What is a food allergy?

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 8 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 are the symptoms of a food allergy?

Symptoms of a food allergy can appear almost immediately or up to two hours after the food has been eaten. Symptoms include a tingling sensation of the mouth, swelling of the tongue and throat, hives, vomiting, abdominal cramps, difficulty breathing, diarrhea, a drop in blood pressure, and loss of consciousness. Severe allergy reactions called anaphylaxis, can result in death.

How are food allergies diagnosed?

Your doctor can perform a skin test to determine which substances cause a reaction. The skin test involves applying a small amount of an allergen (allergy-causing substance) and then making either a tiny scratch or small prick with a needle in your arm or back. The scratches that become red and itchy indicate which substances trigger a defensive response by your immune system.

Your doctor might also do a radioallergosorbent blood test (RAST) to check the number of antibodies produced by the immune system. Elevated levels of certain antibodies can identify particular food allergies. Also, if you maintain a food diary, your doctor will have a much better starting point when determining your allergy-triggering foods.

How are food allergies treated?

The best way to cope with a food allergy is to strictly avoid the foods that cause a reaction. Mild reactions often will subside without treatment. For rashes, skin creams might ease discomfort, while antihistamines will help reduce itching, congestion, and other symptoms. For more serious reactions, corticosteroids such as prednisone will help to reduce swelling. In life-threatening situations, an epinephrine (Adrenalin®) injection immediately begins reversing symptoms and is the only effective treatment option.

What do I do now?

If you have a food allergy you might wonder how you can eliminate from your diet the foods that trigger a reaction. Be sure to read labels. For instance, did you know that vitamins, processed meats, and packaged dessert mixes are often made with milk or dairy ingredients? Also be aware of the ingredients in processed foods that may contain allergens. A registered dietitian can provide tips on label reading, as well as a list of ingredients to avoid so that all sources of the food allergen are avoided. If you are prone to allergic reactions, be prepared. Carry an epinephrine injection kit with you at all times.

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.

Food Allergen Labeling and Consumer Protection Act (FALCPA)

FALCPA is an amendment to the Federal Food, Drug, and Cosmetic Act and requires that the label of a food that contains an ingredient that is or contains protein from a "major food allergen" to declare the presence of the allergen in the manner described by the law.

Manufacturers are given two ways in which to label food allergens. They may either state the food source name of a major food allergen in the list of ingredients, most often contained within parenthesis. For example, you might see (casein [milk]) or the word "contains" in the label, such as "contains peanuts.”

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.

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.

Living with food allergies

Once you and your doctor have determined which foods you should avoid, it is important that you maintain a healthy, nutritious diet. Ask your doctor to recommend foods that will provide you with the necessary nutrition and make an appointment with a registered dietician.


© Copyright 1995-2017 The Cleveland Clinic Foundation. All rights reserved.

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: 5/13/2016…#9196