If you or your child has been diagnosed with a nut allergy, you may be looking for some good nut-free milk alternatives. In this article we’ll discuss how to navigate a plant-based diet with a nut allergy.
Allergic to Tree Nuts, Looking for Nut-free Milk Alternatives
Dear Healing With Plants, “My daughter has a tree nut allergy (I honestly think it’s only cashews, maybe pistachios since they’re closely related, but she hasn’t had those) so we were advised to avoid all nuts at this point. Maybe because she’s only 2? What would be a good milk substitute?… Also, any recommendations a substitute for nut butters?”
First, Which Nuts to Avoid?
Nut allergies seem to be increasingly frequent—while some research suggests peanuts are the most common cause of allergy, others estimate that nearly 1/3 of children are allergic to pistachios, and many of these may also be allergic to cashews which belong to the same botanical family (both pistachios and cashews contain several of the same protein allergens). Thus many people are concerned with what nuts they should avoid and which alternatives are safe. Just because a person is allergic to peanuts does not mean they will be allergic to all nuts. The same is true of those with tree nut allergies who are not necessarily allergic to peanuts also. In a review of the science published in Clinical and Experimental Allergy, authors from the Children’s Allergy Unit at Guy’s and St. Thomas’ NHS Foundation Trust in London, UK write that,
“Nut avoidance has consequence on both quality of life and nutrition.”Clinical & Experimental Allergy, 2014.
They point out that nut avoidance and emergency medication are the mainstays of treatment today, but point out that some medical terminology, “may cause confusion and lead to unnecessary dietary restrictions.” They recommend that:
“In peanut or tree nut‐allergic children, introduction of specific nuts to which the child is not allergic may improve quality of life and should be considered in patients with multiple foods allergies, vegan or ethnic‐specific diets, in whom nuts are an important source of protein.”Clinical & Experimental Allergy, 2014.
There is much variation in food allergies and there are many benefits to eating nuts, so it is advisable to discover which specific allergies you or your child has so you won’t suffer needed anxiety and so that you can enjoy the greatest variety of nuts possible.
To help provide guidance for nut exclusion diets, researchers conducted a study with children diagnosed with peanut or tree nut allergies to see if their allergy extended to other nuts. Over 5 years they challenged 145 children with diagnosed nut allergies. When children with peanut allergies were fed homemade biscuits containing tree nuts, none of those who had negative allergy prick tests to tree nuts had a reaction. For the peanut allergic children who had a positive allergy prick test to tree nuts, just 7 of 22 (31.2%) had a reaction to the tree nut biscuits. When children with tree nut allergies were fed biscuits containing peanuts, 3 of 38 (7.9%) with a negative allergy prick test to peanuts reacted and 5 of 13 (38.4%) with a positive prick test reacted. The researchers concluded that,
“Oral challenges to clarify allergy status in all nuts show co-existing allergies even in young children and in so doing may reduce anxiety, minimize unnecessary dietary restrictions and prevent later episodes of anaphylaxis through uniformed exposure.”Pediatric Allergy and Immunology, 2011.
Nut-Free Milk Substitutes
Luckily, there are several nut-free milk alternatives for those with allergies to tree nuts. Rice milk, soy milk, coconut milk, oat milk, and hemp milk are all good choices. If you have a severe allergy, remember to always check the label on any plant-based milk to ensure that they are made on nut-free equipment since some brands are made on equipment that also make milk from tree nuts. Also, watch out for added proteins and sugars in your plant-based milks. I always steer clear of any plant-based milk that boasts “added protein” and which contains ingredients like isolated pea protein (read more on the dangers of added protein here).
Look for brands which contain minimal ingredients, or make your own. If you can crack open a fresh coconut, you can blend up the flesh and water to make the creamiest and most delicious plant-based milk imaginable. For homemade oat milk, simply blend 1 cup of whole grain oats with 4 cups of water. To strain the pulp from your homemade plant-milks, I recommend a nut milk bag (but a mesh strainer, cheese clothe, or clean towel, also works).
Nut-Free Nut-Butter Substitute
If you’re looking for a delicious and nutritious alternative to nut butter, seeds are excellent replacements. My two favorite seed butters are made from sunflower seeds and sesame seeds.
Sunflower seeds are a great source of iron, protein, healthy fats, vitamins, and minerals. They can be used to make non-dairy nut-free cheeses, butters, salad dressings, pesto, and energy balls. The best sunflower seed butter is made purely of sunflower seeds, and perhaps a pinch of salt. Many commercial brands contain unnecessary additives, but Trader Joe’s Sunflower Seed Spread is the whole-foods winner for store-bought brands as it contains just roasted sunflower seeds and salt.
Sesame seeds are another awesome nut-free alternative for both nut-butters and for making creamy plant-based milk. Sesame seeds have more calcium per ounce than any other nut or seed—130 mg of calcium in a single ounce of seeds. Not only are these seeds great sprinkled on tofu, sushi, and bread, they are also delicious when ground into a creamy butter called tahini. Tahini is a key ingredient in hummus and my favorite Lemon Tahini salad dressing. Tahini can be a delicious base of many dressings, sauces, and spreads. It’s also delicious in smoothies. Try adding a large spoonful of tahini in your next banana or chocolate banana smoothie—voila, your have the Banini! (Get my simple recipe for this smoothie +32 other healthy drink recipes in my free ebook Drink to Your Health).
Chances of Outgrowing a Nut Allergy
Most nut allergies manifest in childhood with over half of cases appearing by age 2 and over 90% appearing by age 7. Thankfully, there is hope for a nuttier future for children whom experience adverse reactions after eating peanuts or tree nuts and for those who test positive for nut allergies. Recent studies suggest that 20% of children with peanut allergies and 10% of children with tree nut allergies will likely outgrow their allergies. A 2009 study published in the Journal of Allergy and Clinical Immunology fed tree nuts to children who had a history of reaction on ingestion to evaluate if they might have “outgrown” their allergy. They report that 9 out of 20 patients who had previous reaction to tree nuts passed the challenged, meaning they showed no adverse reaction after eating the nuts. Another 19 patients who had never previously ingested tree nuts, but whom had tested positive for a tree nut allergy, passed the challenge.
Eating a Plant-Based Diet Without Tree Nuts
There’s nut’n stopping you or your children from enjoying a nutrient-rich diet of whole plants free of allergic reactions. Here’s a few final tips to summarize the advise from professionals in the field as well as my suggestions as a plant-based nutrition educator.
- Read the labels! If you have a severe allergy, make sure the product you are purchasing was not made on equipment with food containing your allergen.
- Go for the whole food option: Read the ingredients in a product before you buy it and chose the option with the least number of ingredients, and ones whose names you recognize. Avoid products with added processed protein, fat, and sugar.
- Don’t exclude where you don’t have to: It’s worthwhile to challenge your food allergy in a safe manor so that you don’t exclude foods you aren’t allergic to. This will help reduce food anxiety and uncertainty and increase your nutritious options.
- Explore a variety of alternatives: Pumpkin seeds, chia seeds, flax seeds, hemp seeds, soy beans, whole grain oats, sunflower seeds, sesame seeds and coconuts are all great non-dairy alternatives for those with peanut or tree nut allergies. All of these seed foods contain a healthy amount of protein, fat, vitamins, minerals, and phytonutrients that nourish the body and protect your health.
Countless yummy and nutritious smoothies, sauces, soups, and sandwich spreads can be made with the nut-free milk and butter alternatives shared in this article. With so many delicious whole plant options to chose from, there’s hardly nut’n to worry about.
SOURCES: 1. Allergy, "Cashew allergy: observations of 42 children without associated peanut allergy." 2. British Medical Journal, "Clinical study of peanut and nut allergy in 62 consecutive patients: new features and associations." 3. Clinical & Experimental Allergy, "Dietary Management of Peanut and Tree Nut Allergy: What Exactly Should Patients Avoid?" 4. Current Allergy and Asthma Report, "The natural history of peanut and tree nut allergy." 5. Journal of Allergy and Clinical Immunology, "The natural history of tree nut allergy." 6. Pediatric Allergy and Immunology, "Single nut or total nut avoidance in nut allergic children: outcome of nut challenges to guide exclusion diets."