In addition to being a popular snack, the peanut is frequently incorporated in several common foods. Peanut consumption in the United States is very high, possibly the highest worldwide. By 2 years of age, an estimated 80% of children have been exposed to the peanut, primarily because of the common use of peanut butter early in life. Most peanut proteins are heat-stable and maintain their allergenicity in roasted peanut.¹ Allergy to peanut is usually severe and long-lasting. In fact, it has been responsible for most cases of food-induced fatal anaphylaxis.

A similar problem, albeit not as common, is allergy to tree nuts. Whereas peanut is a legume, the true tree nut family includes Brazil nut, hazelnut, pecan, and walnut. Less common allergic reactions have been reported to other nuts, such as almond (plum family), cashew and pistachio (cashew family), and chestnut and beechnut (beech family).

Several recent studies have demonstrated that although cross-antigenicity (positive skin test or in vitro test) between various members of a botanical family is . . . [Full Text of this Article]