More than 160 foods are known allergens, but only eight foods or food groups account for 90 percent of all serious allergic reactions in the United States. These foods include basics such as milk and eggs, and staples of a healthy diet like seafood. Whether you’re food shopping or eating out, always know your ingredients. Under the Food Allergen Labeling and Consumer Protection Act (FALCPA), labels have to identify the food source names of all ingredients that are among the eight “major food allergens.” The Food and Drug Administration warns that food allergens that aren’t ingredients can still be introduced through “cross-contact,” when different foods are processed using shared equipment. Look for “advisory labeling” that a food may contain allergen traces. When you bring groceries home, the American College of Allergy, Asthma & Immunology recommends setting up “allergy-friendly” shelves in the cupboard or refrigerator for easy access and to avoid cross-contamination. Here’s what you need to know about the eight major food allergens and how you can still have a well-rounded diet without them. Milk Having a milk allergy is not the same as being lactose intolerant. Allergies involve an immune system response, whereas intolerance means you aren’t able to fully digest a food – in this case, a sugar found in milk. Fortunately for people with a milk allergy, there are several substitute options. One of the most popular is soy milk. There are rice, oat, almond, and coconut milks; but check with a doctor before introducing almond or coconut milk in your diet, especially if you may have a tree nut allergy. There are also dairy-free margarines and cheeses. Some non-dairy foods contain the milk protein casein, so check the label. Eggs Avoiding eggs is tricky since they’re in everything from sauces to sweets. The term “egg substitute” can be misleading, as these products are meant to help control cholesterol, not allergies, and contain egg. There are egg replacement products containing no eggs that can be used in baking. If you want a substitute for a cooked egg, try tofu. “Many people who have been diagnosed with an egg allergy will make scrambled tofu in place of traditional scrambled eggs,” said Lauren Cohen, MS, RD, CDN, a registered dietitian and clinical nutritionist in northern New Jersey. Peanuts and Tree Nuts Peanut and tree nut allergies are very common, and the number of children in the United States with them continues to rise. While some kids outgrow them, these allergies tend to be life-long for most people. You can be allergic to one and not the other: Peanuts are legumes, like beans; while tree nuts include walnuts, almonds, cashews, and Brazil nuts. If you’re allergic to peanuts and want to replicate the flavor of peanut butter, Cohen suggests trying butters that are made with soybeans or sunflower seeds. Most, but not all, are free of tree nuts as well. People with tree nut allergies are often allergic to several kinds of nuts, so avoidance of all tree nuts is always best. Check ingredients very carefully because nuts can show up in a variety of foods, such as cereals, candies, and energy bars. Fish and Shellfish A person can be allergic to both fish and shellfish, even though there’s no cross-reactivity between them. “Some people with shellfish allergies may still be able to eat fish, therefore they can still enjoy tuna, salmon, tilapia or other fish,” said Cohen. Though people with a fish allergy may not be allergic to all types of fish, doctors generally advise avoidance of any fish. Besides avoiding finfish or shelled fish, always check ingredients for seafood. As Cohen points out, imitation shellfish products, such as mock crab or shrimp, may contain shellfish or fish. Fish like anchovies can turn up in sauces and salad dressings. Seafood is a great source of omega-3 fatty acids, which are good for heart and brain health. If you have to eliminate fish from your diet, be sure your diet includes other foods high in omega-3 such as eggs and dairy foods (as long as you’re not allergic to them), and leafy greens like spinach or kale. If you can’t eat seafood, which is low in fat and high in protein, other healthy protein-rich choices include poultry, low-fat dairy products, and beans. Soy A product of soybeans, soy is difficult to avoid. It’s found in everything from crackers, cereals, and baked goods to condiments, soups, and deli meats. Soy and soybeans may appear under other names or in different forms such as bean curd, edamame, miso (soybean paste), or tofu. There are many soy-free food products available in stores, but make sure they don’t contain any other potential allergens. Some people with a soy allergy are allergic to other legumes like beans, for example. Wheat A wheat allergy is different from celiac disease, a digestive disorder triggered by the gluten found in wheat, barley, rye, and sometimes oats. However, as a result of the rising awareness about celiac disease, the explosion in gluten-free food options means more wheat-free alternatives in supermarkets and on menus. People who are allergic to wheat usually can eat other grains, such as barley, buckwheat, and quinoa. For baking, there are non-wheat flour alternatives made from potato, rice, and sorghum. “There are many products out there that are manufactured specifically for people who need to avoid wheat,” said Cohen. But, as with any allergy, always check the ingredients carefully. If you’re in doubt, talk to your allergist.
