Fish And Shellfish Allergy

Allergy to Fish

Fish species are abundant and exist in many edible forms in most countries of the world. The allergenic part of the fish is usually in the meat (muscle) of the fish. However, there is evidence that fish gelatin made from skin and bones may also be allergenic. Fish gelatin contains a high level of collagens. Collagen is an important protein in all connective tissue; it converts to gelatin when it is boiled. Consequently there is concern that certain collagens made from fish might be a cause of allergy. Collagens are used in a variety of cosmetics and may be a cause of allergy in fish-allergic users of these products, as well as people who consume collagen protein in fish. This subject needs to be investigated further.

It is not yet known whether antigens in different types and species of fish cross-react, making it necessary for fish-allergic people to avoid all species of fish if they are allergic to one species. In most cases, it is usually necessary for allergic people to avoid the specific type of fish to which they are allergic. However, there is increasing evidence that certain fish allergens may be common to several species. Not a great deal is known about individual fish allergens except for the antigen in cod named gad c 1, which was one of the first food allergens to be studied. The antigen is a type of protein called parvalbumin, and it can be found in a variety of fish species unrelated to cod, for example, carp, tuna, and salmon. It is still unclear whether a person allergic to one of these species should avoid all fish. At the present time, the advice is this: If there is no risk of an anaphylactic reaction, avoid only the fish species that have caused a reaction when consumed. If there is a risk of an anaphylactic reaction, avoid all fish and their derivatives in the interests of safety.

Fish and shellfish are quite distinct antigenically, so a person who is allergic to shellfish rarely needs to avoid free-swimming fish. To avoid unnecessary dietary restrictions, it is important to clearly identify the species of fish to which a person reacts adversely.

It is usually easy to avoid fish because its presence in a recipe is obvious, and its inclusion in a manufactured food is almost always indicated on the label. Table Terms on labels that indicate the presence of fish lists terms that indicate the presence of fish or fish product in manufactured foods and recipes.

Nutrients in Fish

Fish is a significant source of niacin, vitamin B6, vitamin B12, vitamin E, phosphorus, selenium, and in smaller amounts vitamin A, magnesium, iron, and zinc. These nutrients are also present in meats, grains, legumes, and oils, which can be eaten on a fish-free diet.

Table Terms on labels that indicate the presence of fish

Terms That Indicate the Presence of Fish Protein

Fish (all species) Fish oils, such as
Roe

Caviar

Surimi

- Cod liver oil

- Halibut liver oil

- Salmon oil

- Menhaden oil

- Efamol Marine

Foods That May Contain Fish Protein

Asian dishes such as Caesar salad (with anchovy) Baked goods
- Egg rolls

- Sushi

- Sashimi

- Tempura

- Thai recipes

- Chinese recipes

- Satay sauces

Chili Cookies

Candy bars

Prepared and frozen desserts

Any food containing gelatin,

unless the source of the

gelatin is given

Note on Fish Oils

Although pure oils are nonallergenic, it is very likely that any fish oil is contaminated with protein of the fish from which it was extracted. Fish-allergic people should avoid oil from the species of fish to which they are sensitive. If they don’t know which fish species they are allergic to, then they should avoid all fish oil, especially if there is a risk of anaphylaxis.

Shellfish-Free Diet

A person who is allergic to shellfish is usually advised to avoid shellfish of all types because even unrelated species tend to cause an adverse reaction when eaten by a sensitized individual. Therefore, a shellfish-restricted diet eliminates all species of crustaceans, such as crab, lobster, shrimp, prawn, and all species of mollusks (bivalves), such as clams, mussels, scallops. However, a person who reacts to shellfish does not need to avoid fish, since there is no evidence to suggest a relationship between the two types of seafood.

Table Terms on labels that indicate the presence of shellfish lists names and terms that indicate the presence of shellfish. Kosher food products do not contain shellfish and therefore are safe for a person with shellfish allergy.

Table Terms on labels that indicate the presence of shellfish

Terms That Indicate the Presence of Shellfish

Crustaceans

Crab

Lobster

Shrimp

Prawn

Scampi

Crawfish (crayfish)

Mollusks

Abalone

Oyster

Clam

Cockle

Mussel

Scallop

Whelk

Winkle

Octopus

Squid

Calamari

Escargot (snail)

Quahog

Food That May Contain Shellfish Protein

Asian dishes

Japanese dishes

Vietnamese dishes

Thai dishes

Chinese dishes:

- Congee

- Oyster sauce

- Satay sauce

- XO sauce

- Fish sauce

- Fish soup

- Fish balls

Shrimp noodles

Shrimp balls

Shrimp chips

Shrimp salad roll

Prawn chips

Haw Gow

Sui My

Sashimi

Sushi

Taro cake

Daikon cake

Flavoring in imitation fish

products

Stuffing

Note: This list is not exhaustive. The shellfish-allergic person should inquire about the source of ingredients whenever a new food is eaten, especially in an Oriental restaurant


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