Food Allergy Pearls

Frequently asked questions about food allergy answered

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  • Milk

    • Cow’s milk and goat’s milk are more than 90% cross-reactive.

    • Sheep’s milk is not a safe alternative.

    • Shellfish is occasionally dipped in milk to reduce odors.

    • Kosher pareve products may contain small amounts of milk protein.

    • Lactose: Some dry powder inhalers are prescribed for asthma, although the level of milk protein contamination, if any, is unknown

  • Egg

    • Measles-mumps-rubella vaccines may be given safely to egg-allergic individuals (and is
      recommended by the American Academy of Pediatrics).

    • Influenza vaccines may contain a small amount of egg, but recent studies indicate that they may be safely administered in graded doses to most children with egg allergy.

    • Varicella (chicken pox) vaccines do not contain egg.

    • Egg lecithin: propofol (general anesthetic) Risk of a reaction is presumed to be low

  • Peanut

    • Peanut is a legume (in the same family as beans such as soy).

    • More than 90% of peanut-allergic individuals tolerate soy as well as other legumes. But an exception is that there is a risk of cross-reaction between peanuts and lupine.

    • Having peanut allergy is associated with developing a tree nut allergy.

    • Studies show that most allergic individuals can safely eat peanut oil that has been highly refined (but not cold-pressed, expeller-pressed, or extruded peanut oil).

  • Tree nuts

    • Cashews and pistachios are highly cross-reactive. Mortadella may contain pistachios.

    •  Walnuts and pecans are highly cross-reactive.

    • Almonds and hazelnuts are cross-reactive.

    • Coconut is characterized by the FDA as a tree nut, but allergy is uncommon.

    • Nutmeg, water chestnuts, and butternut squash are not tree nuts.

  • Fish and shellfish

    • Fish and shellfish proteins can become airborne during cooking.

    • Having an allergy to fish or shellfish is not a contraindication to the use of radiocontrast

    • Noncrustacean shellfish (eg, clams, mussels, oysters, squid) do not have to be identified under FALCPA.

  • Soy

    • Soybean, soy, and soya are interchangeable.

    • Most individuals allergic to soy can safely eat soy lecithin, which contains a trace amount of detectable soy protein.

    • Most allergic individuals can safely eat soybean oil that has been highly refined (not cold- pressed, expeller-pressed, or extruded soybean oil).

    • Soy lecithin: certain inhalers Risk of a reaction seems very low

  • Wheat

    • Spelt is considered allergenically similar to wheat.

  • Sesame seed

    • Allergies to other seeds (eg, poppy, sunflower, pumpkin, rapeseed, and flaxseed/linseed)
      are much less common than sesame allergy.

    • People who are allergic to one type of seed do not necessarily need to avoid all others

Nonfood Items - Potential Allergens

  • Oral medications (check labels, specifically inactive ingredients)  

  • Egg lysozyme (enzyme found in egg white): nasal decongestants

  • Cosmetics Milk, tree nut oils, wheat, and soy

  • Modeling Dough Wheat

  • Finger Paints Egg white

  • Latex Gloves Casein (used as antistick agent)

  • Alcoholic Beverages Egg, cow’s milk, and seafood (used as clarifying agents)

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