food allergies and intolerance

woman checking labels

food allergies

A food allergy is the immune system's response to a food the body mistakenly believes is harmful. This response can include respiratory, gastrointestinal, skin, or cardiovascular reactions. An estimated 11 million Americans are allergic to common foods such as milk, eggs, nuts and shellfish. There’s no cure for food allergies; avoidance is the only way to prevent an allergic reaction.

food intolerance

Food intolerance is more common than food allergy. If you experience headaches or bloating after eating certain foods, you may have a food intolerance. Gluten intolerance is one of the most common types of food intolerance. Click here to learn more about starting and maintaining a gluten-free lifestyle.

mom and daughter eating

food allergies and intolerance in children

A child with one or more food allergies may have difficulty getting enough calories and nutrients. Your physician or dietitian can help you develop an appropriate diet and safe grocery list and an also teach you and your child how to read food labels to locate safe ingredients.

milk allergy

A milk allergy is caused by an immune reaction to the protein in milk. A milk allergy is much more common in young infants and children than in adults. Lactose intolerance, which is different from a milk allergy because it does not involve an immune response, is common in adults.

symptoms

Abdominal pain, diarrhea, nausea, vomiting, gas, bloating, stuffy/runny nose, pain and serious drainage from the ears, and skin conditions such as eczema or hives.

treatment

If you're allergic to milk, a milk-free diet is essential. Because people with lactose intolerance or a milk allergy often need to avoid dairy products, it's important to find other sources of calcium and vitamin D. Soy, rice, and almond milk can be good substitutes.

reading food labels for milk

Avoid the following foods and ingredients if you are on a milk-free diet:

  • Butter, butter fat, butter oil and artificial butter flavor
  • Buttermilk
  • Casein, Caseinates
  • Cheese
  • Cream
  • Cottage cheese
  • Curds
  • Custard
  • Ghee
  • Half and half
  • Hydrolysates
  • Lactalbumin, Lactalbumin phosphate
  • Lactoglobulin
  • Lactose
  • Lactulose
  • Milk (derivative, powder, protein, solids, malted, condensed, evaporated, dry, whole, low-fat, non-fat, skimmed, and goat's milk)
  • Nougat
  • Pudding
  • Rennet casein
  • Sour cream, sour cream solids
  • Sour milk solids
  • Whey (in all forms including sweet, delactosed, protein concentrate)
  • Yogurt

shopping tips

  • Deli meat slicers are frequently used for both meat and cheese products.
  • Some brands of canned tuna and many other non-dairy products contain casein, a milk protein.
  • Some meats may contain casein as a binder. Check all labels carefully.
  • Many restaurants put butter on steaks to add extra flavor. The butter is not visible after it melts.
  • Beware of cross-contamination of food products at salad bars.

baking & cooking tips

  • Milk is one of the easiest ingredients to substitute in baking and cooking.
  • Substitute with equal amounts or water or fruit juice (ex: substitute 1 cup milk with 1 cup water).
  • Use pureed vegetables (like potatoes) to thicken soups.
  • Fruit smoothies and popsicles are alternatives to milkshakes and ice cream

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egg allergy

An egg allergy is caused by an immune reaction to egg proteins. The proteins responsible for egg allergy are mostly present in egg white, but some proteins in egg yolk may also cause allergic reactions. Egg allergy is much more common in children under the age of five, and will cause a more severe reaction in children than in adults.

symptoms

Abdominal pain, diarrhea and vomiting, skin conditions such as eczema and hives, breathing problems and occasionally anaphylaxis

treatment

If there is a known or suspected allergy to egg, a totally egg-free diet is essential at first. If you eat egg proteins, there is a risk of an allergic reaction, so all products containing egg or components of egg must be avoided. Even some egg substitutes contain egg white, so pay close attention to product labels and ingredients.

reading food labels for eggs

Avoid the following foods and ingredients if you are on an egg-free diet:

  • Egg products (eggs, egg white, egg yolk, egg powder, egg protein, egg from all other poultry)
  • Globulin
  • Livetin
  • Mayonnaise
  • Ovalbumin
  • Ovoglobulin
  • Ovomucin
  • Ovomucoid
  • Ovovitellin
  • Vitellin

hidden sources of egg

  • Some salad dressings, including Caesar
  • Some sauces, including Hollandaise, Béarnaise, and Newburg
  • Battered foods
  • Pancakes and waffles
  • Candy made with egg, including nougat
  • Meatloaf and sausage (egg is sometimes used as a binding agent)
  • Commercial, low-cholesterol, egg replacements

baking tips

For each egg, substitute one of the following in recipes:

  • 1 teaspoon baking powder, 1 tablespoon liquid, 1 tablespoon vinegar
  • 1 teaspoon yeast dissolved in ¼ cup warm water
  • 1½ tablespoons water, 1½ tablespoons oil, 1 teaspoon egg-free baking powder
  • 1 packet gelatin and 2 tablespoons warm water. Don’t mix until ready to use.

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fish and/or shellfish allergy

A fish/shellfish allergy is caused by an immune reaction to the protein in fish and shellfish. Allergic reactions to fish and shellfish are commonly reported in both adults and children. It is recommended that individuals who have had an allergic reaction to one species of fish avoid all fish and/or shellfish.

symptoms

Nasal congestion, hives, itching, swelling, wheezing or shortness of breath, nausea, upset stomach, cramps, heart burn, diarrhea, lightheadedness, or fainting. Allergic reactions to fish and shellfish can be severe and are often a cause of anaphylaxis.

treatment

A totally fish/shellfish-free diet is necessary if there is a known or suspected allergy.

reading food labels for fish and/or shellfish

Different types of fish and shellfish contain similar proteins, so it may be best to avoid all fish and shellfish. Be particularly cautious in seafood restaurants, since allergens can be spread by shared cooking utensils and equipment. The most common fish known to cause an allergic reaction include: cod, salmon, trout, herring, sardines, bass, orange roughy, swordfish, halibut, and tuna.

Avoid the following foods and ingredients if you are on a shellfish-free diet:

  • Abalone
  • Clams
  • Cockle
  • Crab
  • Crawfish
  • Lobster
  • Mollusks
  • Mussels
  • Oysters
  • Prawns
  • Scallops
  • Shrimp (crevette)
  • Snails (escargot)
  • Squid (calamari)

shopping tips

  • 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) contains fish.

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wheat allergy

Wheat allergy is caused by an immune reaction to one or more of the proteins in wheat. A wheat allergy is different from gluten intolerance and celiac disease. To learn more about these conditions, view our gluten-free brochure.

symptoms

Diarrhea, nausea, vomiting, gas, bloating, pain, nasal congestion, sneezing, runny nose, itchy, water eyes, hives, tissue swelling and eczema.

treatment

A totally wheat-free diet is essential if there is a known or suspected allergy. Read labels carefully. You may be surprised at the amount of food products that contain wheat, but fortunately, manufacturers offer an increasing number of wheat-and gluten-free foods.

reading food labels for wheat

Avoid the following foods and ingredients if you are on a wheat-free diet:

  • Bulgur
  • Couscous
  • Cracked wheat
  • Durum
  • Farina
  • Kamut
  • Semolina
  • Spelt
  • Triticale
  • Wheat berries
  • Wheat germ
  • Wheat bran
  • Wheat
  • Wheatena

baking tips

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

shopping tips

  • Read labels carefully. For example, hot dogs and ice cream could contain wheat.
  • 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.

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soy allergy

Soybeans are legumes, and many people are allergic to more than one type of legume. Soy allergy is caused by an immune reaction to soy proteins.

symptoms

Allergy to soy protein has many features similar to those of cow's milk protein allergy. In infants, soy allergy can cause loose stools and diarrhea, vomiting, abdominal discomfort, irritability, crying, intestinal blood loss, anemia, and poor weight gain. Other symptoms include coughing, wheezing, asthma, runny nose, hives, tissue swelling, and eczema.

treatment

A totally soy-free diet is essential if an allergy to soy exists or is suspected. If soy proteins in any form are consumed, it is likely that you would have an allergic reaction. An anaphylactic reaction to soy is extremely rare. If you have a soy allergy, you may also want to avoid other legumes such as navy beans, kidney beans, string beans, black beans, pinto beans, chickpeas, lentils, carob and licorice.

reading food labels for soy

Avoid the following foods and ingredients if you are on a soy-free diet:

  • Emulsifiers*
  • Hydrolyzed plant protein (HPP)*
  • Hydrolyzed vegetable protein (HVP)*
  • Lecithin*
  • Miso
  • Shoyu
  • Sobee
  • Soy products (Soy, Soy albumin, Soy beans, Soy flour, Soy lecithin, Soy milk, Soy nuts, Soy oil, Soy protein, Soy protein isolate, Soy sauce, Soy sprouts, Soy-based infant formulas)
  • Stabilizers*
  • Tempeh
  • Textured vegetable protein (TVP)*
  • Tofu
  • Unspecified sprouts*
  • Vegetable broth*
  • Vegetable gum*
  • Vegetable oil*
  • Vegetable paste*
  • Vegetable protein*
  • Vegetable shortening*
  • Vegetable starch*

shopping tips

Be aware that pet foods often contain soy. Keep away from children to prevent accidental ingestion. Some cosmetics contain soy oil and should be avoided.

*These items may not contain soy, but the source is seldom listed on a food label.


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peanut allergy

Peanut allergy is caused by an immune reaction to the proteins in peanuts. Peanuts are one of the most frequently cited causes of life-threatening anaphylactic reactions. If you have been diagnosed as anaphylactic to peanuts, extreme caution must be exercised in avoiding all sources of peanuts.

Peanuts are legumes and are botanically related to other legumes such as soy, lentils, fresh and dried peas and beans, licorice and carob. To be safe, most experts recommend that peanut-allergic patients also avoid tree-nuts such as walnuts, Brazil nuts, hazelnuts, etc.

symptoms

Hives, tissue swelling, wheezing, asthma, vomiting, runny nose, itching, nausea, eye irritation.

treatment

Reactivity to peanuts is usually a lifelong allergy. Peanuts can cause a fatal allergic reaction, so your doctor may advise you to avoid any products containing nuts. Keep in mind that prepared foods and restaurant foods can be contaminated with peanuts or peanut oil.

reading food labels for peanuts

Avoid the following foods and ingredients if you are on a peanut-free diet:

  • Arachis oil
  • Artificial nuts
  • Goober nuts
  • Goober peas
  • Hydrolyzed peanut protein
  • Mandalona nut
  • Mixed nuts
  • Peanut butter
  • Peanut flour
  • Peanut oil
  • Peanut protein

hidden sources of peanut

  • Artificial nuts can be peanuts that have been deflavored and reflavored with a nut, such as pecan or walnut. Mandalonas are peanuts soaked in almond flavoring.
  • Arachis oil is peanut oil.
  • Peanut-allergic patients should 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.
  • Foods sold in bakeries and ice cream shops are often in contact with peanuts.
  • Many brands of sunflower seeds are produced on equipment shared with peanuts.

shopping tips

  • Label reading and extreme caution is absolutely necessary.
  • There is often cross-contamination with peanuts in bulk nut bins. Utensils used to handle peanuts are often used with other nuts without prior cleaning. It is advisable to buy plain nuts packaged by the manufacturer.
  • Candies, confectioneries, desserts, and ice cream containing "nuts" may also contain peanuts and should be avoided.

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