This article is made available through the Brunel Open Access Publishing Fund. Copyright @ 2013 Barnett et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits
unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.Objective: Food labelling is an important tool that assists people with peanut and tree nut allergies to avoid allergens.
Nonetheless, other strategies are also developed and used in food choice decision making. In this paper, we examined the
strategies that nut allergic individuals deploy to make safe food choices in addition to a reliance on food labelling.
Methods: Three qualitative methods: an accompanied shop, in-depth semi-structured interviews, and the product choice
reasoning task – were used with 32 patients that had a clinical history of reactions to peanuts and/or tree nuts consistent
with IgE-mediated food allergy. Thematic analysis was applied to the transcribed data.
Results: Three main strategies were identified that informed the risk assessments and food choice practices of nut allergic
individuals. These pertained to: (1) qualities of product such as the product category or the country of origin, (2) past
experience of consuming a food product, and (3) sensory appreciation of risk. Risk reasoning and risk management
behaviours were often contingent on the context and other physiological and socio-psychological needs which often
competed with risk considerations.
Conclusions: Understanding and taking into account the complexity of strategies and the influences of contextual factors
will allow healthcare practitioners, allergy nutritionists, and caregivers to advise and educate patients more effectively in
choosing foods safely. Governmental bodies and policy makers could also benefit from an understanding of these food
choice strategies when risk management policies are designed and developed.United Kingdom Food Standards Agenc
