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Special Feature: Food allergies and the holiday season
In this special feature you will:
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'Tis the season for families and close friends to celebrate the holidays with mouth watering buffets and irresistible desserts. But for people with food allergies, the season brings with it an air of caution.
It only takes a small amount of an allergic food to trigger a dangerous reaction. Food allergies can be severe and even life threatening if proper steps are not taken to avoid the risk of accidental exposure. During the holiday season, it's important to know what is in the food you're eating.
The most common food allergies include:
- wheat
- eggs
- milk
- soy
- fish or shellfish
- legumes (especially peanuts)
- tree nuts such as almonds, hazelnuts, pecans and walnuts
These common allergens are often used as ingredients in many recipes and baked goods throughout the holidays.
Diagnosis of a food allergy
An allergist/immunologist will determine whether a food allergy exists after taking a thorough history, examination and utilization of food allergy tests. When allergy skin testing is performed, and if a probable allergy to a specific food exists, a small wheal [a raised bump] will develop at the test site. Your doctor may also order a blood test [RAST or CAP RAST] to evaluate if food allergies are present. If the diagnosis is still not certain, a supervised food challenge may be needed to settle whether you actually have a true food allergy.
Steps to take for prevention
Reading food labels and avoiding the allergic food and its related ingredients is extremely important. Learn the different and unfamiliar technical names of ingredients. Homemade items do not have ingredient lists and can be contaminated with trace amounts of allergenic foods through contact with storage containers, baking sheets and utensils. If you are not sure, always ask about possible hidden ingredients. Here are some additional steps you can take for prevention:
- Inform the host about the food allergy and ask about the ingredients used to prepare the meal selected.
- Homemade items do not have an ingredient list, so be sure to ask the preparer about the ingredients.
- Be prepared with a self-injectable epinephrine when attending a holiday party where unrecognized food allergens may be hiding.
- If you are a parent of a food allergic child, remember to pack a snack for them, this will help ensure your child has something safe to eat during holiday school activities.
- Avoid holiday party foods if you are allergic to their main ingredients, such as eggs, milk, wheat and nuts.
- Remind family members and friends that strict avoidance is key when managing food allergies and even one little bite can hurt.
Treatment of an allergic reaction
Someone who has a food allergy may have the following reactions:
- Atopic dermatitis - itchy, scaly skin;
- Hives - itchy, raised red bumps on the skin;
- Gastrointestinal symptoms - including nausea, vomiting, swelling of the stomach and gas, diarrhea, abdominal cramping and pain, a red rash around the mouth, or itching and swelling of the mouth and throat; or
- Anaphylaxis - a systemic allergic reaction that is very serious and requires emergency medical attention and follow up with an allergist.
The most important steps for treating a reaction are to recognize early symptoms, react immediately and follow your doctor's instructions for treatment. You also need to be prepared for emergencies that may occur. This may include properly understanding and correctly using an injectable epinephrine (i.e. an EPI-Pen auto-injector), as well as having antihistamines on hand. Epinephrine helps to reverse an anaphylactic reaction. However, in spite of your best efforts at avoidance, reactions may occur. The best possible treatment is successful prevention and education.
Allergen-Free Holiday Recipes
If you are allergic to a certain food, avoidance is the best way to avoid a food reaction, but that does not mean you have to go without the holiday foods you enjoy. You could substitute allergy-free ingredients in your favorite recipes or try making one of the allergy-free holiday recipes listed below from the Food Allergy and Anaphylaxis Network (FAAN). Listed below are recipes for entrees and desserts. For additional allergen-free recipes, visit www.foodallergy.org or call The Food Allergy & Anaphylaxis Network at (800) 929-4040.
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Key to Symbols: M, Milk-free; E, Egg-free; W, Wheat-free; P, Peanut-free; S, Soy-free; N, Nut-free
Roasted Pork Tenderloin with Apples and Sweet Potatoes
M, E, W, P, S, N
Ingredients:
1 tsp. salt
1/2 tsp. ground cinnamon
1/2 tsp. ground cardamom
1/4 tsp. pepper
3 1/2 cups sweet potato, peeled and cubed (1-inch)
4 tsp. olive oil, divided
2 (3/4-lb. each) pork tenderloins
3 large Granny Smith apples, each peeled and cut into 4 wedges
Directions: Preheat oven to 500 degrees. Coat a 15x10-inch jelly roll pan with cooking spray. Set aside. In a small bowl, combine salt, cinnamon, cardamom, and pepper. Set aside. In a large bowl, combine sweet potato, 1 tsp. spice mixture, and 3 tsp. oil; toss well. Set aside. Trim frat from pork and rub remaining spice mixture over pork. Drizzle remaining 1tsp. oil over pork. In a single layer in pan, arrange sweet potatoes. Bake 10 minutes. Add apples and pork and bake 10 minutes. Turn sweet potato, apples, and pork and bake an additional 10 minutes. Turn once more and bake 10 minutes.
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Key to Symbols: M, Milk-free; E, Egg-free; W, Wheat-free; P, Peanut-free; S, Soy-free; N, Nut-free
Rotini with Turkey and Veggies
M, E, P, S, N
Ingredients:
1 1/2 cups hot cooked rotini pasta
2 T. oil
1 cup carrots, sliced
1/2 cup onion, chopped
1 cup broccoli
1 plum tomato, sliced
1/2 lb. cooked turkey, cut into 2x1/4-inch strips
1/4 tsp. fennel seed
Directions: In large skillet over medium heat, heat oil until hot. Stir in carrots and onion. Cook 2 to 3 minutes or until tender, stirring occasionally. Add broccoli and tomato. Cook and stir 1 to 2 minutes or until broccoli is tender. Stir in turkey and cook until thoroughly heated, about 2 minutes. Combine pasta and turkey mixture.
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Key to Symbols: M, Milk-free; E, Egg-free; W, Wheat-free; P, Peanut-free; S, Soy-free; N, Nut-free
Chocolate Snicker Doodle Cookies
M, E, P, S, N
Ingredients:
1 cup milk-free, soy-free margarine, softened
3/4 cup light brown sugar, firmly packed
3/4 cup sugar
3 T. water, 3 T. oil, 2 tsp. baking powder; mixed together
2 cups quick oats, uncooked
1 1/2 cups flour
1/4 cup plus 2 T. unsweetened cocoa powder
1 tsp. baking soda
Coating Mix
M, E, W, P, S, N
2 T. sugar
2 T. unsweetened cocoa powder
2 T. ground cinnamon
Directions:
Preheat oven to 375 degrees. Lightly grease cookie sheets. Beat margarine, brown sugar, and 3/4 cup white sugar in large bowl until light and fluffy. Add water, oil, and baking powder mixture; mix well. Set aside.
In a medium bowl, combine oats, flour, 1/4 cup cocoa, and baking soda. Stir into margarine and sugar mixture until blended. Set aside. In a small bowl, combine the coating ingredients. Drop dough by rounded teaspoonfuls into cinnamon mixture; toss to coat. Place 2 inches apart on prepared cookie sheets. Bake 8 to 10 minutes or until firm in center. Do not overcook. Remove to wire racks to cool.
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Key to Symbols: M, Milk-free; E, Egg-free; W, Wheat-free; P, Peanut-free; S, Soy-free; N, Nut-free
Pumpkin Pie
M, E, W, P, S, N
Ingredients:
2 cups canned pumpkin
3/4 cup brown sugar, firmly packed
1 1/2 cups water
6 1/2 T. corn starch
1 tsp. cinnamon
1/2 tsp. salt
1/4 tsp. ground cloves
1/2 tsp. ginger
pie crust*
Topping (optional)
1/4 cup brown sugar
1/4 cup coconut
Directions: Preheat oven to 375 degrees. In a medium saucepan, combine all ingredients. Cook over medium heat until mixture begins to thicken, stirring constantly. Pour into pie crust. Bake for 30 minutes or until firm. Remove pie from oven, sprinkle coconut topping on top. Bake 5 more minutes.
* To make this recipe wheat-free, use your favorite wheat-free pie crust recipe.
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For additional information please check out the following links:
 Allergic Conditions: Food Allergy
Tip Brochure Series: Food Allergy
This topic was reviewed on 11-01-03 for medical accuracy by
Stuart A. Friedman, MD, FAAAAI, Patients and Consumers Center Editor.
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