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.

Carbohydrates (meaning “carbon plus water”) are the most efficient fuel for your body. They provide steady healthy energy. Along with fat and protein, carbohydrates are an essential nutrient. The two major forms of carbs are: simple sugars (simple carbohydrates), found in sugars such as fructose, glucose, and lactose, as well as in nutritious whole fruits; and starches (complex carbohydrates), found in foods such as starchy vegetables, grains, rice, and bread and cereals.

What makes carbs different from other essential nutrients (fat and protein) is that they are easily converted to energy by the body. Furthermore, the simplest carbohydrate, glucose, is essential fuel for the brain and muscles. When glucose is absorbed from the intestine into the bloodstream, blood-glucose levels increase, and your pancreas begins to secrete insulin to help get that sugar out of the blood and to the brain and muscles. The problem occurs when too much glucose over-whelms the metabolism. In other words, if you regularly eat great amounts of foods with refined starches and sugars—the bad carbs—the pancreas makes too much insulin and the blood sugar drops too far, which, in turn, makes you feel hungry. Furthermore, muscle cells will stop taking in the glucose, and so more of this sugar will be stored as fat, which will result in weight gain.

GOOD CARB FOODS: Complex carbohydrates are the good carbs. Among good carbs are high-fiber, low-sugar fruits, vegetables, legumes, whole oatmeal and all other whole grains, and all types of beans (a Latin staple!). Sweet potatoes, brown rice, grapefruit, fat-free milk (organic and in moderation, please), whole grain pasta (also in moderation), and apples, like other good carbs, cause a gradual rise in blood-sugar levels, which is optimal for sustained energy, mental clarity and focus, and a balanced mood. Also, eating good carbs will help curb your cravings for bad carbs, which in turn can help you avoid chemical imbalances in the brain that can cause depression.

NOTE: I always recommend buying organic products, because they’re free of potentially harmful ingredients.