Tag Archives: Project Allergy

Living with Dietary Restrictions: Shellfish and Fish

Shellfish and fish allergies are two of the most prevalent of the top food allergies.   These food items account for over half of all food allergies in the United States.  According to AllergicChild.com, “Approximately 12 million Americans suffer from food allergy, with 6.9 million allergic to fish and/or shellfish.”  However unlike many other food allergens, overall shellfish and fish are easier to stay away from  since with the exception of some food, vitamin and cosmetic items, their inclusion in most recipes is fairly obvious.

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       What’s the difference between shellfish and fish allergies?

Shellfish are overall pretty basic as they are divided into two different groups, mollusks and crustaceans.  Crustaceans include items like crabs, lobster, crayfish, shrimp and prawn, while mollusks include sub-categories such as Bivalves (clams, mussels, oysters and scallops), Gastropods (limpets, periwinkles, snails (escargot) and abalone) and Cephalopods (squid, cuttlefish and octopus).  The Mayo Clinic advises that “Some people are allergic to only one type of shellfish, but can eat others.”  This means it’s important to always ask a physician before eating any shellfish to be positive of which types must be avoided and which might be edible.  The Clinic continues by saying, “You’re at increased risk of developing a shellfish allergy if allergies of any type are common in your family.”

Fish allergies in contrast are much more varied compared to many other types of food allergies.  Since there are so many different types of fish, it’s hard to know exactly what to avoid.   Reactions can be caused by anything from scaly or bony fish to an entire family/species of fish.  Because the proteins in most fish are similar it’s a good idea to avoid all fish products to be safe and avoid an allergic reaction. 

Photo from talkallergy.com

                                     What should be avoided?

Even though it may seem pretty obvious to avoid items like crab, shrimp, lobster, cod, salmon and other types of shellfish and fish it’s also highly important to know about all of the items that contain these allergens.  While you may not realize it there are fish products lurking in many different types of sauces and food toppings.  AllergicChild.com lists many of these items and what they contain: Caesar salad dressing (anchovies), Worcestershire sauce (anchovies), Caponata (anchovies), fish sauce (shellfish/fish) and Patum Peperium or Gentelman’s Relish (anchovies).   The Food Allergy & Anaphylaxis Network also reminds to be on the lookout for ingredients in Barbecue sauce which often contains Worcestershire sauce.   It’s also important to be careful when eating foods like gumbo, paella and many different types of Asian cuisine which can often contain shellfish and/or fish.  

Some everyday products even use Menhaden (a type of fish) such as vitamins, soap, cosmetics and insect spray.  AllergicChild.com also warns of the use of a new type of bandage being used in Iraq.  This item, used since 2003, called a HemCon® Bandage, is actually made from the shells of shrimp. However, so far during the product’s allergy testing no individuals had an allergic reaction, including the 8 patients with known shellfish allergies.  But as with any other shellfish/fish product, it’s important to be cautious when using such an item.

Photo from VegeUsa

                    Shellfish/Fish Alternatives and Eating on the Go

Unlike many other food allergies, there aren’t a huge amount of alternatives to shellfish/fish available.   Because of this it’s easier to look for Vegan options.  This is because Vegan foods will not contain actual animal products and/or by-products which make them a safe alternative and unlikely to suffer from cross-contamination.  VegeUSA suggests that the lack of seafood alternatives is due to the fact that it’s harder to replicate than most other types of meat.  However, they worked at the process and came up with Shrimp, Fish Fillets and Tuna Roll alternatives which are all vegan (aka shellfish/fish free).

With the exception of Seafood based restaurants, eating shellfish/fish free is overall a bit more manageable than other food allergies.  However, it’s always good to remember a few tips.  Avoid ordering French fries or other fried food from a place that also serves fried seafood due to cross-contamination of the frying oil.  Eating out at a Japanese restaurant may also be a no-no since it’s very common for multiple items to be cooked on the same surface (ex: going from cooking one customer’s fish to preparing your steak).  Eating With Food Allergies gives another great tip for eating out with any type of food allergy.  The site instructs that it’s helpful to either eat earlier or later than the normal crowds (i.e. before 6 PM or after 9 PM).   This strategy is essential in order to get more attentive service which can be vital in a server realizing that you suffer from an allergy and that your food needs are a necessity and not simply a preference.

While preparing to go out to eat, it’s always comforting to be able to research the available options on sites like Project Allergy in order to find out what the policies are at your favorite restaurants and hotels.  However, if you’re out and about there are some great casual restaurants to visit.  Macaroni Grill, On the Border, Famous Dave’s, Chili’s and Ruby Tuesday’s all offer online lists that cover each of their foods and what major allergens they may contain.  If you’re looking more for fast-food and/or delivery, Domino’s Pizza, Wendy’s and Boston Market all have similar informational sheets.  With many of these restaurants there are often mostly non-shellfish/fish options and at several places the only seafood item is Caesar Salad Dressing which is often sealed in packets that do not come in contact with other food items.

Photo from VegeUSA

                  Delicious Shellfish/Fish Free recipes to try at home

Vegan Shrimp Scampi from VegeUSA

Anchovy-Free Caesar Salad Dressing from Jewishfood-list

How do you or your family members deal with being Shellfish/Fish Free?  Please share your story. 

Image from MorgueFile

Living with Dietary Restrictions: Tree Nuts and Peanuts

Image from MorgueFileCan you imagine an elementary school lunch without a peanut butter and jelly sandwich?   How about getting on an airplane without getting a tiny bag of nuts?  And as if both of those weren’t enough, what if you couldn’t even eat chili to warm you up on a cold fall evening?   These are just a few items on the do not eat, touch, etc. list for people suffering from nut allergies.   And while it isn’t necessarily the most common item to be allergic to, nut allergies have begun to occur more and more.   Robert Wood, MD, director of the division of pediatric allergy and immunology at Johns Hopkins University School of Medicine in Baltimore told WebMD, “The number of people with peanut allergies doubled over a recent five-year period, from four in 1,000 people in 1997 to eight in 1,000 in 2002.”  This growth may mean more people could potentially suffer from the ill effects of the stray peanut or tree nut, but it also means an increased awareness to the allergy.

What’s the difference between tree nut and peanut allergies?

Often when a person is diagnosed as allergic to peanuts they are also told to avoid tree nuts and vice versa.  This is because according to the Food Allergy Initiative, “30-40% of people who have peanut allergy also are allergic to tree nuts.”  But what exactly is the difference?  The main answer is simply the plant family from which they are produced.

Tree nut allergies are basically nuts grown on trees.  The proteins in these nuts are what cause the allergic reaction.  The Food Allergy & Anaphylaxis Network (FAAN) says that about 1.8 million Americans are allergic to this family of nuts which are also one of the leading causes of death among those with food allergies.

Peanut allergies are caused by a similar protein to that in tree nuts and basically present the same reactions (anything from breaking out in hives to anaphylaxis).   The main difference between the two is that a peanut is a member of the legume family along with items like peas and lentils.

What should be avoided?

Image from MorgueFileSince there are so many different types of nuts, it can be difficult to know exactly what to avoid.  While it may sound easy at first to just avoid a peanut or an almond there is a lot more to the process.  First, for tree nut allergies it’s important to know what qualifies under U.S. law as that particular item which means it must be labeled as containing tree nuts on packaged food items.  The Food Allergy Initiative lists the following as being considered tree nuts under U.S. law:  almond; Brazil nut; cashew; chestnut; filbert/hazelnut; macadamia nut; pecan; pine nut (pignolia nut); pistachio; walnut.  For peanut allergy sufferers the basic peanut is the main culprit to avoid.

But just because you avoid the tree nut or peanut in its most basic state, doesn’t mean that’s the only item to stay away from.  Items like barbecue sauce, chili and even spaghetti sauce sometimes use peanut butter or peanut flour as a thickener.  NBC Washington also advises to be careful with pancakes, salad dressing, pasta, pie crust and meatless burgers that may contain traces of different types of nuts.  When eating out it’s a good idea to also avoid ice-cream parlors (due to shared scoops) and Asian and African restaurants due to the risk of cross-contamination since many of their foods contain different types of nuts.  Kids Health even warns to be especially careful when performing some everyday activities due to the possibility of coming in contact with nuts.  They list items such as bird seed, hamster food and bedding, cosmetics and even ant traps as items that could cause a reaction due to nut contamination.

What are some alternatives?

Thankfully for allergy sufferers, items containing these products must be marked on the outside of the package as either containing or possibly coming in contact with nuts.  This leads to a pretty wide variety of products that are nut-free.  PeanutSafeFood.com  has a fairly comprehensive list of several products nut-free and non cross-contaminated items including: Sun Chips, Vanilla Wafers cookies, Skittles, Special K Bars, Betty Crocker Angel Food Cake Mix, Kraft Macaroni & Cheese and Blue Bell Creameries Dutch Chocolate Ice Cream.  And if you’re in the market to try some goodies specially made to be peanut-, tree nut-, milk-, and egg-free, check out Divvies.  Their facility specializes in making items with minimal cross contamination and as allergen-free as possible.   They offer items ranging from gourmet popcorn to cupcakes and even have a cupcake to help you make your own nut free items at home.

Eating Tree Nut and Peanut Free on the Go

Eating nut-free on the go can be a bit more difficult than some allergies due to the ability for small traces to cause big reactions.  Just as in our previous dairy-free post, it’s extremely important to be aware of the possibility of cross-contamination.  Because reactions can be severe, it’s extremely important that you make servers or your host aware of your allergy ahead of time to prevent any accidents from happening in the kitchen.   It’s important to remember that even something as small as not fully sanitizing a knife that has come in contact with a nut can cause a severe reaction.  Kids Health advises, “If the manager or owner of a restaurant is uncomfortable about your request for peanut- or nut-free food preparation, don’t eat there.”

In the meantime, if you’re on the go and curious as to where it’s safe to eat, you can rest assured that there are options available.  A great site for looking up ingredients and policies at different restaurants prior to visiting is Project Allergy.  This site has a plethora of places that are nut-allergy friendly that’s not only includes restaurants, but also lists hotels and airlines as well.  Project Allergy restaurant lists include everything from kid-focused places to the family-friendly and just about anything else you might be craving.  For the kids, Chuck E. Cheese’s warns against cross-contamination in many birthday and sweets options, but overall could be an option.   If you’re looking for family dining Applebee’s  can provide around three pages worth of everything from appetizers right down to desserts that are safe to dine on for nut-allergy sufferers.  Even theme parks like Holiday World (in Indiana) and Hershey Park (in Pennsylvania) have joined in to help make sure everyone can have a fun getaway without having to worry about a bad allergic reaction.

Delicious Tree Nut and Peanut Free recipes to try at home

Nut-Free Pesto from Parents Connect

Peanut-Free “Mock” Buckeyes from Kids With Food Allergies

How do you or your family members deal with being Tree Nut and Peanut Free?  Please share your story.