Food Allergies: How to Cope

If you have a food allergy, your doctor will tell you how to avoid an allergic reaction. Here are some general tips on living with food allergies.

How Do I Avoid an Allergic Reaction?

The only real way to prevent a reaction is to completely avoid foods you're allergic to. Eating even a tiny bit of a food you are allergic to can cause a serious reaction.

Avoiding a food you're allergic to means more than not eating that food. Some people even have to avoid touching or breathing in foods they're allergic to. Sometimes things that aren't food — like cosmetics — may still contain ingredients you're allergic to.

Here are important ways to avoid coming into contact with foods you may be allergic to:

1. Read Food Labels

In the United States, food manufacturers must say on their labels if foods contain any of these most common allergens:

• peanuts
• tree nuts (such as walnuts and cashews)
• shellfish
• fish
• wheat
• milk
• sesame
• eggs
• soy

Food allergy information will be on the label in one of two ways:

1. The food will show up in the list of ingredients.
2. There will be an alert somewhere on the label (e.g., "contains peanuts" or "contains shellfish").

Foods sold in the United States are supposed to label foods clearly so people with common allergies can stay safe. But not all allergens will be included in ingredient lists or named in a recognizable way. This is often the case with allergens other than the most common ones. Sometimes, an allergen could be hidden in a long list of scientific-sounding ingredients or included in "natural flavors," "coloring," "spices," or other additives.

Products sometimes change ingredients, and different size versions of the same product may have different ingredients, so check every package every time.

2. Know About Cross-Contamination

One thing that might not show up on a label is cross-contamination risk. Cross-contamination happens when a food you are not allergic to comes in contact with a food you are allergic to. This can happen if a manufacturer uses the same equipment to grind lots of different foods, for example.

Some companies put statements on their labels to alert customers to the risk of cross-contamination — messages like: "May contain peanuts," "Processed in a facility that also processes nuts," or "Manufactured on equipment also used for shellfish." You'll want to avoid products that have these kinds of alerts about foods you're allergic to.

But companies are not required to put cross-contamination alerts on a food label. So it's best to contact the company to see if a product might have come in contact with a food you are allergic to. You may be able to get this information from a company website. If not, contact the company and ask.

How Can I Stay Safe When Eating Away From Home?

Restaurants, cafeterias, and food courts are getting better about preparing foods for people with allergies. But cross-contamination is still a risk when you dine out: Foods you're allergic to can get into your food when kitchen staff use the same surfaces, utensils, or oil to prepare different foods.

When you're not at home, ask what's in a food you're thinking of eating. Find out how the food is cooked. Many people find it's best to bring safe food from home or eat at home before heading out. If friends you're visiting or eating with don't know about your allergy, tell them in plenty of time so they can prepare. Don't share a drink or eating utensils with friends if they're eating foods you're allergic to, and avoid tasting any of their food.

You also can carry a personalized "chef card." It details your allergies and helps restaurant staff understand how to prepare a safe meal for you. If the manager or owner of a restaurant seems uncomfortable about your request for safe food preparation, don't eat there.

It may be best to avoid some types of restaurants:

• If you have a peanut or tree nut allergy, you may want to avoid places that use lots of peanuts, peanut oil, or tree nuts in their foods. If you have a fish or shellfish allergy, you may need to avoid places with open stovetops or steam tables where fish or shellfish is cooked.
• Buffets and salad bars can be risky since people might move serving spoons and other utensils from one food to another.
• Be careful in bakeries, ice cream parlors, or candy shops. The risk of cross-contamination from shared scoops or machinery is high.
• When eating at restaurants, avoid fried foods. Many places cook multiple foods in the same oil.

What If I Have an Allergic Reaction?

Always carry two auto-injectors with you in case of a reaction. This way you are prepared to treat a serious reaction. Your doctor will give you an allergy action plan so that you know when you should use your epinephrine. Talk to your friends about your allergy, and make sure they know where to find your epinephrine in case you need it.

Always tell an adult if you are having symptoms of a reaction — even if they are mild. The adult can help you follow your allergy action plan to treat any reactions. Sometimes serious reactions start with mild symptoms.

By avoiding the foods you are allergic to, being prepared, and always carrying your epinephrine, you can keep yourself safe.

For more about managing food allergies, visit:

• Food Allergy Research & Education (FARE)