Food Allergies

For all you peanut allergic individuals, have you ever wondered about eating at restaurants that use peanut oil for cooking. Five Guys and Chick-fil-A are probably the two most well known examples. They use peanut oil in their fryers.

Cooking oils used by most restaurants, especially the big commercial franchises that use peanut oil, use a highly processed, refined peanut oil. Why is this important? The refining process involves high heat, deodorization, bleaching, purification, and other methods of processing to strip away the peanut proteins that are responsible for the allergic reaction to peanuts and leaves a purified, refined oil.

The peanut oils to avoid are often the gourmet peanut oils. These types of oils may have things like "cold-pressed," "natural," "unrefined," "gourmet" or "aromatic" on the labeling of the bottle. Found in the cooking oil aisles at supermarkets or specialty stores, these oils often forego the refining process and retain allergic proteins.

There are research studies that back up these findings, and the FDA makes specific note of oils in Food Allergen Labeling and Consumer Protection Act of 2004 (FALCPA) [Paragraph 1-201.10(B)]. So, if you are craving those fries cooked in the peanut oil, chances are you can probably feel safe eating them. Now, the only reasons to avoid Five Guys might be the actual peanuts in their restaurants or your expanding waistline.

Always inquire about the oil before ordering, and discuss with your allergist if you have any questions or reservations.

For more information on FDA guidelines concerning food allergens or for a convenient way to let restaurant staff know about your food allergies, try our convenient food allergy cards.

With Good Friday and Easter just around the corner, most of us are finishing the final preparations for either dinner, Easter egg hunt or some type of family activity. In my household, my parents would put together Easter baskets then hide them at night so in the morning we would wake up early and begin the hunt!

Fortunately for us boys, the Easter Bunny knew just what we liked. So he would go easy on the jelly beans and heavy on the Cadbury eggs for me while doing the exact opposite for one of my younger siblings. Sweets and candy weren't the only things that came with our Easter baskets. In every basket was a stuffed animal. Mostly rabbits, but often ducks or turtles, from small to large, there was always one in each basket. Another favorite was a pail with a small plastic shovel and rake (which is great for filling with rocks, making sandcastles or mudpies with later). Other times there might be a pack of toy cars, plastic army men or even oversized chalk (that my dad LOVED to see us use on the sidewalk in front of the house!). There was also, always, an outfit - usually a pair of shorts and a shirt. These types of things can serve two purposes. First, they certainly last much longer than a chocolate bunny, but for children affected by food allergies, they can keep the baskets fun without the focus on candy.

As we grew up and began families of our own we also started having an annual Easter Egg hunt. While there always were at least a dozen or two colored eggs, most of what was hidden were plastic eggs, and though no one in the family has food allergies, some of the things my mother did were a bit forward thinking in that regard.

Starting from just a couple dozen and expanding to nearly three hundred, mom would purchase hollow plastic eggs in a variety of sizes and colors. Some would hold candy, like a small packet of jelly beans, individually wrapped chocolates or packets of sweet tarts (a favorite of mine). She would also fill many with a variety of other things, that while not the intention, were very food allergy friendly.

Running around a massive three acre yard we would find colorful plastic eggs with stickers, rubber bouncy balls, or money. The ones with money were what we called the "jackpot eggs". Filled with anywhere from fifty cents to a whopping two bucks, the older we got, the more these eggs became priceless to us. Another fun idea is to put tickets in the eggs. Number the tickets to match with a corresponding, larger, prize that will prolong the anticipation. They could be redeemable or things like a larger stuffed animal, an inexpensive pair of earrings, an iTunes gift card or even events like a couple hours of bowling or roller skating.

Though we didn't do this, before the event, you can have the children help you decorate the eggs. In reality you can get as extravagant as you want, from using simple stickers to going as far as hot gluing beads or other decorations on each egg. Ribbon or paints can also be used. For real eggs, you can fall back on the trusty Paas coloring kit or even use packets of Kool-Aid to dye the eggs. (Oh, and PLEASE make sure you boil them first! You or your child will only make this mistake, once.) Again though, for children with food allergies, the plastic, or even a purely decorative wooden egg, is likely your best bet to avoid and potential problems.

If you put on your own Easter egg hunt, here's a few tips, coming from years of experience. There are easy hiding spots as well as more difficult ones, so cater to your age ranges. By placing as much or more emphasis on things OTHER than food and candy, you can subtly make the event more inclusive for all kids. Lastly, don't let things get too big. Even with six to twelve kids searching, three hundred eggs is... a bit much. If you don't keep track of exactly how many you had to start with, you might have another annual experience that we had, finding them with the lawn mower a few weeks later.

There is nothing quite like hearing the audible change in the sound of the mower as you buzz through a plastic egg, or watch the contents spew out of the mower into a thousand little slivers (particularly when it is a George Washington that was obliterated). Nearly as bad, if not worse, when you hit one of the real, boiled eggs, after it had been sitting in the yard for three weeks.

For many people, Easter is much like other holidays in that a big part of it is gathering with family or friends. While things like food allergies shouldn't be completely ignored, they do not have to dampen the fun. There are a variety of easy ways to be more inclusive and to ensure all the children and adults involved have an enjoyable time!

Author: Kevin Gilmore

This morning while I was getting ready for work, I had the NPR news app running on my iPad. I like to listen to it since it's short enough but broad enough that it at least gives me quick roundup of some of the headlines of the day. One of the stories that caught my attention was one about the use of a yellow rice. This yellow rice, "golden rice," is not a natural food. It has been genetically modified to contain high amounts of beta-carotene, hence the color. On its face, this sounds like a good idea. In areas across Asia and Africa, millions of people do not get enough vitamin A in their diet, and beta-carotene is a primary source of this nutrient. What I wondered was how a food like this plays into the food allergy conversation.

Yesterday I came across a very in-depth article in the NYT about a large food allergy study/experiment on children who were highly allergic to multiple foods. Through oral immunotherapy a doctor was able to raise the tolerance of children to multiple food allergens to the point where they could again safely interact and grow up more like normal children. Some of the cases were extremely severe, to the point where even crumbs or traces of food allergens would send some of these children into anaphylactic shock - a nightmare scenario for any parent. Foods like wheat, dairy, nuts, and the usual suspects were actors in this play, but what struck me was the unspoken reality that accompanies the rise in food allergies - no one knows exactly why. So with such a big question mark, I wondered how does this relate to the "golden rice"?

There are many theories about the causes of allergies, and while the most popular, the "hygiene theory" does seem to hold some water when it comes to respiratory allergies like rhinitis, hay fever, and sinusitis, it meets a serious challenge when you try to apply it to food allergies. Studies have shown that children raised on farms or environments that are a little more germ-friendly than the typical suburban American household do show lower instances of allergies and asthma. However, in even these places, respiratory allergies are still increasing, and food allergies are rising at a much higher rate.

So why? Why is the food that has sustained the human race for centuries now threatening the lives of so many of our youth? Dr. Nadeau from the NYT piece leans away from the hygiene theory and more towards the chemicals and toxins that saturate modern life. The idea is that environmental factors damage genes or transform them at a very fast rate. These genes are then passed down, which could explain why children of parents with allergies are much more likely to have allergies.

There is some evidence to support this theory - research pieces that show higher rates of allergies in children when allergic parents as well as others that demonstrate the development of food allergies in children who have immigrated with their parents and adopted a "western diet" (even when there is no parental history of allergies).

This brings me back to the "golden rice". I understand the potential of such a crop, but I also understand some of the dangers commonly levied against genetically modified foods. (FYI, a quick look through your pantry will likely reveal that about 30% of the processed foods you find have genetically modified substances in them.) Brushing these aside and focusing only on the allergy aspect, I keep coming back to a singular question. We do not know why many of the foods that we eat are threatening the lives of more and more children every year, so is it wise to push ahead by adding yet another variable into the mix? We have yet to figure out why the foods we currently eat are affecting food allergies and would most certainly have even less knowledge as to how these new foods could play into that mix.

When turn this question over in my head, I think of a chef who can't figure out why his dish turned out tasting so poorly, but instead of working his way back, eliminating ingredients and trying to find the culprit in the recipe, he simply adds more ingredients and hopes for the best.

To read the full NYT Oral Immunotherapy Story or the NPR story about "golden rice".

Author: K. Gilmore

When it comes to allergies, rarely are they isolated or singular. Often there are groupings, like allergen punches in bunches, that can affect the body. Peanut allergy sufferers are often allergic to other types of tree nuts, or those allergic to ragweed pollen are also likely affected by dust mites. But more than being multi-allergenic, cross reactivity is also an issue for many allergy sufferers. Cross-reactivity is the body's immune system mistaking a similar protein or chemical as one it typically has a reaction to, and most people see this reaction with food.

So what are some common cross reactive allergens? Birch is one of the biggest culprits. A protein found in apple peels is very closely related to one found in birch, and this means the body can sometimes confuse the two. You may be diagnosed with an allergy to birch, but then, while eating a raw apple, you might experience tingling, swelling or itching around the mouth and lips. This type of symptom is most common for people with cross reactions to foods. Another example of this is with grass pollens and seemingly unrelated foods like kiwis, tomatoes, or peanuts. Sometimes referred to as "latex-fruit syndrome," a third common cross-reaction stems from a latex allergy and a sensitivity to certain fruits like bananas and kiwi.

Unfortunately, the problem with this can be felt year round. So while your spring allergy season may play hell on your birch pollen allergy, a reaction to eating fresh apples is likely to appear regardless of the season.

Challenges in identifying and categorizing these reactions can be difficult and cause false positive test results. Common allergen tests, like the skin prick test, can reveal a sensitivity to a particular allergen, potentially a cross reactive food, but then lead to a diagnosis of a full blown allergy to this food. Cross-reactivity does not mean that someone will have a reaction to ALL types of food that share a particular, similar protein. Because of this, eliminating an entire class of foods from the diet because of cross reactivity can sometimes be a bit unwarranted, though not uncommon.

One interesting away around this can be by cooking foods. While the cross reactions can be common when it comes to fresh food, cooked food often alters the proteins enough that the body no longer misidentifies them. This is not always the case (particularly with a cross-reaction to nuts), but this does explain why someone with a birch pollen allergy can feel a tingling in the lips and mouth when eating a fresh apple but experience no symptom at all when eating apple cobbler or drinking apple cider.

Without a doubt, cross reactivity complicates our understanding of allergies and the allergic response. Yet, solving the problem of allergies can't be solved until more is known, and cross reactivity is just another part of puzzle. If you think you may be cross-reactive, talk to your doctor or allergist. While the knowledge in this area is still rapidly expanding, he may be able to help further pinpoint the actual cause of the issue.

Author: K. Gilmore

With the Olympics in full swing, millions around the world watch each day as athletes from across the globe compete. For those of us who sometimes feel that allergies and asthma are a problem we deal with on our own, it is always a good idea to take note of how others who cope with these conditions continue to push and achieve. There are numerous athletes who have overcome allergies or asthma to shine in the Olympics, and perhaps Dana Vollmer is the brightest star in group.

After struggling for years with a variety of ailments, including shoulder problems and a heart condition that required surgery in 2003, Vollmer continued to excel by winning gold as a member of the U.S. 4x200 freestyle team in 2004 and again in 2007. In 2010, Vollmer had to drop out of a race she had traditionally swum due to fatigue and unexplained stomach pains severe enough to put in her in hospital on three separate occasions.

With no medical explanations for her condition, Vollmer was tested for allergies and food sensitivities. The results showed that one of the staples in her diet, eggs, may have been causing her problems. Vollmer was allergic to eggs, and was sensitive to gluten, dairy, and walnuts.

After changing her diet, she began to notice her energy was returning and stomach pains were going away. Like in 2004, Vollmer qualified for the women's U.S. Olympic swim team. Just days ago, Vollmer swam in the final of the 100-meter butterfly, and bested the world record and won the gold. From health issues and failing to qualify for the Beijing games, to feeling better and winning Olympic gold, Dana Vollmer's story highlights a few important things for those who suffer from food allergies. Food allergies can affect anyone, including Olympic athletes, and their impact can slow even world-class swimmers. However, proper diagnosis and management of food allergies can mean the difference between feeling poorly and performing at your best, when it matters the most.

Author: Kevin Gilmore

Despite the topsy-turvy weather, I hope this summer is treating everyone well.  Children are out of school, families are going on vacation, and people should be enjoying the outdoors and all that summer has to offer.  For those with allergies, summer provides something of a break from the spring and fall pollen seasons, but the season can present new challenges.  A recent trip to a Saturday farmer's market held a local church highlighted one of these challenges for my friend "Gabe."

Now, Gabe isn't his real name, but he was  bit embarrassed by the whole ordeal, so I offered to give him a suitable cover name.  In any event, Gabe, another friend of ours, and I were at the local market last Saturday looking for fresh fruits and veggies.  I'm a big fan of summer tomatoes, and my single plant doesn't seem to be producing enough to satisfy.  Gabe had picked out a couple quarts of fresh picked strawberries and a few genuine Georgia peaches.

As we are heading home, as often happens, our new purchases prove to be too tempting to wait.  About a block from the house, I happen to look over at Gabe, who has already dispatched a half a quart of his strawberries, and I was almost certain his lips looked... puffy.  I continue towards the house and ask, "Gabe, you have allergies, right?"  He rattles off a short list of things he's allergic too, not noticing the slight swelling that's going on just under his nose.

When we get to the house, I turn to Gabe and simply tell him.  "Put down the strawberry."  And after a little prompting he pulled down the sun visor and looked at himself in the small mirror.  We all went inside, and Gabe took some Benadryl, and within the hour his swelling has nearly completely cleared up.

Though Gabe does have allergies, he was unaware that strawberries was on his list, and thankfully for all of us, his reaction wasn't so severe that it required an Epipen or a trip to the ER.  This does highlight something common among allergy sufferers.  Allergies are rarely a "one and done" deal.  Most who suffer from allergies are affected by multiple allergens, and not all of them will be immediately known.  For all the research and testing that goes into the field of allergies, there is still much that is unknown, particularly why they occur, why they sometimes go away, and why sometimes, new ones just seem to crop up.

For severe allergy sufferers, it is always a good idea to remain aware of what you are eating, and it never hurts to have an Epipen handy.  Though this won't discourage Gabe from going to the farmer's market with us another weekend, it does mean he'll likely be sticking to the peaches for a while.  As for me, I won't complain about a free quart of strawberries that Gabe gifted me after the incident.

Author: Kevin Gilmore

For anyone with severe food allergies, one of the most basic needs can feel like a perpetual challenge - eating. Eating out is a near constant worry, and even preparing your own meals can be difficult, particularly when first diagnosed and trying to come up with safe, healthy alternatives. As food allergies have dramatically increased in occurrence and awareness, there has been a variety of companies spring up to help meet the needs of this growing population. Tailored and specially designed foods, free of allergens, are growing in popularity, but it can still be daunting in trying to select the right products for your needs.

A friend of mine recently introduced me to Pamela's Products. Tracing its history as a offshoot of a family health food bakery in the early 1940's, Pamela's Products specializes in gluten-free foods. More than that, they also specialize in allergen free food and recipes. Allergy information is posted so you can check before you try.

As with any new recipe or food product, I always suggest trying it out before jumping all the way in. You can find many of Pamela's Products in brick and mortar stores like Whole Foods and even supermarket chains or order larger quantities online.

Do you have any specific recipes you want to share for food allergy sufferers? Leave a comment and we'll post it!

Dining out with food allergies can be a very daunting task. A quick search for online articles about dining out and food allergies reveals stories that range from some discomfort on the drive home to consequences far more severe.

Part of the reason why eating out can be so difficult for food allergy sufferers is that while YOU know about your allergy, the staff that prepares your food does not. Complicating matters even more, food is generally not prepared by only one person. So any given dish may have as many as 2-4 people, including a server who have some contact with your meal. Further complicating the matter is that with some very severe allergies, any contact with the allergen can have dramatic consequences.

So what can you do? You can avoid eating out, and for those with very severe allergies, that is likely the best alternative. You can try food allergy cards. While they are not a comprehensive solution, they do quickly and conveniently let your server and staff know about your food allergy in advance.

Another alternative is to select your dining choice carefully. As awareness of food allergies grows, so does the response by the food service industry. Even some state legislatures have begun to require certain training and staff at restaurants to help create a safer environment for all diners. While Massachusetts is currently the only state to require specific allergy training, Rhode Island is soon to join them. Even some large chains have begun to move in this direction.

Noted recently in a Wall Street Journal article, The Melting Pot has taken very specific actions in regard to customers with food allergies. From separate food preparation and serving dishes to staff training and sanitization procedures, The Melting Pot is attempting to cater to an ever growing clientele with food allergies.

While food allergy training and transparency about the ingredients used in dishes is growing, there are still hurdles to overcome. As noted in the WSJ article, Domino's rolled out a gluten-free pizza. The problem is that the designation as gluten-free couldn't actually be proven. Facing the same and likely largest hurdle when it comes to dealing with food allergies in restaurants, Domino's couldn't ensure that no cross-contamination would occur.

Short of eliminating common reaction inducing foods, like wheat, peanuts, dairy, tree nuts, shellfish, and eggs, restaurants are struggling with cross-contamination issues. Take a fryer for instance. If you deep fry something breaded then follow that with french fries for a customer who has a severe wheat allergy, there can be serious trouble ahead. For severe allergies, even trace amounts of the allergen can create a life or death situation.

So we come back to, what can you do? As the number of food allergy sufferers increases annually, the best answer is prepare and remain vigilant. Restaurateurs continue to adapt and change to serve the needs of this growing population, but they remain far their goal. As individual, prepare for the worst, but with careful planning and open communication with your server and the restaurant staff, you can avoid or at least minimize the risk of having the "dining experience from hell."

Author: Kevin Gilmore

For parents of children with food allergies, having and EpiPen/auto-injector on hand is almost second nature. With severe food allergies the risk of anaphylactic shock after exposure to the offending food allergen makes having and EpiPen nearby and easily accessible a necessity. Schools are generally responsive to the needs of children with food allergies, but laws governing the handling of EpiPens and food allergies are different from state to state. On Thursday, VA Governor Bob McDonnell is set to sign a bill that would require Virginia school to carry auto-injectors and train staff on their use.

Shortly after the death of a 7-year-old in VA in January, legislation was put forth that would require schools to stock EpiPens and train staffers on their use. Similar laws have been passed in Illinois and Georgia.

In November, Senators Dick Durbin and Mark Kirk introduced legislation that would provide incentives for schools across the nation to provide access to and stock auto-injectors in schools. While most states allows students to self-administer epinephrine, nearly twenty-five of all anaphylaxis cases in schools involve students with no prior history of food allergies. Laws like this and those passed at the state level aim to remedy that.

Auto-injectors administer a measured dose of epinephrine, an effective countermeasure to anaphylactic shock. Most often EpiPens are associated with those who have severe food allergies, but they are effective for anyone suffering from a severe allergy that can cause anaphylaxis.

While it often takes a tragedy before meaningful and lasting action is taken, this does not have to be the case. On a personal level, take control of potential life-threatening allergies and keep you local school informed. On a larger level, working with food and other allergy networks and advocacy groups (like those listed in our Allergy Resource section on this page) can not only spread awareness but ultimately influence legislation and enact minor but critical changes.

Though milk is often fortified with vitamin D, from grade school health classes on we've learned that much of the vitamin D we receive is from exposure to sunlight. In addition to keeping bones strong and healthy, vitamin D and sunlight may play an important role in the development of food allergies and eczema.

A recent collaborative study between European and British researchers has found an association between exposure to sunlight and the development of food allergies and eczema.

Focusing on Australia, researchers were able to study a wide variety of climates and regions with widely varying amounts of sunlight. In areas with less sunlight (the southern part of the country), they found that children were nearly twice as likely to develop allergies to eggs and peanuts or eczema.

While this research is still in the early stages, it gives some early indications as to what may be behind these increasingly common conditions, and more importantly, how to possibly prevent them in the future.