Living With a Food Allergy

Strictly avoiding your trigger foods is the only way to prevent a reaction and maintain control over your food allergy. To make sure you eat a well-balanced diet while avoiding your triggers, talk to a registered dietician. Here are some tips to get your started.

• Work with your healthcare provider to develop a written action plan that outlines what to do in the case of a reaction. Make sure your friends and loved ones know what to do in an emergency.
• Always take worsening symptoms seriously.
• Diversify your diet by eating fruits and vegetables that are more exotic, especially if you are allergic to those that are more common.
• Invest in a cookbook with recipes that cater to your food allergy. In some cases, common food allergens can be easily removed or substituted in recipes.
• Be aware of any changes in how you feel after eating. Recognizing the onset of a reaction allows you to take quick action.

Become Label Savvy

• Read all food labels. Learn alternate names for foods to which you may be allergic. For example, if you are allergic to milk, you need to avoid products that list the following in their ingredients: casein, sodium caseinate, lactoglobulin, and nougat. If you are allergic to eggs, check the ingredients for egg whites and albumin.
• Don't take chances. If a food doesn't have a label and you don't know for certain what's in it, or if you're still uncertain after reading the label, contact the retailer or manufacturer, or just don't eat it.

 Always Be Prepared

• Be prepared for an emergency. If you have severe allergies and have medication to prevent anaphylaxis, carry your medicine with you at all times in case you accidentally eat a trigger food. If you have an anaphylactic reaction, be sure someone knows to take you to the emergency room.
• An organization called The Food Allergy Initiative advises people with food allergies to carry a card that lists the foods to which they are allergic. The card can be given to the chef, manager, or server prior to ordering food at a restaurant.

 Take Note of Hidden Sources of Problem Foods

Allergy-triggers can be found in the least suspecting foods, so keep the following points in mind.

• The same deli meat slicer used to cut meats is likely used to cut cheese products, too. When this is done, small particles of cheese can be transferred to sliced meats.
• To add flavor, some restaurants melt butter on steaks after they have been grilled.
• Casein, a milk protein, is sometimes used in canned meats.
• Eggs are sometimes used to create the foam topping on specialty coffee drinks.
• Some ethnic dishes, such as African, Chinese, Indonesian, Mexican, Thai, and Vietnamese foods, contain peanuts or are prepared in areas near peanuts.
• Some beanbags and hacky sacks are filled with crushed nutshells.
• Some labels use the term "may contain" to indicate the possible, but unintentional, presence of foods allergens in their products.

Living With a Milk Allergy

If you suffer from a milk allergy, strictly avoiding milk and food containing milk and milk products is the only way to prevent a reaction, which can include bloating, abdominal cramps, flatulence, diarrhea, or constipation. But, it is not always easy to avoid these foods since many unsuspecting products contain milk or milk products.

Always check the label ingredients before you use a product. In addition, check the label each time you use the product. Manufacturers occasionally change recipes, and a trigger food may be added to the new recipe. Here are some examples of milk products and foods that may contain milk along with a list of milk substitutes.

Dairy products are an important source of calcium and Vitamin D, so it's important that you eat other foods rich in these nutrients, such as broccoli and spinach.

• Avoid milk and all milk products. This includes yogurt, cheese, cream, butter, ice cream and sour cream.
• Taking milk digestive aids will not help you tolerate milk if you have a true allergy.
• Avoid processed foods as much as possible. Milk is a hidden ingredient in many items. Stick with simple, pure, fresh foods - which are more healthful anyway.
• Read all labels very carefully. Look for the words milk solids, casein, sodium caseinate, lactose or sodium lactylate, as well as any word that begins with "lact." Stay away from products containing these ingredients.
• Watch out for labels that say "dairy-free." That doesn't necessarily mean that they're milk-free. Many contain casein. Prime culprits are coffee whiteners and nondairy creamers.
• Avoid products that list "natural flavors" and "seasonings" in their ingredients. They often contain milk products.
• Call a manufacturer for answers if a product isn't clearly labeled. Many prepared foods - even luncheon meats - use milk as a filler.
• Be wary of eating canned tuna. Most brands contain lactose in the broth.
• Check the ingredients on medications and vitamins. Some may contain milk products; for example, a number of liquid antibiotics use lactose as a filler.
• Check with your doctor or pharmacist if you are unsure about an ingredient.
• Take care when eating foods containing galactose. It is a byproduct of lactose, the milk sugar, and some people have reactions to it.
• Buy vegan foods. Vegan foods do not contain any animal products, including milk.
• Order vegan foods (if available) when traveling on an airplane. This will ensure a milk-free meal.
• Be diligent in restaurants. Ask what the dish contains. Stick to simple recipes without heavy gravy and sauces, which tend to contain milk.
• Buy a dairy-free cookbook, or use kosher and vegan cookbooks for milk-free recipes.
• Remove milk from recipes: Use soy butter or margarine instead of butter, and replace milk with water, fruit juice, soy milk or rice milk. Use a vegetable oil instead of melted butter.
• Supplement with vitamin C with added bioflavonoids, 1,000 to 5,000 mg daily, and/or quercetin, 500mg twice daily. They both help strengthen the immune system and decrease reaction to allergens.
• Take 100mg bromelain twice daily. It enhances the absorption of quercetin.
• If you are mildly allergic to milk, you may be able to try milk products again. First abstain from all milk products for at least six months, and then try a small amount. If you don't have a reaction, you may be able to tolerate it occasionally.

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Living With an Egg Allergy

• Egg allergy -- especially to egg whites -- is more common in children than in adults and reactions range from mild to severe. Mild reactions tend to involve the skin and gastrointestinal tracts. Severe allergy can be instantaneous.
• If you suffer from an egg allergy, strictly avoiding eggs and food containing egg and egg products is the only way to prevent a reaction. But, it is not always easy to avoid these foods since many unsuspecting products contain eggs.
• Always check the label ingredients before you use a product. In addition, check the label each time you use the product. Manufacturers occasionally change recipes, and a trigger food may be added to the new recipe. Also, keep in mind that some egg substitutes contain egg white.

Examples of egg products and foods that may contain eggs include:

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Living With a Soy Allergy  

Soybeans are legumes. Other foods in the legume family include navy beans, kidney beans, string beans, black beans, pinto beans, chickpeas (garbanzo or chichi beans), lentils, carob, licorice and peanuts. Many people are allergic to more than one legume. If your doctor is unable to identify which soy product is causing your allergy, it is best to avoid them all. It is not always easy to avoid these foods since many unsuspecting products may contain soy.

Who Gets Soy Allergy?

Soy allergy is more common in infants. The average age at which the allergy manifests is 3 months but the majority of infants outgrow it by the age of two. Although adults do suffer from soy allergy, it is rare.

 How Do I Avoid Exposure?

Always check the label ingredients before you use a product. In addition, check the label each time you use the product. Manufacturers occasionally change recipes, and a trigger food may be added to the new recipe.

Examples of soy products and foods that may contain soy include:

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Allergy-Proof Your Environment

Medicines help treat allergy symptoms once they strike, but there are several steps you can take to prevent symptoms altogether. The following recommendations can help you avoid allergy triggers whether you're at home, outdoors, or out on the town.

At Home

• Keep windows closed and use air conditioning if you're allergic to pollen. Don't use fans since they can stir up dust.
• Filter the air. Cover air conditioning vents with cheesecloth to filter pollen and use high efficiency particulate air filter. Clean air filters frequently and air ducts at least once a year.
• Keep the humidity in your house below 50% to prevent mold growth.
• If you have pets, consider keeping them outside or perhaps ask someone else to take care of them. Animal dander and saliva are common allergens for many people. If you must keep your pets indoors, do not allow them in the bedroom and be sure to bathe them often.
• Avoid areas where molds may collect, including basements, garages, crawl spaces, barns and compost heaps. Have someone else clean these areas often.
• Install dehumidifiers in basements and other areas of the house where molds tend to collect. Clean these devices every week.
• Air out damp clothes and shoes (in the house) before storing.
• Remove laundry from the washing machine promptly. Don't leave wet clothes in the washer where mold can quickly grow.
• Wash shower curtains and bathroom tiles with mold-killing solutions.
• Don't collect too many indoor plants as soil encourages mold growth.
• Store firewood outside.
• Use plastic covers for pillows, mattresses and box springs. Avoid overstuffed furniture and down-filled bedding or pillows.
• Wash your bedding every week in hot water.
• Don't allow smoking in your house.
• Wear a mask and gloves when cleaning, vacuuming, or painting to limit dust and chemical exposure.
• Vacuum twice a week.
• Limit throw rugs to reduce dust and mold. If you do have rugs, make sure they are washable.
• When possible, choose hardwood floors instead of carpeting. If you must have carpeting, choose low-pile material.
• Avoid dust-collecting Venetian blinds or long drapes. Replace old drapes with window shades instead.
• Make sure there is an exhaust fan over the stove to remove cooking fumes.

In the Car

• Keep windows closed and set the air conditioner to use recirculated air if you are allergic to pollen.
• Don't permit smoking in the car.

Outdoors

• Minimize walks in wooded areas or gardens.
• Check the forecast. Stay indoors as much as possible on hot, dry, windy days when pollen counts are generally the highest.
• Try to avoid extreme temperature changes -- they are triggers for some people with asthma.
• If possible, stay indoors between 5 and 10 a.m. when outdoor pollen counts are usually highest.
• Wear a mask (such as an inexpensive painter's mask) when mowing the lawn if you are allergic to grass pollen or mold. Avoid mowing and being around freshly cut grass if possible.
• Wear a mask when gardening, as flowers and some weeds release pollen and can cause allergy symptoms.
• Avoid raking leaves or working with hay or mulch if you are allergic to mold.
• After being outdoors, take a shower, wash your hair, and change your clothes to remove pollen that may have collected in your clothes and hair.
• To protect yourself from insect stings, wear shoes, long pants and sleeves, and do not wear scented deodorants, perfumes, shampoos, or hair products.
• Don't hang clothes or linens out to dry, as pollen and molds may collect in them and can make your allergies worse.

Traveling

• Pack your medicines with you in your carry-on bag.
• Bring an extra supply of medicines in case you need them.

Staying in a Hotel

• Ask for a nonsmoking room.
• Remove feather pillows and ask for synthetic, nonallergenic pillows -- or bring your own plastic pillow cover from home.
• If possible, keep the vent on the room air conditioner shut.

Dining

• Eat in smoke-free restaurants.
• For food allergies, avoid the foods that cause your allergy symptoms by carefully reading ingredient labels and asking about the food preparation methods when dining out. Choose fresh foods rather than prepared or processed foods. If you have severe reactions, such as anaphylaxis, carry an epinephrine injection kit with you at all times.

For Children in School

• Discuss your child's allergies with school personnel.
• If your child suffers from food allergies, discuss them with school officials, teachers, and lunchroom staff.
• Educate your child about his/her allergies early, so your child can learn to avoid situations where he or she may eat a food that will trigger an allergic reaction. Arrange for an epinephrine kit to be left at the school, and make sure school officials (and your child when they are old enough) are able to use it correctly.
• Inform school personnel about the medicines your child is taking and make arrangements to leave necessary medicines at school.
• Encourage sports participation, but inform coaches of medicines that may need to be taken before activities.

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Reviewed by the doctors at The Cleveland Clinic Department of Pulmonary, Allergy and Critical Care Medicine. www.clevelandclinic.org/pulmonary

Edited by Cynthia Haines, MD, WebMD, April 2005.

Resources

"Cooking for People with Food Allergies", Home and Garden Bulletin No.246, is available from the U.S. Department of Agriculture.

"Quaker Oats Allergy Cookbook" is from Quaker Oats Company, Merchandise Mart Plaza , Chicago , Illinois 60654 .

"Special Recipes and Allergy Aids" can be obtained from General Foods, Consumer Center , 250 North Street , White Plains , New York , 10625 .

The Food Allergy News Cookbook: A Collection of Recipes from Food Allergy News and Members of the Food Allergy Network by Anne Munoz-Furlong (editor), Chronimed Publishing, 1998 ISBN 0471346926. Allergy-free cooking can be challenging, stimulating and fun. This book is your comprehensive guide to understanding food allergies and learning how to eat properly. Enjoy cooking and creating tasty foods with a collection of 300 recipes.

For more information regarding food allergies for you and your family, check out www.foodallergy.org

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