Christmas feasting without worries

So people with nut allergies can enjoy the festive season without any worries

01-Dec-2025

When the scent of cinnamon and vanilla wafts through the kitchen, the most wonderful time of the year begins for many. For people with nut or peanut allergies, however, gingerbread and fruit bread pose an increased risk. Even small traces, such as walnut splinters, can trigger an allergic reaction - from tingling in the mouth to life-threatening anaphylactic shock. Particularly treacherous: even a pollen allergy can be unpleasant due to cross-reactions at the Advent table. It is therefore important to know how to protect yourself and others - and what to do in an emergency.

Peanuts are one of the most common triggers of food allergies in children and cause almost one in four food-related anaphylaxis cases (1). In Germany, around 0.2% of children are affected by an allergy to peanuts (2). Allergies to tree nuts such as hazelnut, walnut or cashew are less common.1 In contrast to many other food allergies, peanut and nut allergies persist into adulthood.

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Anaphylaxis: recognize warning signs early and act immediately

In extreme cases, an allergy can develop into anaphylaxis at any time. The body reacts suddenly and strongly to the allergen, which previously only caused mild symptoms such as itching or a skin rash. In rare cases, this excessive immune reaction can become life-threatening within minutes. It is therefore important to take allergic symptoms seriously, to be aware of risk factors and to seek medical help early if in doubt. "Anyone who notices such symptoms must act immediately, every minute counts," says Prof. Dr. med. Margitta Worm, Head of the Department of Allergology and Immunology at Charité Berlin. "It is therefore important to know and be able to apply a clear emergency plan. The emergency medication adrenaline, which people at risk of anaphylaxis should carry with them at all times, plays a central role in this. Family and friends should also know how to react correctly in an emergency - this is particularly important if children are affected."

According to medical guidelines, adrenaline is the emergency medication of choice for anaphylaxis (3). It is available on prescription and can be part of the emergency kit that people at risk of anaphylaxis should always carry with them. It is available to patients as an adrenaline autoinjector and - as a new form of therapy - as nasal adrenaline.

Careful preparation protects - and there are many delicious nut alternatives

To prevent an emergency situation from arising in the first place, however, clever menu planning can help. Anyone affected by a nut allergy should inform family, friends and girlfriends in good time and explain what to look out for. Invitees, on the other hand, should actively ask about allergies and intolerances. After all, nuts can be replaced with just a few tricks, such as sunflower and pumpkin seeds when baking cookies, coconut flakes and dried fruit for cake or stollen fillings or roasted oat flakes as a salad topping.

However, if you don't want to do without nuts, you should ensure that they are prepared separately to avoid cross-contact, i.e. use separate work surfaces, kitchen utensils, baking trays, pans and pots. Also: check the ingredients list carefully! This is because nuts are often hidden ingredients, for example in vegan cheese alternatives, pesto, chocolate or nougat cream.

1 Worm M, Reese I, Ballmer-Weber B, et al. Update of the SK2 guideline on the management of IgE-mediated food allergies. Allergology Select. 2021;5:195-243.

2Pfaar O, Ankermann T, Augustin M, et al. Guideline on allergen immunotherapy in IgE-mediated allergic diseases. Allergology Select. 2022;6:167-232.

3German S2k guideline "Acute therapy and management of anaphylaxis", AWMF 061-025, 2021.

Note: This article has been translated using a computer system without human intervention. LUMITOS offers these automatic translations to present a wider range of current news. Since this article has been translated with automatic translation, it is possible that it contains errors in vocabulary, syntax or grammar. The original article in German can be found here.

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