How to Recognize, Avoid, and Treat Food Allergies

Food allergies likely are caused by an interplay of genetics and environment. Children who have a parent with allergies are more likely to also have allergies — but they may be allergic to different irritants than their parent. In some cases, they may not inherit allergies at all.

Allergies are an immune response that can affect multiple organs. Eating just a microscopic amount of the allergen or even touching or inhaling it can set off a reaction. While some reactions are mild, some are severe. Unfortunately, every three minutes, a food allergy sends someone to the emergency room.

Those with severe allergies will likely be prescribed an epinephrine autoinjector (such as an EpiPen). For those with minor reactions, over-the-counter or prescribed antihistamines may reduce symptoms.

When caring for a loved one with known allergies, make sure you know their allergens, their medications, and how to administer them. An emergency room visit may still be necessary, especially after a severe episode.

A food intolerance or sensitivity is generally not life-threatening. It typically only affects the digestive tract. And while people with a food intolerance should avoid the offending food, some people may be able to eat a small amount and not have any issues.

There are 32 million people in the U.S. with food allergies, according to Food Allergy Research and Education (FARE). That's nearly 11 percent of people over the age of 18 and 8 percent of kids.

How to Diagnose Allergies

To diagnose a true allergy a doctor will supervise one of the following tests:
Skin test: A drop of liquid containing an extract of the suspected food irritant is placed on the skin with a light prick. If a raised bump appears, chances are the person is allergic to the food.
Blood test: Blood is drawn after the person eats the suspected allergen. A lab tests the blood for immunoglobulin E (IgE), an allergen-related antibody, which indicates an immune response to the allergen.
Oral food challenge: The person eats or drinks a small portion of the offending food in increasing amounts over time and monitors for reactions.

Signs & Symptoms of Food Allergies

Signs and symptoms can appear anywhere from within minutes to a couple of hours (less common) after consuming the offending food. Symptoms include:

• Vomiting, diarrhea, and/or stomach cramps
• Hives/rash
• Flushed skin
• Itchy or tingling mouth
• Swollen lips, tongue, face, throat, and/or vocal chords
• Shortness of breath
• Coughing or wheezing
• Drop in blood pressure
• Tight, hoarse throat; trouble swallowing or talking
• Difficulty breathing
• Weak pulse
• Pale or blue color to skin
• Dizziness, light-headedness, and/or feeling faint

The Big 8 Allergies

More than 160 foods can be considered allergens, but just eight account for 90 percent of allergic reactions, according to the United States Department of Agriculture. These foods, and any proteins derived from them, must be labeled on food packaging.

Keep an eye out for sneaky places allergens hide. Always check ingredient lists. When in doubt, call the manufacturer. Luckily, there are smart swaps for the big eight allergens:

Fish & Shellfish

Many condiments can be made with fish and shellfish. Replace fish sauce with a vegan alternative. And watch out for soups and sauces made with fish and/or seafood broths and stocks or bonito flakes. Use vegetable-based stocks and broths instead.

Dairy Milk

Swap it for nut, soy, rice, oat, or hemp milks. There are now many vegan dairy products, including yogurt, on the market.

Peanuts & Tree Nuts

Since peanuts are a legume and not a tree nut, people who are allergic to peanuts often can safely consume tree nuts and vice versa. Peanut butter and almond butter are great substitutions for each other.

Eggs

Try store-bought egg replacers, such as Ener-G Egg Replacer, The Neat Egg, or Bob's Red Mill Egg Replacer. Baking? Give aquafaba a try: It's the liquid drained from a can of chickpeas. Whip it until it reaches a meringue-like texture, then fold into recipes for baked goods. Or stir together 3 tablespoons water and 1 tablespoon flaxseed meal. Let it sit for a few minutes until the texture mimics a beaten egg.

Wheat

There are many wheat-free flours on the market: rice, brown, millet, potato, soy, and tapioca. Find wheat-free bread and crackers in the health food section of your grocery store.

Soy

Replace soybean oil with canola oil. Remember that vegetable oils can sometimes contain soy. Use coconut aminos in place of soy sauce.

Is There a Cure for Allergies?

Sadly, there are no known cures for food allergies. The good news, though, is that allergies can be outgrown, and their severity can change over time. According to the Mayo Clinic, 60 to 80 percent of children with milk and egg allergies no longer have them by age 16. But only about 20 percent of kids with peanut allergies have the same good fortune.

Peanut Allergy Prevention

Introducing babies to peanuts can help prevent peanut allergies from developing later on, according to Massachusetts General Hospital. Talk to your doctor first, who may suggest the baby be tested. To safely introduce a baby to peanuts, Massachusetts General Hospital recommends mixing smooth, all-natural peanut butter with an equal amount of fruit or veggie purée, then watch for signs of a reaction for at least two hours.

Beware of At-Home Allergy Kits

Several at-home allergy kits on the market promise to tell users what foods they should avoid by detecting antibodies. But these kits often only detect immunoglobulin G (IgG) antibodies, and the American Academy of Allergy, Asthma, and Immunology (AAAAI) does not support using IgG testing to determine food allergies and intolerances. These allergy kits are not approved by the Food and Drug Administration, either. To determine an allergic response, IgE antibodies must be detected. The presence of IgG antibodies is often a normal immune response to food exposure, the AAAAI says.

Many allergy test-kit companies also sell supplements or meal replacements to help people adjust to their new (usually completely unnecessary) diet — a big red flag. If a food allergy or intolerance is suspected, always seek advice from your doctor.

Can Dogs Have Allergies?

Dogs can have allergies that trigger an immune response, such as hives, swelling and itchy skin, gastrointestinal issues, and in the most severe cases, anaphylaxis. But rest assured: Food allergies are not common in dogs. If a food allergy or intolerance is suspected, check with your vet before changing your pet's diet. Eliminating an entire food group without veterinary supervision could be dangerous. When it became trendy to put dogs on grain-free diets, heart disease in dogs spiked. An allergy test or supervised elimination diet will likely be used to pinpoint the cause.

This article originally appeared in the June/July 2021 issue of Allrecipes Magazine.

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