This article was originally authored and published by Dr. Jill Carnahan.
Living with food allergies can sometimes feel like a curse. Allergies require constant vigilance and lots of explaining. It can almost make eating seem like a chore. And it can be a bummer to explain that you can’t dig into that pizza at the Super Bowl party. It can also feel pretty lonely.
But it doesn’t have to be this way.
No one should be defined by their allergies. And going out with your friends shouldn’t have to be a stressful experience. So it’s time to get creative! I’ll show you how you or your loved one can enjoy mealtime again with tips on how to avoid the most common allergy-triggering foods and what you can replace them with.
Most Common Food Allergies
In the U.S., about 4% of adults and 8% of children suffer from food allergies, costing about $25 billion every year. And the numbers keep growing. There are over 170 known allergy-triggering food substances (also known as allergens), but scientists have found that only eight of them cause 90% of food-allergy reactions.
We’ll go into more detail about each of the eight most common allergens and the alternatives you can use to make safe (and still delicious) dishes. Below you’ll find a cheat sheet of my favorite allergy substitutions followed by a more detailed look into each:
|Instead of This…||Use This|
|Cow’s Milk||Rice, Almond, Coconut, or homemade nut milkHomemade nut milk recipe:
Blend ½ cup of raw nuts or seeds with 1 cup of water until smooth
|Eggs||Ener-G Egg Replacer, mashed banana, unsweetened applesauce, or ground flaxseeds|
|Peanuts||Tree nuts like almonds, hazelnuts, cashews, and pecans (maybe), pumpkin seeds, sunflower seeds, flaxseeds, chia seeds, and sesame seeds|
|Tree Nuts||Peanuts (maybe), pumpkin seeds, sunflower seeds, flaxseeds, chia seeds, and sesame seeds|
|Soy||Beans, lentils, quinoa, almond milk, coconut milk, green peas, soy-free vegan butter and yogurt, other legumes and grains|
|Wheat||Gluten-free flours and grains, such as flours made with: coconut, almond, oat, rice, quinoa, amaranth, millet, teff, arrowroot, tapioca bean, and nuts and seeds|
|Fish (Finned)||Shellfish, eggs, dairy, other types of meat, high-protein vegetables and legumes like lentils, beans, and broccoliFish oil alternatives: flaxseed oil, walnut oil, soy oil, canola oil|
|Shellfish||Finned fish, mollusks, eggs, dairy, other types of meat, high-protein vegetables and legumes like lentils, beans, and broccoliFish oil alternatives: flaxseed oil, walnut oil, soy oil, canola oil|
Cow milk allergy is the most common type of allergy among young children and infants, affecting between 2 and 7.5% of them. Fortunately, most tend to outgrow it. The likelihood of a child outgrowing milk allergy depends on the level of cow’s milk antibodies in the child’s blood – the higher the antibody levels, the more likely it is for the allergy to continue into adulthood.
To replace milk, you can use dairy-free alternatives, such as rice, almond, coconut, or homemade nut milk. Homemade nut milk can be made by blending ½ cup of raw nuts or seeds with 1 cup of water. Many of these options taste great, are affordable, and are easy to find!
Eggs are so commonly used in our foods that it can be a challenge to avoid them. It is the second most common food allergy in children after milk, affecting 0.5 to 2.5% of children.
And avoiding eggs is not an easy task. People with egg allergy can be accidentally exposed to them, especially at restaurants or bakeries where an egg-free item can easily come into contact with another item that contains eggs.
But being allergic to eggs doesn’t mean you have to settle for tasteless muffins or other baked goods! While you may not be able to eat egg-focused dishes, there are plenty of egg substitutes, like Ener-G Egg Replacer, mashed banana, ground flaxseeds, and unsweetened applesauce.
Have you noticed that schools near you are banning peanut products?
Peanut allergy deserves special attention because it accounts for a majority of severe food-related allergic reactions, including death. Not only is peanut allergy a growing problem, you can’t outgrow it, and even tiny amounts of peanuts can trigger a reaction in highly sensitive people.
Despite its name, peanuts are actually legumes, not nuts. So even if you can’t enjoy peanut butter, there are many options made of other types of nuts that’ll make your sandwich taste almost as good, like almond, hazelnut, walnut, cashew, and pecan butter.
Unfortunately for some of you with peanut allergy, you could also be allergic to tree nuts. In one large study examining peanut allergy, 86% of individuals with peanut allergy were also sensitive to tree nuts, and 34% of them had documented tree nut allergy. It turns out that this “cross-reactivity” occurs because peanuts and some tree nuts share similar allergenic proteins!
So what are tree nuts? Tree nuts include:
- Macadamia nuts
- Brazil nuts
- Shea nuts
As with peanuts, you can swap tree nuts for pumpkin seeds, sunflower seeds, flaxseeds, chia seeds, and sesame seeds. Many of these are especially good if you lightly toast them first.
Soy is a product of soybeans, a legume that is commonly used in Asian cuisines. It is rich in nutrients, including vitamin B, fiber, potassium, and magnesium.
While more research needs to be done about soy’s effects on human health, what’s clear is that soy allergy is becoming more common, affecting 0.4% of children. Fortunately, allergic reactions to soy tend to be mild and approximately 50% of children with soy allergy outgrow their allergy by the age of 7, and most will by the age of 10.
However, everyone is different, and it’s advised that those with soy allergy avoid foods with soy. Instead, you can substitute soy products with beans, almond milk, coconut milk, green peas, soy-free vegan butter and yogurt, among many others.
As one of the most widely grown crops worldwide, wheat is used in many foods and drinks, such as sweets, breads, pasta, pizza, ketchup, and beer. It is even used in hot dogs!
Wheat allergy is often confused with gluten sensitivity or intolerance, but they are not the same thing. Gluten is just one of 27 allergens found in wheat, meaning not everyone with wheat allergy is allergic to the same part of the plant.
Although many children outgrow wheat allergy, some people can still have life-threatening reactions, and should opt for wheat-free products. For example, instead of flour made with wheat, look for the following types of flours:
- Tapioca bean
- Nuts and seeds
You can use a blend of these flours to replace the full amount of wheat flour.
Even if you don’t have wheat allergy, I would still highly recommend that you avoid it as much as possible. In fact, this lifestyle change could end up saving your life. Eating wheat can increase your exposure to glyphosate, a toxic chemical found in the popular herbicide Roundup. I’ve written about the health-related dangers of glyphosate several times (most recently here), and I feel that the information we know now is just the tip of the iceberg.
Remember, it’s much easier to be proactive than reactive, especially when it comes to your health.
Fish consumption has increased worldwide, and so have reports of fish allergy, affecting between 0.5 and 5% of the population. Although fish allergy often develops during childhood, 40% of people experience their first allergic reaction to fish as adults.
The most common fish species people have reported being allergic to include salmon, tuna, and halibut. Many people who are allergic to one type of fish are also allergic to other types of fish, so avoiding all fish and fish products is essential, including fish oil.
As an alternative to fish, you can try eating shellfish. Since finned fish and shellfish are not related, you can still consume one while being allergic to the other. For fish oil alternatives, you can check out oil from plant sources, such as flaxseed oil, walnut oil, soy oil, and canola oil.
Like fish, shellfish allergy is a lifelong problem, and 60% of people with this allergy experience their first adverse reaction as adults.
There are two groups of shellfish, crustaceans and mollusks. Examples of each include:
- Crustaceans: crabs, lobsters, shrimp, and krill
- Mollusks: mussels, octopuses, clams, oysters, and snails
Typically, it is the crustacean group that causes the greatest number of allergic reactions. Some people with shellfish allergy have been known to be able to tolerate mollusks.
People with shellfish allergy may not be allergic to finned fish. However, if you happen to be allergic to both, you can still get your protein by consuming eggs, dairy, and other meat products (assuming you’re not allergic to any of them). If you’re a vegetarian, you can replace fish and shellfish with high-protein vegetables and legumes, such as lentils, beans, and broccoli.
Heal Your Gut With An Elimination Diet
If you suspect that you or a loved one has food allergies, it is important to identify the allergens, which may not be as easy as it sounds. The best way to do so is with an elimination diet.
According to The Institute for Functional Medicine (IFM), an elimination diet can help not only clear your body of the allergens, but it can also help restore balance to your gut microbiome. There is a growing body of evidence that says changes to your gut microbiome play a role in the development of food allergies. In fact, the lack of certain types of bacteria like Lactobacilli have already been linked to a higher risk of developing allergies in children. Are you surprised?
An elimination diet is typically a short-term program that first requires the participants to remove certain foods and food types from their diet. This gives the body an opportunity to heal, reducing oxidative stress and inflammation. After the initial elimination period, the foods are then slowly reintroduced one at a time, over 2 to 3 days, to see which ones trigger a negative reaction. When the allergen is identified, you can remove it from your diet. The entire process usually takes around 5 to 6 weeks.
IFM recommends that you attempt to reintroduce foods that provoke symptoms after 3 to 6 months, which gives your gut sufficient time to heal. Once your gut microbiome is more balanced, you may find that you can reintroduce those foods without symptoms.
Reintroduction can safely be done at home. However, for people with severe allergic reactions, this part should only occur in the presence of a doctor or another healthcare professional. Elimination diets for children should always be done under the supervision of a doctor.
Do You Have A Food Allergy?
Food allergies can present a daily challenge, but we now have more options than ever to substitute common allergens with safe and delicious alternatives.
Now I want to hear from you. Do you have a food allergy? Have you tried an elimination diet? What strategies or substitutes have you found useful? Share your experiences and thoughts in the comments!