Consumer

Individual food allergies

Eggs
Milk
Nut/peanut
Fish/shellfish
Lactose
Wheat (Coeliac condition)

Egg allergy

The main causes of egg allergy are three proteins in the white of eggs, ovomucoid, ovalbumin and conalbumin. Cooking can destroy some of these allergens, but not all, which means that some people might react to raw eggs but not cooked eggs. Occasionally someone might react to egg because they have an allergy to chicken, quail or turkey meat, or to bird feathers. This is called bird-egg syndrome.

AVOID

Food ingredients to avoid

Egg in any form (including whole egg, dried egg, powdered egg, egg solids, egg yolk, egg white, egg white solids and egg substitute) Albumin Apovitellin
Fat substitutes: Globulin, Livetin, Lysozyme, Ovalbumin, Ovoglobulin, (and any other ingredients that begin with the prefix ‘ovo’, including ovovitella, ovovitellin, ovomucin, ovomucoid, and ovotransferrin Silici albuminate Simplesse (a fat replacer) Vitellin

Foods to avoid

Baked Goods: Bread and rolls, pancakes, cakes, cookies, cream-filled pies, meringue, French toast, waffles, doughnuts, muffins, crackers, pretzels, baking mixes, desert powders: the shiny yellow glaze effect on many baked goods such as bagels is achieved by using eggs or egg product
Beverages: Eggnog, beer, root beer, orange Julius, ovaltine, wine, coffee, latte
Breaded and battered fried foods: Breaded meats (such as chicken nuggets), meatballs, meatloaf, sausage
Commercial egg substitutes: Many of which are made with egg whites
Deserts: Chocolate candies filled with cream fillings, marshmallow candy, fudge, icing, custard, pudding, ice-cream, sherbert, gelatine deserts, meringue, meringue powder
Pasta: Egg noodles, vermicelli, macaroni, spaghetti
Salad dressings and sauces: Béarnaise sauce, hollandaise sauce, Newburg sauce, Caesar dressing, mayonnaise, cream sauces, tarter sauce
Soups: Clear soups and broth, noodle soups, consommé, Chinese egg drop soup

EAT INSTEAD

Sometimes it is easy to assume that because you have a food allergy there are more foods that you can’t eat than foods that you can eat. However, there are alternative foods that will give you all the nutrients that you need. If you are concerned about your diet, you should talk to a dietician who will be able to advise you about eating a healthy diet while avoiding the foods that you are allergic to.

It is important not to cut any food group out of your diet without medical advice. In accordance with the food pyramid/eatwell plate, people are advised to plan their everyday food choices around 2 portions from the meat, fish and alternatives block.

Eggs contain Vitamins A, D, E, a range of water soluble vitamins along with minerals such as calcium, iodine, zinc, selenium and phosphorus. Alternative foods which people can eat containing these include;

Fortified margarine
Cheese
Butter
Liver
Fatty fish
Dark green vegetables
Fortified breakfast cereals

An extensive range of egg free pastas and also egg substitute products can now be found in all major supermarkets and are also available on the internet.

Milk allergy

Cows' milk allergy is caused by a reaction to a number of proteins in cows' milk and people can react to whole milk or to casein or whey (casein is the curd that forms when milk sours and whey is the watery part that is left when the curd is removed). People can be allergic to either whey or casein (or both) and can react to very small amounts of these. Heat treatment, such as pasteurisation, changes whey so people who are sensitive to whey might not react to pasteurised milk. But heat treatment doesn't affect casein so someone who is allergic to casein will probably react to all types of milk and milk products.

AVOID

If you have a cow’s milk allergy, check labels carefully for the following ingredients:

milk
whey
dried milk solids
casein
lactalbumin
sodium caseinate
potassium caseinate
calcium caseinate
butter
cheese
margarine and
curds.

Bear in mind that goats milk and sheep’s milk are unsuitable alternatives to cow’s milk as they share similar proteins with cow’s milk and could result in cross-reactivity.

Do not eat the following foods:

Milk
Cream
Yogurt
Lactaid Acidophilus milk
Ice cream and ice milk
Sherbet made with milk or frozen yogurt
Cream sauces and soups, white sauces
Butter or margarine (except parve)
Cheese
Baked goods made with milk, including breads
Mashed potatoes and other vegetables prepared with milk, cheese, butter or cream
Instant cocoa, breakfast mixes and cereals containing dried milk

EAT INSTEAD

Milk is rich in protein, calcium and vitamins A and B, so these are the nutrients you need to replace in a dairy free diet.

Soya is rich in protein while potatoes, vegetable oil and fish (including cod liver oil and fish oils) are rich in vitamin A.
Calcium can be found in sardines, watercress, figs, rhubarb, almonds and other nuts.
Fresh fruit and vegetables are an excellent source of vitamins and minerals.
Rice milk is a good alternative for drinking and also if required over a breakfast cereal. It can also be used in baking or as a thickening agent.
Cooking substitutes for cow’s milk include water, broth or juice. Health professionals recommend special casein hydrated formulae (e.g. Nutramigen or Pregestimi) which have been made from cow’s milk that has been treated to change the proteins.

Nut/Peanut Allergy

Peanut is one of the most allergenic foods frequently causing very severe reactions including anaphylaxis. An allergy to peanuts begins in childhood and is usually maintained throughout life. If you have an allergy to nuts or peanuts you should be very careful with Malaysian, Thai, Chinese and Indian dishes because these commonly contain nuts or peanuts or are cooked in oils made from nuts or groundnuts. Nuts can also be ground up which means you might not be able to see them, for example, ground almonds or peanut flour can be used to thicken sauces in Indian food and the chef may not immediately think of this when you ask about the content of the meal. It may be safer to avoid eating meals or takeaways from these types of restaurants if you are in any doubt

AVOID

Peanut/ may contain traces of peanuts
Cold – pressed or expeller expressed peanut oil
Ground nuts
Mixed nuts
Peanut butter, flour, oil, starch
Beer nuts
Arachis (part of the pea family, at least one species is peanut)
Gianduja (sweet chocolate contains 50% hazelnut and almond paste)
Goober peas and nuts
Mandalona (a nut substitute derived from peanut meal)

Common food sources containing nuts include:-

Asian foods
Baked goods – breads, muffins, pastries, cookies
Baking mixes
Cereals
Granola
Crackers
Chilli
Ice-cream
Mortadella (Italian cold cut salume flavoured with nutmeg, coriander etc)
Nut burgers
Sauces (peanuts often used as a thicker)
Soups (mostly dried)

EAT INSTEAD

Nuts are good sources of protein, fat, iron, zinc and niacin (vitamin B3). However if you are allergic to nuts you will be able to obtain these vitamins and minerals from various other alternative food substitutes. Foods rich in these vitamins and minerals are:-

Oily fish
Red meat
Eggs
Green vegetables

Nuts make up part of the meat, fish and alternatives section of the food pyramid / eatwell plate so you can choose any two of the other options so that you do not lose out on a major food category from your diet.

When making foods which normally contain nuts the following substitutes can be used as alternatives;

Grape-nut cereal
Dried fruit
Granola
Rolled oats (toasted)
Chocolate chips (in sweet deserts)

Fish/Shellfish Allergy

The incidence of seafood allergy is higher in populations with a high dietary consumption of fish and shellfish. Cooking does not destroy the allergens in fish or shellfish and some individuals may be allergic to cooked, but not raw, fish. Although shellfish allergies are unusual in children, reactions to fish are found in both children and adults.

AVOID

Caesar salad dressing
Omega 3 supplements
Chilli
Prepared meals
Any food containing gelatine

There are very few foods in which shellfish is a hidden ingredient which is helpful for individuals who suffer from a shellfish allergy. Below outlines common names of fish and fish products:

Crustaceans
Molluscs
Octopus
Crab
Abalone
Squid
Lobster
Clams
Calamari
Shrimp
Conch
Quahog
Prawn
Mussels
Scampi
Oysters
Crawfish
Scallops

Common sources of foods containing fish include:-

Asian sauces and dishes
Sushi
Sashimi
Tempura
Fish sauce
Fish soup
Fish balls
Taro cake
Daikon cake
Fish/shellfish flavouring
Worcestershire sauce
Thai food
Chinese food
Japanese food
Vietnamese food
Shrimp balls, noodles, chips
Shrimp salad roll
Prawn crisps
Haw Gow
Sui my
Stuffing (check labels)

EAT INSTEAD

Lactose Intolerance

Lactose is the main sugar in milk. The inability to break down lactose is due to a lack of, or reduction in, the production of lactase enzyme in the small intestine. The result is that lactose is not absorbed by the body but remains undigested in the gut. This leads to digestive upset with symptoms such as bloating and diarrhoea. Goat’s and sheep’s milk also contain lactose and are therefore unsuitable. (Some individuals who are lactose intolerant may be able to consume sheep or goats milk depending on their sensitivity). However, if you treat milk with the enzyme lactase in advance of drinking it, this should break down all the lactose present into smaller more digestible sugars rendering the milk perfectly OK to drink.

AVOID

Ingredients to avoid include:

Milk
Lactic acid
Milk protein
Casein
Nougat
Milk solids
Whey powder/protein
Albumin
Whey syrup
Rennet
Lactose (milk sugar)
Curds
Yoghurt
Caseinates
Lactoglobulins

Foods to avoid include:-

Cheeses
Butter and butter-like spreads
Skim milk
Evaporated milk
Bakery goods such as cakes, buns, pastries, biscuits etc
Chocolate
Instant pudding mixes
Salad dressings
Sweets
Ice-cream
Butter and cream
Margarine
Whole milk
Instant deserts
Baking powder
Condensed milk
Creamed foods
Yorkshire pudding
Custard
Cake toppings
Powder/dried milk
Scrambled eggs
Cake mixes
Junket (desert made of flavoured, sweetened curds)
Mashed potato

Foods high in oxalate should be limited or avoided as these reduce the absorption of calcium. These foods include beetroot, nuts, chocolate, rhubarb, spinach and tea. A 30 minute daily exposure to sunlight will ensure adequate vitamin D which is used to help absorb calcium from the diet. It is advisable to take a lactose-free calcium supplement if you are taking less than three portions of dairy or dairy alternatives daily.

EAT INSTEAD

Alternatives which can be used in baking, over breakfast cereals, tea, coffee and also in the making of curries, sauces and smoothies:

Rice milk
Oat milk (high in calcium, good for a drink or over cereal)
Almond milk/ hazelnut milk
Coconut milk – good for sauces etc
Soy milk Soy is a good alternative when wanting a treat. Soy yoghurts are widely available along with soy deserts, ice-cream and soy chocolate flavoured drinks.
Lactofree (made from semi-skimmed cows milk and is gently filtered to remove the milk sugars)

Individuals who suffer from lactose intolerance can obtain their calcium from various other food sources. The following foods are good, non-dairy sources of calcium:-

Canned sardines
Canned pink salmon
Tofu
Kidney beans
Tofu
Blackberries
Sunflower seeds
Pumpkin seeds
Green leafy vegetables
Almonds
Nut milks
Seaweed
Enriched soy milk
Spinach (cooked)
Broccoli
Lentils (cooked)
Pears
Kale (form of cabbage)
Cauliflower
Melon
Swede
Oat milk
Pilchards (small, oily fish)
Leeks
Cabbage
Dates and raisins
Apples
Green beans
Kiwi fruit
Tempeh (good source of protein made from soybeans)
Hazelnuts
Baked beans

Coeliac condition / Wheat Allergy

Coeliac condition Coeliac condition is a genetically based auto-immune disorder of the small intestine which means the body produces antibodies that attack its own tissues. It is caused by a reaction to gluten which is found in wheat, barley, rye oats and other cereals. Gluten is really a mixture of two types of proteins – prolamines and glutelins. A prolamine called gliadin seems to be particularly problematic in coeliac condition. The strength of the reaction depends on the sensitivity of the individual and the type lf gluten found in the cereal. Many coeliacs do not react to oats.

Coeliac condition is not the same as a food/wheat allergy as it does not involve the production of the allergy antibody IgE and is not associated with anaphylaxis. Instead, gluten causes an inflammatory reaction within the lining of the small intestine which then becomes deformed and swollen which in turn leads to malabsorption of nutrients from the gut. As with all allergies, the only treatment is a life-long avoidance diet for gluten.

Wheat allergy

As with other food allergies, the symptoms of an allergy to wheat are mediated by the production in the body of the antibody IgE. A number of wheat proteins, including albumin, globulin and gliadin can cause an allergic reaction in susceptible people. Because of this, people with a wheat allergy are sometimes recommended to eat a gluten-free diet. However, it is important to note that wheat allergy and coeliac condition are different and foods that are labelled as being gluten free may not be suitable for people with a wheat allergy as they may contain other proteins such as albumins or globulins.

AVOID

Breads-including pitta, chapatis, naan, and rye
Cakes
Pastries
Pizzas
Pasta
Sausage meats
Spaghetti
Certain soups, sauces, gravies and breakfast cereals.

The following is a list of common names of wheat and gluten containing products

All-purpose flour
Wholewheat flour
Semolina (refined durum flour)
Couscous (cracked wheat)
Kamut
Spelt
Graham flour
Bulgar (partially cooked and toasted cracked wheat)
Wholemeal flour
Plain and self-raising flour
Barley (extract, flavour, flour, malt)
Farro
Farina
Polenta
Wheat can be found in many food products in different forms:
Food starch
Starch / modified starch
corn starch
special edible starch
Cereal filler/extract/binders/protein/starch
edible starch
wheat protein/starch/berries/bran
wheatmeal
thickening agent / thickener
hydrolyzed vegetable protein (HVP)
MSG
Binder
Foods in batter/breadcrumbs
Rusk

EAT INSTEAD

CORN: flour, pasta, cornflakes, crispbread, chips, polenta, bread, nachos, tortillas, popcorn. - cornflour is one of the best thickening agents (ensure the corn flour is 100% corn flours with no added wheat flour); cornmeal can be prepared as polenta.
MILLET: flour, pasta, flakes – millet grains are boiled as rice and are very nutritious – good in soups and casseroles; millet flakes are great for making your own muesli.
BUCKWHEAT: also called 'kasha’ - flour, pasta. Despite it’s name, buckwheat is NOT related to wheat at all. Buckwheat oats are also great for making your own muesli. Japanese soba noodles are made from buckwheat (check labels on supermarket brands). Buckwheat flour is useful for making blinis, pancakes and other baking recipes. (check label to ensure it is 100% buckwheat).
RICE: flour, pasta, flakes, cakes, bread. Basmati or brown rice is best.
QUINOA (pronounced 'keen-wa’): flour, flakes, pasta, quinoa puffs (a 'complete’ protein, very nutritious – can be called the perfect food), quinoa grains are boiled as rice and can be used as an alternative to couscous.
AMARANTH, TAPIOCA (from the cassava plant), ARROWROOT, GRAM FLOUR (from chickpeas),
LENTIL FLOUR (useful for thickening agents), gram flour can be used to make wheat free popadums. If you are avoiding wheat only and can tolerate oats, rye, and barley then the following may be options for you to explore: OATS: oatmeal, flour, oatcakes. Oats make a great breakfast, raw with fruit and chopped nuts. Oatcakes are a good substitute for crackers
RYE: bread, flour, crispbread; ensure bread and crispbread are 100% rye by checking labels.
BARLEY: flour is useful for pancakes

Helpline:

Consumer

Individual food allergies