2. About Food Allergies
Food allergy is a serious medical condition affecting
up to several million people worldwide , including 1
in 13 children. Whether you’re newly diagnosed or
brushing up on the facts, learning all you can about
the disease is the key to staying safe and living well
with food allergies
2 Chef Ashokkumar
3. What is Food Allergy?
The job of the body’s immune system is to identify and
destroy germs (such as bacteria or viruses) that make
you sick. A food allergy results when the immune system
mistakenly targets a harmless food protein – an allergen
– as a threat and attacks it.
A food allergy is a medical condition in which exposure to
a food triggers a harmful immune response. The immune
response, called an allergic reaction, occurs because the
immune system attacks proteins in the food that are
normally harmless. The proteins that trigger the reaction
are called allergens.
The symptoms of an allergic reaction to food can range
from mild (itchy mouth, a few hives) to severe (throat
tightening, difficulty breathing).
Anaphylaxis is a serious allergic reaction that is sudden
in onset and can cause death.3 Chef Ashokkumar
4. Food Allergies vs. Food Intolerances
Unlike other types of food disorders, such
as intolerances, food allergies are “IgE mediated.”
This means that your immune system produces
abnormally large amounts of an antibody called
immunoglobulin E — IgE for short. IgE antibodies
fight the “enemy” food allergens by releasing
histamine and other chemicals, which trigger the
symptoms of an allergic reaction.
4 Chef Ashokkumar
5. To Which Foods Are People Allergic?
More than 170 foods have been reported to cause
allergic reactions.
Eight major food allergens – milk, egg, peanut, tree
nuts, wheat, soy, fish and crustacean shellfish – are
responsible for most of the serious food allergy
reactions in the United States.
Allergy to sesame is an emerging concern.
5 Chef Ashokkumar
6. Types of Allergens
Peanut
Tree nuts
Milk
Egg
Wheat
Soy
Fish
Shellfish
Another common allergen is sesame, which affects
hundreds of thousands of People.
6 Chef Ashokkumar
7. Peanut Allergy
Chef Ashokkumar7
Peanut allergy is one of
the most common food
allergies. Peanuts can
cause a severe,
potentially fatal, allergic
reaction (anaphylaxis).
9. Tree Nuts
Chef Ashokkumar9
Tree nut allergy is one of the most common food allergies
in children and adults. Tree nuts can cause a severe,
potentially fatal, allergic reaction (anaphylaxis).
Tree nuts include, but are not limited to, walnut, almond,
hazelnut, cashew, pistachio, and Brazil nuts. These are
not to be confused or grouped together with peanut,
which is a legume, or seeds, such as sunflower or
sesame.
A person with an allergy to one type of tree nut has a
higher chance of being allergic to other types. Therefore,
many experts advise patients with allergy to tree nuts to
avoid all nuts. Patients may also be advised to also avoid
peanuts because of the higher likelihood of cross-contact
with tree nuts during manufacturing and processing.
11. Milk Allergy
Chef Ashokkumar11
Allergy to cow’s milk is
the most common food
allergy in infants and
young children.
Symptoms of a milk
allergy reaction can
range from mild, such
as hives, to severe,
such as anaphylaxis.
12. Differences between Milk Allergy and Lactose
Intolerance
Chef Ashokkumar12
Milk allergy should not be confused with lactose
intolerance. A food allergy is an overreaction of the
immune system to a specific food protein. When the food
protein is ingested, in can trigger an allergic reaction that
may include a range of symptoms from mild symptoms
(rashes, hives, itching, swelling, etc.) to severe
symptoms (trouble breathing, wheezing, loss of
consciousness, etc.). A food allergy can be potentially
fatal.
Unlike food allergies, food intolerances do not involve the
immune system. People who are lactose intolerant are
missing the enzyme lactase, which breaks down lactose,
a sugar found in milk and dairy products. As a result,
lactose-intolerant patients are unable to digest these
foods, and may experience symptoms such as nausea,
cramps, gas, bloating and diarrhea. While lactose
intolerance can cause great discomfort, it is not life-
13. Avoid foods that contain milk or any of these
ingredients
Chef Ashokkumar13
Butter, butter fat, butter
oil, butter acid, butter
ester(s)
Buttermilk
Cheese
Cottage cheese
Cream
Curds
Custard
Ghee
Half-and-half
Lactose
Lactulose
Milk (in all forms, )
Milk protein hydrolysate
Pudding
Rennet casein
Sour cream, sour cream
solids
Sour milk solids
Whey (in all forms)
Whey protein
hydrolysate
Yogurt
14. Milk is sometimes found in the following:
Chef Ashokkumar14
Artificial butter flavor
Baked goods
Caramel candies
Chocolate
Lactic acid starter culture and other bacterial cultures
Luncheon meat, hot dogs, sausages
Margarine
Nisin
Nondairy products
Nougat
15. Some Unexpected Sources of Milk*
Chef Ashokkumar15
Deli meat slicers are frequently used for both meat and
cheese products.
Some brands of canned tuna fish contain casein, a milk
protein.
Many non-dairy products contain casein (a milk
derivative), listed on the ingredient labels.
Some specialty products made with milk substitutes (i.e.,
soy-, nut- or rice-based dairy products) are manufactured
on equipment shared with milk.
Some meats may contain casein as a binder. Check all
labels carefully.
Shellfish is sometimes dipped in milk to reduce the fishy
odor.
Many restaurants put butter on steaks after they have
been grilled to add extra flavor. The butter is not visible
after it melts.
Some medications contain milk protein.
16. Egg Allergy
Chef Ashokkumar16
Egg allergy is one of the
most common food allergies
in children, second only to
milk allergy. Symptoms of an
egg allergy reaction can
range from mild, such as
hives, to severe, such as
anaphylaxis.
While the whites of an egg
contain the allergenic
proteins, patients with an
egg allergy must avoid all
eggs completely (the egg
white and the egg yolk). This
is because it is impossible to
separate the egg white
completely from the yolk,
causing a cross-contact
issue.
17. Avoid foods that contain eggs or any of
these ingredients:
Chef Ashokkumar17
Albumin (also spelled albumen)
Egg (dried, powdered, solids, white, yolk)
Eggnog
Lysozyme
Mayonnaise
Meringue (meringue powder)
Ovalbumin
Surimi
18. Eggs are sometimes found in the following:
Chef Ashokkumar18
Baked goods
Egg substitutes
Lecithin
Macaroni
Marzipan
Marshmallows
Nougat
Pasta
19. Some Unexpected Sources of Egg*
Chef Ashokkumar19
Eggs have been used to create the foam or topping on
specialty coffee drinks and are used in some bar drinks.
Some commercial brands of egg substitutes contain egg
whites.
Most commercially processed cooked pastas (including
those used in prepared foods such as soup) contain egg
or are processed on equipment shared with egg-
containing pastas. Boxed, dry pastas are usually egg-
free, but may be processed on equipment that is also
used for egg-containing products. Fresh pasta is
sometimes egg-free, too. Read the label or ask about
ingredients before eating pasta.
Egg wash is sometimes used on pretzels before they are
20. Cooking and Baking Tips
Chef Ashokkumar20
Milk
Fortunately, milk is one
of the easiest
ingredients to substitute
in baking and cooking. It
can be substituted, in
equal amounts, with
water or fruit juice. (For
example, substitute 1
cup milk with 1 cup
water.)
21. Cooking and Baking Tips………….
Chef Ashokkumar21
Eggs
For each egg, substitute one of the following in
recipes. These substitutes work well when baking
from scratch and substituting 1 to 3 eggs.
1 tsp. baking powder, 1 T. liquid, 1 T. vinegar
1 tsp. yeast dissolved in 1/4 cup warm water
1 1/2 T. water, 1 1/2 T. oil, 1 tsp. baking powder
1 packet gelatin, 2 T. warm water. Do not mix until
ready to use.
22. Cooking and Baking Tips………….
Chef Ashokkumar22
Wheat
When baking with wheat-free flours, a combination
of flours usually works best. Experiment with
different blends to find one that will give you the
texture you are trying to achieve.
Try substituting 1 cup wheat flour with one of the
following:
7/8 cup rice flour
5/8 cup potato starch flour
1 cup soy flour plus 1/4 cup potato starch flour
1 cup corn flour
24. Wheat Allergy
Chef Ashokkumar24
Wheat allergy is most common in children, and is usually
outgrown before reaching adulthood, often by age three.
Symptoms of a wheat allergy reaction can range from
mild, such as hives, to severe, such as anaphylaxis
A wheat allergy can present a challenge for the diet as
well as for baking, because wheat is the nation’s
predominant grain product. Someone on a wheat-
restricted diet can eat a wide variety of foods, but the
grain source must be something other than wheat. In
planning a wheat-free diet, look for alternate grains such
as amaranth, barley, corn, oat, quinoa, rice, rye, and
tapioca. When baking with wheat-free flours, a
combination of flours usually works best. Experiment with
different blends to find one that will give you the texture
you are trying to achieve.
25. Differences between Wheat Allergy and
Celiac Disease or Gluten Intolerance
Chef Ashokkumar25
A wheat allergy should not be confused with “gluten
intolerance” or celiac disease. A food allergy is an
overreaction of the immune system to a specific food
protein. When the food protein is ingested, in can trigger
an allergic reaction that may include a range of
symptoms from mild symptoms (rashes, hives, itching,
swelling, etc.) to severe symptoms (trouble breathing,
wheezing, loss of consciousness, etc.). A food allergy
can be potentially fatal.
Celiac disease (also known as celiac sprue), which
affects the small intestine, is caused by an abnormal
immune reaction to gluten. Usually diagnosed by a
gastroenterologist, it is a digestive disease that can
cause serious complications, including malnutrition and
intestinal damage, if left untreated. Individuals with celiac
disease must avoid gluten, found in wheat, rye, barley
and sometimes oats. Learn more about celiac disease>
People who are allergic to wheat often may tolerate other
26. Avoid foods that contain wheat or any of
these ingredients:
Chef Ashokkumar26
Bread crumbs
Bulgur
Cereal extract
Couscous
Durum
Flour (all purpose, bread,
cake, durum, enriched,
graham, high gluten, high
protein, instant, pastry,
self-rising, soft wheat,
steel ground, stone
ground, whole wheat)
Hydrolyzed wheat protein
Matzoh, matzoh meal
Pasta
Semolina
Spelt
Sprouted wheat
Vital wheat gluten
Wheat (bran, durum,
germ, gluten, grass, malt,
sprouts, starch)
Wheat bran hydrolysate
Wheat germ oil
Wheat grass
Wheat protein isolate
Whole wheat berries
27. Wheat is sometimes found in the following:
Chef Ashokkumar27
Glucose syrup
Surimi
Soy sauce
Starch (gelatinized starch, modified starch, modified
food starch, vegetable starch)
28. Some Unexpected Sources of Wheat*
Chef Ashokkumar28
Read ingredient labels carefully, even if you would
not expect the product to contain wheat. Wheat has
been found in some brands of ice cream, marinara
sauce, play dough, potato chips, rice cakes, turkey
patties and hot dogs.
Wheat also may be found in ale, baking mixes,
baked products, batter-fried foods, beer, breaded
foods, breakfast cereals, candy, crackers, processed
meats, salad dressings, sauces, soups, soy sauce,
and surimi.
Some types of imitation crabmeat contain wheat.
30. Soy Allergy
Chef Ashokkumar30
Soybean allergy is one of the more common food
allergies, especially among babies and children.
Approximately 0.4 percent of children are allergic to soy.
Studies indicate that an allergy to soy generally occurs
early in childhood and often is outgrown by age three.
Allergic reactions to soy are typically mild; however,
although rare, severe reactions can occur
Soybeans are a member of the legume family, which
include plant species that bear seed pods that split upon
ripening. Some examples of other legumes include
beans, peas, lentils and peanut. People with a soy allergy
are not necessarily allergic to other legumes. If you are
allergic to soy, you do not have a greater chance of being
allergic to another legume (including peanut) than you
would to any other food.
31. Avoid foods that contain soy or any of these
ingredients:
Chef Ashokkumar31
Edamame
Miso
Natto
Shoyu
Soy (soy albumin, soy cheese, soy fiber, soy flour, soy grits,
soy ice cream, soy milk, soy nuts, soy sprouts, soy yogurt)
Soya
Soybean (curd, granules)
Soy protein (concentrate, hydrolyzed, isolate)
Soy sauce
Tamari
Tempeh
Textured vegetable protein (TVP)
Tofu
32. Some Unexpected Sources of Soy*
Chef Ashokkumar32
Soybeans and soy products are found in many
foods, including baked goods, canned tuna and
meat, cereals, cookies, crackers, high-protein energy
bars and snacks, infant formulas, low-fat peanut
butter, processed meats, sauces, and canned broths
and soups.
34. Fish Allergy
Chef Ashokkumar34
Finned fish can cause severe allergic reactions
(such as anaphylaxis).
Salmon, tuna and halibut are the most common
kinds of finned fish to which people are allergic.
More than half of all people who are allergic to one
type of fish also are allergic to other fish, so allergists
often advise their fish-allergic patients to avoid all
fish. Finned fish and shellfish do not come from
related families of foods, so being allergic to one
does not necessarily mean that you must avoid both.
It has been estimated that there are upwards of
20,000 species of fish. Although this is not an
exhaustive list, allergic reactions have been
commonly reported to:
36. Some Unexpected Sources of Fish*
Chef Ashokkumar36
Caesar salad and Caesar dressing
Worcestershire sauce
Bouillabaisse
Imitation or artificial fish or shellfish (surimi, also
known as “sea legs” or “sea sticks,” is one example)
Meatloaf
Barbecue sauce
Caponata, a Sicilian eggplant relish
37. Fish Allergy
Chef Ashokkumar37
Many people who are allergic to fish or shellfish are
allergic to more than one kind.
The protein in the flesh of fish most commonly causes
the allergic reaction; however, it is also possible to have a
reaction to fish gelatin, made from the skin and bones of
fish. Although fish oil does not contain protein from the
fish from which it was extracted, it is likely to be
contaminated with small molecules of protein and
therefore should be avoided.
Carrageenan, or "Irish moss,” is not fish. It is a red
marine algae that is used in a wide variety of foods,
particularly dairy foods, as an emulsifier, stabilizer and
thickener. It appears safe for most individuals with food
allergies.
39. Shell fish Allergy
Chef Ashokkumar39
Shellfish can cause severe allergic reactions (such
as anaphylaxis). This allergy usually is lifelong.
Approximately 60 percent of people with shellfish
allergy experienced their first allergic reaction as
adults. Shrimp, crab and lobster cause most shellfish
reactions. Finned fish and shellfish do not come from
related families of foods, so being allergic to one
does not necessarily mean that you must avoid both.
To prevent a reaction, strict avoidance of shellfish
and shellfish products is essential.
40. Shell Fish Allergy
Chef Ashokkumar40
There are two kinds of shellfish: crustacea (such as
shrimp, crab and lobster) and mollusks (such as
clams, mussels, oysters and scallops). Reactions to
crustacean shellfish tend to be particularly severe. If
you are allergic to one group of shellfish, you might
be able to eat some varieties from the other group.
However, since most people who are allergic to one
kind of shellfish usually are allergic to other types,
allergists usually advise their patients to avoid all
varieties.
41. Shellfish are sometimes found in the
following:
Chef Ashokkumar41
Bouillabaisse
Cuttlefish ink
Glucosamine
Fish stock
Seafood flavoring (e.g., crab or clam extract)
Surimi
42. Irish Moss
Chef Ashokkumar42
Carrageenan, or "Irish
moss,” is not shellfish. It
is a red marine algae
that is used in a wide
variety of foods,
particularly dairy foods,
as an emulsifier,
stabilizer, and thickener.
It appears safe for most
individuals with food
allergies.
44. Sesame Allergy
Chef Ashokkumar44
Although the exact prevalence of sesame allergy is
unknown, several reports have shown that sesame
allergy prevalence has increased significantly in the
worldwide population over the past two decades.
46. Examples of foods that may contain sesame
include:
Chef Ashokkumar46
Baked goods (such as bagels,
bread, breadsticks, hamburger
buns and rolls)
Bread crumbs
Cereals (such as granola and
muesli)
Chips (such as bagel chips, pita
chips and tortilla chips)
Crackers (such as melba toast and
sesame snap bars)
Dipping sauces (such as baba
ghanoush, hummus and tahini
sauce)
Dressings, gravies, marinades and
sauces
Ethnic foods such as flavored rice,
noodles, risotto, shish kebabs,
stews and stir fry
Falafel
Goma-dofu (Japanese dessert)
Herbs and herbal drinks
Margarine
Pasteli (Greek desert)
Processed meats and sausages
Protein and energy bars
Snack foods (such as pretzels,
candy, Halvah, Japanese snack
mix and rice cakes)
Soups
Sushi
Tempeh
Turkish cake
Vegetarian burgers
Non-Food Items that May Contain
Sesame
47. Other Allergens
Chef Ashokkumar47
While only eight foods (milk, egg, peanut, tree nuts, fish,
shellfish, wheat, and soy) account for approximately 90
percent of all food-allergic reactions, a person can be
allergic to virtually any food.
While the list below is not exhaustive, allergic reactions
have been reported to:
Corn
Gelatin
Meat (beef, chicken, mutton, and pork)
Seeds (sesame, sunflower, and poppy being the most
common)
Spices (caraway, coriander, garlic, mustard, etc.)
Allergic reactions to fresh fruits and vegetables, such as
apple, carrot, peach, plum, tomato and banana, to name
a few, are often diagnosed as Oral Allergy Syndrome.
48. Un common Food Allergy
Chef Ashokkumar48
Corn Allergy
Allergic reactions to
corn are rare and a
relatively small number
of case reports can be
found in medical
literature. However, the
reports do indicate that
reactions to corn can be
severe. Reactions to
corn can occur from
both raw and cooked
corn.
50. Chef Ashokkumar50
Allergies to meats, such as beef, chicken, mutton or
pork, are also rare. A person who is allergic to one
type of meat may not need to avoid other types of
meat. Heating and cooking meat can reduce the
allergen city of product.
those with egg allergy are generally not advised to
also avoid poultry, and vice versa.
Some people with allergy to mammalian meat
experience allergic symptoms 3-6 hours after
ingesting beef, pork or lamb. This type of meat
allergy has been attributed to allergy to a type of
sugar in meat called “alpha-gal”. This type of allergy
has been traced to having had tick bites.
51. Gelatin Allergy
Chef Ashokkumar51
Gelatin is a protein that
is formed when skin or
connective tissue is
boiled. Although rare,
allergic reactions to
gelatin have been
reported.
It is a translucent,
colorless, brittle (when
dry), flavorless food
derived
from collagen obtained
from various animal
body parts. It is
commonly used as
53. Seed Allergy
Chef Ashokkumar53
Allergic reactions to seeds can be severe. Sesame,
sunflower, and poppy seeds have been known to
cause anaphylaxis.
Seeds are often used in bakery and bread products,
and extracts of some seeds have been found in hair
care products.
Some seed oils are highly refined, a process that
removes the proteins from the oil. However, as not
all seed oils are highly refined, individuals with a
seed allergy should be careful when eating foods
prepared with seed oils.
55. Spice Allergy
Chef Ashokkumar55
Allergies to spices, such as coriander, garlic, and
mustard, are rare and are usually mild, although
severe reactions to spices have been reported.
Some spices cross-react with mugwort and birch
pollen, so patients who are sensitive to these
environmental allergens are at a higher risk for
developing an allergy to spice
56. Anaphylaxis
Chef Ashokkumar56
It is a serious allergic reaction that is rapid in onset
and may cause death, It typically causes more than
one of the following: an itchy rash, throat or tongue
swelling, shortness of breath, vomiting,
lightheadedness, and low blood pressure. These
symptoms typically come on over minutes to hours.
58. Allergy versus Intolerance Food Allergy
Food Intolerance
Food Allergy Food Intolerence
Chef Ashokkumar58
An immune response to an
ingested food or food
additive that contains a
protein or a molecule linked
to a protein
Reaction is not dose-
dependent
Requires a “sensitizing
event”that primes the
immune system for future
response
Allergic potential is an
inherited characteristic (is
idiosyncratic)
A generic term describing an
abnormal physiological
response to an ingested food or
food additive which is not a
result of an immune
response
Does not require “priming”
Reaction is dose-dependent:
symptoms are dependent on
amount and frequency of
consumption
Reaction is sometimes
inherited, but not always
59. Examples of Food Intolerance
Chef Ashokkumar59
MSG sensitivity
Mechanism unknown
Sensitivity to food
additives
Various mechanisms
Sensitivity to biogenic
amines
Tyramine
Histamine
Lactose intolerance:
Deficiency of lactase
Sucrose intolerance:
Deficiency of sucrase
Sulphite intolerance:
Possibly deficiency of
sulphite oxidase
60. Celiac Disease
Chef Ashokkumar60
A hypersensitivity to gluten
a protein found in wheat, barley, rye, and certain
other grains.
Chronic inflammatory disorder of small intestine.
Cell-mediated allergic response.
May also include dermatitis herpetiformis
a chronic skin disorder caused by an IgA-mediated
hypersensitivity to gluten.
61. Managing Food Allergy
Chef Ashokkumar61
Avoid the allergen-containing food(s)
Develop a Food Allergy Action Plan
Inform and involve family, friends, and caretakers.
Early symptom recognition
Emergency therapy: Epinephrine (adrenaline).
Medical identification necklaces/bracelets
Education:
Be able to identify the allergenic food and alternative names
for the allergen.
Avoid foods likely to contain, or be contaminated by the
allergen
Be aware of all terms on food labels that would indicate the
possible presence of the food.
