SPECIAL REPORTS

How to Eat Around Allergies

Cooking for people with food allergies and special diets

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A Dinner Everyone Will Love | Guide to Food Allergies

Still, anyone can develop a food allergy, at any time, says Scott Sicherer, M.D., associate professor of pediatrics at the Jaffe Food Allergy Institute at Mount Sinai in New York and author of Understanding and Managing Your Child’s Food Allergies (Johns Hopkins Press, 2006). Some allergies—including milk, eggs, soy and wheat allergies—appear more often during childhood, and many kids outgrow them. Others, like shellfish allergies, tend to develop during adulthood. Such is the highly individual (and unpredictable) nature of the food-allergy beast.

Many people mistake localized discomfort, say a rumbling tummy after eating certain foods, as a food allergy, but it’s generally not. In fact, according to Dr. Sicherer, “Roughly 20 percent of people think they have food allergies, but the majority of them don’t.” They may, for example, have suffered a single bout of food poisoning or have trouble digesting certain sugars, but these don’t fall under the food-allergy umbrella. Knowing the difference is often tricky, which is why consulting a doctor is so important.

For instance, milk is one food to which people can either be allergic or intolerant (or both), so it’s useful for highlighting the difference between the two terms. When the milk’s protein triggers an immune reaction like hives or breathing problems, this is usually a milk allergy. But when a person can’t digest the milk’s sugars (often causing loose stools), this is usually lactose intolerance.

According to Annie Khuntia, M.D., clinical associate of allergy and immunology at the University of Chicago, two main tests can help determine the presence of a food allergy. One involves putting a small amount of the suspected allergen underneath the skin and looking for a raised bump, or wheal. “This method provides quick, easy results within 15 or 20 minutes,” Dr. Khuntia says. Another, the RAST blood test, “gives you a quantitative number to follow over time.” (Both tests have high rates of false positives, so follow-up testing is sometimes necessary.) Once allergies are identified and foods are eliminated, patients may need advice on maintaining proper nutrition. It’s unwise to self-diagnose and avoid foods haphazardly, since you risk depriving your body of important nutrients.

Avoiding known triggers is the only surefire way to prevent reactions—which can be life-threatening, particularly with peanuts, tree nuts and shellfish. So people with allergies must be on high alert at all times, fastidiously reading labels and avoiding cross-contamination. Even trace amounts of peanut protein lingering on a utensil can cause trouble for someone with a peanut allergy.

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