PHOENIX -- Only half of people with a nut allergy can visually identify all the nuts they're allergic to, a researcher said here.
On the other hand, when presented with a tray of nuts, most parents of a child with a nut allergy could pick out those that would affect the child, according to Todd Hostetler, MD, of Ohio State University in Columbus.
And overall, most adults -- whether or not they were allergic -- were able to identify only 11 of 19 different forms of nut, Hostetler reported at the annual meeting of the American College of Allergy, Asthma, and Immunology.
The finding comes from a study in which 1,005 adults and children were shown a tray with different nuts, in the various forms in which they are commonly seen -- whole, slivered, crushed, and in the shell.
Only 21 of the participants -- or 1.9% -- were able to identify all 19, Hostetler reported.
On average, he reported:
- Adults were able to identify 58.4% of the nuts, while those under 18 were able to name just 24.2% , or 4.6 of the 19.
- More than half of adults were able to identify a range of common nuts, with peanuts leading the way at 94.7% for unshelled nuts and 80.5% when they were in the shell.
- Less than half could pick out such nuts as hazelnuts or pecans.
- Allergic adults were able to identify 13 nuts on average, not significantly different from the 11 that were familiar to nonallergic adults.
- Of parents with an allergic child, 73.3% were able to name all those that affected the child.
- Allergic children could only name 34.2% of the nuts, or 6.5.
Hostetler noted that over a five-year period, about 55% of people with peanut allergy had reactions after accidentally eating the wrong nut. The study implies, he said, that treatment for nut allergy should include education on how to recognize different nuts.
The study shows "we're woefully unknowledgeable about nuts," according to John Oppenheimer, MD, of the New Jersey Medical School in Newark, who was in charge of the program for the meeting but was not part of the study.
But the up side, he told MedPage Today, is that at least those with a nut allergy were a bit better than average.
Still, the lack of awareness is alarming, he said, "We as clinicians need to do a little bit better" to educate patients, Oppenheimer added.
The only safe way to avoid one kind of nut is to avoid them all, said Gailen Marshall, MD, of the University of Mississippi in Jackson and editor of Annals of Allergy, Asthma and Immunology.
"I tend to tell my patients with a true peanut allergy to just stay away from all nuts," he told Medpage Today. Among other issues, he said, "you never know when there's going to be some peanut, especially in mixed nuts."
The study had no industrial support.
Hostetler said he had no conflicts.
Marshall had no links with industry.
Oppenheimer reported financial links with AstraZeneca, GlaxoSmithKline, Merck, Schering-Plough, Novartis, Genentech, and Boehringer Ingelheim.
Zalman S. Agus, MD Emeritus Professor
University of Pennsylvania School of Medicine and Dorothy Caputo, MA, RN, BC-ADM, CDE, Nurse Planner
American College of Allergy, Asthma, and ImmunologySource Reference: Hostetler T, et al "THe ability of adults and children to visually identify peanuts and tree nuts" ACAAI 2010; Abstract 48.