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As soon as we discovered that our son had a life threatening peanut allergy, mine and Ian’s takeaway habit ground to a sudden halt. The allergy doctors at the hospital had warned us of the risks of eating, for example, Indian and Chinese foods and we had been given a leaflet which advised that:

“Curries, Indian, Chinese and Thai dishes and Pesto sauce can all contain peanuts. The spices in some of these foods may hide the warning signs of an allergic reaction. This makes them particularly risky as a significant quantity of peanut may have been eaten before the problem is recognised.”

In order to maintain a nut free home, it therefore felt safer to impose a blanket ban on Indian, Chinese and Thai takeaways going forward.

Nut free fish and chips?

What about fish and chips? Were they now off the menu too? We’ll be moving house soon and, on previous house moves, it’s become a bit of a tradition to celebrate move in day with fish, chips and champagne, eaten whilst perched on a packing crate.

Was that going to be possible now that we’ve joined the nut allergy world?

As I understand it, the key ingredients for “fish and chips” are fish, flour, potatoes and oil. So at first glance, not something that is necessarily automatically risky for someone with a peanut or tree nut allergy  (provided we followed our doctors’ and the Anaphylaxis Campaign’s advice on eating out). However, a passing comment by another allergy mum at the Manchester Allergy Support Group has stuck with me: she had just discovered that her local chippy (that she had previously regarded as safe) had started frying their food in peanut oil. So, it seemed it might be safer for us to simply avoid fish and chip shops too…

Fish and chip shops: the nut allergy danger areas

All the same considerations apply to ordering food from a takeaway as for any other food outlet. For example, are there nuts in the ingredients? Will the outlet take steps to minimise cross contamination, including, for example, using separate, clean utensils, cleaning down the preparation surfaces etc. (I recently spotted “chef cards” on the FARE website, which look to be very helpful to hand over, to reinforce the message to the kitchen staff when dining out.)

As regards fish and chip shops specifically, the Anaphylaxis Campaign note:

“Some fish and chip shops choose refined peanut oil because it performs well at high temperatures and lasts well. Peanut oil has unique properties. Its stability and long life can make it a preferred choice for frying.”

They also note that there is a cross contamination risk, if the chip shop uses the same oil to fry peanut or nut containing products.

If you have a peanut allergy do you need to avoid peanut oil?

Should we be worried about peanut oil?

Our allergy doctors’ advice is that “Refined peanut oil is safe and does not need to be avoided” (see leaflet).

The Anaphylaxis Campaign website has detailed information on this issue. They note that although research has found that refined peanut oil:

“is highly unlikely to trigger allergic reactions… Nevertheless we always advise people to consult their allergist and to err on the side of caution”.

Despite the fact that the researchers believe “refined peanut oil is highly unlikely to be allergenic to people with peanut allergy, even if their reactions to peanut solids have been anaphylactic”, for me, personally, we will avoid anything with the dreaded P-word on the label, even refined oil.

For more information on this, see the following documents by the Anaphylaxis Campaign: Peanut oil – questions and answers and Vegetable oils.

Allergy aware fish and chip shops

On the train home from the Allergy Show North, I was playing spot the allergy show attendees (a game made easy by the amount of people holding Udi’s goodie bags). The two ladies opposite me were chatting to the ladies across the aisle about living with coeliac disease.

It turned out my table mates ran Fletchers Fish and Chip Shop (5 Compstall Rd, Romiley, Stockport SK6 4BT – 0161 430 3036) and that they served fish with gluten free batter, every day except Fridays.

We got talking and they were confident that their fish and chips would be nut free too. I promised to telephone if we were ever in the area to run through the ingredients, so they could double check everything would be safe for D.

So I’m hoping we’ll still be able to celebrate moving house with a chippie tea. However, I’d be very interested to know how other nut allergic families handle the issue of takeaway food. And if you know of an allergy aware fish and chip shop, do post a recommendation below!

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Planning a holiday in the UK? Does someone in your party have a peanut or nut allergy? If so, I’ve compiled the information below (with links to useful resources), which I hope might assist a nut allergic visitor to Britain.

Medical help

  • Dial 999 in an emergency
  • Contact NHS Direct (“if you need medical help fast, but it’s not a 999 emergency”). The telephone number varies by area (it is either 111 or 0845 4647) – to find the correct number for your area, see this list.
  • The NHS Choices website also has search tools to find your local hospitaldoctor (search for “GP”) and pharmacy.

Other sources of advice

The following charities have allergy helplines:

If English isn’t your first language, the Allergy Action website has free translation cards.

For details of Embassies in the UK, see the London Diplomatic List.

Grocery shopping

Understanding UK food labelling

The ingredients list on prepacked food must be accurate. So if even a tiny amount of peanut (for example) has been intentionally added to a food, “peanut” must appear in the ingredients list.

“Peanuts” and “nuts” are two of the top 14 allergens listed in the legislation. If a prepacked food or alcoholic drink contains peanuts or nuts (or an ingredient made from them), this must be either specified in the name of the food or clearly marked elsewhere on the label.

Although the law is due to change in December 2014, for now the allergen labelling requirement does not apply to, for example:

  • Foods sold loose.
  • Cake or pastries baked and sold in a cake shop.
  • Bread rolls baked in-store at a supermarket.
  • Ice cream sold by the scoop in an ice cream shop or ice cream van.
  • Meat sold from a delicatessen counter.
  • Meals served in a restaurant, cafe, take away etc.

Some manufacturers may also use:

  • Allergen warning boxes (for example “Contains: nuts”).

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  • “May contain” wording (for example “May contain nut traces” or “Produced in a facility that also processes nuts”), to cover allergens that have got into the product by accident via cross-contamination.

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Both allergen warning boxes and “may contain” labelling are voluntary. So if there is no:

  • Allergen warning box, this does not necessarily mean the product is free from nuts: you must read the ingredients list.
  • “May contain” label, this does not necessarily mean that the product has not been accidentally contaminated with nuts or nut traces. You could contact the manufacturer to check their policy on using “may contain” labels and enquire whether the product is made in a nut free facility.

For more detail on UK allergen labelling law (both now and when the law changes in December 2014), see Deciphering UK food allergen labelling law.

One final point to note is that some companies are already introducing the new look labelling (compulsory from December 2014). So you might see the (voluntary) “Contains” boxes on some products, and the allergens highlighted (in bold, italics, underlined or in a different colour) on others. For an example of the “new look” labelling, see page 5 of Advice on food allergen labelling by the Food Standards Agency.

  • A quick note on “Ingredients: Cannot guarantee nut free”

A reader from the US recently contacted me about the Tesco advisory labelling:

“Recipe: No nuts. Ingredients: Cannot guarantee nut free. Factory: No nuts”.

What does the ingredients statement mean, if the factory was nut free?

I wondered the exact same thing when my son’s peanut allergy was first diagnosed (see Mission: create a nut free home). My understanding is that “Recipe: No nuts” is confirming there are no nuts listed in the product’s ingredients (i.e. which have been intentionally added to the recipe). Then “Ingredients: Cannot guarantee nut free” is used if they cannot vouch that all of those raw ingredients have not been near nuts at some point during the production process (before coming to the final “no nuts” factory).

Where to shop and finding safe brands

If you are going to be staying somewhere where you can have your food delivered, then I personally find the Ocado site really handy for grocery shopping, as you can filter by allergen and they also have very detailed product descriptions. As a family, we tend to stick to Ocado or Sainsbury’s, however the FreeFrom Foods Matter website has a detailed list of those UK Supermarkets, retailers and on-line stores which sell free from foods.

See also the Nut free food page, which has links to the allergy information pages for various food brands.

Eating out

Advice

For advice on eating out safely with food allergies in the UK, please see:

Restaurant recommendations

For national chains, our local branches of Pizza Express have always looked after us well (see Let’s hear it for Pizza Express!). I also understand that McDonald’s tends to be a safe bet, although my son hasn’t yet visited. Otherwise, local pubs who cook their food from scratch have tended to be the most helpful/willing when it comes to preparing a nut free meal. Here’s a list of the restaurants, pubs and cafés we have so far visited in:

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This Easter, we went to stay with friends in the Lake District for a few days. This was the first time we had stayed at someone else’s house following my son’s anaphylactic reaction to a peanut butter cookie. It also turned out to be the first time we have left the children with a babysitter other than their granny. Although our friends were brilliant about my son’s allergy, staying over in someone else’s home did throw us out of our nut free comfort zone, so I thought I would share some of the things which cropped up.

What foods can he eat?

Before we came to stay, my friend and I discussed what foods are safe for D. I explained that he could eat any prepacked foods, provided that:

  • Peanuts and nuts were not listed in the ingredients list; and
  • There was no other nut allergy warning on the food label (for example, “may contain nut traces” or “not suitable for nut allergy sufferers”).

(For more information, see my previous blog posts on supermarket shopping and food allergen labelling law).

We agreed that my friend would do the food shopping but that I also would bring some emergency supplies, just in case D couldn’t eat what she had bought.

Reading ingredients labels

Before my friend cooked anything during our stay, she ran the food packet past me, so I could double check it was safe for D. This gave us both peace of mind.

One question which came up was whether D could eat nutmeg. Luckily, this was one of the queries we had encountered when we first started scrutinising ingredients labels, so I was able to confirm that nutmeg is a seed (not a nut) and he has eaten nutmeg-containing foods many times previously without a reaction. For further information on nutmeg, see:

Can we have a takeaway?

On past visits, we would usually have a take away night at some point. When D was diagnosed peanut allergic, our allergy doctors specifically warned us that curries, Indian, Chinese and Thai dishes and pesto sauce can contain hidden peanuts. In order to ensure a nut free home, our takeaway habit ground to an abrupt halt following D’s peanut allergy diagnosis. It might sound extreme, but even eating a takeaway after he had gone to bed would make us feel uneasy. Also, once the leftovers and cartons were bagged up and disposed of in the outside bin, we would probably give ourselves indigestion by frantically running round the house with dettol wipes, lest any nut traces remain.

So we decided against having a takeaway this time … even though, provided it was eaten once the children were upstairs asleep and we cleaned up thoroughly afterwards, the risk would be minimal. I think we were being overcautious here. However, since D’s anaphylactic reaction, I myself feel uncomfortable eating something which could contain peanuts or nuts, even if I’m outside of the home and, say, not going to see D until the next day. Just another emotional after effect of anaphylaxis, I guess.

Heading home: sandwich shops vs supermarket

We stopped off at Keswick on the way home, to visit the park and look around the town centre. Despite the array of sandwich shops, at lunchtime, we brought bread and ham from a supermarket and made our own. Even when you know what allergy questions to ask, it often still feels simpler and safer to go for the prepackaged option when available.

Final thoughts and further useful resources

We know it’s unrealistic to expect the outside world to be the same nut free haven as our own house. This trip showed us that, provided obviously we keep a vigilant eye on D (and keep him away from, for example, kitchen food cupboards … or the Easter Egg shelf!), venturing outside our nut free bubble can go without a hitch.

I found that talking to our friends about safe foods beforehand helped a lot. Here are links to two helpful articles on the information you should give to hosts and new babysitters about your child’s food allergies:

  • Handy checklist of things to talk through with a babysitter beforehand, by Linda Coss (Kids With Food Allergies)
  • Article with tips on how to explain your child’s food allergy and its severity from Linda Coss, Elizabeth Goldenberg and Lynda Mitchell (published on calorielab.com).
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When my son was initially diagnosed as allergic to peanuts, the hospital doctors advised us:

  • To check the ingredients list on food packets and avoid anything containing peanuts and nuts.
  • That he could eat products that say “may contain traces of nuts”.

We were told that, in the UK and EU, the ingredients list on food packaging must be accurate. I remember asking why, in that case, food companies bothered with “may contain” wording? I was told “it’s just the lawyers”. Curious, I decided to look into the UK’s food allergen labelling laws, to find out:

  • What details food manufacturers must provide.
  • The point of “may contain” wording.
  • How the existing UK food allergen labelling laws are going to change in December 2014. Continue Reading
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As we approach the first anniversary of my toddler son’s anaphylactic reaction to a peanut cookie, I thought it would be a good time to take stock and think about all the things we’ve had to learn since his allergy diagnosis. If you are reading this as the parent of a young child recently diagnosed with a life threatening peanut or nut allergy, I hope you find this useful. Continue Reading

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When we first met with the specialist allergy nurse after D’s anaphylactic reaction to peanuts, she talked us through how to eat out safely. I remember asking her, feeling somewhat overwhelmed, whether there were ANY restaurants which were generally considered “safe” for nut allergy sufferers. We were told that McDonald’s tended to be a safe bet.

Now, each time a social occasion arises, before we talk allergies with the restaurant, Ian and I joke that we can always just get D a happy meal. However, almost one year on, is this still true?

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