Six Safety Tips for Living with Food Allergies

Having food allergies doesn't mean you need to give up healthy eating or the social benefits of eating out with friends and family, you just need to know the ways to prevent a potentially life-threatening allergic response.

The server approaches your table. You tell him you have a gluten allergy. He looks puzzled. And suddenly, you lose your appetite.

For people living with food allergies, dining out—or eating any meal, anywhere—can bring a level of stress that people without food allergies will have difficulty understanding fully. Some people even believe food allergies aren’t real. But they are. And they can be life-threatening. But with care and attention people with food allergies can enjoy the nutrition of healthy eating and the social benefits that come from sharing a good meal with friends and family.

For example, if someone with a peanut allergy eats anything that’s made with peanuts, contains peanuts or is baked in peanut oil, the potential exists for anaphylaxis (a severe allergic reaction). Signs can include swelling of the lips, tongue or airways, hives, itching, shortness of breath, stomach pain, dizziness, fainting and vomiting that can be so violent it could cause an esophageal tear.

“While an anaphylactic symptom such as severe vomiting is relatively uncommon, it absolutely can happen,” says Jefferson allergist and immunologist Dr. John Cohn, who is the parent of a child with a peanut allergy.

Infographic depicting top major food allergens

Unpacking the food allergy mystery
If you’re hearing more about food allergies in the news recently, it’s no surprise. A study published in the medical journal JAMA in January 2019 estimated that more than 26 million U.S. adults (about 11%  of the total U.S. population) have a food allergy.

And while peanuts get the lion’s share of attention when it comes to food allergies, the U.S. Food & Drug Administration (FDA) requires that these “top nine” allergens appear in plain language on manufactured food packages:

  • Cow’s Milk
  • Eggs
  • Fish
  • Shellfish
  • Tree nuts
  • Wheat (gluten)
  • Peanuts
  • Soybean
  • Sesame

Sesame is the newest on the FDA’s list, with prevalence rates similar to that of soy and pistachio.

While there is no single reason for the increase in the amount of food allergies, knowing which foods you may have be allergic to is an essential first step. In some cases, people who are diagnosed with one allergy—for example, a soy allergy—as a child may find they have allergies to other foods as they grow older. Other people may find they now are able to eat foods that troubled them as a child.

It’s important to know the difference between food allergies and food intolerance. A food intolerance may cause nausea, heartburn, stomach discomfort or nausea, but won’t include anaphylactic symptoms.

“The best way to know if you have a food allergy is to have evaluation by an allergy specialist who can review the patient’s history and perform appropriate skin tests and/or blood tests to identify food allergies,” Dr. Cohn says.

Inforgraphic with food allergy basics

Six safe secrets to living with food allergies
Once you know if you have a food allergy—and to which foods you are allergic—you can take steps to prevent a potential life-threatening allergic response. Dr. Cohn offers these six tips:

  1. Avoid any food to which you are allergic at all times, unless your allergist directs otherwise.
  2. Know all names for that food. For example, cow’s milk may also appear as casein on labels. Foods seasoned with tahini actually contain sesame (tahini is made with sesame seeds).
  3. Know all the risks. For example, peanuts are in the legume family, different from tree nuts, but developing allergies to both is not uncommon. Cooked foods may be tolerated even though partially cooked or raw versions may cause symptoms. Cooked foods may “taste” differently to your immune system, too.
  4. Tell people about your food allergies. This includes restaurant servers and any friends or family members who may be preparing food for you. If you’re dining out and you think your server doesn’t understand your particular food allergy, explain it to them, or ask for a manager or the cook.
  5. Know the signs of a reaction (lip swelling, hives, trouble breathing) and get to an emergency room or call 9-1-1 as soon as possible.
  6. Travel wisely. If suggested by your doctor, always carry an epinephrine injector with you at home, at work and on any trips. If you travel abroad, know the language of the country you’re visiting so you can identify allergens on restaurant menus.

Living with a food allergy may not always be easy. But these six tips can help you create a safer environment and help you avoid potential pitfalls.

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