Find out what the symptoms of the most common food allergies are. Get advice on how to deal with food allergies and discover how to prevent them.
The Centers for Disease Control and Prevention estimate that 32 million Americans, including 6% of children, suffer from food allergies. Despite the high prevalence of these allergies, the U.S. isn’t exactly allergy-proof. From trying mystery sauces at restaurants to cross-contamination in a school cafeteria or a first kiss after a dinner date, the risk of exposure to allergens is everywhere. Even small—or trace—exposures to the food people are allergic to can lead not only to symptoms like itching and skin rash, or hives, but also swelling of the face and throat, as well as difficulty breathing. In the most severe instances, an allergic reaction can be fatal.
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Given the seriousness of food allergies, it’s important to heed any of a broad range of possible symptoms after food is consumed and seek medical attention for adults or kids to ensure proper diagnosis and allergy management. Here’s what you should know about common food allergens and how to stay safe if you’re allergic to them:
Many major food allergens are there to spread food allergies
The Food and Drug Administration designates nine foods as the most common food allergens:
- Milk.
- Eggs.
- Fish.
- Crustacean shellfish.
- Tree nuts.
- Peanuts.
- Wheat.
- Soybeans.
- Sesame.
Milk
Food allergies are usually caused by proteins. Casein and whey are the two types of proteins found in cow’s milk. The most common allergy in infants and young children is to cow’s milk. Items to stay away from include butter, milk powder, custard, chocolate, yogurt, cheese, cottage cheese, sour cream, and milk. Be especially cautious about processed grains that might contain whey or casein, two derivatives of milk. Keep in mind that lactose intolerance, or difficulty digesting the sugar (lactose) in milk, is not the same as a milk allergy.
Eggs
Both egg whites and egg yolks contain the protein that can cause allergies, but an allergy to egg whites is most common. However, since it’s impossible to separate the white and the yolk without any cross-contamination, you must avoid eggs as a whole. Foods to avoid: eggs, of course, but also albumin, mayonnaise, and meringue. Ice cream and many baked goods also contain eggs, as well as other foods where eggs are often a hidden ingredient, such as salad dressings and meatballs.
Fish
Fish, or specifically finned fish such as tuna, halibut, or salmon, is another common food allergen. Even cooking fish, such as sautéing on your stove, which can aerosolize the protein, can impact someone with a fish allergy. Fish is a common ingredient in Worcestershire sauce, Caesar salad, and many Asian dishes that use fish-based stock.
Crustacean shellfish
Adult shellfish allergy is the most common type of food allergy. All types of shellfish, including mussels, crab lobster, shrimp, scallops, and crab, should be avoided, as well as any meals that contain them. People who are allergic to shellfish frequently react, even when they are just a few feet away from the shellfish.
Tree nuts
Nut butters and other foods containing nuts, like pralines and other candies, are examples of tree nuts. Almonds, cashews, walnuts, Brazil nuts, hazelnuts, chestnuts, macadamia nuts, pecans, and pistachios are also included in this category. Tree nut allergies are among the foods most commonly associated with anaphylaxis, the potentially fatal, fast-acting allergic reaction, along with shellfish and peanuts. In addition to avoiding the allergen, it’s advised that people have other allergy medications on hand in case of an unplanned allergic reaction, such as epinephrine, which can reverse potentially fatal effects like a dangerous drop in blood pressure during anaphylaxis.
Peanuts
For kids, peanut allergies are the worst. Children should take great care to avoid consuming any product that contains even a trace amount of peanuts or peanut butter because this legume can result in an anaphylactic reaction from even a small amount of exposure. Since peanuts are a common ingredient in many foods, it’s crucial to check the ingredient list of every food if your child has a peanut allergy.
Wheat
Celiac disease and wheat allergies are not the same thing. Cereals, pastas, crackers, and ice cream are just a few of the foods that contain wheat. The following foods should also be avoided: flour, food starch, bulgur, seitan, couscous, faro, and bread crumbs.
Soybeans
Soybeans are a member of the legume family, but that doesn’t mean you’re automatically allergic to other legumes. Foods to avoid: soybeans, soy milk, tofu, edamame, miso, soy protein, and soy sauce. Pay particular attention to granola bars, energy drinks, baked goods, and foods that may have added soy.
Sesame
In January 2023, sesame became a new addition to the list of top allergens. The edible seeds are found in hummus, tahini, sushi, hamburger buns, bagels, energy bars, sesame oil, and certain spice blends.
Daily contact with common food allergens
Avoiding allergic reactions is difficult for those who have food allergies. Daily risk increases include cross-contamination, mislabeled or unclear food labels, aerosolized contact, and indirect contact with people consuming the allergen nearby. Food distributors must prominently label products that include or “may contain” the nine most common allergens, per FDA regulations. But there’s not a lot of guidance provided by that “may contain” label.
“When labels say things like’may contain’ or ‘traces of’ or ‘processed in a facility with,’ nobody knows what that actually means,” says allergist and immunologist Dr. Farah Khan, who is with the Nationwide Children’s Hospital in Columbus, Ohio.
These labels could imply dangerous scenarios like allergens being processed on the same machinery as the food you are trying to buy or not-so-worrisome situations like being processed in two different rooms or hallways apart from each other. But, she adds, there’s no way to know unless you try to call the company.
“Sometimes it just feels impossible to get down to what a food actually contains,” Khan says. “In those cases, we really are encouraging patients to have a conversation with your allergist about ‘what does this mean?’”
How common food allergies develop?
Avoiding allergic reactions is difficult for those who have food allergies. Daily risk increases include cross-contamination, mislabeled or unclear food labels, aerosolized contact, and indirect contact with people consuming the allergen nearby. Food distributors must prominently label products that include or “may contain” the nine most common allergens, per FDA regulations. But there’s not a lot of guidance provided by that “may contain” label.
How do doctors test people for food allergies?
Doctors can use a skin test to assess a person for food allergies. The test involves placing a small amount of the suspected allergen on the patient’s skin, then scratching or pricking the skin to deepen contact. The provider will watch for any redness or swelling to determine whether or not the patient is experiencing a reaction to the substance. This tends to take about 15 minutes.
The test is not always 100% accurate, so it is reserved for those who come in expressing concerns or symptoms and not given to all patients. Further, the severity of someone’s response to the food allergen cannot be determined through testing, Khan says. “It just tells us the likelihood of having allergic reaction symptoms to that food.”
In some cases, practitioners may also use bloodwork testing to examine your immune system’s response to particular foods by measuring allergy-related antibodies.
“Sometimes we use the skin test and the bloodwork together to give us a picture of the likelihood that this is a true allergy versus some other kind of reaction,” Khan says.
Living among food allergens
Allergic reactions can be scary, but living among common food allergens doesn’t have to be. “Our job as allergists is to educate our patients, our parents, and our families so that allergies don’t have this substantial impact on their quality of life where they’re constantly living in fear,” says Khan.
Increasing awareness about the top food allergens, especially for people who don’t have them, can help loosen the pull they have on the quality of life for people who are allergic. Reducing shame around having allergies and normalizing advocating for oneself are also essential steps in harm reduction, Khan says.
“I don’t want them to be afraid to advocate for themselves,” Khan adds. “If you’re going out to eat, you can definitely do that. But that means communicating effectively with your waiter, the kitchen staff, or the chef that you have an allergy so that they can be careful.”
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Disclaimer: The opinions and suggestions expressed in this article are solely those of the individual analysts. These are not the opinions of HNN. For more, please consult with your doctor.
