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Essential Food Allergy Management Guide

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0% found this document useful (0 votes)
129 views25 pages

Essential Food Allergy Management Guide

Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as PDF, TXT or read online on Scribd

Your Food Allergy Field Guide

Table of Contents

Introduction . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3
A Checklist for Getting Started. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 4
Managing Food Allergies: What You Need to Know. . . . . . . . . . . . . . . . . . . . . . . . . . . . 5
Understanding Food Labels . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 9
Tips for Avoiding Your Allergen. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 11
How to Avoid Cross-Contact . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 13
Dining Out With Food Allergies. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 14
Preparing Others to Care for Children With Food Allergies. . . . . . . . . . . . . . . . . . . . . . 16
Food Allergies: Frequently Asked Questions. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 18
Glossary of Food Allergy Terms. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 20
FARE Offices . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 22
FARE Fundraising Events. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 23
More Food Allergy Resources . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 24
Acknowledgements . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 25

[Link]
©2016, Food Allergy Research & Education (FARE) 2
Introduction

Thank you for downloading FARE’s Food Allergy Field Guide, a packet for individuals and
families who have been newly diagnosed with food allergies. FARE is the nation’s leading
organization working on behalf of the 15 million Americans with food allergy, including all those
at risk for life-threatening anaphylaxis. FARE is committed to providing all those affected by
food allergies with the resources and tools they need to live well with food allergies.

Within this packet, you’ll find content from our “Managing Food Allergies: What You Need to
Know” brochure, a checklist for getting started, information on food labels, tips for avoiding
allergens and cross-contact, advice about dining out with food allergies, frequently asked
questions and much more.

A food allergy diagnosis is life-altering. We are here to help. These educational materials, along
with the extensive resources on our website, [Link], are designed to equip you
with the knowledge you need to effectively manage food allergies.

The information provided here is designed to support, not replace, the relationship that exists
between a patient and his/her existing physician. Always be sure to consult your doctor for
specific questions.

Let’s get started!

[Link]
©2016, Food Allergy Research & Education (FARE) 3
A Checklist for Getting Started

Your Food Allergy Field Guide is a resource created and provided by Food Allergy Research & Education (FARE). FARE is
a national non-profit organization, whose mission is to improve the quality of life and the health of individuals with food
allergies, and to provide them hope through the promise of new treatments. More general resources on food allergies,
including articles, support groups, and webinars, can be found on our website at [Link]. For questions
related to your specific food allergy care plan, please consult your doctor.

A food allergy diagnosis is life-altering. There is a lot to learn, and it can be tough to know where to start. This field guide
checklist can help point you toward important information and resources that will help you learn more about managing
food allergies.

Educate Yourself
¨¨ FIRST STEP: Read all of the information in this Food Allergy Field Guide, starting with the Managing Food Allergies
section.
¨¨ Carry the Tips for Avoiding Your Allergen sheet with you to help with reading labels or asking about ingredients.
¨¨ Visit the FARE website at [Link] to learn more about food allergies and strategies for staying safe.
¨¨ FOR PARENTS: Know your child’s food allergies inside and out so you can communicate their needs to caregivers.

Be Prepared
¨¨ FIRST STEP: Fill your prescription for epinephrine auto-injectors. Learn how to use an epinephrine auto-injector and
practice by using a trainer. Teach family members and friends how to use the auto-injector.
¨¨ Put a reminder on your calendar about refilling your prescription before the epinephrine auto-injector’s expiration
date.
¨¨ FOR PARENTS: Help your child understand their allergies and teach them to ask questions about ingredients and
any food being served.

Have a Plan
¨¨ FIRST STEP: Fill out the enclosed Food Allergy & Anaphylaxis Emergency Care Plan with your doctor.
¨¨ Order medical identification to make emergency responders aware of your or your child’s food allergies.
¨¨ FOR PARENTS: Make sure your child has a food allergy management plan in place at their school or child care
facility.

Get Connected and Stay Informed at [Link]


¨¨ Sign up for FARE’s regular email updates and alerts for food-allergy-related product recalls.
¨¨ Search for a local support group on the FARE website.
¨¨ Keep up-to-date by attending FARE’s free monthly webinars or attending our Annual Conference.
¨¨ Become a member of FARE. You can join online at [Link]/membership.
¨¨ Join our social media communities on Facebook, Twitter, Pinterest and more. You can find links to these groups at
[Link].
¨¨ Sign up for FARE’s Advocacy Action Center to help us pass critical legislation. Join at [Link].
¨¨ FOR PARENTS: Encourage your teen to follow FARE’s teen blog at [Link].

[Link]
©2016, Food Allergy Research & Education (FARE) 4
Managing Food Allergies:
What You Need to Know

Food allergies are serious, but you can manage them with help from your allergist and others. This packet will help you
learn more about the disease so that you can be prepared, stay safe and live well with food allergies.

What Is a Food Allergy?


A food allergy is when your body’s immune system reacts to a food protein because it has mistaken that food protein as a
threat.

The food you are allergic to is called a “food allergen.” The response your body has to the food is called an “allergic
reaction.”

People can be allergic to any food, but eight foods cause most food allergy reactions in the U.S. They are: milk, egg,
peanuts, tree nuts (such as walnuts or pecans), wheat, soy, fish, and shellfish (such as lobster, shrimp or crab).

What Is the Difference Between a Food Allergy and a Food Intolerance?


Unlike a food intolerance, food allergies involve the immune system and can be life-threatening. With a food allergy, your
immune system makes too much of an antibody called immunoglobulin E (IgE). IgE antibodies fight the “threatening”
food allergens by releasing histamine and other chemicals. This chemical release causes the symptoms of an allergic
reaction.

A food intolerance is when your body has trouble digesting a food. It can make you feel badly, usually with an upset
stomach or gassiness, but it is not life-threatening. The most common intolerance is to lactose, which is a natural sugar
found in milk.

Are Allergic Reactions Serious?


Yes. Allergic reactions can range from mild to very serious. The most dangerous reaction is called anaphylaxis
(pronounced an-uh-fil-LAX-is). Anaphylaxis is a severe allergic reaction that happens quickly and may cause death.

Anaphylaxis can affect several areas of the body. It can make it hard to breathe and make it hard for your body to
circulate blood. The first-line treatment for anaphylaxis is a medicine called epinephrine.

Carefully avoiding problem foods is the only way to prevent allergic reactions.

Not All Reactions Are the Same!


You can still have a life-threatening reaction to your problem food, even if you have never had a serious reaction before.
Past reactions do not predict future reactions!

[Link]
©2016, Food Allergy Research & Education (FARE) 5
Managing Food Allergies: What You Need to Know

Avoid Problem Foods Plan Ahead


Even a trace amount of a problem food can cause No matter how hard you try to avoid food allergens,
a serious reaction. Learn how to find your problem accidents will happen. These simple steps go a
foods in both obvious and unexpected places. long way in being prepared for an allergic reaction.

• Read every label, every time. Ingredients in 1. Always carry your epinephrine auto-injector.
packaged foods may change without warning. Epinephrine is the only medicine that can stop
Check ingredient statements every time you life-threatening reactions. Carry your
shop. Even the same product from the same epinephrine auto-injector with you at all times
company can have different warning labels. If and check to make sure it has not expired, is
you have questions, call the manufacturer. kept at a safe temperature, and that it has not
been damaged.
Federal law requires packaged food labels to
list when one of the top eight food allergens 2. Fill out a Food Allergy & Anaphylaxis
is an intended ingredient. The top eight food Emergency Care Plan with your allergist.
allergens are: milk, egg, peanuts, tree nuts, These plans tell you and/or those who care
wheat, soy, fish, and shellfish. Read more for your child how to recognize and respond
about this law and tips for avoiding unintended to an allergic reaction. Sample plans can
ingredients at [Link]/food-labels. be downloaded from FARE’s website in both
English and Spanish ([Link]/
• Be mindful of cross-contact. Cross-contact downloads).
happens when a food that is an allergen comes
into contact with a safe food and their proteins 3. Know your plan and share it with others. Make
mix. As a result, each food contains small sure everyone who knows you understands what
amounts of the other food. These amounts are to do in case of an emergency. Keep your Food
so small that they usually can’t be seen. One Allergy & Anaphylaxis Emergency Care Plan in
example of cross-contact is when the same a place where others can find it. For parents,
utensil is used to serve a food that contains an give your child’s plan and medicines to their
allergen and a safe food. school or preschool as soon as possible.

Cross-contact can happen in restaurants, 4. Wear medical identification. Medical IDs will
school cafeterias, home kitchens, or anywhere help protect you or your loved one—at home or
that an allergen may be present. Get more tips wherever you may be during an emergency.
for avoiding cross-contact at
[Link]/cross-contact.

Safety First!
Never take a chance by trying “just a bite” of a food that
may contain your allergen. Even a tiny amount can put your
life at risk.

[Link]
©2016, Food Allergy Research & Education (FARE) 6
Managing Food Allergies: What You Need to Know

Recognize & Treat a Reaction Give Epinephrine for a Serious Reaction


Seconds matter! It is important to be able to Epinephrine is a type of adrenaline. It helps reverse
quickly recognize and treat an allergic reaction. the symptoms of a severe reaction. It is considered
Work with your allergist to know what to look for a very safe medicine. There are currently three
and how to respond. Have them fill out a Food types of epinephrine auto-injectors available in the
Allergy & Anaphylaxis Emergency Care Plan for U.S. Have your doctor train you to use the device
you. you want and practice with a trainer (a device
that does not have a needle or medicine in it).
What will a reaction look like? Instructions for using each auto-injector and more
Food allergy reactions are hard to predict. The last information is available at
reaction a person had could look nothing like the [Link]/epinephrine.
next one.

The first symptoms usually appear between a few


minutes and two hours after exposure to a food
allergen, but they can also begin later.

Symptoms can affect many different parts of the


body. The symptoms can be mild (itchy nose or
a few hives), but they can also be severe (trouble
breathing, repetitive vomiting, weak pulse, etc.).
Find a complete list of symptoms at
[Link]/symptoms.

In some food allergy reactions, after the first


symptoms go away, a second wave of symptoms
can start one to four hours later. This is called a
biphasic reaction.

How do I treat an allergic reaction to food?


Anaphylaxis should always be treated with an
injection of epinephrine (see pages 6-7 for more
information). Antihistamines can be used to relieve
mild allergy symptoms, but they cannot control
anaphylaxis, and they should never be given as
a substitute for epinephrine. Mild symptoms
can quickly turn into a life-threatening reaction.
Anyone having a reaction to a food allergen should
be monitored closely.

[Link]
©2016, Food Allergy Research & Education (FARE) 7
Managing Food Allergies: What You Need to Know

After Using Epinephrine


After you use an epinephrine auto-injector:

1. Call 911 immediately! An epinephrine auto-injector buys time, but it is important to receive follow-up
treatment as soon as possible. An ambulance can provide treatment on the way to the hospital.

2. Tell the 911 operator:

• Epinephrine has been given for a suspected food allergy reaction.

• Send an ambulance that has epinephrine on board.

3. Lay the person flat and raise their legs. If their breathing is difficult or they are vomiting, have them sit up or
lie on their side.

4. If symptoms do not get better, or symptoms return, more doses of epinephrine can be given about 5 minutes or
more after the last dose.

5. Have the ambulance take the person to the Emergency Room. They should stay there for at least 4 hours to
make sure symptoms do not return.

You will also need to make a follow-up appointment with an allergist as soon as possible. Be sure to:

• Bring the used epinephrine auto-injector(s) to be safely thrown away.

• Describe how the reaction happened.

• Get a prescription to replace your used auto-injector(s).

Three Important Things You Should Know


1) Allergic reactions are unpredictable. How severe the reaction is, and which symptoms you get,
can change from one reaction to the next.

2) It’s vital to always carry your epinephrine auto-injector with you. In the case of severe reaction,
minutes can make a difference.

3) Know the possible symptoms of an allergic reaction, and know how and when to use your
epinephrine auto-injector.

[Link]
©2016, Food Allergy Research & Education (FARE) 8
Understanding Food Labels

The only way to prevent a serious allergic reaction is to avoid the food allergen.

Reading every food label, every time is one of the best ways to keep you or your loved one safe. Many people who are
managing food allergies use the “Rule of 3” for reading ingredient labels—read the label at the store, when unloading
your groceries, and before serving the food—to triple-check that a food is safe. Others use a system of colored stickers on
foods in the pantry or refrigerator to indicate that an adult has read the ingredient label and determined whether the food
is safe or contains the allergen.

There are a variety of approaches that can work, and laws like the Food Allergy Labeling and Consumer Protection Act
(FALCPA) help make it easier to understand food labels so that you can safely manage your or your child’s food allergies.

What is FALCPA?
This law requires that food labels show in plain English when a “major food allergen” or any ingredient that contains
protein from a major food allergen is added as an ingredient in that product.

What foods have to be labeled?


Imported (when sold in the United States) or domestic (made in the United States) pre-packaged foods are required to
have a label that lists the major food allergens when they are intentionally added as an ingredient, or when any ingredient
contains protein from one of the major food allergens.

Which foods are considered major food allergens under FALCPA?


The U.S. Food and Drug Administration (FDA) considers the following foods major food allergens: milk, wheat, egg,
peanuts, tree nuts, fish, crustacean shellfish, and soy. These foods account for 90 percent of food allergy reactions in the
United States.

How do the labels show the major food allergens?


Manufacturers have two options to indicate a major food allergen on product labels. The first option is to list the allergen
in parentheses after the ingredient. The second option is to list the allergen at the end of the ingredient list. Often this
“Contains” statement is bolded. See the box below for examples of these two options.

Example 1: Ingredients: Whey protein (milk), lecithin (soy), cherry, sugar, natural flavors (almond), salt.

Example 2:
Ingredients: Whey protein, lecithin, cherry, sugar, natural flavors, salt.
Contains: Milk, soy, and almond.

Does the label have to include the “Contains” statement at the end with the major allergens bolded?
No. The “Contains” statement is one of two options that food manufacturers have for listing the presence of major food
allergens.

[Link]
©2016, Food Allergy Research & Education (FARE) 9
Understanding Food Labels

Does the label have to declare “traces” of Do the specific types of nuts, fish or shellfish
peanut, milk or other allergen that have come have to be indicated on the label?
about through processing? Yes. The specific type of fish (e.g., tuna, salmon),
No. FALCPA applies to ingredients that are intentionally crustacean shellfish (e.g., shrimp, crab) or tree nut (e.g.,
added to processed food products. Precautionary cashew, walnut) must be declared.
warnings or advisory statements (e.g., “May contain…”,
“Processed in a facility with…”) are voluntary. A Do all foods need to be declared on food labels?
manufacturer does not have to warn you that there may No. The only foods that have to be declared are those the
be unintentional traces of an allergen due to cross- FDA considers major food allergens: milk, wheat, egg,
contact during processing. peanuts, tree nuts, fish, crustacean shellfish, and soy, or
ingredients that contain proteins from these foods.
Should we avoid products with precautionary
warnings (e.g., May contain…)? Do major food allergens contained in dyes
Most allergists recommend avoiding these products. (food coloring), spices, flavorings, additives and
Studies have shown that some of the products actually do processing aids have to be listed on labels?
contain allergens in amounts significant enough to cause Yes. If these ingredients contain a major food allergen,
an allergic reaction. the allergen must be indicated on the label.

If a product does not have a precautionary What about food from bakeries, delis, etc.?
warning, does that mean the product is safe to FALCPA does not apply to foods placed in a container or
consume? wrapper for a customer’s individual order, such as food
Not necessarily. Manufacturers are not required to warn from a bakery or a sandwich from a restaurant.
you if the product is processed on lines or in a facility
with any other food. How can consumers find out about other
allergens such as sesame, kiwi, mustard and
What foods are not covered by FALCPA? others?
FALCPA does not apply to fresh meats, fresh fruits and Other food ingredients may or may not be declared on the
vegetables. Restaurant foods that are placed in a wrapper label. Consumers can call the manufacturer and ask if a
or carry out box for an individual customer order are product contains their allergen(s). In some cases, food
exempt. Highly refined oils (even if they are derived from manufactures may prefer not to disclose their ingredients
a major allergen, such as peanut or tree nut) are also or recipes.
exempt.

Is shellfish considered a major allergen?


Only crustacean shellfish (e.g. shrimp, crab, lobster) is
considered a major allergen. The FDA does not consider For more information, visit:
molluscan shellfish (scallops, clams, mussels, and [Link]/food-labels
oysters) to be a major allergen, so these types of shellfish
do not have to be declared on food labels.

[Link]
©2016, Food Allergy Research & Education (FARE) 10
Tips for Avoiding Your Allergen

• All FDA-regulated manufactured food products that contain a “major food allergen” (milk, wheat, egg, peanuts, tree
nuts, fish, crustacean shellfish, and soy) as an ingredient are required by U.S. law to list that allergen on the product
label. For tree nuts, fish and crustacean shellfish, the specific type of nut or fish must be listed.
• Read all product labels carefully before purchasing and consuming any item.
• Be aware of unexpected sources of allergens, such as the ingredients listed below.
• *Note: This list does not imply that the allergen is always present in these foods; it is intended to serve as a reminder
to always read the label and ask questions about ingredients.

For a Milk-Free Diet For an Egg-Free Diet


Avoid foods that contain milk or any of these ingredients: Avoid foods that contain eggs or any of these ingredients:
butter, butter fat, butter lactalbumin, solids, whole) albumin (also spelled livetin vitellin
oil, butter acid, butter lactalbumin milk protein hydrolysate albumen) lysozyme words starting with
ester(s) phosphate pudding egg (dried, powdered, mayonnaise “ovo” or “ova” (such
buttermilk lactoferrin Recaldent® solids, white, yolk) meringue (meringue as ovalbumin)
casein lactose rennet casein eggnog powder)
casein hydrolysate lactulose sour cream, sour cream globulin surimi
caseinates (in all forms) milk (in all forms, solids
cheese including condensed, sour milk solids Egg is sometimes found in the following:
cottage cheese derivative, dry, tagatose
baked goods fried rice meatloaf or meatballs
cream evaporated, goat’s whey (in all forms)
breaded items ice cream nougat
curds milk and milk from whey protein
drink foam (alcoholic, lecithin pasta
custard other animals, lowfat, hydrolysate
specialty coffee) marzipan
diacetyl malted, milkfat, yogurt
egg substitutes marshmallows
ghee nonfat, powder,
half-and-half protein, skimmed, Keep the following in mind:
Milk is sometimes found in the following: • Individuals with egg allergy should also avoid eggs from duck, turkey,
artificial butter flavor culture and other nisin goose, quail, etc., as these are known to be cross-reactive with chicken
baked goods bacterial cultures nondairy products egg.
caramel candies luncheon meat, hot nougat • While the whites of an egg contain the allergenic proteins, patients with
chocolate dogs, sausages an egg allergy must avoid all eggs completely.
lactic acid starter margarine

Keep the following in mind:


• Individuals who are allergic to cow’s milk are often advised to also avoid For a Soy-Free Diet
milk from other domestic animals. For example, goat’s milk protein is
similar to cow’s milk protein and may, therefore, cause a reaction in
individuals who have a milk allergy. Avoid foods that contain soy or any of these ingredients:
edamame soy protein (concentrate, hydrolyzed,
miso isolate)
natto shoyu
soy (soy albumin, soy cheese, soy soy sauce
For a Wheat-Free Diet fiber, soy flour, soy grits, soy ice tamari
cream, soy milk, soy nuts, soy tempeh
Avoid foods that contain wheat or any of these ingredients: sprouts, soy yogurt) textured vegetable protein (TVP)
soya tofu
bread crumbs protein, instant, semolina soybean (curd, granules)
bulgur pastry, self-rising, soft spelt
cereal extract wheat, steel ground, sprouted wheat Soy is sometimes found in the following:
club wheat stone ground, whole triticale
couscous wheat) vital wheat gluten Asian cuisine vegetable gum
cracker meal hydrolyzed wheat wheat (bran, durum, vegetable broth vegetable starch
durum protein germ, gluten, grass,
einkorn Kamut® malt, sprouts, starch) Keep the following in mind:
emmer matzoh, matzoh meal wheat bran hydrolysate
farina (also spelled as wheat germ oil • The FDA exempts highly refined soybean oil from being labeled as an
flour (all purpose, matzo, matzah, or wheat grass allergen. Studies show most allergic individuals can safely eat soy oil
bread, cake, durum, matza) wheat protein isolate that has been highly refined (not cold pressed, expeller pressed, or
enriched, graham, pasta whole wheat berries extruded soybean oil).
high gluten, high seitan • Most individuals allergic to soy can safely eat soy lecithin.
• Follow your doctor’s advice regarding these ingredients.
Wheat is sometimes found in the following:
glucose syrup soy sauce surimi
oats starch (gelatinized
starch, modified
starch, modified food
starch, vegetable
starch)

[Link]
©2016, Food Allergy Research & Education (FARE) 11
Tips for Avoiding Your Allergen

For a Shellfish-Free Diet For a Tree-Nut-Free Diet


Avoid foods that contain shellfish or any of these Avoid foods that contain nuts or any of these ingredients:
ingredients: almond hickory nut nut pieces
barnacle lobster (langouste, prawns artificial nuts litchi/lichee/lychee nut pecan
crab langoustine, Moreton shrimp (crevette, beechnut macadamia nut pesto
crawfish (crawdad, bay bugs, scampi, scampi) Brazil nut marzipan/almond paste pili nut
crayfish, ecrevisse) tomalley) butternut Nangai nut pine nut (also referred
krill cashew natural nut extract to as Indian, pignoli,
chestnut (e.g., almond, walnut) pigñolia, pignon,
Mollusks are not considered major allergens under food labeling laws chinquapin nut nut butters (e.g., piñon, and pinyon
and may not be fully disclosed on a product label. coconut* cashew butter) nut)
filbert/hazelnut nut meal pistachio
Your doctor may advise you to avoid mollusks or these gianduja (a chocolate- nut meat praline
nut mixture) nut paste (e.g., almond shea nut
ingredients: ginkgo nut paste) walnut
abalone limpet (lapas, opihi) sea cucumber
clams (cherrystone, mussels sea urchin Tree nuts are sometimes found in the following:
geoduck, littleneck, octopus snails (escargot) black walnut hull nut distillates/alcoholic walnut hull extract
pismo, quahog) oysters squid (calamari) extract (flavoring) extracts (flavoring)
cockle periwinkle whelk (Turban shell) natural nut extract nut oils (e.g., walnut
cuttlefish scallops oil, almond oil)
Shellfish are sometimes found in the following: Keep the following in mind:
bouillabaisse fish stock surimi
• Mortadella may contain pistachios.
cuttlefish ink seafood flavoring (e.g.,
glucosamine crab or clam extract) • There is no evidence that coconut oil and shea nut oil/butter are
allergenic.
Keep the following in mind: • Many experts advise patients allergic to tree nuts to avoid peanuts as
well.
• Any food served in a seafood restaurant may contain shellfish protein due
to cross-contact. • Talk to your doctor if you find other nuts not listed here.
• For some individuals, a reaction may occur from inhaling cooking vapors ** Coconut, the seed of a drupaceous fruit, has typically not been restricted
or from handling fish or shellfish. in the diets of people with tree nut allergy. However, in October of 2006,
the FDA began identifying coconut as a tree nut. Medical literature
documents a small number of allergic reactions to coconut; most
occurred in people who were not allergic to other tree nuts. Ask your
doctor if you need to avoid coconut.
For a Peanut-Free Diet
Avoid foods that contain peanuts or any of these
ingredients: For a Fish-Free Diet
artificial nuts goobers nut meat
beer nuts ground nuts peanut butter Fish is sometimes found in the following:
cold pressed, expeller mixed nuts peanut flour barbecue sauce fish oil pizza (anchovy topping)
pressed, or extruded monkey nuts peanut protein bouillabaisse fish sauce imitation fish roe
peanut oil nut pieces hydrolysate Caesar salad or shellfish isinglass salad dressing
caviar lutefisk maw, maws seafood flavoring
Peanut is sometimes found in the following: deep fried items (fish maw) shark cartilage
African, Asian baked goods (e.g., enchilada sauce fish flavoring fish stock shark fin
(especially pastries, cookies) marzipan fish flour fishmeal surimi
Chinese, Indian, candy (including mole sauce fish fume nuoc mam (Vietnamese sushi, sashimi
Indonesian, Thai, chocolate candy) nougat fish gelatin (kosher name for fish sauce; Worcestershire sauce
and Vietnamese), and chili gelatin, marine beware of other ethnic
Mexican dishes egg rolls gelatin) names)

Keep the following in mind: Keep the following in mind:


• Mandelonas are peanuts soaked in almond flavoring. • If you have fish allergy, avoid seafood restaurants. Even if you order a
non-fish item off of the menu, cross-contact of fish protein is possible.
• The FDA exempts highly refined peanut oil from being labeled as an
allergen. Studies show that most allergic individuals can safely eat • Asian cookery often uses fish sauce as a flavoring base. Exercise caution
peanut oil that has been highly refined (not cold pressed, expeller when eating this type of cuisine.
pressed, or extruded peanut oil). Follow your doctor’s advice. • Fish protein can become airborne in the steam released during cooking
• A study showed that unlike other legumes, there is a strong possibility of and may cause an allergic reaction. Stay away from cooking areas when
cross-reaction between peanuts and lupine. fish is being prepared.
• Arachis oil is peanut oil.
• Many experts advise patients allergic to peanuts to avoid tree nuts as
well.
• Sunflower seeds are often produced on equipment shared with peanuts.
• Some alternative nut butters, such as soy nut butter or sunflower seed
butter, are produced on equipment shared with other tree nuts and,
in some cases, peanuts. Contact the manufacturer before eating these
products.

[Link]
©2016, Food Allergy Research & Education (FARE) 12
How to Avoid Cross-Contact

What is cross-contact?
Cross-contact happens when one food comes into contact with another food and their proteins mix. As a result, each food
then contains small amounts of the other food. These amounts are so small that they usually can’t be seen.

Even this tiny amount of food protein has caused reactions in people with food allergies!

The term “cross-contact” is fairly new. Some people may call this “cross-contamination.”

Why don’t we use the term cross-contamination?


Cross-contamination usually refers to bacteria or viruses that get on food and make it unsafe to eat. In cross-
contamination, cooking the food will lower the chance of a person getting sick.

This is not the same with food allergies and cross-contact. Cooking does not remove an allergen from a food!

The only way to stop you from having a reaction is to avoid the food and carefully clean anything that came in contact
with it using soap and water.

Examples of cross-contact

Direct Cross-Contact Indirect Cross-Contact


(allergen was directly applied and then removed) (allergen was not directly applied)

Peeling cheese off a cheeseburger to make it a Using the same spatula that flipped a
hamburger cheeseburger to flip a hamburger

Not washing hands after handling shrimp before


Removing shrimp from a salad
making the next salad

Scraping peanut butter off a piece of bread and Wiping off—not properly cleaning—a knife used to
using it to make a different sandwich spread peanut butter before using it to spread jelly

Tips to avoid cross-contact


• Use utensils, cutting boards and pans that have been thoroughly washed with soap and water. Consider using
separate utensils and dishes for making and serving safe foods. Some families choose a different color to identify the
safe kitchen tools.
• If you are making several foods, cook the allergy-safe foods first.
• Keep the safe foods covered and away from other foods that may splatter.
• If you make a mistake, you can’t just remove an allergen from a meal. Even a small amount of cross-contact makes a
food unsafe.
• Wash your hands with soap and water before touching anything else if you have handled a food allergen. Soap and
water or commercial wipes will remove a food allergen. Sanitizing gels or water alone will not remove an allergen.
• Scrub down counters and tables with soap and water after making meals.
• Do not share food, drinks or utensils. Teach children not to share these when they are at school or with friends.

[Link]
©2016, Food Allergy Research & Education (FARE) 13
Dining Out with Food Allergies

When you are dining out with food allergies, planning ahead is important. Follow these tips on what to do before you go
out and when you are at the restaurant to have a better dining experience.

Before You Go

Restaurant Selection
• Ask around. Your allergist and other individuals and families who manage food allergies may have recommendations.
To see if a particular restaurant may be a good choice, check out the website and review the menu in advance.
Some restaurants who have completed food allergy safety training also choose to be listed on SafeFARE. Check
[Link] to see which restaurants in your area have registered.
• Pick a restaurant that best fits what you can eat. Avoid riskier choices, which could include:
–– Buffets. With a wide variety of foods so close to one another, the risk for accidental exposure and cross-contact is
high.
–– Bakeries. There is a high risk of cross-contact, since many items are made with common allergens and many are
not packaged.
–– Restaurants that serve pre-made foods. The staff may not have an accurate list of the ingredients in a pre-made
item. Since the dishes are not prepared from scratch, you can’t ask the chef to remove the problem ingredient
from an item that would otherwise be safe to eat.
–– Restaurants that are known to use allergens in many dishes. For instance, peanuts and other nuts are used
frequently in Asian cuisines. In ice cream shops, shared scoops increase the risk of cross-contact. If you have a
fish or shellfish allergy, it’s a good idea to avoid seafood restaurants.
• Consider chain restaurants, especially when you’re traveling. Each restaurant is likely to use the same ingredients
and prepare foods the same way, and a growing number are allergy-aware.
• Know your options. If you plan to attend a catered event where the food will be prepared in advance, ask if it’s
possible to provide an allergy-friendly option.

Prepare for Your Dining Out Experience


• Call ahead and ask to speak to a manager. You can find tips and sample questions to use when calling restaurants on
our website at [Link]/SafeFARE.
• Timing is everything. Choose a day and time when restaurant kitchens are not as busy. The best time to dine at any
restaurant is during the first hour of a service period. The staff is more alert and attentive, and the kitchen is much
cleaner. If possible, plan for an early meal.
• Bring a chef card. This wallet-sized card lists your food allergies and states that your food must be cooked in a clean
and safe area to avoid cross-contact. You can find online sources for cards in multiple languages, make your own, or
download a template on our website.
• Be prepared. No matter how carefully you’ve planned or how safe you feel at a particular restaurant, never leave
home without your epinephrine auto-injector and any additional medications, and be sure to wear your medical
identification (e.g., bracelet, other jewelry).

[Link]
©2016, Food Allergy Research & Education (FARE) 14
Dining Out with Food Allergies

At the Restaurant

Communicating with Restaurant Employees


Communication between restaurants and customers with food allergies is essential to a safe dining experience.

• Talk to everyone. The restaurant manager and wait staff should know about your food allergy. Remind a manager or
the head waiter about your allergies before you are seated. Present your chef card and ask that it be shown to the
chef.
• Ask what is in your dish and how it is prepared. Make sure your server understands what you are allergic to, and
explain that cross-contact must be avoided. Consider speaking to the manager and the chef, just to be sure. Know
what procedures a restaurant should follow to keep your food safe.
• Never be embarrassed if you feel you’re not communicating well. If the wait staff doesn’t seem to understand your
situation, always trust your gut and seek out another staff member or manager. Sometimes, the safest choice is to
avoid eating, enjoy the company of your friends, and find a safe meal somewhere else afterwards.
• Reward excellent service and build a relationship. If you have a good experience at a restaurant, tell the staff about it
and go back.

Meal Selection
• Keep it simple. If you have to ask a lot of complicated questions about the items on a menu, ordering more simple
fare—like a baked potato, broiled chicken or steamed vegetables—may be the safest way to go.
• Avoid fried foods. Both the grill and the frying oil are ripe for cross-contact; it’s best to avoid fried foods unless you
know for sure that they are prepared safely.
• Be very careful when ordering desserts. Desserts are often a source of unexpected allergens. Since many restaurants
order their desserts from specialty shops, the staff may not be able to provide a complete list of ingredients. If in
doubt, wait and have a safe dessert at home.

More information on dining out with food allergies is available on the FARE website at
[Link]/SafeFARE.

[Link]
©2016, Food Allergy Research & Education (FARE) 15
Preparing Others to Care for Children
with Food Allergies

Working with Schools


Education, planning and cooperation are the keys to managing food allergies at school. Follow these steps to help
children with food allergies stay safe and included at school:

1. Educate Yourself
Before planning for your child’s care at school, you need to learn everything you can about your child’s food allergies, the
policies at your child’s school and what accommodations you are seeking.

• Every parent should know and be able to explain:


–– The foods their child must avoid.
–– The signs of an allergic reaction.
–– The role of epinephrine in treatment.
–– The right way to use an epinephrine auto-injector.
• Find out as much as you can about your school’s approach to managing food allergies. Many schools have already
adopted food allergy management strategies. A good starting point is a local food allergy support group, where you
can connect with parents whose children attend schools in your area. You can find a local support group on FARE’s
website at [Link]/support-groups.
• Learn what practices and accommodations are recommended. In 2013, the Centers for Disease Control and
Prevention (CDC) published “Voluntary Guidelines for Managing Food Allergies in Schools and Early Care and
Education Programs.” These national guidelines and other information, including links to state guidelines, can be
found on FARE’s website.

2. Create a Plan that Keeps Your Child Safe and Included


In addition to a Food Allergy & Anaphylaxis Emergency Care Plan, FARE recommends that parents and schools create a
written food allergy management plan. One type of plan is called a 504 Plan.

A 504 Plan (named for Section 504 of the Rehabilitation Act of 1973) is a plan that outlines the accommodations, aids
or services that a student with a disability needs in order to use, and fully participate in, a free and appropriate public
education.

Children whose food allergy may result in severe, life-threatening reactions (in the opinion of the child’s doctor) meet the
definition of disability under Section 504.

504 Plans are a legal right in schools that receive federal funding. This includes many private schools. Students who go
to private schools that do not take federal monies are covered under the Americans with Disabilities Act and can work
with their schools to set up similar plans. Religious schools may be exempt from Section 504, but state laws may apply.
Each school should have a 504 Coordinator who can help.

3. Visit Our Website—[Link]—For More Information About Managing Food Allergies at School.

[Link]
©2016, Food Allergy Research & Education (FARE) 16
Preparing Others to Care for Children
with Food Allergies

Talking to Caregivers
Managing food allergies is a team effort, and babysitters, extended family members and other caregivers are often
important members of that team. Educating caregivers and planning ahead will help ensure that your child is safe
and included while you are gone. Here are some important steps you can take to prepare caregivers:

• Explain the allergy, which foods to avoid, and the safety precautions you follow at home. Be sure to provide
enough time for the caregiver to absorb the information. You may want to set up a meeting in the days or week
prior to when they will be caring for your child to ensure you have enough time to review everything and they have
enough time to ask questions.
• Carefully explain to the caregiver the symptoms of a food allergy reaction and what to do if a reaction occurs.
Refer them to the food allergy reaction symptoms as described in your Food Allergy & Anaphylaxis Emergency
Care Plan (FAAECP). A magnet listing common symptoms that can be used as a reference on your fridge or
another easy-to-access location is available for purchase from FARE’s Online Store.
• Show the babysitter how to use an epinephrine auto-injector, and make sure the sitter is comfortable using it.
Using expired pens or trainers, let the sitter practice on an orange to get a feel for it. Instructional videos for
a variety of epinephrine auto-injectors can be found on the FARE website at [Link]/treating-an-
allergic-reaction/epinephrine.
• Tell the caregiver to act first and call you later. Let the caregiver know that the most important thing they need
to do in case of a severe reaction is to inject epinephrine and call 911. Let them know that, when in doubt, they
should choose to use epinephrine and that you will not be upset at their decision.
• Make it easy to reach you. Leave your cell phone number with the caregiver, as well as the number of at least one
other person in case you are away from the phone.
• Explain the dangers of cross-contact and how to avoid it. Have them read the How to Avoid Cross-Contact sheet in
this guide.
• Teach the caregiver how to read labels. Make a copy of the Tips for Avoiding Your Allergen sheet in this packet
and keep it in the kitchen or in another easily accessible location. Practice reading a few labels with the
caregiver.
• Leave a tray of safe foods that they can give your child while you are out.
• Have the caregiver arrive after your child has eaten and is ready for bed. This strategy is probably the least
stressful until you feel comfortable leaving your child with someone else.
• Put it all in writing. Keep all important information and instructions together in an easily accessible place, such
as a brightly colored binder in the kitchen, and make sure to update it as needed.

More information about working with caregivers is available on FARE’s website at


[Link]/babysitters-and-caregivers.

[Link]
©2016, Food Allergy Research & Education (FARE) 17
Food Allergies: Frequently Asked Questions

What is a food allergy?


A food allergy is when your body’s immune system reacts to a food protein because it has mistaken that food protein as
a threat. Symptoms can range from mild to life-threatening.

What is the difference between food allergy and food intolerance?


Food allergy is sometimes confused with food intolerance. Food allergies involve your immune system and can be life-
threatening. An intolerance is when your body has trouble digesting a food. It can make you feel badly, usually with
an upset stomach, but it is not life-threatening. The most common intolerance is to lactose—which is a natural sugar
found in milk.

What are the most common food allergens?


More than 170 foods are known to cause food allergies, but eight foods account for 9 out of 10 reactions in the United
States. They are milk, eggs, peanuts, tree nuts, soy, wheat, fish and shellfish.

What are the symptoms of a food allergy reaction?


An allergic reaction to food can have many different symptoms, and a single person can experience different symptoms
from one reaction to the next. Many reactions start with skin symptoms, like hives or a rash, but some do not. More
serious symptoms like a drop in blood pressure and trouble breathing can be life-threatening. Talk to your allergist
and work with them to fill out a Food Allergy & Anaphylaxis Emergency Care Plan to be prepared in an emergency. A
complete list of symptoms of a food allergy reaction is available at [Link]/symptoms.

What is anaphylaxis?
Anaphylaxis is a serious allergic reaction that comes on quickly and may cause death. Early use of an epinephrine
auto-injector is the primary treatment for anaphylaxis. A complete list of the symptoms of anaphylaxis and more
information are available at [Link]/anaphylaxis.

Will antihistamines stop anaphylaxis?


No. While antihistamines can help relieve some mild symptoms from an allergic reaction, such as an itchy mouth or
hives, they cannot stop the life-threatening symptoms of anaphylaxis.

How much of a food allergen does it take to cause a reaction?


Even trace amounts of a food allergen can cause a reaction in some people with food allergies. Although ingestion
is the primary cause of severe reactions, in some cases, skin contact or breathing in a food protein (e.g., steam from
cooking shellfish) can cause symptoms.

How long does it take for a reaction to start after eating a food?
Symptoms usually start as soon as a few minutes after eating a food and as long as two hours after. In some cases,
after the first symptoms go away, a second wave of symptoms comes back one to four hours later (or sometimes even
longer). This second wave is called a biphasic reaction. The risk of a biphasic reaction is why patients who have a
severe reaction should stay at a hospital for four to six hours for observation.

[Link]
©2016, Food Allergy Research & Education (FARE) 18
Food Allergies: Frequently Asked Questions

Who is most at risk for a severe allergic reaction to food?


Anyone who has a food allergy can have a severe allergic reaction to food. However, having asthma puts you at higher
risk. Fatal outcomes of anaphylaxis include a disproportionate number of teens and young adults, possibly because
they take more risks with their food allergies (eating dangerously and delaying treatment).

Can the severity of a person’s allergic reactions to food be predicted from his or her previous
reactions?
No. Someone whose reactions have been mild in the past may suddenly experience severe reactions that could be
deadly.

How many people have food allergies?


As many as 15 million Americans have food allergies, including nearly 6 million children.

Why are food allergies increasing?


The Centers for Disease Control and Prevention have reported a 50 percent increase in the number of children with
food allergies since the late 1990s. Many theories have been suggested as to why the number of people with food
allergies is growing, but scientific research has not yet found the cause.

Is there a cure for food allergy?


Not yet. Strict avoidance of the food allergen is the only way to prevent a reaction and an epinephrine auto-injector is
the only medicine to stop a severe reaction called anaphylaxis.

Can a person outgrow their food allergies?


Peanut, tree nut, fish and shellfish allergies usually are lifelong. Milk, egg, wheat and soy allergies usually begin in
childhood and eventually may be outgrown.

If I think I or my child has outgrown an allergy to a food, is it okay to try a small amount of that
food?
No. Only your allergist can test for this. For more information on tests for food allergies, visit
[Link]/diagnosis-and-testing.

[Link]
©2016, Food Allergy Research & Education (FARE) 19
Glossary of Food Allergy Terms

The following words and phrases are often used to talk about food allergies.

A
Acute symptoms – Physical signs that begin suddenly or last only a short amount of time.
Adrenaline – A hormone made by the body (also known as epinephrine).
Adverse reactions – An unwanted response to a food (such as a rash, vomiting, etc.).
Allergen – Anything that causes an allergic reaction.
Allergic reaction – An immune system response to something that the body mistakes as a threat.
Anaphylaxis – A serious allergic reaction that comes on quickly and may cause death.
Anaphylactic shock – A symptom of anaphylaxis where there is a severe drop in blood pressure.
Angiodema (or edema) – Swelling of a part of the body.
Antibody – A protein in the blood that is meant to identify and attack foreign objects like bacteria or viruses. In food
allergies, these antibodies mistake some food proteins as a foreign object.
Antigen – Anything that causes the immune system to react when it enters the body.
Antihistamine – A medicine used to block the effects of histamine, a chemical that is released during an allergic
reaction. Antihistamines do not stop anaphylaxis.
Asthma – A chronic disease of the lungs in which the airways become blocked or narrowed. This blockage can make it
hard to breathe. Many people with food allergies also have asthma. Those with both asthma and food allergies are at a
higher risk for a severe allergic reaction.
B
Biphasic reaction – An allergic reaction that has two stages. After the first wave of symptoms goes away, a second wave
of symptoms comes back one to four hours later. Because of the risk of biphasic reactions, patients who have a reaction
requiring epinephrine should stay at a hospital for four to six hours after the initial reaction for observation.

C
Chronic – Happening often or lasting a long time.
Cross-contact – When one food comes into contact with another food and their proteins mix. As a result, each food then
contains small amounts of the other food. These amounts are so small that they usually can’t be seen. Even this tiny
amount of food protein has caused reactions in people with food allergies.

E
Eczema – Also called atopic dermatitis. It is an itchy, red rash usually found at the folds of the elbows and behind the
knees. It can cause so much itching that the person may scratch until the skin bleeds. In young children, eczema is
sometimes caused by a food allergy.
Eosinophilic Esophagitis (EoE) – A disorder that causes large numbers of eosinophils, a type of white blood cell, to gather
in the esophagus (the tube that connects the mouth to the stomach). As a result, the lining of the esophagus becomes
inflamed, making it difficult for food to go down. EoE can be triggered by certain foods.
Epinephrine – Also called adrenaline. It is a self-injectable medicine and is the first-line treatment for a severe or
life-threatening allergic reaction (anaphylaxis). Epinephrine is a highly effective medicine that can reverse severe
symptoms. It must be given quickly when anaphylaxis occurs to be most effective. Delayed use of epinephrine during an
anaphylactic reaction has been associated with deaths.

[Link]
©2016, Food Allergy Research & Education (FARE) 20
Glossary of Food Allergy Terms

F
FALCPA (Food Allergy Labeling and Consumer Protection Act) – A federal law that took effect January 1, 2006. It
requires that the labels of foods containing major food allergens (milk, eggs, fish, crustacean shellfish, peanuts, tree
nuts, wheat and soy) note the allergen in plain language.
Food allergy – When the immune system mistakes a food protein as a threat and creates an antibody to that food
protein. When the food is eaten again, the immune system releases histamine and other chemicals that cause an
allergic reaction.
Food Allergy & Anaphylaxis Emergency Care Plan – A document that outlines the recommended treatment in case of
an allergic reaction. It is signed by a physician and includes emergency contact information. It should be on file at
school for every student with food allergies, and it is also useful at home, when traveling and for educating caregivers
what to do in an emergency.

H
Histamine – One of several chemicals released by the body that causes many of the symptoms of an allergic reaction.
Hives – Mosquito-bite-like bumps that are very itchy and can appear anywhere on the body. Many different things can
cause hives, including allergic reactions to food.

I
Immunoglobulin E (IgE) – An antibody created by the immune system that triggers food allergy symptoms.
Intolerance – A reaction to a food that does not involve the immune system. For example, people with lactose
intolerance lack an enzyme needed to digest milk sugar. When they eat milk products, they may have symptoms such
as gas, bloating and abdominal pain.

O
Oral food challenge – A test used in a clinical setting to confirm or rule out a suspected food allergy by feeding the
patient, under an allergist’s supervision, very small but increasing amounts of a possible allergen.

R
RAST (radioallergosorbent tests) – A blood test that measures the presence of IgE antibodies to specific foods. The
term is antiquated because modern tests are not “RAST” tests. See “Serum test for food-specific IgE.” Negative
tests usually (not always) indicate that there is no immediate type of allergy, but positive tests do not necessarily
indicate an allergy. Tests must be interpreted by your doctor taking into consideration your medical history.

S
Skin prick test (SPT) – A test that measures the presence of IgE antibodies for a suspect food. SPTs are inexpensive,
produce immediate results, and can be performed in the doctor’s office. Negative tests usually (not always) indicate
that there is no immediate type of allergy, but positive tests do not necessarily indicate an allergy. Tests must be
interpreted by your doctor taking into consideration your medical history.

U
Urticaria – A medical term for itchy rash or hives.

W
Wheal – A raised white bump surrounded by a small circle of itchy red skin.

[Link]
©2016, Food Allergy Research & Education (FARE) 21
FARE Offices

FARE’s mission is to improve the quality of life and the health of individuals with food allergies, and to provide them
hope through the promise of new treatments. Support our mission!

Donate today! Your tax-deductible donation to FARE can make a difference in the lives of up to 15 million Americans
with food allergies. Contribute online ([Link]/donate), by phone (703-691-3179) or by mail (7925 Jones
Branch Drive, Suite 1100, McLean, VA 22102).

Become a member! Advance FARE’s mission and enjoy great benefits, including the latest food allergy news and
discounts on conferences and products. Complete the enclosed membership response card or visit
[Link]/membership to get started.

Shop for food allergy resources! Visit [Link] to check out our FARE merchandise and education
materials.

FARE National Headquarters


7925 Jones Branch Drive, Suite 1100
McLean, VA 22102
800-929-4040

FARE Chicago Office


8707 Skokie Boulevard, Suite 104
Skokie, IL 60077
847-260-9724

FARE New York Office


515 Madison Avenue, Suite 1912
New York, NY 10022
212-207-1974

[Link]
©2016, Food Allergy Research & Education (FARE) 22
Get Involved: FARE Fundraising Events
Please consider joining us in our quest to raise valuable funds for food allergy education programs, advocacy initiatives,
awareness efforts and research projects by participating in one of the below events.

FARE Walk for Food Allergy


The FARE Walk for Food Allergy, presented by Mylan Specialty L.P., raises critical funds and awareness
to advance FARE’s mission and create a safer, more inclusive world for children and adults who are
managing food allergies. Tens of thousands gather at walks in more than 50 communities nationwide
to support their loved ones, friends, co-workers and neighbors who are living with this life-altering and
potentially life-threatening disease. Visit [Link] for more details.

Team FARE
Team FARE partners your passion for supporting food allergy research, education and advocacy with
your own personal fundraising coach, campaign and website. The fundraising options are endless,
but the goal is the same: raising money to support FARE and its mission. Become a member of
Team FARE and create your own campaign today! Visit [Link] for more details.

Food Allergy Action Month


FARE has declared the entire month of May as Food Allergy Action Month—a time to take action and
make an impact on behalf of the 15 million Americans with food allergies. Our goal is to go beyond
raising awareness in order to inspire action so that we can improve understanding of the disease,
advance the search for a cure, create safer environments and help people live well with food allergies.
FARE provides an action that individuals can take each day of the month to make a difference!

The Teal Pumpkin Project


Start a new tradition and help make Halloween safer for children with food allergies. The Teal Pumpkin
Project encourages people to provide non-food treats for trick-or-treaters and paint a pumpkin teal—
the color of food allergy awareness—to place in front of their house to raise awareness and indicate
they have non-food treats available. Designed to promote safety, inclusion and respect for individuals
managing food allergies, The Teal Pumpkin Project keeps Halloween a fun experience for all. Visit
[Link] for more information.

Special Events
FARE’s special events—such as our galas and luncheons—let you raise urgently needed funds while
enjoying the company of other supporters who share your commitment to the cause. These events
attract corporate and individual donations to advance FARE’s mission. To find an event near you, or to
start a new event, please reach out to your regional office.

[Link]
©2016, Food Allergy Research & Education (FARE) 23
More Food Allergy Resources

When you are new to food allergies, there is a lot to learn. FARE can help! Check out these key resources on our website
to learn more about living well with food allergies and the latest advancements in food allergy research.

Information on Specific Allergens Emotional and Social Impact


Although nearly any food is capable of causing an allergic Sometimes, it can seem like life is all about managing food
reaction, in the United States, 8 foods account for 90 allergies. If you or your child has just been diagnosed or
percent of all food allergy reactions. Our website offers a recently had an anaphylactic reaction, you may be having
more in-depth look at each of these common food allergens, an especially tough time. Whether you have a food allergy
as well as other allergens, and provides guidance for avoiding or care for someone who does, it is important to take care of
ingredients that contain these food proteins. your mental and emotional well-being.

Learn more at [Link]/allergens. Find tips at


[Link]/emotional-and-social-issues.

Managing Food Allergies at…


Learning how to create a safe environment is important. Support Groups
In our Managing Food Allergies At… section, you’ll find Meeting other individuals and families who are managing
resources about making these environments safe and food allergies and sharing experiences and support can be
inclusive: incredibly helpful.
• School • Work
• Camp • Dining out Find a support group in your area by visiting
• Home • Traveling [Link]/support-groups.
• College

Visit [Link]/managing-food-allergies.
Become an Advocate
The FARE Advocacy Network helps you make your
Resources for… voice heard. Keep informed about important legislative
developments and show your legislators you support life-
FARE has a variety of resources designed to help individuals,
saving initiatives at the federal, state and local levels.
families and communities stay safe and live well with food
allergies. In our Resources For… section, you can find tips
Sign up at [Link].
for:
• Newly Diagnosed • Healthcare Providers
• Parents • Schools, Camps and
• Kids Child Care Facilities Advancing a Cure
• Teens • Colleges & Universities FARE invests in world-class research that focuses on
• College Students • Restaurants and Food increasing our understanding of food allergies and developing
• Adults Manufacturers therapies that can protect against life-threatening reactions.

Visit [Link]/resources-for. Learn more at [Link]/research.

[Link]
©2016, Food Allergy Research & Education (FARE) 24
Acknowledgements

This resource was developed by FARE staff and reviewed by members of FARE’s Education
Working Group:

Maria Laura Acebal, JD Connie Green


FARE Board of Directors, former CEO of the Food FARE Support Group Leaders Executive Council,
Allergy & Anaphylaxis Network Founder of the SF Bay Area Food Allergy Network,
parent
Denise Bunning
Mothers of Children Having Allergies (MOCHA) Co- Linda J. Herbert, PhD
Founder, parent Pediatric Psychology Fellow, Children’s National
Medical Center
Mary Beth Feuling, MS, RD, CSP, CD
Advanced Practice Dietitian—Quality Improvement Stacie Jones, MD
& Research, Children’s Hospital of Wisconsin Professor within the Department Of Pediatrics and
the Section Chief of Allergy and Immunology at
Rebecca Fishner, MS, CRC, CPRP Arkansas Children’s Hospital
Rehabilitation Counselor, food writer, adult with
adult-onset food allergies Scott H. Sicherer, MD
Professor of Pediatrics and a researcher at the Jaffe
Joshua Flebowitz Food Allergy Institute at Mount Sinai in New York
Harvard Medical School, Class of 2015, adult with
food allergies, writer Sally Schoessler, MEd, BSN, RN
Director of Nursing Education, National Association
of School Nurses

Additionally, Chef Joel Schaefer, owner/president of Allergy Chefs, Inc., collaborated on the dining section of
this guide.

This digital resource is made possible through


an unrestricted sponsorship by Mylan Specialty L.P.

[Link]
©2016, Food Allergy Research & Education (FARE) 25

Common questions

Powered by AI

Creating a Food Allergy & Anaphylaxis Emergency Care Plan with your doctor is essential for emergency preparedness. This plan provides detailed instructions on recognizing and responding to an allergic reaction, including the use of epinephrine auto-injectors . Such a plan is crucial because allergic reactions can vary significantly in severity, and swift intervention can be lifesaving . It ensures that caregivers and family members are informed and prepared to act effectively during a reaction .

The Food Allergen Labeling and Consumer Protection Act (FALCPA) requires FDA-regulated food products containing major food allergens—such as milk, wheat, egg, peanuts, tree nuts, fish, crustacean shellfish, and soy—to list these allergens on product labels . The label must specify the specific type of tree nut, fish, or crustacean shellfish used . However, FALCPA does not cover fresh meats, fresh fruits, vegetables, highly refined oils, or restaurant foods prepared per individual order . Moreover, it does not require advisories for unintentional traces of allergens due to cross-contact in facilities .

Anaphylaxis is a serious allergic reaction that occurs quickly and can lead to death . The primary treatment is the early administration of an epinephrine auto-injector, as it effectively counteracts the severe, life-threatening symptoms. In contrast, antihistamines only alleviate mild symptoms like itchiness but cannot address the systemic effects of anaphylaxis .

Individuals with soy allergies should avoid foods containing soy and associated derivatives like soy cheese, soy flour, soy milk, etc. While highly refined soybean oil is generally safe for soy-allergic individuals, and many can consume soy lecithin without issue, it is essential to follow a healthcare provider's advice concerning these derivatives . Being vigilant about reading food labels and understanding food derivatives is crucial .

Food allergies involve the immune system and can be life-threatening, whereas food intolerances, such as lactose intolerance, involve digestive issues and are not life-threatening . This distinction is important because the management and risks associated with each are different. For food allergies, strict avoidance and an emergency care plan are required to prevent severe reactions .

Teens and young adults are at a higher risk of fatal outcomes from anaphylaxis because they are more likely to engage in risky behaviors, such as ignoring food allergy precautions or delaying treatment . This demographic may underestimate the severity or immediacy of allergic reactions, leading to dangerous outcomes if they do not administer epinephrine promptly or seek medical help .

Effective management of a food allergy involves several steps. Firstly, educating oneself about food allergies and their management is crucial. This includes reading the Food Allergy Field Guide and carrying with you a sheet with tips for avoiding allergens . Secondly, being prepared involves filling prescriptions for epinephrine auto-injectors, practicing their use, and ensuring family members know how to use them . Developing a comprehensive Food Allergy & Anaphylaxis Emergency Care Plan with a doctor is essential . Furthermore, staying connected and informed through resources such as FARE's website, support groups, and regular updates is crucial . Lastly, ensuring a management plan is in place at school or child care facilities and helping the child understand their allergies are important steps for parents .

Molluscan shellfish, like scallops, clams, mussels, and oysters, are not classified as major allergens under current food allergen labeling laws and therefore do not need to be indicated on food labels . Unlike crustacean shellfish, which require specific labeling, mollusks' presence is not mandated to be disclosed, potentially requiring additional vigilance by consumers of such allergens .

Most allergists recommend avoiding products with precautionary warnings such as "May contain…" because studies have shown these products can contain allergens in amounts significant enough to cause allergic reactions . These labels are voluntary, meaning that their absence does not necessarily indicate safety, as manufacturers are not required to disclose all potential cross-contact with allergens .

A biphasic reaction is when symptoms return one to four hours after the initial allergic reaction symptoms have subsided . Hospital observation is recommended after a severe reaction because this second wave can occur, sometimes even longer after the first, posing additional risks requiring medical intervention . Staying in a medical facility allows for monitoring and treatment if symptoms re-emerge .

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