Adult-onset food allergies are a real thing, and they’re actually pretty common. Researchers at Northwestern University found that about 15 percent of patients who received a food allergy diagnosis were adults who were having their first symptom at age 31, on average.
While children most commonly experience allergies to milk, eggs, and peanuts, adults are more likely to be diagnosed with allergies to tree nuts and shellfish, according to the American College of Allergy, Asthma, and Immunology. Allergies to peanuts and tree nuts are also the most likely to persist from childhood through adulthood.
Getting diagnosed with a tree nut allergy, or taking care of a child who’s been diagnosed, can be overwhelming. Avoiding trail mix or chocolate-covered almonds is obvious, but you also have to learn all the foods, products, and recipes that tree nuts slip into.
Whether you’re feeding yourself, your child, or a friend with a tree nut allergy, here are some sneaky foods you might not realize can contain nuts.
Tikka masala, a popular Indian dish of chicken marinated in a creamy tomato curry, is often (but not always) made with ground almonds or cashews.
Some gluten-free baked goods use almond flour. It’s especially popular in gluten-free pie or tart crusts.
Marzipan is an Italian treat made from almond paste and almond extract. Steer clear.
Pesto may just seem like basil, garlic, and olive oil, but it contains pine nuts to get its pleasant toasty, creamy flavor.
Some veggie burgers can be made with nuts like walnuts, pine nuts, or cashews to create a heartier, more textured patty. If you’re making one at home, look for recipes that use seeds and grains instead, like sesame, quinoa, pumpkin seeds, or rice. Find out how to make this vegan quinoa burger that’s free of tree nuts.
Maraschino cherries are often made with almond extract. (So that’s what that flavor is!) As a general rule, be wary of ingredients labels that list “natural flavors,” as these may include nuts or nut flavors. Stick to fresh cherries instead.
Some mole sauce strays from tradition and incorporates ground nuts for an extra layer of flavor. It’s not the norm, but it’s a good idea to ask the waitstaff anyway to be safe.
Dairy-free alternatives like vegan ice cream, cheese, and yogurt are typically made with cashew, almond, or macadamia nuts. If you don’t eat or can’t tolerate dairy, look for non-dairy options made from rice milk, oat milk, soy milk, or hemp milk. Here are more tips for food allergy substitutions.
Accidentally consuming tree nuts when you have an allergy can be very risky and even life threatening. If you are experiencing symptoms of anaphylaxis, call 911 and get to the nearest emergency room as soon as possible.
Your best bet is to remain vigilant and informed. Ask your waiter and read labels to ensure you can enjoy your favorite foods safely.