Eat, Drink and Be Healthy

Food allergies require precautions

Food allergies
(Monika Melnychuk for The Washington Post)
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Tuesday, December 14, 2010; 10:59 PM

A few weeks ago my 17-year-old daughter brought home from a school field trip the second half of a Thai wrap she'd bought for lunch. Before stashing it in the fridge, she plucked a peanut from the filling and put it in her mouth.

Next thing she knew, her throat started to itch. Then the sensation migrated to her inner ear. By the time she came to tell me about it, her face had turned red, and soon she had a headache and stomachache. Her pediatrician suggested keeping an eye on her and giving her a Benadryl, which relieved some symptoms. She also prescribed keeping on hand an EpiPen, an adrenaline injector that can stall an allergic reaction long enough to get the patient to the emergency room.

But my daughter's skin test for a peanut allergy came up negative, as did a subsequent blood test. In January her allergist will perform a controlled peanut challenge in his office, in which he will feed her peanuts and see how she responds.

Welcome, Huget family, to the maddening world of food allergies.

We once coasted through life without paying the slightest attention to potential allergens in our food. Now we read labels and harbor suspicions like never before.

We regret the loss (for now, anyway) of peanuts in my daughter's life, but at least that seemed manageable. That is, until Thanksgiving dinner at my mom's house, where my daughter had another reaction. This time our best amateur guess was that lima beans were the culprits; limas, like peanuts, are legumes.

It's not unheard of for grown people to suddenly develop a food allergy. With the holidays nigh, I wondered how people of any age with food allergies navigate the season's food-centered festivities. I talked with three experts to get some guidance. They are Stanley Fineman, the Atlanta-based president-elect of the American College of Allergy, Asthma and Immunology; Jeffrey Factor, a Hartford, Conn., area allergist (who, as it happens, is in the same practice group as my daughter's allergist); and Dee Sandquist, a spokeswoman for the American Dietetic Association.

One thing they all agreed on was that getting a solid diagnosis from an allergist is key to managing your condition. (See sidebar.) Once you or a loved one receives a diagnosis, consider these steps to stay safe while dining away from home:

Call ahead. Let your host, or the restaurant you'll be eating at, know in advance about your allergy so they have a chance to make accommodations.

Share safe food. Offer to bring a dish or two to a gathering. That way you'll be sure there's something you can eat.

Ask questions. Don't be shy about asking your host detailed questions about the ingredients in the foods they're serving. Milk, eggs, peanuts, wheat and tree nuts are among the most common food allergens (soy, fish and shellfish are others), and they can lurk in all kinds of foods. (For instance, Sandquist notes, sausages and luncheon meats can contain milk products.)

If you can, ask to read labels of packaged foods included in the offerings. And find out whether cooking tools and serving vessels might have been used to handle foods containing your allergen. (If you're hosting an event, Fineman suggests putting labels next to serving dishes listing the potential allergens they contain.)

Ask more questions. Be sure to ask about potential cross-contamination, Factor advises. "It's just something that a lot of people don't think about," he says, noting that a cook might bake two batches of cookies, one with nuts and the other without, but use the same spatula or cookie sheet for both. "It doesn't cross their mind because they don't have a child or relative who has a food allergy."

Quiz the chef. In a restaurant, ask to speak directly with the chef about your allergy, and don't be satisfied unless you're confident that he or she is knowledgeable and understands your concerns, Factor advises. If you can, call ahead to speak with the chef during a time when he or she is not likely to be too busy cooking. Sandquist suggests printing up cards listing your food allergies; your server can take the card back to the chef, and you don't have to worry about information getting lost in translation.

Bring your own. If you're not sure a restaurant can meet your needs, don't be shy about packing your own lunch or dinner. "That may be the safest way to avoid the risk of a reaction," Factor says. (You should to call ahead, though, to be sure the restaurant will permit you to bring in food.)

Be prepared. Always keep your epinephrine injector (such as an EpiPen) handy, just in case. "The onus is really on the person who has the allergy," says Fineman.

May you all have a happy and healthy holiday season! We sure plan to, peanuts or no peanuts.

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