Christmas, Hanukkah, New Years, and other holiday events should be a time of celebration and joy for you, your family and your friends. But those with children who have food allergies also see the holiday season as a time when the possibility of exposure to food allergens, and potentially dangerous reactions, are more likely. But you should know that you don't have to stop holiday fun! The following tips can help you, your child or holiday guests who may be at risk have an enjoyable, allergen free holiday.

Hosting A Holiday Gathering

If you are the host of the party, friends and family will often ask to bring something to share with the group. Be ready with simple and safe suggestions. Be sure to let every guest know that your child has dietary restrictions, so that there are no surprises. You could ask that instead of food, they could bring holiday themed plates, cups, napkins or safe beverages. You might also consider asking the wine lover in your family to bring a bottle that will compliment the meal, or that friends bring fruit that can be served as dessert. You could even ask the music lover in the group to create a custom playlist of holiday favorites for the occasion!

And be sure to save the ingredient labels from the "safe" food you are serving, so that guests with other food allergy concerns can review before their own children dig in.

While holiday traditions differ between families and cultures, Christmas can offer more flexibility in main dish options as opposed to other holidays such as Thanksgiving. Hanukah has a more traditional menu, but most of these dishes can be made allergen free as well. As the host, things are obviously made easier by doing the cooking yourself, though some holiday food traditions - candy or chocolate, cookies or beverages - can be a little more difficult to manage.

For main dishes, poultry (especially turkey, geese and ducks) and ham are probably the most traditional Christmas entrees. These and many other options are available that can be made allergen free, such as roasted meats (like roast beef or pork loin) or vegetarian main dishes like stuffed vegetables.

Hanukkah celebrations usually feature traditional dishes that involve a lot of oil (to signify the one day's worth of oil that burned for eight), such as potato latkes, or sufganiyot (jelly donuts). But there are many recipes available that avoid "big eight" allergens and gluten. Some great holiday examples:

Allergy-Safe Duck with Sage Sauce is a great main course for Christmas celebrations, and free from all "big eight" food allergens; also sesame-free, and optionally corn-free, sulfite-free, citrus-free, and free from most other common allergens.

Or maybe try Allergy-Safe Roast Chicken for Hanukkah this year, also a "big eight" safe main course; and also free of corn, sesame, sulfites, and most other common allergens. A great Kosher alternative could be Brisket in Wine Sauce, which can be made safe for all "big eight" allergies. Always be sure to use allergen free condiments too, like Nomato Tomato Free Ketchup for this particular recipe.

For your side dishes, you might consider some of the many vegetarian options available, most of which can be prepared to avoid any specific food allergen(s).

Attending Holiday Gatherings

When attending holiday festivities away from your home, be sure to let your host know about your child's food allergy before or upon your arrival. Also be sure to educate your host about cross-contamination issues, and if possible, make yourself available before the event for ingredient questions that may come up.

You can offer to bring a safe dish or treat that both you and other guests can enjoy. And you can help out even further, and make it less likely that you will experience potential problems, by offering to cook one or two of the dishes that are most likely to contain allergens. If the holiday party is at school, church, temple, etc., volunteer to provide the snacks for the party.

If you're attending a party or gathering where you're not sure whether safe food will be served, curb the temptation to explore the buffet by eating before you arrive. You'll be less likely to try something out of hunger just because it seems like it should be safe. This is especially useful for children -- serve them a snack first, and also pack them a favorite and safe treat.

And as always, be prepared with emergency medicines in hand, just in case unrecognized food allergens are hiding in holiday dishes or treats. By following these tips, you can ensure that you and your family have a joyous and happy holiday season!

Labels: big eight, christmas, food allergen, food allergy, hanukkah, holiday dining

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Jennifer Herskowitz spent years scouring aisles and studying labels at Whole Foods and stores like it, wishing there was a shop that stocked well-organized, clearly labeled allergy-free products for her kids, who have serious food allergies.

Herskowitz, an attorney with no retail experience, found a solution in 2007: She opened such a store herself.

The Allergy-Free Shop has grown steadily since its inception, with an evenly balanced cash flow as of this year.

Read More

The Allergy Free Shop exists to provide parents and caretakers with allergen-free foods and products for those with food allergies and sensitivities. We also strive to provide resources that help to provide guidance to those just beginning their education about specific food allergies affecting their children. This series focuses on the "Big Eight" - the eight most prevalent food allergies found in the U.S. Most are very common in other parts of the world as well. They are Peanut Allergy, Egg Allergy, Dairy Allergy, Tree Nut Allergy, Seafood Allergy, Shellfish Allergy, Soy Allergy and Wheat Allergy.

One of the most potentially dangerous allergies in both children and adults is peanut allergy. In very serious cases the reaction to peanut proteins in allergic individuals can progress to anaphylaxis - a severe, whole-body allergic reaction which requires immediate medical attention and response.

Those with peanut allergy are hypersensitive to the proteins found in whole peanuts, peanut particles and peanut-based oils. This causes an overreaction of the body's immune system, which in a small percentage of people may lead to severe allergic response and potentially life-threatening physical symptoms. It should be noted that peanut allergy is distinct from allergies related to tree nuts, but the majority of those allergic to peanuts are also allergic to other nuts, like walnuts, cashews or brazilnuts.

The Body's Reaction To Peanuts

After initial exposure, the body reacts to the peanut proteins by generating IgE antibodies, which then will attach to most of the mast cells with the next exposure to peanuts. The IgE signal then tells the cells to flood the body with histamines and other mediator chemicals, which causes the allergic reaction. Reactions to peanuts or peanut proteins can happen within a few minutes, or hours after exposure. Initial symptoms often include wheezing, a tingling or itchy sensation on the lips, tongue or in the throat, sneezing, feelings of light headedness and or warmth and flush skin. Vomiting, diarrhea, hives, angioedema (swelling of the lips, face, throat and skin) and asthma attacks can all occur.

Without acute medical treatment, symptoms can quickly progress to bronchospasm, or obstruction of the lower and/or upper airway, and hypotension, a sudden drop in blood pressure. This may lead to full anaphylactic shock, with potential heart failure and even death.

Causes And Prevalence

The exact cause of the development of peanut allergy is unknown, but similar to many other food allergies, it is believed to have a strong genetic component, and is more likely to develop in children who have 1st-degree relatives with atopic disease (other allergies). Other factors, such as race, also play a role; Native Americans in particular seem less prone to develop peanut allergy.

It is not believed that exposure to peanuts during pregnancy or during breast-feeding is a cause of peanut allergies, though some studies have found that delaying the introduction of peanut products with children can potentially increase the risks of developing a peanut allergy.*

The Asthma and Allergy Foundation estimates that peanut allergy is the most common cause of food-related death. However, deaths from peanut allergy reactions are still relatively rare; about 100 people per year die from peanut allergies. It should be noted that asthmatics that also have peanut allergy are more likely to develop life-threatening reactions.

Prevalence among children and adults is roughly the same, about 1%. But as with many other food allergies, peanut allergy seems to be on the rise in children in the United States. The number of young children affected with peanut allergy doubled between 1997 and 2002, although about 25% of children with a peanut allergy will eventually outgrow it.**

Treatment Of Peanut Allergy

There have been recent studies that have attempted to de-sensitize children to peanut allergens by exposure to minute, but escalating doses of peanut protein, and has met with some success. But it should be noted that currently there is no confirmed treatment to cure, or prevent, allergic reactions in those with the allergy that are exposed to peanuts.

An exclusion diet, with strict avoidance of peanuts and peanut protein containing products, is the only sure way to avoid allergic reactions. This can be difficult, since some products that you might not expect to contain peanut proteins - such as chocolate and other candies, ice cream, crackers, chili and spaghetti sauce - may in fact contain them. The ubiquity of peanut containing foods in our diet makes avoidance difficult. This makes accidental ingestions and reactions fairly common. For this reason, it is highly recommended that both children and adults with peanut allergy carry epinephrine injectors in case of anaphylaxis.

Allergy Free Shop offers a wide variety of foods that are Peanut Free. Some of our best sellers are Vermont Nut Free Milk Chocolate Skippers, Orgran Outback Animals, and the Enjoy Life Boom Choco Boom Rice Milk Chocolate Bar. You can view our entire stock of over 600 Peanut Free foods and beverages here.

Our goal is to provide you with a wide variety of allergy-free products for you and your children, a place where you can find EVERYTHING that you need in one place. And with ongoing vigilance, and armed with an understanding of your child's or loved one's food allergy, you CAN avoid exposure and reactions to these specific food allergens!

* Food allergy advice may be peanuts, Science News magazine, Dec 6 2008

** Great Ormond Street Hospital for Children NHS Trust and UCL Institute of Child Health, Peanut Allergy - Family Factsheet

Labels: allergens, allergic reaction, allergy free, anaphyaxis, anaphylactic, angioedema, food allergy, ingredients, peanut allergy, peanut proteins

The Allergy Free Shop exists not only to provide parents and caretakers with allergen-free foods and products for those with food allergies and sensitivities, but also to provide educational information that can help provide guidance and product options to those just beginning their research and education about specific food allergies affecting their children.

Prevalence And Treatment Of Food Allergies

To begin with, any food protein which triggers an allergic response is termed a "food allergen." It is estimated that up to 12 million Americans have food allergies or reactions to food allergens, and the prevalence is rising. Six to eight percent of children under the age of three have food allergies and nearly four percent of adults have them.* And food allergies cause roughly 30,000 emergency room visits and 100 to 200 deaths per year in the United States.**

Treatment consists of either immunotherapy/desensitization, or in many cases avoidance, in which the allergic person avoids all forms of contact with the food to which they are allergic. Although there are promising areas of food allergy research, including anti-IgE antibody and specific oral tolerance induction, as of now there is no "cure" (other than immunotherapy) for many people with food allergies. Individuals diagnosed with a food allergy may choose to carry an autoinjector of epinephrine (such as a Twinject or EpiPen), wear some form of medical alert jewelry, or (with the guidance of their doctor) develop an emergency action plan. This is due to the potential serious reactions that are possible to many people with food allergies.

Common Symptoms of Food Allergy Reactions

The most common type of food allergy reaction is called a "Classic immunoglobulin-E (IgE)-mediated" or Type-1 Immediate-Hypersensitivity Reaction. These allergic reactions have an acute onset (from seconds to one hour) and may include symptoms such as Angiodema, or soft tissue swelling, usually involving the eyelids, face, lips, tongue, larynx and trachea, which can obstruct the upper airway and make breathing difficult; hives; nausea, vomiting, diarrhea, stomach cramps and/or abdominal pain; wheezing; scratchy or itchy mouth, throat, eyes or skin; nasal congestion; shortness of breath and difficulty swallowing.

In very serious cases the reaction can progress to Anaphylaxis, which is a severe, whole-body allergic reaction which requires immediate medical attention and response, and that can even result in death without acute medical intervention.

Anaphylaxis, or "Anaphylactic Shock", is defined as a systemic reaction involving several different bodily systems, and includes hypotension, or a sudden drop in blood pressure, a loss of consciousness, and the shutdown of vital bodily functions as the individual goes into shock. Many different food allergens have been reported as triggers for Anaphylaxis, but the most common allergies associated with this type of reaction are peanuts, nuts, egg, milk and seafood.

Potential Causes And Types of Food Allergy Reactions

Food allergy has been diagnosed in all types of individuals, but is thought to develop more easily in patients who display atopic syndrome. Atopic syndrome is a common combination of diseases in people who exhibit "localized, and immediate, hypersensitivity to allergens" through eczema, allergic conjunctivitis and rhinitis, and asthma. A family history of allergic diseases is often indicative of atopic syndrome, and these combinations of allergic reactions are strongly correlated to family heredity.

Conditions caused by food allergies are classified into 3 groups according to the mechanism of the allergic response. The first is the "classic" response described above, the IgE-mediated reaction, or Type-I Immediate-Hypersensitivity Reaction.
The second category is called "IgE or non-IgE mediated" eosinophilic esophagitis, gastritis and gastroenteritis reactions, which refers to acute inflammation of the esophagus, stomach or intestines caused by reactions to allergens by white blood cells, which control mechanisms associated with allergy and asthma. The last category is includes other "non-IgE mediated" reactions, such as milk-soy protein intolerance (MSPI); or conditions like food protein induced enteropathy (a pathology of the intestines), found in the common condition of Coeliac Disease, which is an adverse immune reaction to the protein gluten.

The Big Eight Food Allergies

The term "Big Eight" refers to the most common food allergies.*** They account for over 90% of the food allergies found in the United States. They are:

Egg Allergy
Dairy Allergy
Peanut Allergy
Tree Nut Allergy
Seafood Allergy
Shellfish Allergy
Soy Allergy
Wheat Allergy

Outside the U.S. the list of top allergens tends to vary somewhat from country to country, but milk, eggs, fish, shellfish, peanuts, tree nuts, sesame, soy and wheat tend to be in the top 10. Allergies related to seeds, especially sesame, appear to be rising in most countries. There are also other more rare food allergies, including corn, rice, flour, various vegetables and fruit allergies and even red meat allergy, among others.

There are other conditions which can require food allergen avoidance but are not technically allergies, such as lactose intolerance, which is actually an enzyme deficiency, not an allergy; various causes of irritable bowel syndrome (IBS); or rarer conditions such as C1 esterase inhibitor deficiency, or hereditary Angiodema. We will address some of these conditions in upcoming blogs.

Diagnosis Of Food Allergy

If you suspect a food allergy, the best method for diagnosing the condition is by visiting an allergist. The allergist will review the patient's history and the symptoms or reactions that have been noted after food ingestion. If the allergist feels the symptoms or reactions are consistent with food allergy, he/she will perform allergy tests, which may include skin prick testing (Non-IgE mediated allergies cannot be detected using this method, however), which can provide quick and usually conclusive results, diagnostic blood tests (also not effective for Non-IgE mediated allergies), or food challenges, often conducted in a hospital environment due to the potential risk of Anaphylaxis. Other tools for diagnosis of eosinophilic or non-IgE mediated reactions can include endoscopy, colonoscopy and biopsy.

This Educational Series

There are various strategies and theories regarding prevention and treatment of many food allergies, and as we continue through our educational series on the "Big Eight," we will focus on each food allergy separately, addressing the potential causes, relevant statistics, prevalent scientific opinion and research, and the treatment for each of the individual allergy categories. We will also provide information and links to our new and existing food choices and other products that we offer at Allergy Free Shop that address each specific allergen. Through this informational series, we hope that we can help you better understand - and respond - to your child's individual allergy-free needs!

In our next "Big Eight" post: Peanut Allergy.



* National Institute of Allergy and Infectious Diseases (July 2004), National Institutes of Health. pp. 35.

** Food Allergy Facts and Statistics. Food Allergy & Anaphylaxis Network. 2007.

*** "Food Allergy Facts & Figures". Asthma and Allergy Foundation of America. March 28, 2007.

Labels: allergens, allergy free, anaphyaxis, dairy allergy, food allergy, peanut allergy, tree nuts allergy, wheat allergy

Many families will leave the cooking and cleaning to others this Thanksgiving holiday, and be dining at restaurants or other people's homes instead. But failure to establish a clear line of communication between patron and establishment when dining out or with your host when eating with friends and family, along with surprise ingredients sometimes found in traditional dishes, are frequent causes of allergic reactions. And sometimes even clear communication can result in errors, such as restaurant staff that provide answers to ingredient questions with incomplete or inaccurate information.

If your family is planning on dining out this year, know how to avoid high risk situations. Here are some examples:

Creative Chefs

Thanksgiving is a holiday filled with traditional dishes - ones that many have known and loved for years. But never assume that a dish contains only traditional ingredients. In an effort to add new or unique flavors to dishes, chefs will often experiment with other surprise ingredients, so don't be caught off-guard when ordering. For example, many whipped potato side dishes contain walnuts in them. Other examples of unexpected ingredients sometimes found in traditional Thanksgiving dishes:

- Cranberry sauce: pecans, wheat
- Gravy: peanut butter, soy, Worcestershire sauce (fish)
- Mashed potato: cheese, cream cheese
- Pumpkin pie: peanut butter
- Stuffing: almond, crab, oysters, shrimp
- Sweet potato casserole: eggs, milk, pecans, walnuts

Buffet Style Restaurants

As is always the case, you can avoid problems by steering clear of help yourself dining styles, where serving utensils are sometimes shared between dishes or food is accidentally dropped into other food containers. If you do find yourself in a buffet style restaurant, work with the manager and order from the menu instead. If you are in someone's home, make arrangements to serve yourself first.

Fried Foods

You should avoid fried foods, as they are often all prepared in the same cooking oil. For example, if a fryer was used to fry shrimp, and the same oil is later reused to fry chicken, the chicken will then contain shrimp protein, and could cause an allergic reaction in someone who is allergic to shrimp.

Desserts

A study of allergic reactions to peanuts or tree nuts in restaurants found that 43% of the reactions were caused by desserts*. For example, many wait staff may not have an all-inclusive knowledge of which desserts contain nuts, and may incorrectly inform you that an item is nut-free. Often the best choice is to avoid eating desserts completely while dining out. Instead, have a special allergen-free - and worry-free - dessert or treat waiting for you when you return home!

Establish Clear Communication

In the same study, it was found that of 106 individuals with known food allergies who suffered allergic reactions while dining out, only 45% gave prior notification about the allergy to the dining establishment*. And for at least 83 (78%) of these 106 reactions, someone in the establishment knew that the food contained the allergen as an ingredient; in 50% of these incidents, the food item was "hidden" (in sauces, batter, dressings, etc.), making visual identification impossible. So be sure to inform wait staff, and ask questions! Also be sure to keep your medications, such as an EpiPen, on hand just in case. And remember, these tips can also be applied to any other traditional dishes you may encounter throughout the year.

With some preparation and by following these tips, you can help assure yourself of an allergy-free Thanksgiving holiday. So that most importantly, you can enjoy this special time with friends and family!

*Furlong, Terence J., M.S.; The Journal of Allergy and Clinical Immunology; 01-NOV-2001; 11692117 (PubMed ID)

Labels: allergens, allergy free, dairy allergy, dining out, ingredients, peanut allergy, Thanksgiving, traditional dishes, tree nuts allergy, wheat allergy