Food Allergy Guidelines: Holiday Edition

The holiday season is now upon us!  Along with shopping for gifts and pulling out your ski gear, this means holiday gatherings throughout the upcoming month and seeing family and friends.  So often these events revolve around food which can be stressful for those of us living with food allergies. Here are some of the guidelines I’ve put in place for myself to help ease any uncertainty I may have in these environments and allow me to enjoy the event:

  1. Find out what type of event it is in advance.  I find cocktail parties much easier to navigate as there is less focus on the food and whether or not you are eating.  I try to speak to the organizer in advance and, if the event is at a restaurant, I will often contact the restaurant directly.  I often end up not eating at all at these events, but it’s helpful to know if any of my most severe allergens are being passed around.
  2. Offer to host a dinner yourself!  While this can be a lot of work, it will ensure that you know exactly what is being served and what you can eat safely.
  3. Get involved with the planning.  For work parties, I have often been on the organizing committee and involved in the venue and menu selection.  The ability to influence the decision on where the event is held and what will be served is key and you can also be an advocate for other people with dietary restrictions to ensure others are comfortable asking questions about the menu.
  4. Bring your own meal.  If it is a gathering revolving around a meal (ie. a sit-down lunch or dinner), speak to the host/hostess about bringing your own food.  I typically try to match my food to follow the same theme as what they are planning to serve and bring it in my own container that I can easily heat up.
  5. Eat first!  If you are going to an event where food will be passed around, be sure to eat beforehand so that you don’t end up hungry by the end of the night.
  6. Be first in line.  While it may appear rude to some, I have always felt more comfortable dishing my food early in the serving process when the serving utensils are not being passed between dishes and there is a smaller chance of cross-contamination.
  7. If you are attending a lunch or dinner, offer to bring a dish that is substantial enough that you can just eat that, if necessary.  Also bring along a set of dedicated serving utensils to ensure that they are clean and not being passed between dishes.

If you feel unsure about something, don’t feel the need to eat or drink it.  Those of us who are hyper aware of cross-contamination will know that guests or servers often pass around different food trays, mix & match serving utensils and even touch drink glasses without thinking about what they’ve previously touched or eaten.

The holidays and all the events associated with them can be a real time of stress and anxiety for those of us with food allergies, but if you can plan ahead, communicate well, and are comfortable with the fact that not all gatherings will revolve around the food, then you can enjoy them safely!

– Alison M.

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Generalized Anxiety Disorder and Life-Threatening Allergies

Having a life-threatening food allergy can be scary, but what happens when you also suffer from a diagnosed anxiety disorder? How do you cope with having a sensitive food allergy, without having anxiety attacks every time you go out to eat, or go to a party?

About five years ago, I was diagnosed with a form of Generalized Anxiety Disorder but had been noticing symptoms for far longer than that. For me, Generalized Anxiety Disorder symptoms come in the form of constant worrying, with certain situations making those worries feel even more intense. Prior to this diagnosis, I experienced two anaphylactic reactions, both of which required me to administer my EpiPen®. One of these anaphylactic reactions occurred at a Christmas party I was at, and another was at a casual fast food restaurant, where there was a miscommunication between myself and the cashier. Both instances caused my anxiety levels to rise and made me feel intensely worried anytime I ate away from home.

Overcoming the obstacles of being able to eat food that I didn’t prepare myself was a challenge, but with time and preparation, eating out became a manageable task, which didn’t cause me to feel severe anxiety.

The first step I took in managing my food allergy anxiety was making a promise to myself to be far more diligent than I had been in the past. One area of my life that I recognized I needed to take more control over in order to help manage my anxiety was going to events with baked goods. Typically, if I went to this kind of event , I felt confident enough to eat it if the baker assured me that they were tree nut and peanut safe. However, this still left the possibility of “what if?” As a healthier alternative for my mental health, I started bringing my own baked goods, or potluck items to parties in two separate containers – one container for myself, to ensure that my items didn’t get cross contaminated with other items, and another container for the rest of the party-goers to enjoy. If I wanted to enjoy food that I didn’t bring, I started to make sure that it was pre-packaged from a store and had ingredient labels on it that I could read. I would also ensure I was the first one to grab food out of the package before any other cross-contamination could occur.

The second step I took in managing my food allergy anxiety, was being more careful and inquisitive at restaurants – even fast food ones. Typically, when going to a fast food restaurant, I had a bad habit of not mentioning my food allergies at all. When ordering a sandwich, which was supposed to be allergy safe, it mistakenly had a sauce on it which included tree-nuts. This bad experience caused me to have severe anxiety whenever I visited any type of restaurant or fast food establishment. After this incident, I started being more diligent to ensure that every restaurant I visited – from fast food to fine dining – was aware that I had life-threatening allergies to tree nuts and peanuts. I also started to make sure that I asked about the food making and cooking procedures at the restaurant, and whether or not the kitchen used tree nuts and peanuts in their dishes. Doing my research and asking lots of questions helps to minimize my anxiety and helps to ensure I feel safer when eating out in public.

The third and final step that I took in conquering my food allergy anxiety was being more confident. Not only did I feel anxious about my food allergies, but I also constantly worried about whether I was being a burden to the people around me when asking lots of questions about allergy safe items or holding up the server at a restaurant to ensure my dish was safe for me to eat. Since being diagnosed with Generalized Anxiety Disorder, I’ve come across a lot of resources which have helped me deal with my constant worries. Over time, I’ve learned that I’m not being bothersome when asking about allergy safe food, because without doing that, my life could be at risk.

Having life-threatening food allergies, and managing anxiety can be tough, but with the right tools and confidence, it’s extremely possible.

– Rachel MacCarl

Guest Post: When an Angling Passion and a Fish Allergy Collide

I learned to enjoy fishing a couple years before learning that I was allergic to fish.

My first fishing experience happened when I was a boy of four. My immediate family was down in Texas on a cattle ranch owned by my mother’s family, which, like most ranches in the area, featured a pond that was regularly stocked with fish.

Accompanied by our dad, my brother and I went to work on the pond with nothing but a cane pole, a plastic bobber, and a worm on a hook. I don’t remember much about that day of fishing, with the exception of a clear memory of gripping the wetted line and hoisting aloft my first, wriggling catch – a perch of what must have been no more than five inches.

Of course, I had plenty of help from my dad but pride swelled in my chest.

A few years later, another sensation signaled that I’d have to take extra precautions with fishing for the rest of my life.

Right after the birth of my third and fourth brothers – the twins – my mother arranged a housekeeper to help tidy up our Northern California home. She was a great help to us, and very generous. The housekeeper’s husband was an avid angler who fished the San Francisco Bay and sometimes ventured into coastal waters for larger fare.

One day our housekeeper turned up with the gift of her husband’s latest catch – a beautiful red snapper. The species of rockfish has since become somewhat endangered off the California coast. My mom dutifully accepted the snapper and proceeded to fillet and cook it.

Like many Western families at the time, our experience of eating fish was limited to the occasional tuna fish sandwich (a nice break from peanut butter and jelly or bologna). So, the spread of snapper and thick potato chips was quite the novelty, and my brother and I made quick work of eating it.

A few minutes after finishing the meal, however, I began to feel a prickly sensation in my mouth and throat. Looking in the mirror, I saw that my lips were ringed with red hives. In a few more minutes, the hives sprang up on my back as well. The reaction (not to mention the age range) was very similar to Simone’s account of her first experience as noted in the blog post linked here: Oral Allergy Syndrome.

Luckily, the reaction stopped there and subsided over the course of a day, but the implication was clear: the snapper had caused an allergic reaction.

This was quite the surprise, given my family’s regular consumption of tuna fish. But fish and shellfish allergies are quite complex, it turns out. Some people are allergic to certain proteins called parvalbumins found in all fish species. Others, like me, are allergic to the parvalbumins found in some fish species but not others.

Unfortunately, there’s no real pattern of intolerance for me to follow. Tuna are in the Scombroidea family, which is the best tolerated fish among those with fish allergies, and I’ve continued to eat tuna to this day with no impact (although I take my tuna sandwich with my epinephrine auto-injector at the ready, just in case).

I’ve had allergic reactions to other species, including cod and mahi-mahi, during a couple of controlled-condition tests in my early 20’s. In each case, the reaction was the same: a prickly sensation in my throat accompanied by hives. It has never risen to a level beyond one that is manageable by a dose of an anti-histamine to minimize the hives on my body.

I’ve stopped testing new fish species since it just doesn’t seem worth it to take the risk. Despite the new allergy, I’ve maintained an interest in angling over the years. When I fish, I follow the recommendations from the American Academy of Asthma and Immunology (AAAI):

  • Wear gloves when handling your catch. Bonus points for wetting them before making contact to minimize trauma to the fish if you’re planning on a release.
  • Minimize the chance of sticking yourself with the hook. The best way to do this is with a good pair of jaw spreaders and fishing pliers. Together, they make quick work of removing a fish hook, which again is easier on the fish.
  • Never forget your epinephrine auto-injector.

Of course, the AAAI cautions anyone interested in fishing to follow their own best judgment. Their rules have worked for me so far, allowing me to keep pursuing my angling interest.

Recently I launched FishingTech.com. Because some of the most rewarding aspects of fishing – cooking and eating them – are off the table for me, the site’s focus is on other areas: the history and future of the electronics, gadgets, and software that make the sport easier for pros, more fun for amateurs like me, and more accessible to folks who couldn’t otherwise be fishing.

I like to tell myself that the fish allergy is also helping me by giving me some kind of karmic boost, with the fish somehow sensing that there’s no possibility of predation. But if that were the case, you’d expect a better success rate.

But I guess that’s why they call it fishing, not catching!

– Andrew M.

Eat, Drink and Be Scary: Allergen-Friendly Halloweens

As hinges creek from an unknown breeze, a door closes when no one was around, and the sound of footsteps follow you up the stairs. When spooky things are in the air and the sky goes dark…you know that Halloween is here! Happy haunts lurk behind every corner and pumpkins decorate porches as ghost’s float in nearby trees. As you can probably tell, I love this time of year for so many reasons, but Halloween is by far the biggest reason. What’s not to love about this wickedly ghoulish time of year? Well, for some of us there is a different chill in the air that has nothing to do with ghosts and goblins, and everything to do with treat bags and what tricks might be in them. Living with a food allergy during this time of year can be hard to navigate, so it’s important to be aware and look out for our allergens. From parties with friends, to having “trick or treaters” at your door, allergens can be anywhere and or hidden in so many unsuspecting things.

For those of us who are younger and out trick or treating, there are ways to stay safe and avoid your allergen(s). One example is waiting to eat until you get home as this will give you more time to read all food ingredient labels. If you’re handing out goodies, make sure you look for the speciality bags or badges that some children may have to indicate that they have allergies. If you plan to accommodate by handing out allergen-friendly goodies, consider putting a teal pumpkin out to show your support of food allergies, or a teal light in support of Food Allergy Canada’s new “Shine a Light” campaign. This also acts as an indicator to parents and kids that you have safe or non-food related treats. A small gesture goes a long way for kids who are out trick or treating and being conscious of allergens can make their night!

Dressing up is one of the best parts of Halloween. Each year my partner and I bet ourselves that we can out do our costumes from the previous year. Some years involve little to prepare while others take a good hour to create and paint. One important thing I’ve learned while living with food allergies at this time of year is to read everything, and I don’t just mean snacks. Make-up, fake blood, and other things that add a touch of flare to a costume may contain your allergens. Whether you’re applying zombie make-up or making sure your vampire comes equipped with blood fangs, make sure your allergens aren’t present in the product before application. I have found that anything from latex, or nut oils, to sulphites can be found in various makeups. Find something allergen-friendly and do a mark/spot test at least 24 hours before you plan to dress up in order to make your ghoulish appearance one to remember.

As you get older, Halloween becomes less about trick or treating and more about parties, scary movie marathons and other activities with our friends. But, much like going out and getting candy, our allergens can still be found at all of these events. One thing to keep in mind whether you’re binging your favourite horror movie series or at a party with friends is that it’s important to follow the same rules you normally follow in your everyday life. Read ingredient labels even if you’ve had that type of candy before. Some candy or chocolate bars could contain slightly different ingredients or have different labelling for Halloween since these smaller products may be processed in different facilities. If there are homemade goods, check with the chef/baker before eating. Ask about allergens, the risk of cross-contamination, etc., and only eat the foods that you’re 100% comfortable eating. A good alternative is to get your cauldron brewing and make your own treats to share with everyone so that you’re positive it’s allergen-friendly. You could also consider buying candy chocolates you’ve researched yourself and feel confident are  allergen-friendly.

As an adult at a Halloween party, you’re sure to run into some boos, wait no I mean booze. Pumpkin flavoured beers and other holiday treats are staples at most adult Halloween parties. Much like any other food, we need to make sure what we’re eating and drinking is allergen-friendly. If it’s a punch bowl, ask what fruits, flavours, and alcohols are involved. If it’s a shared/serve yourself bowl, make sure there is no risk of cross-contamination or see if you can get first dibs or a special cup/bowl just to be sure it’s allergen-friendly with no risk of cross-contamination. Allergen labelling on specialty beers and wines can be tricky, but I always try to call or email the company if I’m unsure of all the ingredients. A good trick for any party is to bring your own drinks, something you know is allergen-friendly and never leave your glass or drink unattended.

As we grow older it’s easy to lose the spirit of Halloween, dismissing it as a childish tradition. I think we need to get back to our childhood roots, tell each other ghost stories, eat candy together and dress up as our favorite characters and people. This year put out a teal pumpkin or light, have some allergen-friendly or non-food treats ready, grab a scary movie or have a party to get into the spooky spirit. Happy Halloween!

– Arianne K.

Cycling Preparations with Food Allergies

Why I’m biking from Toronto to Ottawa:

Last fall, I realized I had spent yet another summer with a pretty new bike and not a lot of biking. I decided that I needed motivation to get on my bike, and the joy of commuting in the rain just wasn’t enough.

I wanted to finally plan a big bike trip. I spoke with my allergist about it who recommended that I plan a route that considers a 30-minute ambulance response time. I’m allergic to a variety of fruits and vegetables, tree nuts, black pepper, and sulphites, so that’s a pretty reasonable request. After meeting with my allergist, I then talked to a paramedic friend of mine, to see where I could bike while staying in range of hospitals and ambulances. “Why not just come on the Paramedic Ride?” he joked. But then we both realized that it was actually a pretty good idea! I’m happy to raise awareness and funds for a Paramedic Memorial, and I get a very safe bike trip in the deal! Plus, I figured that meeting more paramedic friends is not a bad idea!

How I got ready:

This trip was mostly complicated by how to transport my bicycle, and how to manage my food allergies. I started getting ready last fall, by borrowing a winter trainer. I didn’t get it set up until Christmas, but then I got into a rhythm of biking in the garage while watching Netflix. The sawdust in my garage was mildly itchy at times and going outside in the winter after training hard involved quite a brief cold spurt (if I had more space I’d definitely consider bringing the trainer indoors).

I quickly discovered that learning to bike long distances with allergies also involves learning to make sport snacks and foods. I read A LOT in an attempt to figure out how to make an electrolyte drink, and when I realized I was tired from lacking them, I started adding a little more salt and a lot more protein to my biking snacks. I would highly recommend The Feed Zone Portables cookbook for a variety of “from-scratch” sport food ideas.

In the end, I settled for mostly eating bananas, making cookies, and occasionally making granola bars. I gave up on the granola bars half way through the summer when my jaw started hurting because they were too chewy (oops) but I will definitely keep trying recipes. On the electrolyte front, there are a bunch of great DIY recipes, but most involve a few ingredients I am not yet allowed to consume. So I talked to my mom, a nurse in the remote town of Angola, and she explained that for a better-than-nothing solution she usually puts a spoon of sugar, two pinches of salt, and a bit of flavouring into a litre of water. I’ve translated that into 1 scant teaspoon of salt, 1 heaping teaspoon of sugar, and a good splash of homemade ginger syrup into 1.5 litres of water. It’s not perfect or ideal, but I reserve its use for days when it’s really hot or when I’m doing a long bike workout (30-km or more).

With all the food and snacks prepared, I have managed 2500-km of biking so far in 2018, with my longest ride being a 115-km trip around the small town of Carp, Ontario. I might have had a little too much fun in my last week of training, biking around the city on specific streets to “write” out the fundraising website!

 

What I brought with me:

Most importantly, I packed a couple epinephrine auto-injectors. I’d usually bring more for a big trip, but the Canada-wide Epi-Pen® shortage makes my pharmacy reluctant to pass out more than absolutely needed. That being said, I’m not concerned since we’re getting an ambulance escort for the event.

Because I didn’t want to give the ride organizers the extra hassle of arranging safe food for me, I decided I’d pack my own food. Bananas and oranges are pretty much guaranteed to be supplied at biking events, and if not, I can definitely stock up on them in any little grocery store I encounter along the way. I have a few simple snack foods like Nori (seaweed), rice crackers, chocolate chips, and homemade cookies.

That left me with the meal food left to plan, as well as figuring out how to cook it. I didn’t want to just eat sandwiches, and since this ride has the luxury of ambulance support vehicles, I planned a few frozen meals and a number of homemade dehydrated ones as well. To cook these, I brought a one-burner electric stove, a frying pan for at the hotel, and a Hot Logic Mini (basically a plug-in lunchbox which heats meals and keeps them warm; it’s going to be my secret to instant hot meals whenever I stop). The frying pan is for boiling water for breakfast and will act as a general backup for cooking. I know hotels have microwaves sometimes, but they can be a pain to clean up, and they heat things less evenly. Plus, I hear we’re often stopping for lunch in parks for this event.

Lastly, I also made sure to think through my drink situation. At home I drink tap water, because some water filters contain trace amounts of sulphites (including some bottled waters), which give me predictable hives. I know the ride provides bottled water, so I’m just going to fill up each day with the water that I feel most safe drinking.

So now I have allergen-safe food and water, my bicycle, the hotel is booked, and I’ve been biking A LOT all summer. I feel ready, I’ve landed in Toronto… here I go!

– Janice H.

One Restaurant, Two Different Dining Experiences

I travel once a month for work to a small town where I stay for 3 nights. The town has limited restaurant options but enough to give me a variety of foods from which to choose. For this blog post, I want to highlight my experiences at a Tex Mex chain restaurant in particular. I’ve visited countless times and my overall experience has been great! That being said, I want to share two stories of how you can sometimes have completely different experiences at the same restaurant.

Situation #1: The First-Timer

The first time I travelled for work, I chose to eat here because I looked at the menu online and trusted the overall “vibe” I was getting in terms of allergen (peanut/tree nut) safety. What I mean by this is that I saw no peanuts on the menu and the only tree nuts were located in the salad section of the menu, which seems to be very normal these days. They also have a little blurb on the menu outlining their caution with food allergies and their ability to accommodate those living with food allergies. When I got to the restaurant, I let my server know about the severity of my food allergy. She assured me that the restaurant staff are very careful with food preparation in the back and that she would let everyone who handles the food know about my allergy. A few minutes later, the manager approached my table to inform me of their protocols. A specific chef was assigned to the preparation of my meal, sterilized utensils and pots/pans were to be used and they would do everything to ensure there was no risk of cross-contamination in the back. This sounded awesome! I was blown away by the awareness and the careful preparation that their restaurant protocol followed. I was served my meal and the wait staff followed up with me twice to ensure everything was going well, and I have to say, it definitely went well. I walked away feeling quite impressed with my new experience!

Situation #2: The Weird Vibe

The next month when I went back to this restaurant, I asked for the same menu item (steak fajitas-they are SO good!) and the restaurant staff followed the same protocol, with the manager approaching me before meal preparation. Where it got weird was when the manager followed up with my meal after I had taken a few bites. After asking how I was enjoying my meal, she said, “well, we haven’t killed you yet, so that’s a good sign!”

I’m a very easygoing person but for some reason this line irked me. It just didn’t sound right! It could be that the manager was feeling awkward about approaching me as the only person sitting at a table (I’ve noticed wait staff can be very awkward when I go to a restaurant alone, but what else can I do? I’m working!) It could also be that the manager just thought she needed to say something and didn’t filter herself before speaking. Whatever the case, I don’t think a line that includes “not killing” someone should ever be used, especially at a venue that serves food to someone with a life-threatening food allergy.

I’m not overreacting. I’m not even truly upset. I just wanted to share these stories to demonstrate how experiences can sometimes be amazing or weird at the same place for the same person. Weird vibes happen, but what I learned from these two visits is that as a person with food allergies, I should try to not let my guard down or become complacent just because I’ve had a good experience somewhere in the past. Diligence is my number one protector and as long as I am thorough in minimizing my risk, I can feel safe eating out and experiencing the wide world of eating while on the road!

– Dylan B.

Traveling to PEI with Food Allergies

This summer I had the opportunity to travel to the beautiful province of Prince Edward Island (P.E.I) for the first time on a semi-family vacation. As an adult going out east was a bit difficult since I was recently diagnosed with a fresh water fish allergy that has crept over into almost all fish. After a few hives and some close calls, I decided I’d stay away from all fish until I had more tests completed and information received. So what better place to visit this summer then “The Land of Anne” and fresh seafood? Prepping for the trip, I can break down my experiences into three significant food allergy related areas: Road trips, great food and a real confidence boost for me regarding my food allergies.

Part One: On the Road Again

My family and I all piled into an already packed car to drive the 11-ish hours through four provinces, three bags of chips, two bridges and only one cell phone charger. I’m lucky the people in the car knew about my allergies before the trip but that didn’t stop us from encountering a few speedbumps along the way. As a group, we had an on-going group chat where we talked and planned activities. Here I was able to communicate all of my allergies and more importantly, I was able to talk about the risk of cross-contamination, and about how I will not eat anything if I can’t read the ingredients first or know where/how it was made. This was cause for a bit of back and forth regarding homemade baked goods and assurance that it would be safe. For me, I am just not comfortable eating something that I am not familiar with, especially on the road in a new place. Mandatory road snacks aside, the biggest issue on the road came late at night. Our first and only stop before reaching our destination was in the province of New Brunswick late at night. Arriving at the hotel we all had cabin fever from spending nine plus hours in the car. I foolishly assumed we’d be able to find somewhere allergen-friendly to grab food before turning in for the night. Well boy was I wrong! Everything was closed and what was open was a pizza restaurant that couldn’t distinguish between sesame seeds and what they called “flavour seeds.” So I choose to play it safe and not to eat there. At 1:00 am, my only option was a vending machine and breakfast bars that I had packed for the next morning. I realized I packed like an unprepared fool. I had no plan B and I paid for it. The next day when places were open, I was able to find food before the last leg of our trip, but it taught me an important lesson of not taking things like pizza places for granted. I made a mental note to pack sandwiches and other things to eat for our way home.

Part Two: Great Food

It can be tough when travelling to a place where your allergen is extremely prominent, especially if it’s a new allergen. I was diagnosed with an allergy to fresh water fish only a few years ago, and I am still not as comfortable with it as I am with my other allergens. Since my nervousness tends to get the better of me, I did some serious emailing and calling to find some allergen-friendly places to eat in P.E.I before we left home. Luckily, we were planning to stay in a cottage where we had the ability to cook the majority of our meals. But, I was still extremely excited to try some local brew houses and great cuisine, so I was both extremely happy to find incredible safe places to eat and disappointed that some places were not safe. The biggest thing I learned was trusting my gut and calling ahead. I am so glad I took the time to call restaurants ahead of time and even received some suggestions from my sister-in-law on where to go. I didn’t let it get me down when places weren’t allergen-friendly, and I certainly didn’t let it stop me from having a drink there or discouraging others from eating or visiting places where my allergens were present. All in all, I had amazing food both made by me and my travel companions, and in lovely restaurants.

Part Three: Confidence Boost

The most important thing I can say about my trip or any trip for that matter, is to stay positive about your food allergies and not let your limitations get you down. If you’re uncomfortable eating somewhere, let people know or refrain from eating and wait until you get back to an allergen-friendly spot. Always carry extra snacks or something when you’re on-the-go and most importantly, speak up about your allergies and let others know if you feel uncomfortable. Even if it may feel awkward to bring up or impede on your travel companions’ food and traditions, if you feel unsafe, speak up and let others know. The weight you feel lifted off your shoulders when you share your food allergy concerns with others is amazing because they’ll likely want to help you and keep you safe. It can be a real boost in confidence when you speak openly and honestly about your allergies, and I’m always grateful when the people around me care and want to listen as well.

I love to travel, whether its seeing our beautiful country or abroad, it’s amazing to get out of my comfort zone and gain a new perspective. Just because I have food allergies, doesn’t mean that I can’t try new foods, see new places, and enjoy myself. Having a plan, packing safe food, and maintaining a good attitude is a sure-fire way to have the best allergy-friendly vacation. Don’t hold yourself back; trust your gut and go out there and explore the world!

– Arianne K.

By Food Allergy Canada