Food Allergies

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Food Allergy

The Food Allergy Center at the New York-Presbyterian Hospital cares for both children and adults with food allergies.  Our goal is the clinical care of the food allergic patient.  We take a multidisciplinary approach in evaluating and treating patients.  Allergists, gastroenterologists and nutritionists assist in the care of our patients.  All food allergy related conditions are evaluated including hives, swelling, eczema, anaphylaxis, eosinophilic esophagitis and food protein sensitivity.

We take a careful dietary history and medical history as part of our evaluation.  Appropriate testing is performed including skin prick testing, ImmunoCap (blood testing) and food patch testing.  We perform oral food challenges to confirm or refute a food allergy when the diagnosis is in question.  Challenges are performed in a controlled environment with appropriate supervision.

Once a food allergy is identified, our comprehensive dietary management program focuses on patient education.  We guide the patient and his or her family on how to avoid allergenic foods, how to read ingredient labels and substitutions that can be made to maintain a healthy diet.

What foods cause allergies?
A person can be allergic to virtually any food. Certain foods however cause most of the reactions. In children, eggs, milk, wheat, soy, peanuts, tree nuts, fish and shellfish. cause the majority of allergic reactions. In adults, peanuts, tree nuts, shellfish and fish are the main culprits. Seeds such as sesame and mustard are triggering more reactions than in the past.

How do allergies present?
Patients can experience hives (welts) or itching. They can also experience coughing, wheezing, shortness of breath, throat closing and a drop in blood pressure. This is a serious reaction called anaphylaxis that requires an immediate visit to the emergency department. Skin rashes such as atopic dermatitis (eczema) and gastrointestinal symptoms, such as eosinophilic gastroenteritis can also be caused by food allergies.

How do I avoid exposure to the foods I’m allergic to?
All foods eaten by the allergic individual must have the ingredients checked prior to ingestion. When a product says “may contain” or “made in a facility with”, it is unlikely it contains this product. However, it can contain that product and the allergic individual may have a serious reaction to that product if it is ingested. Therefore, we recommend the allergic person avoid products that have these labels. Restaurants are notorious for contaminating dishes. Speak to the management of the restaurants to see if they can make the food free of the allergens you’re allergic to.

Avoidance of Milk
By US law, all products manufactured with milk must be labeled with the word “MILK” on the package.

The following ingredients indicate the presence of milk:
Butter, butter flavor, butter fat, casein, caseinates, cheese flavor, curds, ghee, hydrolysates, lactalbumin, lactoglobulin, lactoferrin, lactulose, nouat, rennet, recaldent, Simplesse and whey.

Products that do not contain milk include:
Cocoa butter, coconut milk, calcium lactate, calcium stearoyl lactylate, oleoresein, and lactic acid.

If a person does not ingest milk they should make sure they are receiving enough Calcium and Vitamin D from other sources.

Avoidance of Tree Nut and Peanuts
By US law, all products manufactured with tree nuts or peanuts must be labeled with the specific tree nut or peanuts on the package.

If a person is allergic to tree nuts it is best that all nuts be avoided.
The following are considered tree nuts:
Almonds, Brazil nut, Cashew, Chestnut, Hazelnut (Filbert), Macadamia nut, Pecan, Pine nut (Pignolia nut), Pistachio, and Walnut.

Marzipam, pesto, Nougat and Nunuts contain nut products and should be avoided. Many tree nuts are processed with peanuts. Peanut flour is commonly used in chili and spaghetti sauce as thickeners. Many chocolate and candies may contain peanuts or tree nuts. Peanut and tree nut oils may contain peanut or nut protein and should be avoided. Nutmeg, water chestnuts and butternut squash are not considered nuts. Cross contamination with nut products can occur at bakeries and ice cream parlors. Always carefully read the ingredients before consuming any product.