Food Allergy
What is a Food Allergy?
A food allergy is an immune system response to a food that the body mistakenly believes is harmful. Once the immune system decides that a particular food is harmful, it creates specific antibodies to it. The next time the individual eats that food, the immune system releases massive amounts of chemicals, including histamine, in order to protect the body. These chemicals trigger a cascade of allergic symptoms that can affect the respiratory system, gastrointestinal tract, skin, or cardiovascular system. Scientists estimate that between 6 and 7 million Americans suffer from true food allergies. At the present time, there is no cure for food allergy. Avoidance is the only way to prevent an allergic reaction. Although an individual could be allergic to any food, such as fruits, vegetables, and meats, they are not as common as the following eight foods which account for 90 percent of all food-allergic reactions:
Tips for Managing a Milk Allergy
Baking
Fortunately, milk is one of the easiest ingredients to substitute in baking and cooking. It can be substituted, in equal amounts, with water or fruit juice. (For example, substitute 1 cup milk with 1 cup water.)
Some Hidden Sources of Milk
- Deli meat slicers are frequently used for both meat and cheese products.
- Some brands of canned tuna fish contain casein, a milk protein.
- Many non-dairy products contain casein (a milk derivative), listed on the ingredient labels. FAAN is currently working with the FDA to have this term eliminated on products that contain milk derivatives.
- Some meats may contain casein as a binder. Check all labels carefully.
- Many restaurants put butter on steaks after they have been grilled to add extra flavor. The butter is not visible after it melts.
Commonly Asked Questions
Is goat milk a safe alternative to cow milk? Goat's milk protein is similar to cow's milk protein and may, therefore, cause a reaction in milk-allergic individuals. It is not a safe alternative.
Can I rely on Kosher symbols to determine if a product is milk-free? The Jewish community uses a system of product markings to indicate whether a food is kosher, or in accordance with Jewish dietary rules. There are two Kosher symbols that can be of help for those with a milk allergy: a “D”, or the word dairy, on a label next to “K” or “U” (usually found near the product name) indicates presence of milk protein, and a “DE” on a label indicates produced on equipment shared with dairy. If the product contains neither meat nor dairy products it is Pareve (Parev, Parve). Pareve-labeled products indicate that the products are considered milk-free according to religious specifications.
Be aware that under Jewish law, a food product may be considered Pareve even if it contains a very small amount of milk. Therefore, a product labeled as Pareve could potentially have enough milk protein in it to cause a reaction in a milk-allergic individual.
Do these ingredients contain milk?
- Calcium Lactate
- Calcium Stearoyl Lactylate
- Cocoa Butter
- Cream of Tartar
- Lactic Acid
- Oleoresin
- Sodium Lactate
- Sodium Stearoyl Lactylate
No, They do not contain milk protein and need not be restricted by someone avoiding milk. BACK TO TOP
Tips For Managing an Egg Allergy
Baking
For each egg, substitute one of the following in recipes:
- 1 tsp. baking powder, 1 T. liquid, 1 T. vinegar
- 1 tsp. yeast dissolved in 1/4 cup warm water
- 1 1/2 T. water, 1 1/2 T. oil, 1 tsp. baking powder
- 1 packet gelatin, 2 T. warm water. Do not mix until ready to use.
These substitutes work well when baking from scratch and substituting 1 to 3 eggs.
Some Hidden Sources of Egg
- Eggs have been used as to create the foam or milk topping on specialty coffee drinks and are used in some bar drinks.
- Some commercial brands of egg substitutes contain egg whites.
- Most commercially processed cooked pastas (including those used in prepared foods such as soup) contain egg or are processed on equipment shared with egg-containing pastas. Boxed, dry pastas are usually egg-free. Fresh pasta is usually egg-free, too. Read the label or ask about ingredients before eating pasta.
Commonly Asked Questions
Is a flu shot safe for an individual with an egg allergy? Influenza vaccines are grown on egg embryos and may contain a small amount of egg protein. If you or your child is allergic to eggs, speak to your doctor before receiving a flu shot.
Can an MMR Vaccine be given to an individual with an egg allergy? The recommendations of the American Academy of Pediatrics (AAP) acknowledge that the MMR vaccine can be safely administered to all patients with egg allergy. The AAP recommendations have been based, in part, on overwhelming scientific evidence supporting the routine use of one-dose administration of the MMR vaccine to egg-allergic patients. This includes those patients with a history of severe, generalized anaphylactic reactions to egg. BACK TO TOP
Tips for Managing a Peanut Allergy
Some Hidden Sources of Peanuts
- Artificial nuts can be peanuts that have been de-flavored and re-flavored with a nut, such as pecan or walnut. Mandelonas are peanuts soaked in almond flavoring.
- Arachis oil is peanut oil.
- It is advised that peanut-allergic patients avoid chocolate candies unless they are absolutely certain there is no risk of cross-contact during manufacturing procedures.
- African, Chinese, Indonesian, Mexican, Thai, and Vietnamese dishes often contain peanuts, or are contaminated with peanuts during preparation of these types of meals. Additionally, foods sold in bakeries and ice cream shops are often in contact with peanuts. It is recommended that peanut-allergic individuals avoid these types of foods and restaurants.
- Many brands of sunflower seeds are produced on equipment shared with peanuts.
Keep in Mind
- Studies show that most allergic individuals can safely eat peanut oil (not cold pressed, expelled, or extruded peanut oil - sometimes represented as gourmet oils).
- Most experts recommend peanut-allergic patients avoid tree nuts as well.
- Peanuts can be found in many foods. Check all labels carefully. Contact the manufacturer if you have questions.
- Peanuts can cause severe allergic reactions. If prescribed, carry epinephrine at all times. Click here for more information about anaphylaxis.
Commonly Asked Questions
Can a peanut allergy be outgrown? Although once considered to be a life-long allergy, recent studies indicate that up to 20 percent of children diagnosed with peanut allergy outgrow it.
Can alternative nut butters (i.e., cashew nut butter) be substituted for peanut butter? Many nut butters are produced on equipment used to process peanut butter, therefore making it somewhat of a risky alternative. additionally, most experts recommend peanut-allergic patients avoid tree nuts as well. BACK TO TOP
Tips for Managing a Tree Nut Allergy
Some Hidden Sources of Tree Nuts
- Artificial nuts can be peanuts that have been de-flavored and re-flavored with a nut, such as pecan or walnut. Mandelonas are peanuts soaked in almond flavoring.
- Mortadella may contain pistachios.
- Natural and artificial flavoring may contain tree nuts.
- Tree nuts have been used in many foods including barbecue sauce, cereals, crackers, and ice cream.
- Kick sacks, or hacky sacks, bean bags, and draft dodgers are sometimes filled with crushed nut shells.
Commonly Asked Questions
Should coconut be avoided by someone with a tree nut allergy? A coconut is the seed of a drupaceous fruit. Coconuts are not typically restricted in the diet of an individual allergic to tree nuts. Some people have reacted to coconut, therefore, discuss this with a doctor before introducing coconut to your diet.
Is nutmeg safe? Nutmeg is obtained from the seeds of the tropical tree species Myristica fragrans. It is safe for an individual with a tree nut allergy.
Keep in Mind
- Tree nuts can cause severe allergic reactions. If your doctor has prescribed epinephrine, be sure to always carry it with you. For information about anaphylaxis, click here.
- Most experts advise tree nut-allergic patients to avoid peanuts as well.
- Most experts advise patients who have been diagnosed with an allergy to specific tree nuts to avoid all tree nuts.
Tips For Managing a Fish and/or Shellfish Allergy
Allergic reactions to fish and shellfish are commonly reported in both adults and children. It is generally recommended that individuals who have had an allergic reaction to one species of fish or positive skin tests to fish avoid all fish. The same rule applies to shellfish. If you have a fish allergy but would like to have fish in your diet, speak with your allergist about the possibility of being challenged with various types of fish.
Keep in Mind
Fish-allergic individuals should be cautious when eating away from home. They should avoid fish and seafood restaurants because of the risk of contamination in the food-preparation area of their "non-fish" meal from a counter, spatula, cooking oil, fryer, or grill exposed to fish. In addition, fish protein can become airborne during cooking and cause an allergic reaction. Some individuals have had reactions from walking through a fish market. Allergic reactions to fish and shellfish can be severe and are often a cause of anaphylaxis. For more information about anaphylaxis, click here.
Some Hidden Sources of Fish
- Caponata, a traditional sweet-and-sour Sicilian relish, can contain anchovies.
- Caesar salad dressings and steak or Worcestershire sauce often contain anchovies.
- Surimi (imitation crabmeat) often contains fish.
Commonly Asked Questions
Should carrageenan be avoided by a fish- or shellfish-allergic individual? Carrageenan is not fish. Carrageenan, or Irish moss, is a red marine algae. This food product is used in a wide variety of foods, particularly dairy foods, as an emulsifier, stabilizer, and thickener. It appears safe for most individuals with food allergies. Carrageenan is not related to fish or shellfish and does not need to be avoided by those with food allergies.
Should Iodine Be Avoided By a Fish or Shellfish Allergic Individual?
Allergy to iodine, allergy to radiocontrast material (used in some lab procedures), and allergy to fish or shellfish are not related. If you have an allergy to fish or shellfish, you do not need to worry about cross reactions with radiocontrast material or iodine. BACK TO TOP
Tips for Managing a Soy Allergy
Soybeans have become a major part of processed food products in the United States. Avoiding products made with soybeans can be difficult.
Soybeans alone are not a major food in the diet, but because they're in so many products, eliminating all those foods can result in an unbalanced diet. Consult with a dietitian to help you plan for proper nutrition.
Keep in Mind
Soybeans and soy products are found in baked goods, canned tuna, cereals, crackers, infant formulas, sauces, and soups. At least one brand of peanut butter lists soy on the label. Studies show soy lecithin and soybean oil can be tolerated by most soy-allergic individuals.
Soy free Stir Fry Recipe:
- Stir-Fried Orange Beef
- 1 tsp. cornstarch
- 1 cup orange juice
- 1 to 1 1/2 lbs. trimmed beef, thinly sliced
- 1 to 2 T. of oil
- 1/4 to 1/2 tsp. crushed red pepper flakes
- 1 clove minced garlic
- 1 T. grated fresh gingerroot
- 1/4 cup green onion, thinly sliced
- 1/4 cup bell pepper, thinly sliced
In small bowl, combine cornstarch and orange juice. Set aside. In wok, add beef, oil, and red pepper flakes. Stir-fry over high heat until beef is browned. Remove beef with slotted spoon. Set aside. Add garlic, gingerroot, onion, and bell pepper to oil remaining in the wok. Stir-fry 2 minutes. Add cornstarch/orange juice mixture. Simmer until thickened. Add beef and toss with sauce. Can be served over noodles or rice. BACK TO TOP
Tips for Managing a Wheat Allergy
Baking
When baking with wheat-free flours, a combination of flours usually works best. Experiment with different blends to find one that will give you the texture you are trying to achieve. Try substituting 1 cup wheat flour with one of the following:
- 7/8 cup rice flour
- 5/8 cup potato starch flour
- 1 cup soy flour plus 1/4 cup potato starch flour
- 1 cup corn flour
Keep in Mind
- Read labels carefully. At least one brand of hot dogs and one brand of ice cream contains wheat. It is listed on the label.
- Many country-style wreaths are decorated with wheat products.
- Some types of imitation crabmeat contain wheat.
- Wheat flour is sometimes flavored and shaped to look like beef, pork, and shrimp, especially in Asian dishes.
Commonly Asked Questions
What is the difference between celiac disease and wheat allergy? Celiac disease and wheat allergy are two distinct conditions. Celiac disease, or celiac sprue, is a permanent adverse reaction to gluten. Those with celiac disease will not lose their sensitivity to this substance. This disease requires a lifelong restriction of gluten. The major grains that contain gluten are wheat, rye, oats, and barley. These grains and their by-products must be strictly avoided by people with celiac disease. Wheat-allergic people have an IgE-mediated response to wheat protein. These individuals must only avoid wheat. Most wheat-allergic children outgrow the allergy.
Are kamut and spelt safe alternatives to wheat? No. Kamut is a cereal grain which is related to wheat. Spelt is an ancient wheat that has recently been marketed as safe for wheat-allergic individuals. This claim is untrue, however. Wheat-allergic patients can react as readily to spelt as they do to common wheat. BACK TO TOP