Fact Sheet. Tree Nuts One of the nine most common food allergens Allergic reactions

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1 Fact Sheet Tree Nuts One of the nine most common food allergens Allergic reactions Anaphylactic reactions are severe allergic reactions that occur when the body s immune system overreacts to a particular allergen. These reactions may be caused by food, insect stings, latex, medications and other substances. In Canada, the nine priority food allergens are peanuts; tree nuts; sesame seeds; milk; eggs; seafood (fish, crustaceans and shellfish; soy; wheat and sulphites (a food additive). What are the symptoms of an allergic reaction? When someone comes in contact with an allergen, the symptoms of a reaction may develop quickly and rapidly progress from mild to severe. The most dangerous symptoms include breathing difficulties, a drop in blood pressure or shock, which may result in loss of consciousness and even death. Severe allergic reactions can occur quickly and without warning. A person experiencing an allergic reaction may have any of the following symptoms: Flushed face, hives or a rash, red and itchy skin Swelling of the eyes, face, lips, throat and tongue Trouble breathing, speaking or swallowing Anxiousness, distress, faintness, paleness, sense of doom, weakness Cramps, diarrhea, vomiting A drop in blood pressure, rapid heart beat, loss of consciousness How are food allergies and severe food allergy reactions treated? Currently there is no cure for food allergies. The only option is complete avoidance of the specific allergen. Appropriate emergency treatment for a severe food allergy reaction includes an injection of epinephrine (adrenalin), which is available in an auto-injector, such as an EpiPen. Adrenalin must be administered as soon as symptoms of a severe allergic reaction appear. The injection is followed by further treatment and observation in a hospital emergency room. If your allergist has diagnosed you with a food allergy and prescribed epinephrine, carry it with you all the time and know how to use it. Follow your allergist s advice on how to use an EpiPen.

2 Frequently asked questions about tree nut allergies Which tree nuts are included in Canada s list of priority food allergens? The tree nuts of concern are almonds, Brazil nuts, cashews, hazelnuts (filberts), macadamia nuts, pecans, pine nuts (pignolias), pistachio nuts and walnuts. Peanuts are part of the legume family and are not considered a tree nut. I have a tree nut allergy. How can I avoid a tree nut-related reaction? Avoid all food and products that contain tree nuts and tree nut derivatives including any product whose ingredient list warns it may contain tree nuts. Should I avoid coconut and nutmeg if I have a tree nut allergy? A coconut is a seed of a fruit and nutmeg is obtained from the seeds of a tropical tree. Therefore, they are not usually restricted from the diet of someone allergic to tree nuts. However, some people have reacted to coconut and nutmeg. Consult your allergist before trying coconut or nutmeg products. How can I determine if a product contains tree nuts or tree nut derivatives? Always read the ingredient list carefully. Tree nuts and tree nut derivatives can often be present under different names, e.g., marzipan. Do not forget that cross-contamination, e.g., using the same knife that was just used to spread butter that is made with tree nuts, can also be a potential source of the allergen. What do I do if I am not sure whether a product contains tree nuts or tree nut derivatives? If you have a tree nut allergy, do not eat or use the product. Get ingredient information from the manufacturer. Avoiding tree nuts and tree nut derivatives Make sure you read product labels carefully to avoid products that contain tree nuts and tree nut derivatives. Always ask questions about food preparation, ingredients and the possibility of cross-contamination when eating out and buying food from retail food outlets, e.g., in-store bakeries, shopping centre food outlets. Avoid food and products that do not have an ingredient list and read labels every time you shop. Manufacturers may occasionally change their recipes or use different ingredients for varieties of the same brand. Refer to the following list before shopping: Other names for tree nuts Anacardium nuts Mandelonas (e.g. peanuts that have been altered to look and taste like tree nuts) Marzipan (almond paste) Nu-Nuts (e.g. peanuts that have been altered to look and taste like tree nuts) Nut meats Pinon Possible sources of tree nuts

3 Artificial nuts, e.g., peanuts altered to look and taste like almonds, pecans and walnuts Baked goods, e.g., cakes, cereal bars, cookies, doughnuts, energy/granola bars, muffins, pastries Baking mixes, cereals, crackers, muesli Cross-contamination, e.g., bulk bins, coffee grinders, containers, products that contain peanuts, utensils Dressings, gravies Ethnic foods Gianduja, e.g., chocolate and chopped nuts mixture found in premium or imported chocolate and ice cream Ice cream, frozen desserts, frozen yogurts, sundae toppings Main course dishes, e.g., almond chicken, chili, trout amandine Natural flavourings and extracts, e.g., pure almond extract Nut butter, nut/peanut oil Nut-flavoured coffee/liqueurs, e.g., amaretto, Frangelico Sauces, e.g., barbeque, pesto, Worcestershire Salads, e.g., Waldorf salad Spreads, e.g., almond paste, cheese, chocolate nut, nougat, Nutella, nut paste Snack foods, e.g., candy, chips, chocolate, popcorn, snack/trail mixes Vegetarian dishes Non-food sources of tree nuts Bean bags, kick sacks/hacky sacks Bird seed Cosmetics, hair care products, sun screens Pet food Note: These lists are not complete and may change. Food and food products purchased from other countries, through mail-order or the Internet, are not always produced using the same manufacturing and labelling standards as in Canada. What can I do? Be informed See an allergist and educate yourself about food allergies. Contact your local allergy association for further information. If you or anyone you know has food allergies or would like to receive information about food being recalled, sign up for the Canadian Food Inspection Agency s (CFIA) free Allergy Alerts and Food Recalls subscription service available at When you sign up you will automatically receive food recall public warnings.

4 Before eating Allergists recommend that if you do not have your EpiPen with you, that you not eat. If an ingredient list says a product may contain or does contain tree nuts or tree nut derivatives, do not eat. If you do not recognize an ingredient or there is no ingredient list available, avoid the product. What is the Government of Canada doing about food allergens? The Government of Canada is committed to providing safe food to all Canadians. The CFIA and Health Canada work closely with municipal, provincial and territorial partners and industry to meet this goal. The CFIA enforces Canada s labelling laws and works with associations, distributors, food manufacturers and importers to ensure complete and appropriate labelling of all foods. The CFIA recommends that food companies establish effective allergen controls to minimize the potential for allergic reactions. When the CFIA becomes aware of a potential serious hazard associated with a food, such as undeclared allergens, the food product is recalled from the marketplace and a public warning is issued. The Food and Drug Regulations require that most pre-packaged foods carry a label and that their ingredients appear in a list in decreasing order of proportion. However, they do not currently require components (e.g. ingredients of ingredients) of certain foods and products, such as flavouring, seasoning, spices and vinegar, to be listed on food labels. Health Canada has worked with the medical community, consumer associations, and the food industry to enhance labelling requirements for priority allergens, gluten sources and sulphite in pre-packaged foods sold in Canada. These regulations would require that the most common food and food ingredients that cause life-threatening or severe allergic reactions are always identified by their common names that consumers can easily recognize on food labels.

5 Where can I get more information? For more information on food allergies and to subscribe to the free Allergy Alerts and Food Recalls subscription service, contact the CFIA at or (8:00 am to 4:00 pm local time - Monday to Friday). For information on this and other Government of Canada programs and services call O-Canada ( ) TTY Below are some of the organizations that can provide additional allergy information: Allergy/Asthma Information Association (English only) Anaphylaxis Canada (English only) Association Québécoise Des Allergies Alimentaires (French only) Canadian Society of Allergy and Clinical Immunology (English only) Health Canada Developed in consultation with the Allergy/Asthma Information Association, Anaphylaxis Canada, Association Québécoise Des Allergies Alimentaires, the Canadian Society of Allergy and Clinical Immunology and Health Canada.

6 Fact Sheet FOOD SAFETY TIPS FOR THE HOLIDAYS What is foodborne illness? Food contaminated by bacteria, viruses and parasites can make you sick. Many people have had foodborne illness and not even known it. It s sometimes called food poisoning, and it can feel like the flu. Symptoms may include the following: stomach cramps nausea vomiting diarrhea fever Symptoms can start soon after eating contaminated food, but they can hit up to a month or more later. For some people, especially young children, the elderly, pregnant women and people with weakened immune systems, foodborne illness can be very dangerous. Public health experts estimate that there are 11 to 13 million cases of foodborne illness in Canada every year. Most cases of foodborne illness can be prevented by using safe food handling practices and using a food thermometer to check that your food is cooked to a safe internal temperature! It s always important to keep foods out of the danger zone, which is between 4C (40F) and 60C (140F). To do this, just keep hot foods hot, at least 60C (140F) and keep cold foods cold at 4C (40F) or lower. Preparing and serving holiday buffets Prepare foods quickly, cook them thoroughly and serve them promptly. Keep hot foods hot with warming trays, chafing dishes or crock pots. Keep cold foods cold by placing serving dishes on crushed ice. Remember the 2-hour rule when entertaining with a large meal or buffet. Don t let perishable foods linger for longer than two hours in the danger zone. Keep replacement dishes of food hot in the oven or cold in the refrigerator during the buffet. Do not add new food to a serving dish that has been sitting at room temperature for more than two hours. Provide serving spoons and tongs for every dish served. Even finger foods, such as cut vegetables, candies and nuts, should have serving implements. Traveling with food Wrap hot food in foil and heavy towels, or carry in insulated containers to maintain a temperature of at least 60 C (140 F).

7 Store cold foods in a cooler with ice/freezer packs so the food remains at 4 C (40 F) or below. Full coolers keep their temperature better than partially full ones. Vegetables, herbs and other foods stored in oil (e.g. basil or other herbs in oil; garlic, mushrooms, sundried tomatoes, peppers in oil and also pesto or antipasto) Home-prepared products in oil can be made safely by adding dehydrated ingredients only to oil. These products can be kept at room temperature. Dehydrated ingredients include ingredients that are very dry and can be kept at room temperature without spoiling, e.g. dried herbs and spices, dry-packed sundried tomatoes, etc. If home-prepared products in oil are made using fresh ingredients, e.g. fresh basil, peppers, mushrooms or garlic, they should be kept refrigerated at all times and must be discarded after one week. These products may be safely frozen for longer storage. Thaw frozen products in the refrigerator. After the products have thawed, they should be kept refrigerated at all times and must be discarded after one week. Consumers who purchase products made with fresh ingredients from fairs or farmer's markets or receive them as gifts should check that they were refrigerated after they were prepared, when they were prepared and discard them if more than one week old. Commercially-prepared products in oil that contain an acid (such as vinegar) or salt in their list of ingredients are generally considered to be safe. Store them in the refrigerator after opening and between each use. Contact the manufacturer if you have questions about a particular product. Eggnog and other recipes with eggs Be sure to handle and prepare these tasty treats safely. Commercial, ready-made eggnog is prepared using pasteurized eggs and does not require heating. Homemade eggnog may contain harmful bacteria if not prepared properly. Serve homemade eggnog using the directions below or use pasteurized egg products, found in most grocery stores. If you choose to make eggnog with whole eggs, heat the egg-milk mixture to at least 71 C (160 F). Refrigerate at promptly, once steaming stops, dividing large amounts into shallow containers so that it cools quickly. Precautions should also be taken with sauces, mousses, and any other recipes calling for raw or lightly-cooked eggs. Use pasteurized egg products, or bring egg-mixtures to a uniform temperature of 71 C (160 F) - 74 C if using a microwave oven. All of these foods must be stored in the refrigerator. Cider Popular holiday beverages, such as unpasteurized apple cider, unpasteurized mulled cider and other drinks made from unpasteurized apple cider may pose a safety risk since they may contain harmful bacteria. Use pasteurized ciders or bring unpasteurized cider to a boil before serving. This is especially important when serving cider to children, the elderly, and people with weakened immune systems. Leftovers and storage

8 While it is tempting to leave turkey and other foods at room temperature for snacking after a meal, you should refrigerate leftovers promptly in uncovered, shallow containers so they cool quickly. Cover once food is cooled and steaming stops. Avoid overstocking the refrigerator to allow cool air to circulate freely. Store turkey meat separately from stuffing and gravy. Reheat solid leftovers to at least 74 C (165 F). Bring gravy to a full, rolling boil and stir during the process. Use leftover turkey meat, bones, stuffing, gravy and other cooked dishes within four days. Safeguarding Canada s Food Supply The Canadian Food Inspection Agency (CFIA) is the Government of Canada s key science-based regulator for animal health, plant protection and, in partnership with Health Canada, food safety. At the CFIA, the safety of Canada s food supply is central to everything we do. For more information on food safety, visit the CFIA Web site at You can also find food safety information on the Health Canada and Canadian Partnership for Consumer Food Safety Education Web sites respectively at and P0531E-06 November 2006