Review · Nutrients · 2018Conflicts declared

Almond allergy, detection methods and labelling gaps

What it found

Almond allergy is rare, and there is not enough data to say how much almond protein is needed to trigger a reaction in allergic people.

Tests can detect tiny traces of almond protein in food, down to less than 1 part per million.

What they found

Studies in people

How common it is

Tree nut allergy is estimated at around 1% of the general population. In the US, almonds are the third most common tree nut to cause allergy after walnuts and cashews. Prevalence data for almond allergy are almost only available for children.

No threshold data

No threshold doses are available for almonds. Threshold studies have been done for peanut, hazelnut, celery, fish and shrimp, but not for almond.

Animal and lab studies

Main almond allergen

Pru du 6, also called amandin, makes up 65% of total almond protein and has been linked to severe reactions after eating almond. It is highly resistant to heat treatments during food processing.

Processing effects

Blanching and roasting did not change the allergenicity of Pru du 6 in lab tests. High-pressure treatment of almond milk reduced Pru du 6 immunoreactivity, but thermal treatment alone did not.

Studies in people and animals

Cross-reactions

A cherry seed spice called mahleb is recognised by anti-almond antibodies from almond-allergic patients. Cashew and pistachio, and pecan and walnut, were the most widely seen cross-reactions.

Other findings

Detection in food

ELISA tests can detect almond protein down to 0.1 mg/kg in food samples within 30 to 35 minutes. Lateral flow devices give results in about 10 minutes and can detect down to 1 ppm. DNA-based methods can detect almond DNA at levels from 1 to 100 mg/kg in spiked biscuits.

What the authors conclude

“Our primary conclusion is that population-based threshold data is needed in order to provide effective risk assessment and consumer advice.”
Mandalari G, Mackie AR, 2018

Also in their conclusions

  • They say that population-based threshold data is needed in order to provide effective risk assessment and consumer advice.
  • They state that more studies need to be undertaken with the relevant allergic groups so that we can move beyond the current precautionary labelling.
  • They note that immunoassay-based methods are still the most widely used and seemingly the most reliable for detecting almond in food products.

How it was done

Food allergy has been rising for years, and almond is a tree nut eaten widely around the world. The authors wanted to pull together what is known about how common almond allergy is, how it is detected, and what threshold data exist.

The authors reviewed published studies on almond allergy, including prevalence surveys, allergen detection methods, and threshold challenge studies. They looked at data from Europe, the US, Canada, Australia and Taiwan, covering both children and adults.

What it can’t tell you

  • This is a review of published studies, so it cannot provide new data on how common almond allergy is or what amount triggers a reaction.
  • The studies looked at different age groups, countries and methods of diagnosis, so comparing them directly is difficult.
  • Most detection methods were tested in lab settings, not in real-world eating situations.

The paper

Title
Almond Allergy: An Overview on Prevalence, Thresholds, Regulations and Allergen Detection
Type
ReviewThe authors read earlier studies and describe what they found. It isn’t a new study.
Evidence
Studies in people · animals · lab
Summarised from
Full text
Cite
Mandalari G, Mackie AR (2018). Almond Allergy: An Overview on Prevalence, Thresholds, Regulations and Allergen Detection. Nutrients. doi:10.3390/nu10111706Free full textPubMed 30412996DOI

Summary written 26 Sep 2026. Check it against the paper before it changes what you eat. How we summarise papers · Report an error