A suspected food allergy can often be frustrating, confusing, and even dangerous. The CDC estimates 4% of adults and about 4-6% of children suffer from food allergies. Allergies can even change over time, leading to even more frustration. Asthma Allergy Centre in Tigard, OR can help you navigate all of your allergy questions through comprehensive food allergy testing. We can diagnose and treat your allergies to give you a greater quality of life daily.
What Is an Allergy?
An allergy is the body’s immune system reacting to a foreign substance (food or environmental) by creating antibodies. For your body to create antibodies, it must be exposed to the substance more than once. Each time you are exposed to the allergen your body will fight it using those antibodies, resulting in an allergic reaction.
Reactions may not always be the same. They may increase or decrease in severity, and there is no way to determine exactly how you will react. The best defense is to avoid potential allergens altogether.
The Top 8
Even though people can develop an allergy to anything that is ingested, most food allergies are caused by eight common foods. However, people can develop allergies to many many more foods than just the top 8, so never rule anything out without an allergy test and a discussion with a qualified health professional.
The top 8 food allergies are dairy, eggs, tree nuts, peanuts, shellfish, wheat, soy, and fish. These 8 foods account for 90% of all allergic reactions.
Dairy
Dairy allergies are one of the most common allergies in babies and very young children. Most children will outgrow their dairy allergy by the time they are school age, but this is not true for everyone. People with a dairy allergy usually cannot tolerate dairy from any animal including cows, goats, and sheep.
It is important to note that a dairy allergy is not the same thing as lactose intolerance; someone with a dairy allergy would still react to lactose-free milk. Dairy is a challenging food to avoid because it is found in so many foods. The obvious things to avoid include:
- Milk
- Cheese
- Butter
- Creams
- Coffee creamer
- Custard/pudding
- Sour cream
- Whipped topping
- Yogurt
Ingredients derived from dairy can often be difficult to identify. Avoid foods with these ingredients listed:
- Casein/caseinates
- Whey
- Curds
- Custard
- Ghee
- Hydrolysates
- Kefir
- Koumiss
- Lactalbumin
- Lactalbumin phosphate
- Lactoglobulin
- Lactose/lactulose
- Nougat
- Paneer
- Pudding
Dairy can also be found in a variety of places you may not think to look. Double-check the ingredients in these foods which are commonly found to contain dairy ingredients:
- Spice packets
- Chicken broth
- Bread
- Lunch/deli meat
- Hot dogs
- Chocolate
- Caramel
- Chewing gum
- Baking mixes
If a product has Kosher labeling, this can help you identify if it is dairy-free. According to Kosher dietary laws, meat products must never be mixed with dairy or dairy derivatives. This means if your hot dogs have a Kosher label, they are safe for someone with a dairy allergy. Kosher pareve products cannot contain dairy, meat, or any derivatives. If your food is labeled Pareve, Parev, or Parve, then it is safe to consume.
Alternatives to dairy are growing exponentially. Oat milk, Ripple milk, almond milk, rice milk, and coconut milk are all excellent choices to replace dairy. Brands such as Violife, Follow Your Heart, Daiya, Chao, and So Delicious all have an amazing selection of dairy-free alternatives for you to enjoy!
Eggs
Egg allergies are most common in children and are extremely rare in adults. Some children with an egg allergy may be able to tolerate only the yolk of the egg, or may even be able to eat foods with eggs baked into them. It is important to work with an allergist to determine the level of egg allergy so you can have as many food options available to you as possible.
Egg alternatives are also becoming more and more common. Just Egg is an excellent egg replacement for scrambled eggs. To replace eggs in baking, you can purchase an egg replacement such as Bob’s Red Mill Egg Replacer, or you can use a mixture of flax seeds or chia seeds and water. Applesauce and bananas can also be used to replace eggs in baked goods. Don’t be afraid to experiment in the kitchen to discover what works best for you!
Tree Nuts
Tree nuts include almonds, Brazil nuts, cashews, hazelnuts, pecans, pistachios, and walnuts. You may be allergic to all of them or just one, but because they are so closely related, they are all included under one allergy classification. According to the FDA, coconuts are also classified as a tree nut. However, most people with tree nut allergies can tolerate coconut without any problems.
Peanuts
Peanuts are the most common food allergy in children, and it is less likely your child will outgrow their peanut allergy than their dairy, egg, wheat, or soy allergy. While peanuts are generally fairly easy to identify and avoid, make sure to double-check what type of oil is used in fried foods.
Chik-Fil-A and Five Guys, for example, use peanut oil to cook their french fries, which could cause a reaction for someone with an allergy.
Shellfish
Shellfish allergies are related to crustaceans and mollusks, such as shrimp, lobster, crab, or crawfish. This allergy is the most common food allergy in adults; about 60% of people with a shellfish allergy have their first reaction as an adult.
Wheat
Wheat allergies are most common in children and are generally outgrown by the time children reach school age. Wheat allergies should not be confused with Celiac disease or gluten intolerance. Unlike Celiac disease, people with a wheat allergy will not experience any permanent damage as long as their allergic reaction is immediately treated.
People with a wheat allergy to not need to avoid all types of gluten, and can usually safely eat barley and rye. Wheat is commonly found in other grains as cross-contamination, so it is important to double-check labels of things like oats to ensure they are completely free of wheat.
Soy
Soy allergies are common in both children and adults. Most children will outgrow their soy allergy by the age of 10. Be sure to avoid all forms of soy, including soy oil, soy sauce, soya, and soy protein. Soy can also be labeled as:
- Tofu
- Edamame
- Tamari
- Miso
- Tempeh
- Natto
- Shoyu
- Textured vegetable protein (TVP)
Fish
60% of people experience their first reaction to fish as a child, and it is not likely to be outgrown. Fish allergies can be more likely to cause severe reactions than other allergies, so it is extremely important to be mindful of accidental exposure.
Most people who are allergic to one type of fish are also allergic to other types. Working with an allergist can help you determine what types of fish to avoid and which may be safe to try.
Sesame
While sesame is not technically a top 8 allergy, it is still fairly common, especially in children. The prevalence of sesame allergies seems to be rising, earning it a spot as the #9 most common food allergy. It is estimated only about 20-30% of children who have a sesame allergy will outgrow it.
It is important to note that foods containing sesame are not required to have an allergy warning label, so it is very important to be vigilant when checking ingredients for sesame. Sesame can be listed as:
- Tahini
- Sesame oil
- Benne/benniseed
- Gingelly
- Gomasio
- Halvah
- Sesamo
- Sesamum indicum
- Sim
- Til
What Is Food Allergy Testing?
Food allergy testing is done in a doctor’s office with an allergy specialist to help determine what foods you may be allergic too. It can be hard to pinpoint specific allergies just from monitoring symptoms alone, so if you suspect you may have a food allergy it is best to speak with a professional to confirm your allergy.
Testing for food allergies may be done through a blood test or a skin prick test. A skin prick test is the fastest way to get results, but a blood test may be done if other factors may prevent a skin prick test (such as a skin rash or antihistamine usage). Neither test can tell you with 100% accuracy what foods you are allergic too, but interpreting the results in conjunction with your symptoms can help identify foods that should be avoided.
Oral food challenges and food elimination diets can also help determine if an allergy exists or if it has been outgrown. These options should always be utilized in conjunction with a healthcare professional who can help you make a plan and accurately interpret the results.
What Is Cross-Contamination?
Cross-contamination can occur when foods come in contact with potential allergens through the manufacturing or packing process. Cross-contamination can even occur where crops are being grown. Some brands of oats are not suitable for people with a wheat allergy due to their proximity to wheat fields.
It is important to check the labels on everything you buy to ensure the product is naturally free from your allergen, as well as free from potential cross-contamination. All food packaging is required to place a warning label if there is a potential for cross-contamination with the top 8 food allergies.
When Do Food Allergies Develop?
Food allergies can develop at any time throughout your life. Many children develop allergies shortly after birth, but then outgrow them by their early childhood years. Adults can develop allergies later in life to foods they have always eaten safely.
There is no way to determine who will develop allergies or when they will appear, but there is some evidence that a family history of food allergies is a good predictor for allergies in children. This is still being studied.
What Are the Signs of an Allergic Reaction?
Allergic reactions can differ significantly between individuals, depending on the level of the allergy. Allergic reactions can be immediate, or they can be delayed up to a few hours after exposure to the allergen. Symptoms of an allergic reaction include:
- Hives
- Stomach pain
- Difficulty breathing
- Swelling of the tongue
- Swelling of the head/neck/face
- Itchy rash
- Vomiting
- Diarrhea
- Low blood pressure
In extremely severe cases, food allergies can cause anaphylaxis. Symptoms of anaphylaxis are similar to those of an allergic reaction, but come on very quickly. These most commonly include rash, low blood pressure, vomiting, swelling, and difficulty breathing. Anaphylaxis can cause loss of consciousness and is life-threatening if not treated immediately. Always call 911 immediately if someone is having a suspected anaphylactic reaction.
What Are The Treatments for an Allergic Reaction?
Severe allergic reactions (anaphylaxis) should be immediately treated with a shot of epinephrine, commonly known as an EpiPen. Anaphylaxis can turn deadly very quickly, so it is important to react swiftly in the event of a suspected anaphylactic reaction. Paramedics should be called for immediate follow-up treatment. One shot of epinephrine is not always enough to stop anaphylaxis; once in the care of professionals, an IV of epinephrine may be given, along with glucocorticoid and antihistamines.
In the case of a less severe reaction, antihistamines may be given to reduce itching or hives associated with a reaction. It is important to note that most antihistamines are not recommended for children under the age of two, so be sure to speak with your pediatrician about the proper steps to take if your infant or toddler experiences an allergic reaction. Other symptoms may be treated with oral cromolyn, but this is not available over the counter and must be prescribed by your physician.
Find Out More About Your Allergies
Allergic reactions can be very scary and can happen even when every precaution is taken to avoid known allergies. For the best defense against food allergies, visit us at Asthma Allergy Centre in Tigard, OR as soon as possible to identify and treat your allergies through food allergy testing.
