Chances are you either have a food allergy yourself or know many people who do. Food allergies affect everyone differently, from severe reactions to mild symptoms. I recently experienced an allergic reaction to Chinese food, an issue I had never dealt with before. My lips and face swelled up significantly, but luckily I didn’t have any other symptoms and Benadryl and a few days’ time took care of it. I traced it back to soy sauce, but won’t know for sure until I visit the allergist. In the meantime, I wanted to learn more about food allergies and how we can more safely eat the foods we love without causing harm to our bodies. I spoke with Julie Funk and Kim Knipe, nutritionists at Penn Medicine’s Chester County Hospital.
PA Eats: What are the top food allergies?
Julie Funk: There are eight major food allergens in the U.S.—milk, eggs, peanut, tree nuts, soy, wheat, fish and crustacean shellfish.
How many Americans suffer from the various food allergies?
Funk: A 2007 survey conducted by the Centers for Disease Control and Prevention estimated one in 20 children and about one in 25 adults have a food allergy.
What are the symptoms—from mild to severe?
Kim Knipe: The reaction to a true food allergy can be mild and involve a skin reaction such as hives or eczema. Sometimes a mild allergy can cause nausea, vomiting or diarrhea. Severe reactions can cause difficulty breathing, coughing or wheezing. Very severe allergies can cause anaphylaxis, which is a reaction that involves the whole body and can be fatal.
I recently discovered an allergy to soy sauce, at least that’s what I traced it to. Is it common to develop food allergies later in life?
Funk: It is possible to develop allergies as an adult. Some children outgrow food allergies only to have them reappear in adulthood. Other times, adults find they can no longer eat foods they never had trouble eating before. So yes, food allergies can show up at any time.
What steps should someone take if they trace symptoms back to eating—both the immediate reaction, and after the allergy attack has subsided?
Funk: Only an allergist will be able to tell if the reaction is a true allergy rather than a food insensitivity. Try keeping a diary that describes the food, quantity eaten, reaction and time the reaction occurred. If the allergist determines that an allergy exists, work with a dietitian and/or a physician to safely remove the allergen from your diet without causing nutrient deficiencies.
If you do experience an allergy attack, respond quickly! It is important to be able to recognize and treat an allergic reaction. Ask your allergist so you’ll know what to look for and how to respond, but be aware that reactions vary and are hard to predict. Symptoms can occur within a few minutes to two hours after being exposed to the food. See a complete list of possible symptoms at online. Your allergist might prescribe an epinephrine injection for a severe food-allergic reaction. Mild allergic reactions might be treated with an antihistamine, like Benadryl.
What are some ingredients you can substitute for the top food allergens? How can we eat around allergies in a healthy way?
Knipe: Sometimes, avoiding an allergen is as easy as not eating peaches or shrimp. Sometimes, it’s very challenging because you have to be vigilant about reading food labels to avoid the allergen in packaged foods. Soy, dairy and egg can be difficult to avoid in many grocery store and restaurant products, for instance. A great website for ingredient substitutions is Eating with Food Allergies. It reminds us that some people with multiple allergies have a much harder time finding a substitute since they might also be allergic to the substitutes. Another good website for those looking at food labels is Nutrition411. It specifies different names your allergen might go by on an ingredient label.
How about the holidays, parties, dinner dates—events that center around food. How can someone with allergies eat and enjoy without endangering themselves?
Funk: This can be challenging. Preparation and communication are definitely key. Consider bringing your own food if it’s a potluck. Contact the host ahead of time and let them know about your allergy—even educating them about cross-contact with preparation and serving (i.e., don’t just pick out the peanuts, don’t use the same knife to cut cheese and then vegetables, etc.). But please be respectful, stressing that you dislike making preparation more difficult, but your health can severely suffer. And, of course, offer to bring something for yourself if they would like.
Eating at a restaurant—what’s the best way to go about dining out when you have one or more food allergies?
Funk: Again, preparation and communication are your best defense. Call the restaurant ahead of time for their protocols for serving people with allergies. Ask if they have dishes that are completely free of your allergens. Ask also if their food preparation and serving team has been trained to avoid cross-contact with your allergens. And, of course, be prepared with your epinephrine injector just in case.
Funk and Knipe recommend the following online resources for understanding and managing food allergies:
- Food Allergy Research and Education
- Your Food Allergy Field Guide
- American Academy of Allergy Asthma & Immunology
These websites are full of great recipes for those of us who have food allergies or are cooking for someone who does:
- Photos: Nina Lea Photography
