Ferdman Ronald M, Church Joseph A
Division of Clinical Immunology and Allergy, Childrens Hospital Los Angeles, Los Angeles, California 90027, USA.
Ann Allergy Asthma Immunol. 2006 Jul;97(1):73-7. doi: 10.1016/S1081-1206(10)61373-7.
Peanuts and tree nuts frequently cause severe allergic reactions. Nut avoidance is the key treatment, and accurate identification of nuts is essential for successful avoidance.
To determine the age at which nut-allergic and nonallergic children can accurately identify various nuts and whether nut-allergic children can identify nuts they should avoid.
A "nut box" was constructed containing samples of 11 common nuts and pine nuts. Nut-allergic and nonallergic children were asked to identify the nuts, and their responses were compared and correlated by age. Nut-allergic children were asked to identify the nut(s) that they should not eat.
One hundred children (37 allergic and 63 nonallergic) were enrolled. The mean number of nuts correctly identified was only 2.7 per child and increased with age, but there was large variation. Fifty-nine children identified 2 or fewer nuts. Peanuts in the shell were identified most often (89% of children), followed by peanuts out of the shell (52%). Other nuts were identified less commonly, ranging from 32% for pistachios to 0% for Brazil nuts. Nut-allergic children were not better able to correctly identify tree nuts and were less able in the case of peanuts. Of the nut-allergic children, 10 (27%) could not identify the peanut or tree nut to which they were allergic.
In general, children, including those who are allergic to nuts, can identify few nuts. This lack of recognition could put them at increased risk for unintentional ingestion. As part of an overall educational plan, nut-allergic children should be taught not only to avoid but also to identify the nut to which they are allergic.
花生和坚果经常引发严重的过敏反应。避免食用坚果是关键治疗方法，准确识别坚果对于成功避免接触至关重要。
确定对坚果过敏和不过敏的儿童能够准确识别各种坚果的年龄，以及对坚果过敏的儿童是否能够识别他们应避免食用的坚果。
制作了一个“坚果盒”，其中包含11种常见坚果和松子的样本。要求对坚果过敏和不过敏的儿童识别这些坚果，并将他们的回答按年龄进行比较和关联。要求对坚果过敏的儿童识别他们不应食用的坚果。
共招募了100名儿童（37名过敏儿童和63名不过敏儿童）。每个儿童正确识别的坚果平均数量仅为2.7个，且随年龄增长而增加，但存在很大差异。59名儿童识别出2种或更少的坚果。带壳花生被识别的频率最高（89%的儿童），其次是去壳花生（52%）。其他坚果被识别的频率较低，从开心果的32%到巴西坚果的0%不等。对坚果过敏的儿童在正确识别坚果方面并不更出色，在识别花生方面能力更差。在对坚果过敏的儿童中，有10名（27%）无法识别他们过敏的花生或坚果。
总体而言，儿童，包括对坚果过敏的儿童，能够识别的坚果很少。这种识别能力的缺乏可能会使他们意外摄入坚果的风险增加。作为整体教育计划的一部分，应该教导对坚果过敏的儿童不仅要避免食用坚果，还要识别他们过敏的坚果。
