It’s time for the old end-of-year office party or family holiday dinner.  During the holiday season the likelihood that you will ingest high-risk foods that may cause allergic reactions is at an all-time high.  So if you are one of the estimated 11 million people affected by food allergies, focus on being a label detective in order to avoid these potentially hazardous ordeals. 

Sharing meals during the holidays is one of the highlights of the season for many families. The most common food allergens in the U.S. are cow’s milk, eggs, soy, wheat, fish, shellfish, peanuts and tree nuts.  Unfortunately, food allergies make up over tens of thousands of emergency room visits annually. Peanut allergy is associated with potentially fatal allergic reactions and often, allergic individuals will not outgrow it.

When invited as a guest to the home of a friend or family member during the holidays, it’s important to explain what your food issues and concerns may be. By doing this, you can hopefully avoid unnecessary trips to the emergency room.

Watch our for these holiday culprits:

• Eggnog (the word albumin on a label indicates the presence of eggs)

• Fruitcakes (may contain nuts)

• Glazed rolls and bread or other bakery items (containing egg)

• Mixed nuts

• Chocolate, candies and other confectionery items (many contain nuts, milk)

• Dips, fondues and salsas (may contain diary cream and egg)

• Quiches (often contain egg)

• Fried foods – if you are seafood-allergic (as the same oil used in the fried fish may also be used in the preparation of other fried foods such as French fries)

• At least some alcoholic beverages (if you are grain or wheat sensitive)

• Soybean oil salad dressings – (if soy sensitive)

• Caesar or Greek salad (may contain anchovies)

• Marzipan (a paste made of ground almonds, egg and/or milk)

• Worcestershire sauce (may contain fish)

• Yams, sweet potato pie (may contain egg, pecans, walnuts or dairy)

• Pumpkin pie (may contain peanut/nuts, nutmeg)

• Gingerbread cookies (may contain egg, milk, soy, corn and wheat)

• Potato pancakes served for a Chanukah celebration (may contain egg)

Here are some strategies for the holidays:

• Use caution if you eat Chinese, Vietnamese, Thai and Mexican cuisine as many foods may contain nuts. 

• Keep a “restaurant food allergen ingredient card” with you to make the kitchen staff aware of your food allergy when dining out.  Ask for a list of ingredients before ordering.    

• Be a label detective! Learn to read food labels as many ingredients can be misleading or confusing.  Check out the recommendations on “How to Read a Label” at www.foodallergy.org.

• When visiting with friends and family, let your host know if you need to avoid certain foods so they can prepare alternate choices. 

• Bring safe, homemade, allergy-free dishes when invited to someone’s house.

• Keep a spot in the food preparation area of the kitchen free of food allergens.

• Be sure and know the earliest signs of an allergic reaction and how to give the emergency medication(s) prescribed by your allergist/physician.

• Develop an emergency plan that includes ample medication, including epinephrine auto-injectors (be prepared for prolonged reactions).

• Plan ahead if you need to travel during the holidays and have safe snacks and foods with you, especially if you have a food-allergic child.

• Stay with “simple dishes” that avoid hidden ingredients.

• Avoid salad bars where containers can have traces of allergens and cross contamination is common.

• Use caution when ordering deli meats where the same equipment may be used to slice meat and milk-based cheeses.

Having an allergy to a food does not mean you cannot enjoy the many and varied holiday foods this time of the year.  Many alternate foods can be substituted and still ensure a safe and enjoyable holiday season!  For more tips on avoiding food allergens during the holidays, vitit www.aaaai.org or www.acaai.org.

Dr. Clifford W. Bassett is an assistant clinical professor of medicine at the Long Island College Hospital and on the faculty of NYU School of Medicine. He is the current vice chair for public education committee of the American Academy of Allergy, Asthma and Immunology. No information in this blog is intended as medical advice to any reader or intended to diagnose or treat any medical condition.

If you have a child with allergies or asthma – this is a very good time to review your “allergy action plan” for the upcoming school year.  First, if your child has asthma – learn about asthma triggers, including exercise associated asthma.

Second, more than 2 million children have allergies to one or more foods, making it imperative to incorporate a savvy avoidance and elimination diet 24/7 both at home and at school.  If you need help, enroll in the Food Allergy and Anaphylaxis Network at www.foodallergy.org.

Third, seasonal allergies and indoor allergies can cause a decrease in learning in the classroom. As a result, your child may require proper attention and pre-treatment before they head to the classroom.

Here are some more tips to get you started:

– All children with a history of severe allergy or allergic emergencies should have an auto-injector with epinephrine immediately available to them and appropriate school personnel. A written plan of action should be in place.

– If your child has asthma – work with your child’s physical education staff to allow for safe and enjoyable athletic activities during the school year. It is very important to provide time for a warm up and adequate cool down as well as have available drinking water during exercise.

– Wear protective eyewear on windy days to reduce pollens and molds entering the eyes.

– Work with your family doctor and/or allergist to get proper allergy treatment for environmental allergies that may be aggravated by exposure to indoor allergies such as pet dander (cat hair is often present in high levels in schools, and is usually from exposure to clothing).

– For kids allergic to food, always plan ahead with safe snacks for school and reinforce “reading food labels.” 

Let’s make the school year a safe, successful and fun-filled experience, especially if your child has allergies or asthma. Learn more at www.acaai.org and www.aaaai.org.

Dr. Clifford W. Bassett is an assistant clinical professor of medicine at the Long Island College Hospital and on the faculty of NYU School of Medicine.  He is the current vice chair for public education committee of the American Academy of Allergy, Asthma and Immunology.  No information in this blog is intended as medical advice to any reader or intended to diagnose or treat any medical condition.

This summer children and adolescents who suffer from food allergies will be attending day and or sleep away camps throughout the U.S.  Now is the right time to review the best strategies to minimize risk and raise the level of protection for affected children. With 2.2 million school age children with food allergies, many camps are now going “peanut and nut free” due to the increased prevalence of food allergic children. 

The best resource for the parents and kids in my practice with food allergies has been the Food Allergy and Anaphylaxis Network (FAAN). Visit www.foodallergy.org for more information. “Going to camp is an event that a child remembers forever. The key to success is clear communication with the camp staff and your child about how to manage food allergy restrictions. With advance planning and preparation, children with food allergies should be able to participate in this unique experience filled with a lifetime of memories,” said Anne Muñoz-Furlong, Founder and CEO of FAAN.

 Eating outside of the home, especially during the summer vacation and camp season, can be done safely when proper education and preparedness as well as communication takes place on behalf of food allergic kids everywhere.  Many states have recently enacted laws that provide for ready access to injectable epinephrine to children attending recreational camps.

Here is a just a partial list of helpful suggestions:

– Be a  “label detective” and know the product and chemical names of common food allergens

– Carry and send safe snacks to camp and communicate with the camp staff about your child’s food allergies before it begins

– Discourage food sharing

– If your child has peanut and/or nut allergies look for camps that are peanut free

– Have an emergency action plan in place for the adults responsible for supervising your child at camp. Work with an allergist to develop this plan, such as FAAN’s Food Allergy Action Plan available at http://www.foodallergy.org/actionplan.pdf.

– Your child should have a “medic alert bracelet”(800-ID-ALERT)

Again there is no substitute for careful planning, coordination and communication with camp staff when you have a child with food allergies for a safe and enjoyable summer.

Dr. Clifford W. Bassett is an assistant clinical professor of medicine at the Long Island College Hospital and on the faculty of NYU School of Medicine.  He is the current vice chair for public education committee of the American Academy of Allergy, Asthma and Immunology.  No information in this blog is intended to diagnose or treat any condition.

Let’s face it; the best defense is a good offense. In the case of allergies, that means you need to develop an emergency plan for allergic conditions such as stinging insect allergy, food allergic reactions, etc if you have a history of a severe allergic reaction and you’re traveling. 

First, make sure if you have a prescription epinephrine auto-injector with a current expiration date. Also it is important, during the summertime, not to store these devices in a location that is excessively hot (such as a car’s glove box). Next, go over with your doctor when to use this device and practice using a trainer – to become familiar with its use if ever needed in time of an emergency. 

It’s also important if you have a history of asthma (trouble breathing, wheezing, etc) that can be brought on by a variety of triggers to carry an adequate supply of medications with you, including a rapid onset rescue bronchodilator inhaler. 

If you have a food allergy, you will need to be a “label detective” and plan ahead by bringing safe snacks that you know are safe for you to eat.  Be sure to let restaurants and hotel staff know what your specific food allergies are when ordering your meals. We recommend that our patients carry a “chef’s card” that spells out your food allergies in writing and is given to the kitchen staff for the chef to see.  All affected individuals with a known food allergy should have an allergist-directed emergency plan in place, and have your family members (and anyone that you travel with) be familiar with how to recognize an allergic reaction as well as knowing what to do in case of a true food allergic reaction.  This is particularly important when traveling by plane, boat or train where emergency personnel may not be immediately available. Check out www.foodallergy.org for more information to keep you safe during the summer travel season.

Have a safe trip!

Dr. Clifford W. Bassett is an assistant clinical professor of medicine at the Long Island College Hospital and on the faculty of NYU School of Medicine.  He is the current vice chair for public education committee of the American Academy of Allergy, Asthma and Immunology.  No information in this blog is intended to diagnose or treat any condition.