Food allergies are becoming increasingly common in the United States. Scientists estimate that approximately 12 million Americans today suffer from true food allergies (1).
Food Allergy vs. Food Intolerance
Many people think the terms food allergy and food intolerance mean the same thing; however, there is a difference.
A food intolerance is an adverse food-induced reaction that does not involve the immune system. Lactose intolerance is one example of a food intolerance. A person with lactose intolerance has an insufficient amount of lactase, the enzyme that is needed to digest milk sugar. When this person eats milk products, symptoms such as gas, bloating, and abdominal pain may occur. Other common intolerances include gluten, sulfites and monosodium glutamate (MSG).
A food allergy occurs when the immune system reacts to a certain food the body mistakenly believes is harmful by producing antigens to that food. The next time that food is consumed, the immune system releases massive amounts of chemicals, including histamine, in order to protect the body. These chemicals trigger a host of allergic symptoms that can affect the respiratory system, gastrointestinal tract, skin, or cardiovascular system.
Making Choices with Your Allergies in Mind
The following is a partial list of ingredients to be used as a general guide. Consult your health care professional for more information.
Ingredients that indicate milk: artificial butter flavor, butter, butter fat, butter oil, buttermilk, casein, caseinates, cheese, cream, cottage cheese, curds, ghee, half & half, lactalbumin, lactulose, milk (in all forms), nougat, pudding, rennet casein, sour cream, sour cream solids, whey, ice cream, sherbet, yogurt.
Milk protein: caramel, chocolate, flavorings, high protein flour, lactic acid starter culture, lactose, some luncheon meats, hotdogs and sausages, margarine, non-dairy margarine.
Ingredients that indicate egg: albumin, albumen, egg (all forms), eggnog, globulin, livetin, lysozyme, mayonnaise, meringue, surimi, custard, soufflé, quiche, Caesar dressings, some egg replacers.
Egg protein: flavoring, lecithin, macaroni, marzipan, marshmallows, nougat, pasta.
Ingredients that indicate peanut: artificial nuts, beer nuts, cold pressed, expelled or extruded peanut oil, goobers, ground nuts, mandelonas, mixed nuts, monkey nuts, nutmeat, nut pieces, peanut, peanut butter, peanut flour, peanut protein, hydrolyzed peanut protein.
Peanut protein: African, Chinese, Indonesian, Mexican, Thai and Vietnamese dishes as well as baked goods, candy, chili, eggs rolls, dried soups, enchilada sauce, flavoring, marzipan, nougat.
- It is advised that people with a peanut allergy should avoid chocolate candies, tree nuts, and seeds unless they are absolutely certain there is no risk of cross-contamination during manufacturing processes.
- Peanuts can cause severe allergic reactions. If prescribed, carry epinephrine at all times.
Ingredients that indicate tree nuts: almonds, artificial nuts, Brazil nuts, caponata, cashews, chestnuts, filbert/hazelnuts, gianduja, hickory nuts, macadamia nuts, mandelonas, marzipan, almond paste, natural nut extracts, nan-gai nuts, nut butters, nut meal, nutmeat, nut oil, nut paste, nut pieces, pecans, pesto, pine nuts (also Indian, piono, pinyon, pignoli, pignolia or pignon nuts), pistachios, pralines, walnuts.
Some Hidden Sources of Tree Nuts
- “Natural” and “artificial flavoring” may contain tree nuts.
- Mortadella, a version of smoked sausage, may contain pistachio nuts.
- Many other foods including barbecue sauce, cereals, crackers, and ice cream.
Ingredients that indicate wheat: bran, bread crumbs, bulgur, couscous, cracker meal, durum, farina, flour (all-purpose, bread, cake, durum, enriched, graham, high-gluten, high-protein, instant, pastry, self-rising, soft-wheat, steel ground, stone ground, whole wheat), gluten, kamut, matzoh, matzoh meal, pasta, seitan, semolina, spelt, vital gluten, wheat (bran, germ, gluten, malt), whole wheat berries, vegetable gum.
Wheat protein: flavoring, hydrolyzed protein, soy sauce, starch, surimi.
Fish and Shellfish
Allergic reactions to fish and shellfish are commonly reported in both adults and children. It is generally recommended that individuals who have had an allergic reaction to one species of fish, avoid all fish. The same rule applies to shellfish. Ingredients that indicate shellfish: abalone, clams, cockle, crab, crawfish (crayfish, ecrevisse), lobster, mollusks, mussels, octopus, prawns, scallops, shrimp, snails, squid.
Shellfish protein: bouillabaisse, cuttlefish ink, fish stock, flavoring, seafood flavoring, surimi.
- Allergic reactions to fish and shellfish can be severe and are often a cause of anaphylaxis (potentially fatal) so be sure to carry medications in case of accidental exposure.
- Cross-contamination may occur with any other seafood during the catching and storing processes.
- Caesar salad dressings and steak or Worcestershire sauces often contain anchovies.
Ingredients that indicate soy: edamame, hydrolyzed soy protein, miso, natto, shoyu sauce, soy (albumin, soy fiber, soy flour, soy grits, soy milk, soy nuts, soy sprouts), soya, soybean, soy protein, soy sauce, Tamari, Tempeh, texturized vegetable protein (TVP), tofu, many Asian cuisines, vegetable broth, vegetable gum, vegetable starch.
- Soybeans and soy products are found in baked goods, canned tuna, cereals, crackers, infant formulas, sauces, and soups.
- At least one brand of peanut butter lists soy on the label.
- Studies show that most soy-allergic individuals may safely eat soybean oil (not cold pressed, expeller pressed, or extruded oil) and soy lecithin. Patients should ask their doctors whether or not to avoid these ingredients.
How can you determine if you have a food allergy or intolerance?
The first step is to seek professional advice from an allergist certified by the American Board of Allergy and Immunology. Once you identify your individual issues, you will want to seek the advice of a registered dietitian to really understand your dietary needs. Simply eliminating foods based on self-diagnosis or a hunch can leave you frustrated as well as nutrient deficient.
If you know you have a food allergy, follow these steps:
- Know what you're eating and drinking. Be sure to read food labels for items that you purchase as home. In our cafes, we generally include the name of the major food allergens in the menu item name, but don’t be afraid to ask questions. The Bon Appétit chefs are your best source of information about foods served in our cafés.
- If you have already had a severe reaction, wear a medical alert bracelet or necklace. Make sure people you spend time with are aware of your allergy and know what to do in case of emergency. No matter how cautious you are, talk with your doctor about carrying emergency medications in case of accidental exposure.
Allergen Labeling in Bon Appétit Cafés
Bon Appétit’s approach to food is unique in the industry. We are dedicated to providing the freshest, highest quality selections that are planned specifically for each of our sites. As a result, we do not operate from a corporate recipe book that outlines all of our ingredients. If you have concerns, our chefs and/or registered dietitian will be glad to work with you on your personal choices. Since everything is cooked from scratch onsite, they can easily tell you what ingredients are in a specific dish and make modifications if necessary. The top eight most common food allergens are present in all Bon Appétit cafés. If you have a food allergy, it is important that you talk with the manager at your site about how to safely eat in our café. Our managers and chefs are well-trained to help you with your food allergy needs.
1. The Food Allergy & Anaphylaxis Network. www.foodallergy.org. Accessed July 2011.
This information is not intended to take the place of advice from a healthcare professional. Check with your physician before starting any diet or exercise program. In addition, while all efforts have been made to ensure the information included in this material is correct, new research is released frequently and may invalidate certain pieces of data. 7/11