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Dr. Scott Sicherer

Are Coconuts Safe with Tree Nut Allergy?

Q. I’ve read differing views on whether it would be safe for a nut-allergic person to eat baked goods with coconut or coconut oil. What’s your view on coconut?

Dr. Scott Sicherer: Despite its name, coconut is not actually a nut, but a fruit. Regardless, the Food and Drug Administration considers it a tree nut, which is why it’s included in U.S. labeling laws.

It is difficult to assess the risk of coconut allergy among those with tree-nut allergies because allergic individuals may become wary of coconut and avoid it. Still, coconut allergy appears rare, and uncommon even among those with tree-nut allergies.

In a national registry of 5,149 people with peanut or tree-nut allergies, only four self-reported an allergy to coconut. And a more recent study of 40 children with positive tests or known allergy to peanuts or tree nuts showed no increased risks for having positive tests or allergy to coconut.

Your allergist would consider your personal allergy history in deciding whether to add coconut to your diet or to perform any testing. However, be aware that tests are often positive to coconut in people who could actually tolerate it, so a physician-supervised feeding test may be necessary for a conclusive answer.

When it comes to coconut oil, there is almost no medical literature on allergic reactions to it, which may reflect the likelihood that the processed forms of coconut oil contain little or no protein, although this has not been studied. Still, for those with verified coconut allergy, avoidance of coconut oil should be considered because it may have residual protein.

Finally, it’s important to note that people with peanut or tree-nut allergies who choose to eat coconut must be diligent to avoid cross-contact with avoided tree nuts or peanut.

Dr. Scott Sicherer is Chief of the Division of Allergy and Immunology of the Jaffe Food Allergy Institute at the Icahn School of Medicine at Mount Sinai in New York. Together with Dr. Hemant Sharma, he writes “The Food Allergy Experts” column in the American Edition of Allergic Living magazine. Questions submitted below will be considered for answer in the magazine.

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