FOOD ALLERGIES

At least one third of all adults believe they have some sort of a food allergy, but true food allergies affects less than 2% of the population. Only five percent of young children are diagnosed with food allergies and many of those outgrow them by the time they reach adulthood.

To a small percentage of the population, food allergies can be fatal. In 1993, three Rhode Islander died as a result of allergic reactions to food; in two cases, the deaths resulted from foods prepared in a commercial food establishment. The individuals did not know they were eating foods to which they were allergic.
A food allergy is a violent reaction to an otherwise harmless food that involves the body's immune system. An allergen is any substance which produces an allergic reaction. The ten most common food allergens are:

Milk
Fish
Shellfish
Wheat
Eggs
Tree Nuts (i.e. Walnuts, Cashews)
Peanuts
Citrus
Melons
Strawberries
Soy

Allergic reactions can begin within minutes to a few hours after eating the problem food. However, in very sensitive individuals, just touching or smelling the food can result in an allergic reaction.

Most often, but not always, the symptoms of an allergic reaction begin with: a sensation that the lips and tongue are swelling; itching or tingling in the mouth; sensation of warmth; redness to the skin, hives; tightness in the throat; eyes may itch, water and swell; nausea, vomiting, cramping, diarrhea; Anaphylaxis occurs when several parts of the body have food-allergic reactions at the same time. This condition is rare, but can be fatal.

Symptoms of food allergy vary among individuals as to the severity, when they begin and the amount of food that is eaten. The same food can produce different reactions in different people and different foods can cause the same reaction in one person. Individuals with asthma appear to be at greater risk of food allergies.

Diagnosing and managing a food allergy requires medical treatment. Once the food allergy is confirmed through an examination including a complete medical history and a series of specialized tests, the only proven treatment is to avoid the offending food.

To eliminate the offending food from the diet it is necessary to read and understand food ingredient labels. By law, a list of ingredients in each food product should be listed on the label. Labels should be re-checked regularly as the ingredients in products change. Specific information about the ingredients is available from the company producing or processing the food product.

Foodservice establishments have a responsibility to provide correct and up to date information about food items on the menu. "Secret" ingredients which are considered allergens such as peanuts, nuts, eggs, milk, shellfish and fish should not be used in any food items.

Waitstaff should take customer inquires about allergies seriously. They should be familiar with all the ingredients in the food items on the menu and how they are prepared. For example, waitstaff should know the ingredients in a batter used to bread meats or fish. If the ingredients change, they should be advised of the change.

Avoid cross contamination during preparation of food items. Cross contamination is the transfer of one food ingredient to another food ingredient by a nonfood contact surface (i.e. human hands, cooking utensils). An individual had an allergic reaction when he ate a sandwich that had been made with a knife that had been used to make a peanut butter sandwich.

If a patron has a allergic reaction, respond quickly. Ask if there is a history of food allergies and check for a medical bracelet or necklace. In Rhode Island, the majority of individuals with this problem carry a syringe loaded with epinephrine (Epi Pen) which can be easily injected. Call 911 for immediate medical assistance. The sooner the reaction is treated, the less severe it will be. People have died because they have disregarded their symptoms.

Persons sensitive to these specific allergens should avoid the following foods/ingredients:

• Eggs
  • Albumin
  • Egg (including whites and yolk)
  • Eggnog
  • Mayonnaise and other dressings
  • Ovalvumin
  • Ovomucoid
  • Simplesse
  • Egg-based glaze on baked goods

   

• Fish
  • Anchovy (including anchovy paste)
  • Caviar
  • Fish byproducts
  • Imitation crab (surimi)
  • Roe
  • Oil used to fry fish would case a reaction

   

• Milk
  • Cream
  • Curds
  • Dry milk solids
  • Lactalbumin, lactalbumin phosphate
  • Lactose
  • Milk (derivative, protein, solids)
  • Artificial butter flavor
  • Butter, butter fat
  • Buttermilk
  • Casein, rennet casein
  • Cheese
  • Sour cream
  • Sour cream or milk solids
  • Caseinates (ammonium, calcium, magnesium, potassium, sodium)
  • Whey (delactosed, demineralized, protein concentrate)
  • Yogurt

   

• Peanuts
  • Peanuts
  • Cold pressed peanut oil
  • Mixed nuts
  • Nu-nuts flavored nuts
  • Peanut butter
  • Peanut flour
  • Foods containing peanut protein including
  • Chinese and Thai dishes - egg rolls
  • Baked goods-pastries, cookies, danish
  • Candy
  • Chili
  • Marzipan
  • Soups

   

• Tree-nuts
  • Almonds
  • Brazil nuts Cashews
  • Chestnuts
  • Filberts/hazelnuts
  • Hickory nuts
  • Giandiju (chocolate nut mix)
  • Macadamia nuts
  • Marzipan/Almond paste

 

Revised 5/00
University of Rhode Island
Cooperative Extension Food Safety Education