Going Nuts.

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Most parents are aware of the benefits of nuts, particularly almonds, peanuts and pecans, for our health and our kids’ health. These powerful pieces of nutrition provide essential fatty acids, proteins, fiber, and Vitamin E and help raise good cholesterol, known as HDL. However, the one drawback to this nutritious diet staple is that nuts can also cause a potentially fatal allergic reaction, known as an anaphylactic reaction.
Due to the potential seriousness of allergies, many schools have started to enforce restrictions on the kinds of foods students are allowed to bring to school. This raises some complicated questions for parents hoping to send their children off to school with healthy, nutritious food. What do we do as parents when our child’s school has banned nuts? For some kids, going without nuts means missing their vegetarian protein source. Should we pack our kids dairy every day and risk raising their LDL cholesterol? Should we send tofu and soy butter, which are more processed than natural nut butters? Should we send sunflower butter, which is also highly allergenic and can also cause anaphylaxis? Should we focus on peanut-free and not tree nut-free?
In addition to the immediate challenges these kinds of bans place on nutrition, they also have the potential to affect the ways our kids interact with one another.  Do we advocate for a nut-free table in the cafeteria, which would set kids with allergies apart? While a “nut-free” table would be organized with students’ safety in mind, in enforcing this rule we risk ostracizing them from their classmates. I have heard some moms in Connecticut are fighting with their children’s schools to allow their child with a nut allergy eat with the other kids. Do we go along with the nut -free school zone? Do we recommend establishing this nut-free zone on a class-by-class basis, pending if someone has an allergy?
Where do we draw the line? I understand this is a sensitive subject, and should be — the risks are very high. I do think a nut free elementary school is advantageous. However, when my son’s school proposed a ban on all food products made in a factory that may be in contact with peanuts (at a school where the children eat lunch in their classroom and there may be no allergy in many classrooms) I felt at a loss. I am a mom, RD, CDE and I am now going to have to take on the responsibility of feeding my kids as if they had an allergy, possibly decreasing their immunity to such foods. Busy parents are challenged enough as it is to feed their kids healthy, let alone nut- free food, and our choices are narrowed even further when we are expected to avoid products from facilities where peanuts may have been processed. I would gladly comply if a child in the class had a documented allergy, but to go through hoops and hurdles when it may not be necessary seems overboard.
This excessive caution seems all the more extreme when we consider how allergens and contamination are regulated (or aren’t).  Avoiding food processed in the same facility as nut products is not always effective. According to a recent article by a panel of experts from the National Institute of Allergy and Infection Diseases:

The FALCPA does not currently regulate voluntary disclaimers such as “this product does not contain peanuts, but was prepared in a facility that makes products containing peanuts” or “this product may contain trace amounts of peanut.” Such disclaimers can leave consumers without adequate knowledge to make objective decisions.

The EP identified 10 studies that examined whether standards for precautionary food labeling are effective in preventing food-induced allergic reactions. No study explicitly attempted to infer a cause-and-effect relationship between changes in frequency of severe symptoms from unintentional exposure (for example, to peanut) as a consequence of implementing food labeling. The identified studies mostly assessed knowledge and preferences for food labeling.1

If this labeling is voluntary, unregulated, and therefore possibly inaccurate, does it make sense for schools to use the kinds of labels to inform their policies regarding allergies? Many of my clients with peanut allergies still have tree nuts, and even peanut butter, in their homes and simply know how to prevent cross-contamination. Many of my clients with these allergies still eat foods processed in a facility that may share equipment with nuts, wheat and other common allergens.   So are our schools being too authoritarian? Are they smart for playing it safe, or is there such a thing as too much caution? Should sweets be forbidden from schools for fear of hyperglycemia or hypoglycemia, conditions that are just as threatening for someone with Type 1 Diabetes? Should grapes be forbidden since they are a choking hazard?
Instead, I recommend schools practice peanut/nut free or safe policies.  Focus on education, emergency plans for allergic reactions and having the epi pen to administer if there is an allergic reaction. Avoiding nuts or rather nut free facilities is not the best answer. Yes, precaution is necessary but we also need an action plan for as we know with voluntary labeling, kids still may be exposed and have an allergic reaction.
What do parents think? Do you believe in nut-free schools?  Do you believe in nut free schools banning food products made in a facility made that may have processed nuts?
 
1. “Guidelines for the Diagnosis and Management of Food Allergy in the United States” Report of the NIAID-Sponsored Panel.”  The Journal of Allergy and Clinical Immunology 126.6, Supplement (2010): Pages S1-S58.



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