Misconceptions About Food Allergies
Food Allergy Awareness Week is May 13-19, 2018. In honor of that, I thought I’d do a few educational posts. Following are the most common misunderstandings I encounter about food allergies:
Not every person with food allergies has a peanut allergy. I can’t count how many times I’ve said, “My son has food allergies...” and before I can get another word out they reply with “Well, this doesn’t have peanuts.” Which leads to the next point:
Peanuts are NOT tree nuts. My son has cashew and pistachio allergies. In the early days after his nut reaction, we were advised to avoid all tree nuts and peanuts. The main reason for this is that peanuts and tree nuts are commonly manufactured or packaged on shared equipment, so cross-contamination with the allergen is possible. Peanuts are actually legumes (in the bean family), and some people who only have tree nut allergies can consume them if they are manufactured safely. In fact, my kiddo LOVES peanut butter. We have determined that Santa Cruz Organic brand is safe for him based on his allergies. (As always, check with the manufacturer yourself if you have allergies.)
Just because a food label doesn’t state that it contains an item doesn’t mean that it doesn’t contain an item. Cross-contamination can occur during cooking, manufacturing, packaging, or serving. Food labels in the U.S. make me (and probably a lot of other people with severe food allergies) crazy. Manufacturers are required to list all ingredients included in a product. Statements about shared equipment and shared facilities are optional. Beyond that, there are times when things get cross-contaminated during serving. One time at a burger joint I saw a cook put a piece of tomato onto a burger, realize he made a mistake, and take it back off. That could be enough to make someone with a tomato allergy sick. (Needless to say, I took it as an opportunity to educate about food allergies!)
Not all allergic reactions occur solely from eating a food. Some reactions occur from touch or airborne exposure. When my son was young and still allergic to eggs, I made the mistake of helping clean up at a picnic. Afterward, I picked up my son - and within a few minutes he had hives and welts everywhere I touched him. It took a few minutes before I realized the sandwich wrappers had mayonnaise on them. While that didn’t cause a severe reaction, if he had scratched his skin and then put his finger in his mouth, nose, or eye, it could have resulted in a more severe systemic reaction.
Food allergies can start at any age and can be to virtually any food. The “Top 8” most common allergens in the U.S. are: dairy, egg, peanuts, tree nuts, fish, shellfish, wheat, and soy. Some people outgrow some or all of their allergies, while others do not.
The severity of one reaction does not predict the severity of future reactions. I’ve heard many people say things along the lines of, “When I eat “x” my throat itches a little, but it is not a severe allergy. I just avoid the food and I don’t carry an EpiPen.” Reactions can vary over time, and avoidance doesn’t always work (see #3 and #4 above).
People assume that we don’t have to be very conscientious because we carry EpiPens. I think EpiPens can create a false sense of security. They don’t always work... sometimes because of the severity or the reaction, delays in using them, or device failures. I’m not suggesting a lot of people die from food allergies - but for me, my child is one too many. Strict avoidance of allergens is still the guidance used by most allergists, and we adhere to that to the best of our abilities.