I read says, ‘Add nuts, they’re 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’d feel like something was missing from my diet.

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

The research supporting nuts as an important component of the daily diet is strong. In one multi-center 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 either extravirgi­n olive oil or mixed nuts.

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

Learning about your nut allergy

Tree nut allergy is one of the most common food allergies, affecting roughly 0.5 to 1 percent of the U.S. 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 a legume, but while they are different from tree nuts from a botanical standpoint, they are similar in terms of health outcomes.

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

If you are among those who have been told they can’t eat nuts, I would advise additional specific testing. Tree nut allergy often is diagnosed in childhood and persists into adulthood, but an estimated 10 percent of children outgrow it over time, according to the AAAAI.

And some people are very allergic to peanuts but not to tree nuts, and vice versa, but may not recognize this. Don’t risk experiment­ing on your own. It’s essential to have close medical guidance.

If you find out 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, healthful fats, fiber and lots of other phytochemi­cals.

Try seeds instead

For those who know they definitely can’t eat peanuts or tree nuts, seeds are a great alternativ­e. Seeds are packages of nutrition that make a young plant grow, and these same nutrients also 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’re talking about pumpkin, sunflower, chia, poppy, sesame seeds and others. According to the AAAAI, people with tree nut allergy typically can tolerate seeds, as well as macadamia and pine nuts, both of which also are seeds.

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

Sunflower seed butter is remarkably similar in flavor to peanut butter or other nut butters. Check the label to find one that doesn’t have sugar added. Adding seed butters to your diet is one fairly easy switch that someone with nut allergies can make to get the additional protein, healthful fats and nutrients they are missing out on by not eating nuts.

Whether you are able to eat nuts or are limited to seeds, you should not just be considerin­g these great foods as snacks. In the morning, I usually have steel cut oats or yogurt with nuts. Nuts or seeds can be part of a salad for lunch and replace cheese and animal products in our meals. In a stuffed pepper recipe, nuts and seeds can even be used to replace ground beef.

Find your go-to snack

For snacking or to sprinkle in salads, dried chickpeas can be a crunchy alternativ­e to nuts.

Dried chickpeas are a legume and tend to be more starchy than most nuts. It’s not a perfect alternativ­e, but as part of the mix they might be a good thing to try.

For another snack alternativ­e, my two go-tos are apples and carrots. They are rich in fiber and nutrients, induce satiety and add only a modest number of calories.

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

Many people snack on dried fruit, but it doesn’t induce satiety as well as other foods. And dentists hate dried fruit because it’s sticky and keeps sugar in contact with teeth.

It’s important to note that no food needs to be totally offlimits. It’s okay to have a favorite-but-less-healthful food now and then. But for day-to-day go-to snacks, it is helpful to declare to yourself what your snacks are and consciousl­y have them available.


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