Food That Sickens: If You Have Allergies, Don’t Despair. Simple Substitutions Can Make Eating Enjoyable Again

By Rose Cox, Anchorage Daily News, Alaska

May 17–Debbie Kindred says she’d kill for a chicken sandwich. It’s hard to believe the soft-spoken grandmother of three would actually make good on that sentiment, but there’s an unmistakable longing in her voice.

“I’m never going to eat another fluffy, white, moist piece of bread,” she laments.

Kindred has food allergies, caused by her immune system’s overreaction to certain food proteins. The Food Allergy and Anaphylaxis Network estimates there are up to 11 million Americans like her, and the count continues to rise.

Allergic reactions to food send 30,000 people to the emergency room each year, according to the Asthma and Allergy Foundation of America. Symptoms range from itchy skin and hives to swelling of the lips, throat and tongue, wheezing, shortness of breath, coughing and hoarseness, headache, nausea, vomiting and abdominal cramps, loss of consciousness and, in some cases, death.

Kindred, an accounting technician for the state Child Support Services office, was diagnosed with allergies to wheat, rice, eggs and poultry in November. That explained her frequent rashes and hives, and the blisters on her palms whenever she prepared chicken.

Her food allergies also contributed to frequent asthma attacks that sent her to emergency rooms in a panic. About 50 percent of the people who have asthma also have food allergies, according to the Asthma and Allergy Foundation. (The term “allergic asthma” is used to describe an asthma attack triggered by exposure to an allergen of any kind.)

Kindred added sunflower seeds to her list of taboo foods after a co-worker shared her chocolate- covered seeds one day. By the time she’d enjoyed the third little seed, Kindred’s throat was swelling inside, and she was having difficulty breathing, both signs of anaphylaxis — a hypersensitivity to a foreign substance that can become fatal within minutes through swelling that shuts off the airways or a dramatic drop in blood pressure.

From previous experiences, Kindred knew to take the oral histamine blocker Benedryl immediately to subdue the reaction. A visit to the doctor confirmed sunflower seeds were the culprit. These days, she carries an EpiPen — an auto-injector that administers epinephrine. She takes no chances, keeping one at home, one in her purse, one in her car and one in her camping gear.

Epinephrine can arrest an attack long enough for Kindred to get to a hospital. But about 300 people a year die of anaphylactic shock in the United States, according to the Asthma and Allergy Foundation. Teens and young adults with peanut or tree nut (walnuts, almonds, cashews, pistachios, pecans, etc.) allergies who also have asthma appear to be at greater risk.

All severe reactions are related to immunoglobulin E, or IgE, an antibody that binds with the allergen and turns on the allergic response, said Dr. Teresa Neeno, a board certified allergist who practices at the Allergy, Asthma and Immunology Center of Alaska. Neeno is also president of the Alaska chapter of the Asthma and Allergy Foundation.

Testing in a doctor’s office can identify allergens and detail their severity, but there is no cure.

“The only treatment is absolute, complete avoidance,” she said. “People tend to be fairly cavalier if they’ve eaten the food before without any effects. But that next bite might kill you.”

People with severe reactions to food don’t even have to take that bite. If the grease that fried their french fries also fried fish or breaded onion rings, and fish and wheat are on their list of allergens, it could land them in the hospital. They wonder if the person who used the grocery cart before them munched on a free cookie while they wheeled down the aisle, leaving wheat flour residue behind.

“It has affected every aspect of my life,” Kindred said. “I can’t visit restaurants, I read labels like crazy. I get very creative in the kitchen, but it’s time-consuming and it makes a bigger mess because I have to cook from scratch.

“You can’t just open the freezer and pull out a frozen dinner.”

But modifying her diet has increased her quality of life many times over, she said.

“I’m healthier, my asthma is under control now.”

Why do some people develop food allergies and others don’t?

“That’s the billion-dollar question,” Neeno said. “But there’s clearly a genetic component, and early exposure to food proteins is a factor. Why one child in a family and not the other has food allergies is an area of active research.”

Just eight foods cause 90 percent of allergic reactions — milk, soy, eggs, wheat, peanuts, tree nuts, fish and shellfish — but a person can develop an allergy to nearly any food.

“You may react to a food, but not consciously, the first time,” said Sherryl Meek, a registered dietitian who works as a nutritional consultant at the Allergy, Asthma and Immunology Center of Alaska. “Your cells regard the food protein as a foreign invader and produce antibodies. Every time you eat that food, you build a little platoon of antibodies. Then one time you eat it, and they send out the whole army.”

The need to avoid ingredients that are pervasive in our prepackaged, fast-food world can seriously complicate life.

“Birthday parties, brunches, buffets, restaurants, travel, dinner at someone else’s house — everything becomes a challenge,” Meek said.

Meek is a board member of the Alaska chapter of the Asthma and Allergy Foundation. She routinely supplies recipes for the chapter’s newsletter that substitute common allergens with an array of other products. Most she developed through trial and error at home, after her daughter was diagnosed with allergies to dairy, eggs, wheat, soy, peanuts and garlic at age 13 months.

“Making the changes was bad enough for me, a dietitian with an interest in food allergy. For someone with no knowledge of it, the change can be simply overwhelming.”

Food allergies turn a simple muffin recipe into an exercise in alchemy.

Baked goods depend on gluten, a component of wheat, to give them bulk and trap yeast gases to make them rise. Without wheat, bread as we know it doesn’t exist.

“Wheat is a big one. If you’re suddenly told you can’t have wheat, it’s quite an adjustment,” Meek said. She recommends wheat-free Ener-G brand bread, sold at Carrs, Fred Meyer and the Natural Pantry for people needing a bread fix.

For muffins, cakes and other baked goods, she substitutes flours made from rice, amaranth, oats, quinoa (pronounced “keen-wa”) and other grains. She recommends sorghum flour for sweet recipes like cake and cookies; bean flours tend to work better for nonsweet recipes.

But it’s not just a matter of cup-for-cup, since different flours have different absorbency, and the flour-to-fluid ratio in any recipe is critical.

Eggs also add rise to dishes and help bind other ingredients together. Meek favors xanthan gum over egg-replacement products.

“Xanthan gum makes the recipe work with about any kind of flour,” she said.

Made from the outer layer of a tiny, inactive bacterium called xanthomonas campestres, it has a unique ability to hold small particles together and can keep cakes and muffins from turning into a pile of crumbles. A 1/2 teaspoon of xanthan gum will replace each egg called for in a recipe.

But be aware that no matter how effective the substitute, the taste, texture and smell of favorite foods are unlikely to be the same.

“The whole thing is to not set your expectation that it’s going to turn out exactly like you’re used to,” Meek said.

To substitute for dairy products, she suggests replacing the milk in baked recipes with sparkling water or 7-Up to add more rise. Other substitutions include soy, oat or rice milk.

Anyone with two or more major (of the eight most common allergens) food allergies is a candidate for nutritional deficiencies, Meek said. “It’s a tough job to get enough protein if you can’t eat meat or dairy.”

To boost calcium intake, look for soy, oat and rice milk that is fortified with calcium, vitamin A and vitamin D. Soy milk has the highest protein of all milk substitutes at 7 grams, nearly as much as milk. In comparison, rice milk has 1 gram.

Beans and broccoli are both rich in fiber and calcium.

“But you’d have to eat two cups of broccoli to get the amount of calcium in one cup of milk.”

Meek also recommends blending flours to boost nutrition. In fact, people with allergies to wheat might have a leg up on those still eating refined, white flour.

“We really should be eating mostly whole grains.”

Allergic to peanuts? Meek raves about SunButter, made from sunflower seeds by SunGold Foods in a factory uncontaminated by peanuts. An alternative is SoyNut Butter made by IM Healthy in a peanut-, gluten- and tree nut-free factory.

Another favorite is Enjoy Life chocolate chips, which are free of dairy, soy and gluten.

Above all, read labels, Meek said.

“Read every label, every time because companies do change their formulas, and you may not know it.”

If you have questions about a product, call the manufacturer.

“Make the phone call and ask the question,” she said. “You will be creating awareness.”

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Copyright (c) 2006, Anchorage Daily News, Alaska

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