Posts Tagged ‘shellfish-allergy-prescription-medicine’

The “Top Ten” Allergens

Thursday, May 19th, 2011

THE “TOP TEN” ALLERGENS

In each of the preceding seven chapters, we have discussed elimination of one specific food or one type of food. In practice, people often need to avoid more than one food, especially while they are trying to determine exactly which ones they are allergic to. If you need to avoid only one, two, or three foods, the previous chapters will give you enough information to do so without risking nutritional deficiencies. By consuming the “foods allowed” for each food restriction, it should not be a problem for you to ensure that you obtain adequate nutrition while on the exclusion diet. However, in some cases, more than two or three foods need to be avoided. This chapter will provide you with the information that will allow you to avoid the ten most allergenic foods and still not risk nutritional deficiency.

The Allergenic “Top Ten” Foods

Milk and milk products, egg, wheat, corn, soy, peanut, tree nuts, chocolate, fish, and shellfish are the most frequent causes of food allergy. The more foods a person needs to avoid, the greater is the risk for nutritional deficiency. When many foods are removed from the diet at the same time, it is important to find substitute foods that will replace the important nutrients that are restricted. Table 15-1 lists substitute foods to ensure adequate nutritional intake when a person is avoiding these ten most highly allergenic foods at the same time.

How Long Should I Stay on a Restricted Diet?

A very restricted diet should not be followed initially for longer than four weeks, after which time each food should be retested to confirm that it really needs to be avoided. If one or more of the specified foods do not cause symptoms when they are consumed after elimination, they can be included in the diet, which will then become more nutritionally complete and easier to manage.

Bach of the ten foods restricted on the diet in Table Diet free from milk, egg, wheat, corn, soy,peanut, tree nuts, fish, shellfish, and chocolate can be found in many products and has many derivatives. It would require extensive lists of foods and their products to cover all possible dietary sources. Reading of food labels is essential to detect the allergen as an ingredient in processed and prepared foods. Because so many foods are restricted on this diet, information is provided only for the foods allowed.

If enough of the foods allowed in the “top ten allergens” elimination diet in Table Diet free from milk, egg, wheat, corn, soy, peanut, tree nuts, fish, shellfish, and chocolate are consumed, and the diet is limited to four weeks, nutritional deficiency should not be a problem. Possibly the only supplements required are calcium and vitamin D. However, a person following this diet for longer than four weeks is strongly advised to check with a physician and a dietitian for guidance in choosing appropriate supplements.

Table Diet free from milk, egg, wheat, corn, soy, peanut, tree nuts, fish, shellfish, and chocolate

Type of Food Foods Allowed
Milk and

Milk Products

• Milk and soy-free products such as

- Rice Dream (made from brown rice and safflower oil)

- Darifree(made from potato starch)

• In recipes, substitute

- fruit or vegetable juice

- homemade soup stock

- water used to cook vegetables or potatoes

• Instead of butter use

-whey-free, soy-free, corn-free margarine (e.g., Canoleo)

- pure jelly

-jam

- honey

- herb-flavored olive oil

• Dressings on vegetables and salad:

- olive oil with herbs

- homemade salad dressings made with allowed ingredients

Grains, Cereals,

and Bakery

Products

Grains and flours:

Amaranth and amaranth flour

• Barley and barley flour

• Buckwheat and buckwheat flour

• Chickpea or garbanzo bean flour (besan)

• Millet and millet flour (bajri)

• T’eff

• Oats and oat flour

• Potato starch and flour

• Quinoa and quinoa flour

• Rice and rice flour

• Wild rice and wild rice flour

• Rye and rye flour

• Sago and sago flour

• Tapioca; tapioca starch and flour

• Cassava flour and starch

Breads and baked goods:

Baked goods and specialty baking mixes containing allowed

ingredients such as:

- Ener-G rice, brown rice, or tapioca bread

- Celimix rice or flaxmeal bread

• Homemade baked goods made with allowed flours and grains

Crackers and snacks:

Potato chips made with allowed oil, such as Nalley 100% Golden

Light Chips

• Pure rye crisp crackers

• Rice cakes

• Rice crackers

Cereals:

Made from any of the allowed grains such as

- Cream of Rice

- Kenmei Rice Bran,

- Puffed rice

- Rice flakes

- Oatmeal

- Rolled oats

- Oat bran

- Rye flakes

- Granola made with allowed ingredients only

- Puffed amaranth

- Puffed millet

- Quinoa flakes

Pasta:

Made from any allowed grains and free from wheat and other

restricted ingredients, such as

- Brown rice pasta

- Wild rice pasta

- Mung bean pasta

- Green bean pasta

- Buckwheat pasta (soba noodles)

- Rice pasta

- Rice noodles

- Potato pasta

- Quinoa pasta

Vegetables • All plain fresh and frozen vegetables and their juices except

- Corn

- Soybeans

- Soybean sprouts

- Mixed sprouts

Fruit • All plain fresh and frozen fruits and their juices
Meat and

Poultry

• All fresh or frozen pure meat or poultry Avoid any meat mixed with additional ingredients, such as processed meats, sausages, and all deli meats.
Fish and Shellfish • None
Eggs • None

• Use egg-free egg replacer products such as Ener-G Egg Replacer

Legumes • All plain legumes and legume dishes prepared with allowed foods, except soy and peanut
Nuts • None
Seeds • All seeds such as

-Anise

- Caraway

- Cumin

- Fennel

-Flax

- Melon

- Mustard

- Pepper

- Poppy

- Pumpkin

- Sesame

- Sunflower

Fats and Oils • Vegetable oils such as

- Olive

- Canola

- Sunflower

- Safflower

- Flaxseed

• Meat drippings

• Lard

• Poultry fat

• Homemade gravy with allowed ingredients

• Tahini (sesame seed butter)

Spices and Herbs • All pure fresh or dried herbs and spices

Fish And Shellfish Allergy

Thursday, May 19th, 2011

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