Food Allergies at Weddings

WhyRiskIt? Teen Allergy Blog

a wedding pic

I get so excited when I receive a wedding invitation in the mail. I love hearing that my friends or families have found that special someone and I love joining in on the celebration!

However, there is usually one slip of paper that comes along with the invitation that brings my thoughts away from the ceremony, the speeches and the party. I’m talking about that slip that asks you to indicate your food selection for the reception.

I love seeing a few options on this slip, as there are usually a couple options I can cross off right away. I am allergic to seafood, and fish is usually one of those options. That typically leaves me analyzing the meat and vegetarian dishes. More information is always better, but sometimes it just says meat with a special sauce, or vegetables with certain fixings. What’s in that special sauce? What on earth…

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Dining with Clients and Cayenne: Guest Post by Patricia J. Pawlak

Pat (dining with cayenne allergy)

 

I have been fortunate enough to have a career where I traveled the world and had to entertain. For me, there is something exhilarating about sitting down with clients for a culinary experience, getting to know them, and knowing you may have to close a deal. In that situation, you want to stay focused and be charming. Nothing zaps the energy out of a dining experience more then having the focus of the evening on your food allergy. I dread the drama of it all and my clients enduring the waiter/ kitchen sprint because of my food allergies.

I have developed such an intolerance to all capsicum, i.e. cayenne, paprika and cumin, that my throat closes up, I start to shake and then, within 10/15 minutes, I actually projectile vomit. It comes on so quickly, violently and unexpectedly that, even during a lunch, I was rushed to the hospital projectiling (as I ruined my new red silk suit).

After several of these rushed trips to the ER, I finally went to an allergy specialist who diagnosed my malaise as the worst possible allergic reaction one can suffer and still survive.

Thanks to Emeril, and the influx of some certain cuisines, most restaurants have infused, charged, and drilled their menus with chili, cayenne, and paprika and made it impossible for me to dine in many restaurants. I have discovered that even the nicest restaurants now marinate all their meat, fish, and chicken dishes with some form of capsicum. That means even a chicken salad is off limits and watch those candied pecans; they have chili on them now.  For some reason, many restaurant salad dressings have cayenne or paprika—even a simple Caesar dressing.  Deserts, from cheesecake to tiramisu, are now spiked with cayenne.  I have even been served strawberries with a “surprise.” Thankfully, I asked what the surprise was or the restaurant would have been surprised! I have gone to restaurants and not been able to have any dish on the menu.

My strategy now is to check out a menu first before I suggest a restaurant for business.  I ignored my own advice last week; I went to a good sushi restaurant thinking that I would not have to bring up my food allergy in front of my clients. To my chagrin, I opened the menu and the first sushi listed was “Jalapeño Sushi” and, along down the line of the menu, most had heat. I had no other choice but to have the proverbial conversation to make sure what dishes I could eat.

The frustration lies not only in its increase of use but in its use in dishes that historically never had any form of heat.  Even when I order a dish that couldn’t possibly have cayenne, Fettuccini Alfredo, I have had it come with cayenne sprinkled all over.  I have asked for plain poached fish (“nothing on it, plain, please”) trying to be discreet. And the fish came covered in chili flakes. When I explained finally that I had an allergy, I was told “You don’t know what good is!” This is not about taste, this is about health and, in my opinion, our taste buds are being hijacked by all this heat!

I am meeting more and more people daily who are developing this allergy due to the proliferation of this spice.  Hopefully, chefs will begin to take notice and will begin to create more interesting dishes instead of just throwing in the heat.
Patricia

Allergy Testing: An Important Part of Your Diagnosis

Doctor writing prescription

Any specific medical information that follows stems from the following article and is not intended to be taken as definitive or wholly sufficient information. Consult your physician or, in this case, an allergist regarding these topics:

James, T. (2002). Allergy testing.  American family physician. 

http://www.aafp.org/afp/2002/0815/p621.html

 

When living with food allergies, the irritable symptoms that certain foods can produce serve as a prominent indicator for identifying what foods need to be avoided.   That being said, also undergoing allergy testing is important to be fully diagnosed with a food allergy and to initiate effective management of food allergies.  An official food allergy diagnosis is described as consisting of a medical history, physical examination, as well as an allergy test.  Allergy testing is also a way to legitimately distinguish between food allergies and food intolerances.  Food allergies and food intolerances can easily be confused.  In basic terms, a food allergy is a reaction that is triggered by the immune system to a food allergen while food intolerance is related to issues with other body systems, such as digestive problems, which also trigger unpleasant symptoms.  Allergy testing works to identify the body’s immune reaction to specific allergens.
While many of us have gone through a variety of allergy testing, we also may have been fortunate to outgrow allergies or, less-fortunately, developed allergies later in life.  Both of these occurrences are good reasons to seek out allergy testing as adults.  Tests available include IgE skin tests, challenge tests, and blood tests. IgE skin tests (or immediate type hypersensitivity skin tests) are the most common form of allergy testing. This test involves exposing the skin to a small amount of allergen through making a small indentation or ‘pricking’ the surface of the skin.  A reaction should occur within 20 minutes and appears as a small red swollen bump on the skin (also known as the ‘wheal and flare’). If a test is negative, and there is still a suspicion of a food allergen, an intradermal injection can be performed injecting a small amount of the allergen just under the surface of the skin. The physician will again observe for a small red bump to form.  Challenge testing for allergies involves eating a small amount of the suspected allergen.  As I’m sure you would agree, this is a form of testing that should ONLY be performed with your allergist present.  Finally, blood tests involve drawing blood and performing an IgE assay to determine the IgE antibody levels present in the blood that correspond for certain allergens.

If preparing to undergo allergy testing, it can be beneficial to know the benefits and drawbacks of each test compared to one another.  Skin tests can be preferable because they give the fastest result and are relatively less expensive than blood tests.  A drawback to these tests includes the obvious annoying itching that is produced with a positive test.  As well, this test may not be appropriate for those on certain medications such as medications with antihistamine properties that include anticholinergic medications, phenothiazine, and tricyclic antidepressants. Skin testing may also be contraindicated in those with certain skin conditions such as atopic dermatitis. The risk of undergoing a severe reaction with skin testing is extremely low with one retrospective study in the USA finding that, out of 18,331 participants whom underwent skin testing over a period of five years, only 6 developed mild systemic reactions (James T.). In terms of the sensitivity and specificity of skin testing, this has been shown to vary with food versus environmental allergens.  Another study conducted found that, when percutaneous skin testing for an allergen was done as part of a two-part allergy test that included a challenge test, the sensitivity of the test ranged from 76-98% with a specificity of 29-57% depending on the food being tested for(James T.). For those unfamiliar with these terms, Sensitivity represents the accuracy the allergy test correctly identifying someone who is in fact allergic. Specificity represents how often someone who doesn’t have an allergy is correctly identified as not having an allergy.  Intradermal tests were found to have a higher sensitivity, but also have a lower specificity.  When comparing this to blood tests, which allow for a laboratory test called an IgE assay to be performed, the IgE has found to be more specific but less sensitive than skin testing(James T.).  It is still more common for skin tests to be performed and blood tests to be more useful only when there is some contraindication to a skin test.  In terms of a challenge test, this is usually performed for one of two reasons: the finding of another allergy test was inconclusive or suspicious OR there is reason to suspect an individual has outgrown a certain allergy.  In some cases, a ‘double blind’ challenge test may occur where the individual eating the food and the medical professional are aware whether the individual is eating the suspected allergen or a placebo.  This is to avoid the possibility of a reaction being triggered based on the idea of eating risky food.  As previously mentioned, this test should only be done under STRICT medical supervision.

Whether you are interested in having an allergy test performed in the near future or not, it never hurts to educate yourself on the ins-and-outs of the testing you may undergo. And it is be better educated on managing as well as understanding your allergies!

 

Caitlyn P.

 

 

 

 

 

 

Food Substitutes for Common Allergies

Cake Temptation

One of the most common responses I get from people when I tell them about my allergies is typically: “What do you even eat!?” I always find this funny to respond to; but I always reply with something along the lines of: “oh trust me, I eat.” I will admit that being allergic to wheat, eggs, and nuts can pose some limitations; though I realize not necessarily as many as others encounter with other allergies. There are, however, numerous food substitutions for allergens that allow you to not have a diet that is lacking important nutrients or yummy food options.

When trying to find replacements, in your cooking and baking, for common allergens, there are some commonly used options that are growing in popularity and can be found at many grocery and health food stores. Wheat flour is a very common in cooking and baking. This poses a challenge to those who have wheat allergies or gluten intolerances.  Numerous wheat-free flours are commonly available now for use. The challenge is getting an appropriate consistency with wheat free flour that best resembles regular wheat flour.  A combination of wheat- free flours is usually recommended to produce the best results when baking.  Different varieties of wheat-free flours include: white rice and brown rice flour, oat flour, potato flour, tapioca flour, and garbanzo (chick pea) flour.  Along with replacing wheat flour in cooking, there are many wheat-free products available in grocery stores and health food stores that include: breads, pastas, cookies, cakes, pizza doughs, etcetera. It is even more common to find gluten-free restaurant options and, with a little more searching, to find even restaurants and bakeries dedicated to being gluten free.

Dairy is another common allergen that is in many different foods. There are various possibilities for substitutions. For milk, there are a variety of dairy-free milks that are available. These include: soy, rice, hemp, almond, and coconut milk.  That being said, someone with nut allergies should exercise caution with almond and coconut milks depending upon their specific allergies.  For substituting butter, margarine may be an option for some; but many other foods are being used for butter in recipes which are considered to be ‘healthier options’.  This includes using coconut oil, applesauce, avocado, and canola oil in your baking in lieu of butter.  For substituting items such as yogurt, sour cream, and cream cheese, dairy-free versions can be found at many health food stores and will often be made from a soy base.  Along with this, soy cheese and other vegan dairy-free cheeses are commonly sold; but these do not melt the same as regular cheese and, therefore, do not work in recipes where this is required.  Nutritional yeast is an item found in health food stores and it is a popular ingredient used in recipes requiring melted cheese (such as ‘mac and cheese’).

In terms of ice cream replacements, sorbet is a chilled dessert that doesn’t contain dairy. However, other dairy-free ice cream options are available—such as ice cream made with rice or coconut milk.

Egg can be a tricky allergen to replace in foods where it is the core ingredient; this is in dishes such as omelets and scrambled eggs.  Eggs are, however, key in baking either as a binder or leavening agent. But you can have various substitutes available that can also serve this purpose.  It is very common to find, in health food stores and some grocery stores, packaged egg replacer. This is a powder that, when mixed with milk, can be used specifically as a replacement for eggs in baking. Other egg substitutes that serve the ‘binding’ purpose in baking include: a half cup of mashed banana, ¼ cup of applesauce, 3-1/2 tablespoon gelatin blend or a ‘flax seed egg’ (1 tablespoon flaxseed mixed with 3 tablespoons water, set for one minute).  For using eggs as a leavening agent, a good substitute can be combining 1- ½ table spoons of vegetable oil with 1-1/2 table spoons water and 1 teaspoon of baking powder. Also see a blog post by Arianne which specifically talks about focusing on replacing eggs!

Peanut and nut allergies are extremely common and can make eating some Asian foods such as Thai a ‘no-go’. These allergies also get rid of the possibility of having that classic ‘go-to peanut butter-jelly sandwich’.  Some alternatives include a variety of ‘seed butters’ available that are made out of seeds such as sunflower, sesame, and pumpkin seeds. Soynut butter and peabutter are also common items now also found in grocery and health food stores.  Seeds can also be a great ingredient to use in salads and other dishes for a ‘nutty-like’ addition.

Soy is a tricky allergen to avoid. As you might have noticed, it is commonly used as a ‘go-to’ for other allergen substitutes.  That being said, more and more soy-free options are becoming available.  With items such as vegan cheese gaining in popularity, it is possible to find a soy-free version for those also allergic to dairy.  Soy-free margarines are also sold; but it does take some time to find what stores are the most soy-free friendly.  Butter is also an option for this if you are not also allergic to dairy.  For replacing soy oil, canola oil as well as olive oil are good options.  Some foods such as soy sauce are inevitably hard to replace; but there is always the option of searching out recipes to create your own version.   There are also chickpea versions of miso available (which is traditionally made from fermented soybeans).

This just highlights some common allergens that have different food substitutes available.  I always like to look at avoiding my allergies as a way to find exciting new ways to prepare food and get creative!  Feel free to share and comment below with other foods you struggle to find substitutes for or ways you have been creative with your food allergies!!

Caitlyn P.

 

Beauty Products with Allergens

Portrait of beautiful woman with blue eyes. Isolated on white background

Summer is a great time to try out new kinds of makeup and fun color combinations. But a lot of people aren’t aware of all the different ingredients that go into makeup. This is especially important for people with allergies. An allergy to a makeup product might manifest as redness, itchiness, hives or blisters; so it’s important to know what’s in your makeup.

One of the most surprising ingredients in makeup I’ve come across is fish. It’s usually listed as “pearlescence” in the ingredients list (probably because no one wants to put fish on their face). It’s found mostly in lipstick and is used to make it shiny, like the scales on a fish. You can find more details about it at the following links:

http://animals.howstuffworks.com/fish/herring-info.htm

http://www.businessinsider.com/15-surprising-things-that-contain-animal-products-2014-3

http://www.cosmeticsandskin.com/cdc/pearl-essence.php

If you’re allergic to fish and want to be safe, there are companies like Smashbox that don’t use any animal byproducts in their makeup. However, these companies will use a lot of plant-based material. For example, one of their foundations contains wheat and barley, and other products contain fruit. While Smashbox doesn’t provide an ingredient list on their website, if you go into their stores, you will find a list on the product’s box.

Aside from makeup, a lot of other beauty products contain ingredients that could potentially cause an allergic reaction. Sunscreen is great for your skin in general and super important to wear in the summer; but it can also contain some chemicals (preservatives and fragrances) that can cause contact dermatitis. If you have really sensitive skin that reacts a lot, try putting a bit of sunscreen on your inner forearm before using it all over your body.

An important fact to mention is that, when a company advertises a product as “hypoallergenic,” it does not mean that the product doesn’t contain any of the priority allergens. For example, I know of a facial scrub that is sulfate-free, paraben-free, hypoallergenic, and dermatologist-tested, yet also contains walnuts as one of the main ingredients. There aren’t any standards that these manufacturers have to meet in order to declare a product as hypoallergenic; so take that claim with a grain of salt.

Remember to always do your research before buying products that will come in contact with your skin. There are many makeup companies out there. So, if one product isn’t safe for you, you can almost be certain that another company has a product that is.

Talia

No Eggs, No Problem: Egg Substitutes

Screen shot 2014-07-03 at 10.01.21 AM

Nothing says welcome home like the fresh smell of baked goods wafting from your kitchen. Cookies, pies, cakes, you name it, sound delicious.  But there is one sneaky ingredient lurking in all of those delicious baked goods that could cause major problems: eggs. Eggs are currently on the list of the most common food allergies in Canada; but that doesn’t have to stop you from enjoying delicious treats of every kind. For many treats, there are many alternatives to crunchy, chewy centers; but what about the very makeup of the treat? Eggs provide rise, moisture, and fill to many different kinds of recipes.  The following three items are my most sacred baking tips for the most delectable, unique baked goods you’ll find. These are recipes that your friends will beg you to tell them or demand you make when you bake.

1)  Yogurt

We all love chocolate chip cookies. They can be gooey and chewy or crunchy and satisfying. But what about those pesky eggs in the recipe?  Well, the purpose of the eggs in this particular recipe is to add moisture to the batter. To add a little kick to your already perfected chocolate chip cookies, try putting a table spoon of plain 1 percent yogurt for each egg called for in the recipe. The yogurt will supply the batter with enough moisture and add a delicious taste that will leave people wondering what that special ingredient is.

2)  Coconut Milk/Butter

It’s delicious, it’s sweet, it’s the perfect low-fat substitute for many baked goods. It provides excellent moisture to batters as well providing items like breads, cookies, and muffins, an extra sweet taste; so you can cut back on the sugar you add to your recipe. Coconut butter can be used in breads and muffins to add sweetness to things that also don’t require a lot of sugar. For each egg called for, use a tablespoon of butter or 1/3 cup of the milk. If you’re using the milk, make sure to add baking soda so your mixture isn’t too wet. If you feel like your batter is too wet, add some flour.

3) Baking Soda

Odorless, virtually-tasteless baking soda is a Godsend to those of us who bake without eggs. Why are they so great? It provides rise or lift to certain baked goods that need to stand to attention, like breads, cookies, muffins, cupcakes, and cakes. It has no taste (always make sure to check it so it hasn’t gone bad. If it has, it will have a very sour taste.) and it gives substantial lift without making your goods too dense or heavy. For each egg, add half a tablespoon of baking soda and a tablespoon of hot water together, mix separately, then add it to mixture.

Baking is fun, therapeutic, experimental, and has endless possibilities. Just because there are certain things we can’t put in our baked goods doesn’t mean we have to place limitations upon the things we bake. So get in the kitchen and see what you can create! Above is my favorite recipe for delicious chocolate-chip cookies. Enjoy, and happy baking!

Arianne K. 

Say Yes! Guest Blogger – Sloane Miller

Allergic Girl photo by Kenneth Chen

By Sloane Miller, MSW, LMSW
Allergicgirl.com

Two years ago I went on a blind date. The date wasn’t a romantic match; but he told me about musical improv-improvisational comedy created in a musical theater form. I had never done anything like improvisational comedy before; but I knew I loved to sing and I loved musical theater. So, a few months later, I signed up for my first class. Being silly, on stage, with a group of strangers was pretty terrifying. But there was a small part of me that also found it exhilarating. The more I practiced, the more classes I took, the more the terror was replaced by joy.

The core premise of improv is to say “Yes, and” to your partner. It does not simply involve being spontaneous. It involved saying ‘yes’ to everything presented to you in a theatrical scene (which hopefully will open up the scene to something potentially funny or brilliant or clever, goofy or simply bring the scene to the next place.

Sloane Improv
Having fun at improv!

As someone who grew up with food allergies, asthma, allergies and eczema, my childhood was filled with a lot of “Yes, but.” “Yes, I’d love to come over for a play date, BUT I can’t because you have dogs and I’ll have asthma issues and allergy issues.” Or, “Yes, I’d love to have a piece of that German Chocolate Cake. BUT it has tree nuts and I’m allergic.” Or, “Yes, I’d love to go outside and ride our bikes. BUT I’ll have asthma and allergy issues.”  Once I left home for college, as a young adult, I set out to discover how to expand my horizons while remaining safe. That is to say, how to add more ‘yeses’ to my life despite the ‘buts’.

Throughout my adult life, especially these last eight years of being a food allergy counselor author and speaker, that has been my task: how to add more ‘yes’ to a life that has some definite ‘buts’ and ‘nos’.

The facts of food allergies and anaphylaxis are clear. Food allergies are real and serious. Have a plan, know your triggers. and know what to do in case of an emergency. Carry your emergency medications on your person at all times as anaphylaxis is a swift and severe reaction that can be fatal. Epinephrine auto-injectors are the first line of defense in a severe, life-threatening allergic reaction.

Those facts are real and cannot be ignored; and those facts can feel like the biggest ‘Nos’ to having a life. No, you can’t eat that cookie without reading the label. Or, No you can’t just have a bit of that cake without asking what’s in it. Or, No you can’t leave your bag or purse with your medications at home when you hang with friends. And, especially: No, you can’t kiss someone who just ate your allergen.

So, how does anyone expand one’s horizons (say yes to fun, connection, joy, expansion, intimacy) while remaining safe (saying no to allergic triggers) especially when food and food-related events seem to be the focus at home, with family, with friends, at college, at work, traveling and/or on romantic dates?

Put simply, by knowing this. Life is more than food and who you are as a person is bigger than simply someone with food allergies. Finding your ‘YES’ as an adult is about exploring, uncovering, and developing who you are as a person, your interests, your passions, your creative outlets, your drives, your spirituality, your athleticism, your focus, and your skills.

So, where will you find your next ‘YES’?

Sloane Miller, MFA, MSW, LMSW

Food Allergy Counselor
http://allergicgirl.com/
Author of Allergic Girl: Adventures in Living Well with Food Allergies (Wiley, 2011)

By Food Allergy Canada