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Special Diets For Food Allergies

A food allergy is caused when the body’s immune system mistakes an ingredient in food—usually a protein—as harmful and creates a defense system (special compounds called antibodies) to fight it. An allergic reaction occurs when the antibodies are battling an "invading" food protein. Although a person could have an allergy to almost any food, the following foods account for almost 90 percent of all food-related allergic reactions:

  • Milk
  • Eggs
  • Peanuts
  • Tree nuts (such as cashews and walnuts)
  • Fish
  • Shellfish
  • Soy
  • Wheat

What do I do now?

Now that you know you have a food allergy, you might wonder how you can eliminate from your diet the foods that trigger a reaction. Here is some helpful information about foods to avoid if you have a food allergy. If you have questions or need help eliminating certain foods from your diet, ask your doctor or a registered dietitian.

NOTE: Be sure to talk to your doctor or a registered dietitian before eliminating any food from your diet or beginning a special diet. You may need to adjust your meal plan or take a nutritional supplement to replace any nutrients lost by eliminating your trigger foods. In addition, the lists of foods and products that appear here are intended to provide examples and are NOT complete. Seek the advice of your doctor or dietitian for a more comprehensive list of foods to avoid for your specific allergy.

Milk allergy diet

If you have an allergy to milk, you will need to remove milk and other dairy products made with milk from your diet. Dairy products are a good source of calcium and Vitamin D, so it’s important that you eat other foods rich in these nutrients, such as broccoli, spinach and soy products.

Always check the label ingredients before you use a product. Many processed or prepared foods contain milk. In addition, check the label each time you use the product. Manufacturers occasionally change recipes, and a trigger food may be added to the new recipe.

Examples of milk products and foods containing milk

Milk/dairy products:

  • Milk and milk solids
  • Non-fat, skim milk or powdered milk and milk solids
  • Buttermilk
  • Evaporated milk
  • Yogurt
  • Cream, cream cheese, sour cream
  • Cheese, cheese powder or cheese sauce
  • Butter, butter fat, artificial butter flavor
  • Curds
  • Whey and whey products
  • Cottage cheese

Foods containing milk/milk products:

  • Au gratin foods
  • Chocolate and cream candy
  • Coffee creamers
  • Creamed or scalloped foods
  • Custard
  • Nougat
  • Ice cream
  • Malted milk
  • Margarines (some, check the label)
  • Many puddings
  • White sauces

Ingredients to look for:

  • Lactalbumin, lactalbumin phosphate
  • Lactoglobulin
  • Casein or sodium caseinate
  • Lactose (milk sugar)

Diet tip: Try substituting soy, rice or almond milk for cow’s milk. In addition, many non-dairy products are now available including some margarines (check the label), non-dairy ice cream, non-dairy chocolate, non-dairy cheese and non-dairy yogurt.

Egg allergy diet

Egg allergies are very common in infants, young children and adults. An egg-free diet eliminates eggs and products that may contain eggs. Read food labels carefully and avoid any egg products or egg-related ingredients, as well as foods that may be made with eggs.

Examples of egg products and products containing eggs

Egg products:

  • Eggs, egg whites, egg yolks
  • Dried eggs or egg powder
  • Egg solids

Foods containing eggs:

  • Eggnog
  • Bavarian creams
  • Breaded foods (some)
  • Cake
  • Candy (some)
  • Cookies
  • Creamed foods
  • Cream pies
  • Cream puffs
  • Custard
  • Doughnuts
  • Egg rolls
  • Egg noodles
  • Frosting
  • Hollandaise sauce
  • Ice cream
  • Mayonnaise
  • Marshmallows
  • Meat or fish cooked in batter
  • Meringue
  • Muffins
  • Pretzels
  • Pudding
  • Simplesse (fat substitute)
  • Soufflés
  • Tartar sauce
  • Waffles

Ingredients to look for:

  • Globulin
  • Albumin
  • Apovitellenin
  • Livetin
  • Ovalbumin
  • Ovomucin
  • Ovomuciod
  • Ovovitellin
  • Phosvitin

Diet tip: Be sure to read labels carefully. For example, some egg substitutes contain egg white.

Peanut allergy diet

Peanuts are one of the most common food allergens (substances that trigger an allergic reaction). Peanut allergies also are among the most serious—and potentially fatal—of the food allergies.

Examples of peanut products and foods containing peanuts

Peanut products:

  • Cold-pressed or expressed peanut oil
  • Peanut butter
  • Peanut flour

Foods containing peanuts:

  • Ground nuts
  • Mixed nuts
  • Artificial nuts
  • Nougat
  • African, Chinese, Thai and other ethnic dishes
  • Cookies, pastries and other baked goods
  • Candy
  • Egg rolls
  • Marzipan

Ingredients to look for:

  • Hydrolyzed plant protein
  • Hydrolyzed vegetable protein

Diet tip: Many prepared foods—including baked goods, candy and ethnic foods—can be contaminated with peanuts if products containing peanuts are prepared in the same place or by the same manufacturer. Always be prepared for this possibility and the risk of a reaction.

Tree nut allergy diet

There is a risk of cross contamination during the processing of nuts in foods. For that reason, many allergists recommend that you stay away from all tree nuts and all products that list "nuts" as an ingredient, even if you are allergic to only one type of nut.

Examples of tree nuts and tree nut products

Tree nuts:

  • Almonds
  • Brazil nuts
  • Cashews
  • Chestnuts
  • Filberts
  • Hazelnuts
  • Hickory nuts
  • Macadamia nuts
  • Pecans
  • Pine nuts
  • Pistachios
  • Walnuts

Tree nut products:

  • Marzipan/almond paste
  • Nougat
  • Artificial nuts
  • Nut butters (such as cashew butter and almond butter)
  • Nut oil
  • Nut paste (such as almond paste)
  • Nut extracts (such as almond extract)

Diet tip: Tree nuts are sometimes used in lotions and shampoos. Be sure to check product labels on these products, as well as food labels.

Fish allergy diets

The proteins in various species of fish can be very similar, so you may need to stay away from all types of fish, unless your allergist is able to determine which species of fish triggers your allergies.

Examples of foods containing fish
  • Worcestershire sauce (may contain anchovy)
  • Caesar salad
  • Caviar
  • Roe (fish eggs)
  • Imitation seafood

Diet tip: It may be wise to avoid seafood restaurants if you have a fish allergy. Even if you order a non-fish meal, your food may become contaminated with fish proteins from a spatula, cooking oil or grill exposed to fish.

Shellfish allergy diet

As with fish, different types of shellfish have similar proteins. You may wish to avoid all types of shellfish, unless your allergist is able to determine which species of shellfish triggers your allergies.

Examples of shellfish
  • Abalone
  • Clams
  • Crab
  • Crawfish, crayfish
  • Lobster
  • Oysters
  • Scallops
  • Shrimp
  • Cockle, sea urchin
  • Mussels

Diet tip: Be careful with fried foods. Some restaurants use the same oil to fry shrimp, chicken and French fries. Imitation shellfish still may use shellfish for flavoring. Before you use it, read the label to be sure.

Soy allergy diet

Soybeans are legumes. Other foods in the legume family include navy beans, kidney beans, string beans, black beans, pinto beans, chickpeas (garbanzo or chichi beans), lentils, carob, licorice and peanuts. Many people are allergic to more than one legume.

Examples of soy products

Soy and soy products:

  • Soy flour, fruits, nuts, milk, sprouts
  • Soybean granules or curds

Products that may contain soy:

  • Miso
  • Soy sauce
  • Tofu (as an ingredient, may indicate the presence of soy protein)
  • Tamari
  • Tempeh
  • Vegetable broth

Ingredients to look for:

  • Soy protein
  • Textured vegetable protein (TPV)
  • Hydrolyzed plant protein
  • Hydrolyzed soy protein
  • Hydrolyzed vegetable protein
  • Natural and artificial flavoring (may be soy based)
  • Vegetable gum
  • Vegetable starch

Diet tip: Soybeans are widely used in processed food products. Soybeans and soybean products are found in many baked goods, cereals, crackers, infant formula, sauces and soups. In addition, soy is sometimes used as a meat extender in prepared meats, such as sausage or deli meats.

Wheat allergy diet

Foods made with wheat are staples of the American diet. The proteins found in wheat are collectively referred to as "gluten."

Examples of wheat products and products that may contain wheat

Wheat products:

  • Whole wheat or enriched flour
  • High gluten flour
  • High protein flour
  • Bran
  • Farina
  • Graham flour
  • Bulgur
  • Durum
  • Semolina
  • Wheat malt
  • Wheat starch
  • Modified starch
  • Starch

Foods made with wheat:

  • Breads, cookies, cakes and other baked goods made with wheat flour
  • Bread crumbs
  • Crackers
  • Many cereals
  • Acker meal
  • Couscous
  • Cracker meal
  • Pasta
  • Spelt

Ingredients to look for:

  • Gluten
  • Gelatinized starch
  • Hydrolyzed vegetable protein
  • Vital gluten
  • Wheat bran
  • Wheat germ
  • Wheat gluten
  • Vegetable gum
  • Vegetable starch

Diet tip: Read all product labels carefully. Many processed foods—including ice cream and catsup—may contain wheat flour. If you have a wheat allergy, you may try substituting flours and other products made from oats, rice, rye, barley or corn

Other considerations: Salicylates, sulfites and molds


Salicylate sensitivity

Salicylates are chemicals found naturally in all plants, although the amount of salicylates varies from plant to plant. For plants, salicylates act as a natural preservative, protecting against rotting, and against harmful bacteria and fungi. For humans, salicylates are a major ingredient of aspirin and other pain-relieving medications. They also are found in many fruits and vegetables, as well as many common health and beauty products.

Some people have a low level of tolerance (sensitivity) to salicylates and may have reactions if more than a small amount is consumed at one time. Symptoms of salicylate sensitivity vary but may include asthma-like symptoms (such as trouble breathing and wheezing), headaches and/or nasal congestion, changes in skin color, itching, skin rash or hives, swelling of the hands and feet, swelling of the face, and stomach pain. In severe cases, salicylate sensitivity can lead to anaphylaxis, a life-threatening reaction involving a severe drop in blood pressure, loss of consciousness and organ system failure. Avoiding products that contain salicylates is the best defense against a sensitivity reaction.

Examples of foods that may contain salicylates

  • Fruits such as apples, avocados, blueberries, dates, kiwi fruit, peaches, raspberries, figs, grapes, plums, strawberries, cherries, grapefruit and prunes
  • Vegetables such as alfalfa, cauliflower, mushrooms, radishes, broad beans, eggplant, spinach, zucchini, broccoli and peppers
  • Herbs, spices and condiments such as dry spices and powders, tomato pastes and sauces, vinegar and soy sauce
  • Beverages such as instant coffee, wine, orange juice, apple cider, regular and herbal tea, beer, rum and sherry
  • Nuts such as pine nuts, peanuts, pistachios and almonds
  • Some candies, such as peppermints, licorice and mint-flavored gum and breath mints

Products that may contain aspirin or a salicylate compound:

  • Fragrances and perfumes
  • Shampoos and conditioners
  • Herbal remedies
  • Cosmetics such as lipsticks. Lotions and skin cleansers
  • Mouthwash and mint-flavored toothpaste
  • Shaving cream
  • Sunscreens or tanning lotions
  • Muscle pain creams
  • Sodium bicarbonate with aspirin (Alka Seltzer)

Ingredients to look for:

  • Aspirin
  • Acetylsalicylic acid
  • Artificial food coloring and flavoring
  • Benzoates
  • Beta-hydroxy acid
  • Magnesium salicylate
  • Menthol
  • Mint
  • Salicylate
  • Salicylic acid
  • Peppermint
  • Phenylethyl salicylate
  • Sodium salicylate
  • Spearmint
Sulfite sensitivity

Sulfites are a group of sulfur-based compounds that may occur naturally or may be added to food as an enhancer and preservative. The Food and Drug Administration (FDA) estimates that one out of 100 people is sensitive to the compounds. A person can develop sensitivity to sulfites at any time in life, and the cause of sensitivity is unknown. For a person who is sensitive to sulfites, a reaction can be life-threatening (anaphylaxis).

In 1986, the FDA banned the use of sulfites on fruits and vegetables that are eaten raw—such as lettuce or apples—as well as on fresh meat and poultry products. Regulations also require manufacturers who use sulfites in their processed products to list the compounds on their product labels.

Although sulfites are no longer used on most fresh foods, they still can be found in a variety of cooked and processed foods. They also occur naturally in the process of making wine and beer.

Avoiding foods that contain or are likely to contain sulfites is the only way to prevent a reaction. If you are sensitive to sulfites, be sure to read the labels on all food items. When eating out, ask the chef or server if sulfites are used or added to food before or during preparation.

Examples of foods that may contain sulfites

  • Baked goods
  • Soup mixes
  • Jams
  • Canned vegetables
  • Pickled foods
  • Gravies
  • Dried fruit
  • Potato chips
  • Trail mix
  • Alcohol, beer and wine
  • Vegetable juices
  • Canned or frozen fruits and vegetables
  • Sparkling grape juice
  • Apple cider
  • Bottled lemon juice and lime juice
  • Tea
  • Many condiments
  • Molasses
  • Fresh or frozen shrimp
  • Guacamole
  • Maraschino cherries
  • Dehydrated, pre-cut or peeled potatoes

Ingredients to look for:

  • Sulfur dioxide
  • Potassium bisulfite or potassium metabisulfite
  • Sodium bisulfite, sodium metabisulfite or sodium sulfite

Mold

Mold is a simple organism that is present is most places, outdoors and indoors. Mold is a type of fungus that works to break down dead material and return nutrients to the environment. Mold grows by digesting plant or animal matter, such as leaves, wood, paper, dirt and food. Mold spreads by releasing tiny, lightweight spores that travel through the air. Mold grows quickly in moist dark spaces, such as basements, garbage cans and piles of rotting leaves.

On food, mold often is visible on the food’s surface, such as the fuzzy green spots that appear on bread. However, molds also have branches and roots. As it grows, the mold’s roots can penetrate deep inside the food, where it cannot be seen.

All of us are exposed to some mold every day with no bad effects. We may breathe in mold spores that are present in the air or eat foods in which mold has begun to grow. People with mold allergies, however, may have a reaction if exposed to too much of the fungus. Symptoms of a mold reaction are those typical of many other allergies. They include wheezing; trouble breathing; stuffy or runny nose; itchy, watery eyes; and a rash or hives on the skin.

If you have a mold allergy, avoiding all exposure to mold may not be possible. However, you can reduce your risk of a reaction by choosing your foods carefully. Check all foods for signs of mold before you eat it. In addition, you can avoid foods that are more likely to contain mold or other fungi (mushrooms and yeast).

Common food sources of mold

  • Cheese
  • Mushrooms
  • Vinegar and foods containing vinegar, such as salad dressing, catsup and pickles
  • Sour cream, sour milk and buttermilk
  • Beer and wine
  • Meat or fish more than 24 hours old
  • Sour breads, such as pumpernickel, and other food made with a lot of yeast
  • Sauerkraut
  • Pickled and smoked meats and fish
  • Dried fruits such as dates, prunes, figs and raisins

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This information is provided by the Cleveland Clinic and is not intended to replace the medical advice of your doctor or health care provider. Please consult your health care provider for advice about a specific medical condition. This document was last reviewed on: 4/30/2009…#10014


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