Tips for Managing Specific Food Allergies
 Milk Allergy
Other names for milk proteins may include:
- Casein, caseinates, rennet casein
- Lactalbumin, lactalbumin phosphate, lactoglobulin, lactulose
Some hidden sources of milk:
- Many restaurants put butter on steaks after they have been grilled for extra flavor but the butter it is not visible after it melts.
- Some brands of tuna fish contain casein (a milk protein).
- Some meats contain casein as a binder – be sure to check the labels carefully.
- Deli meat slicers are frequently used for both meat and cheese products.
Commonly asked questions:
| Q: |
Is goat milk a safe alternative to cow milk? |
| A: |
No, it is not a safe alternative. Goat’s milk protein is similar to cow’s milk protein and may cause a reaction in milk-allergic individuals. |
| Q: |
Do these ingredients (Calcium lactate, Calcium stearoyl lactylate, Cocoa butter, Cream of tartar, Oleoresin, Sodium lactate, Sodium stearoyl lactylate, and Lactic acid) contain milk? |
| A: |
These ingredients do not contain milk protein and need not be restricted by someone avoiding milk. However, lactic acid starter culture may contain milk and should be avoided. |
 Egg Allergy
Other names for egg proteins may include:
- Albumin (also spelled albumen), and meringue or meringue powder.
Some hidden sources of egg:
- Some commercial brands of egg substitutes contain egg whites.
- For you coffee drinkers – be aware that, in some instances, eggs have been used to create the foam or milk topping on special coffee drinks and are used in some bar drinks.
- These items may include egg protein: artificial flavors: lecithin; macaroni; marzipan; marshmallows, and nougat.
- 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. But, as always, it is important to read the label or ask about the ingredients before eating pasta.
- Eggs are used in some salad dressings.
Commonly asked questions:
| Q: |
Is a flu shot safe for an individual with an egg allergy? |
| A: |
If you are allergic to eggs, speak to your doctor before receiving a flu shot. Influenza vaccines are grown on egg embryos and may contain a small amount of egg protein. |
 Peanut Allergy
Some hidden sources of peanuts:
- Arachis oil is peanut oil.
- Artificial nuts can be peanuts that have been de-flavored and re-flavored with a nutty taste, such as pecan or walnut.
- Peanut butter, peanut flour.
- Mandelonas are peanuts soaked in almond flavoring.
- Cold pressed, expelled or extruded peanut oil.
- African, Chinese, Indonesian, Mexican, Thai, and Vietnamese dishes often contain peanuts, or are contaminated with peanuts during preparation. Dishes to avoid include: baked goods; candy; chili; egg rolls; enchilada sauces; flavoring; marzipan; nougat, and sunflower seeds.
- Foods sold in bakeries and ice cream shops are often in contact with peanuts.
- Many brands of sunflower seeds are produced on equipment also used for peanuts.
- Keep in mind most experts recommend peanut-allergic individuals avoid tree nuts.
Commonly asked questions:
| Q: |
Can a peanut allergy be outgrown? |
| A: |
Recent studies indicate up to 20 percent of children diagnosed with a peanut allergy outgrow it. |
Note: Peanuts can be found in many foods – check all labels carefully as they can cause severe allergic reactions. If your doctor has prescribed epinephrine, be sure to carry it with you at all times. Individuals allergic to peanuts are often told to avoid tree nuts as well.
 Tree Nut Allergy
Some hidden sources of tree nuts:
- Artificial nuts can be peanuts that have been de-flavored and re-flavored with a nutty taste, such as a pecan or walnut.
- Mandelonas are peanuts soaked in almond flavoring.
- Mortadella may contain pistachios.
- Tree nuts have been used in many foods including barbecue sauces, cereals, crackers, and ice cream.
- Kick sacks, or hacky sacks, and bean bags are sometimes filled with nut shells.
Commonly asked questions:
| Q: |
Should coconut be avoided by someone with a tree nut allergy? |
| A: |
Coconuts are not usually restricted in the diet of an individual allergic to tree nuts. But some people have reacted to coconut, therefore, discuss this with your doctor before introducing it into your diet. |
| Q: |
Is nutmeg safe? |
| A: |
It is considered safe for someone who is allergic to tree nuts but, as always, consult your physician. |
| Q: |
Should water chestnuts be avoided? |
| A: |
They are not a nut but an edible portion of a plant root, and are considered safe for someone who is allergic to tree nuts. |
Note: Individuals allergic to specific tree nuts are advised to avoid all tree nuts and peanuts as well.
 Fish and/or Shellfish Allergy
Allergic reactions to fish and shellfish are commonly reported in both adults and children. Fish-allergic individuals should be cautious when eating away from home. You should avoid fish and seafood restaurants due to the potential risk of cross-contamination in the food-preparation area of your “non-fish” meal from a counter, spatula, cooking oil, fryer, or grill exposed to fish. Also, fish protein can become airborne during cooking and cause an allergic reaction – some individuals have had reactions from walking through a fish market.
Some hidden sources of fish/shellfish:
- Suriimi (imitation crab meat) contains fish.
- Caesar salad dressings and steak or Worcestershire sauce often contain anchovies.
- Caponata, a traditional sweet-and-sour Sicilian relish, can contain anchovies.
Commonly asked questions:
| Q: |
Should iodine be avoided by fish or shellfish-allergic individuals? |
| A: |
Allergy to iodine, allergy to radiocontrast material (used in some lab procedures), and allergy to fish or shellfish are not related. |
*Allergic reactions to fish and shellfish can be severe and are often a cause of anaphylaxis. 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.
Soy Allergy
Avoiding products made with soybeans can be difficult since soybeans have become a major part of processed food products. Keep in mind, soybeans and soy products are found in baked goods, canned tuna, cereal, crackers, infant formulas, sauces, and soups. Some brands of peanut butter list soy on their labels. Soy-allergic individuals should consult their doctor whether or not to avoid soybean oil and soy lecithin.
 Wheat Allergy
Some hidden sources of wheat:
- Keep in mind to read food labels carefully – some brands of hot dog buns and ice creams contain wheat.
- Some types of imitation crabmeat contain wheat.
- Wheat flour is sometimes flavored and shaped to look like pork, beef and shrimp, especially in Asian dishes.
- Many country-style wreaths are decorated with wheat products.
Commonly asked questions:
| Q: |
Are kamut and spelt safe alternatives to wheat? |
| A: |
No. Kamut is a cereal grain which is related to wheat. Claims that spelt is safe for wheat-allergic individuals are untrue. Wheat-allergic individuals can react as readily to spelt as they do to common wheat. |
Note: If you have food allergies, don’t be shy about asking restaurants, friends, or anyone else serving you food to list the food’s ingredients.
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Eight percent of children in the U.S. are estimated to be affected by food allergies, along with up to 2% of adults. The eight most common food allergens – milk, eggs, peanuts, tree nuts, soy, wheat, fish and shellfish – cause more than 90 percent of all food allergic reactions. However, many other foods have been identified as allergens for some people. Here are some tips to keep in mind.