Tree Nuts and Dairy and Soy, oh my! Rebecca Da Silva, RD Julie Fromm, RD
Allergy or Intolerance? True Allergy Immune system response; body mistakes an ingredient as harmful and creates a defense system to fight the invader Affect 4-5% of the population All amounts of allergic foods must be avoided Diagnosed by skin prick, blood test Intolerance Digestive system response; body is unable to properly digest or breakdown the food. Very common Quantities of reactive foods must be monitored Found through trial and error, elimination diet
What causes food allergies? Sensitivity to proteins in certain foods After exposure to a protein your body thinks is harmful, the immune system responds Antibodies and histamine are released to expel the harmful protein Symptoms appear in the body where histamine is released
The not-so-great Eight Soy Wheat Egg Milk Fish Wheat Shellfish Peanuts Tree Nuts
Diagnosis Skin prick test Least expensive Can be done in the doctor s office Blood test Positive test results show antibodies present in the body, but cannot predict a reaction will occur History of symptoms and food testing are combined with test results to affirm allergy
Treatment Strict avoidance! Label reading Epinephrine Asking questions about food preparation when dining out Learn which foods in which amounts cause symptoms Become familiar with symptoms
Symptoms
Cross Contact and Cleaning Always use soap and water to effectively remove protein from surfaces Simply wiping surfaces is not enough Utensils need to be thoroughly cleaned and properly stored Use disposable plates or purchase extra cutting boards specifically for allergy-free foods Alcohol-based hand sanitizer DOES NOT remove protein from skin Commercial cleaning agents may be needed in place of dishwashing liquid If cooking multiple foods at the same time, cook the allergen- free food first and keep covered ad away from any splatter from other foods
Danger Zones
Use a Chef Card! To the Chef: WARNING! I am allergic to. In order to avoid a life-threatening reaction, I must avoid all foods that might contain, including these ingredients: Please ensure that my food does not contain any of these ingredients and that all utensils and equipment used to prepare my meal, as well as prep surfaces, are thoroughly cleaned prior to use. Thanks for your cooperation.
Recipe Substitutions Milk (equal amounts) Fruit juice Soy milk Rice milk or water (add 1 egg yolk) Coconut milk Eggs (to equal one egg) best done for just 1-2 eggs, may increase baking time 1 tsp baking powder, 1 T water, 1 T vinegar 1 tsp yeast in ¼ C. warm water 1 ½ T water, 1 ½ T oil, 1 tsp baking powder 1 packet gelatin + 2 T warm water 3 Tbl applesauce+1 tsp baking powder 1 Tbl flaxseed+3 Tbl hot water, mix and let stand until thickened 3 Tbl pureed silken tofu+1 tsp baking powder
Recipe Substitutions Wheat; for 1 cup flour: 7/8 C rice flour 5/8 C potato starch flour 1 C soy flour plus ¼ C potato starch flour 1 C corn flour Oils ½ C of fruit puree is equivalent t 1 C butter, ¾ C of puree is equivalent to 1 C oil ¾ C of mashed squashes or sweet potatoes is equal to 1 C butter, or substitute cup-for-cup for oil.
What to Look for in a Label Ingredients! They can change over time Different sizes of the same product can have different ingredients Watch for hidden ingredients Manufacturers Manufacturing practices can change from one plant to another, even if it is from the same company! Natural flavoring/ spice Components of natural flavoring can vary from product to product Spice can contain any of over 40 different spices; always call the company to ensure safety of product before consuming Remember- DON T ASSUME ANYTHING!
Shellfish Barnacles, crab, crawfish, krill, lobster, prawns, shrimp Abalone, clams, cockle, cuttlefish, mussels, oysters, octopus, snails, whelk Shellfish is found in: fish stock, glucosamine, seafood flavoring, surimi (artificial crab) Keep in mind: Seafood restaurants are prime places of contact for shellfish allergies!
Soy Edamame, miso, tamari, tempeh, TVP, tofu, products that have soy in the name Soy is sometimes found in the following: asian cuisine, vegetable broth, vegetable gum, vegetable starch, canned tuna Keep in mind: most allergic individuals can safely consume highly hl refined soy oil and soy lecithin
Wheat Bread crumbs, bulgur, couscous, farina, flour, wheat protein, durum, cracker meal, matzoh, pasta, seitan, semolina, wheat grass Wheat is sometimes found in the following: glucose syrup, starch, surimi, makeup
Eggs Albumin, eggnog, lysozyme, mayonnaise, meringue, ovalbumin, surimi Egg is sometimes found in: baked goods, egg substitutes, lecithin, macaroni, marzipan, marshmallows, nougat, pasta Keep in mind: individuals with egg allergies should avoid eggs from duck, turkey, goose, quail, etc.
Milk/Dairy/Lactose Butter, buttermilk, casein, cheese, cottage cheese, cream, curds, custard, half and half, lactalbumin, lb milk, rennet, sour cream, whey, yogurt Lactose is sometimes found in the following: artificial butter flavor, baked goods, caramel candies, chocolate, lactic acid starter culture, margarine, nougat Keep in mind: Those with mild allergies can usually still tolerate yogurt and cheese; aged cheese has less lactose than other cheeses.
Tree Nuts Almonds, artificial nuts, beechnut, brazil nuts, butternut, cashews, chestnuts, coconut, hazelnuts, ginkgo nut, hickory nuts, macadamia nuts, marzipan, nut butters, nut paste/meal, pecans, pesto, pine nuts, pistachios, praline, walnuts, nut oils/extract t Keep in mind: coconut and shea nut oils may not be allergenic; many individuals id with tree nut allergies may need to avoid peanuts as well
Peanuts Artificial nuts, beer nuts, peanut oil, goobers, ground nuts, mixed nuts, monkey nuts, peanut butter, peanut flour Peanut is sometimes found in: African, Asian, and Mexican dishes, baked goods, candy, chili, egg rolls, enchilada sauce, marzipan, mole sauce, nougat Keep in mind: highly refined peanut oil is exempt from the allergen list, arachis oil is peanut oil, and those with peanut allergies may also have to avoid tree nuts
Remember
Resources The Food Allergy and Anaphylaxis Network, www.foodallergy.org org The American Dietetic Association, www.eatright.org g
Wellness Warrior Nutrition Resources Rebecca Da Silva, RD Registered Dietitian Graduated in 2010 from Ball State University s Dietetic Internship Graduated 2009 from Central Michigan University, BS in Dietetics. Currently working on MS in Dietetics Experience: Clinical Dietitian at St. John s Providence Hospitals Julie Fromm, RD BS from MSU AP4 through Oakland County Health Dept. Clinical experience at Crittenton Hospital Recently worked with maternal-infant health program Graduated from Culinary program at Schoolcraft College
Set up a consultation! Julie Fromm, RD julierd@wayne.edu Availability: T, TH; 9a-2p with some night availability. Rebecca DaSilva, RD rebecca.dasilva@wayne.edu Availability: M,W,F 7a-3p Dietitian Office phone: (313) 577-5857
Food Allergies Allergy Immune response Foods must be avoided in any amount Diagnosed by skin or blood testing Intolerance Digestive response Varied quantities of food may be consumed Eight most common Soy edamame, miso, tofu, tamari, tempeh, TVP Wheat Egg albumin, lysozyme, mayonnaise, meringue, ovaalbumin, surimi, lecithin, some pasta Milk/dairy casein, curds, custard, lactalbumin, rennet, whey Fish Wheat bulgur, couscous, farina, flour, wheat protein, gluten, durum, cracker meal, matzoh, pasta, semolina, seitan, graham, spelt, faro, einkorn, triticale, kamut Non wheat gluten: rye, barley Shellfish crab, surimi (Krab), lobster, shrimp, prawns, abalone, clams, mussels, whelk, glucosamine Peanuts Tree nuts almonds, cashews, coconut (according to FDA), marzipan, pecans, pesto (pine nuts), pistachios, praline Rebecca DaSilva, RD rebecca.dasilva@wayne.edu Julie Fromm, RD JulieRD@Wayne.edu 313 577 5857
Recipe Substitutions Milk Substitute in equal amounts Fruit juice, soy milk, coconut milk, rice milk or water (add 1 egg yolk) Eggs per egg Best done with just 1 2 eggs, may increase baking time 1 tsp baking powder+1 Tbl water + 1 Tbl vinegar 1 tsp yeast + ½ cup warm water 1 ½ Tbl water + 1 ½ Tbl oil + 1 tsp baking powder 1 packet gelatin + 2 Tbl water 3 Tbl applesauce + 1 tsp baking powder 1 Tbl flaxseed + 3 Tbl hot water (let stand until thickened) 3 Tbl pureed silken tofu + 1 tsp baking powder Wheat for 1 cup flour 7/8 c rice flour 5/8 c potato starch/flour 1 c soy flour + ¼ c potato starch/flour 1 c corn flour Oil ½ c fruit puree = 1 c butter ¾ c fruit puree=1 c oil ¾ c mashed squash or sweet potato = 1 c butter or cup for cup with oil www.food Allergy.org http://www.foodallergy.org/page/chef card1 http://www.foodallergy.org/page/hot topics1#foodallergytesting