Just when you think you've thought of everything for your dinner party—food, flowers, music, guests who will enjoy each other—something comes along to remind you that feeding a group of people may present special challenges. In this case, it might be the unexpected food allergy of a guest's date. If only you'd thought to mention that shrimp would be the main course…
Avoiding the above scenario isn't too difficult. It's mostly a matter of communicating with the guests and knowing how to handle certain food allergy issues in the kitchen. This is important because, although an unexpected food allergy situation is inconvenient for the cook, it can be dangerous for the food-allergic guest.
A Food Allergy Primer for the Non-Allergic
Although it may seem that nearly everyone has an allergy to some food or another, in reality true food allergies are quite rare, affecting only 2 to 2.5 percent of the adult population. Food allergies are more common among infants (4 to 6 percent of the population) and children (1 to 2 percent). Many infants outgrow allergies.
There are two types of sensitivities to foods: those that involve the immune system (immunological) and those that don't (non-immunological). All true food allergies are immunological in nature, while non-immunological reactions include a wide variety of adverse food reactions. Here are the basic facts about food allergies, and how they differ from other food sensitivities.
What makes it an allergy?
A true food allergy is a reaction of the body's immune system to something in a food or a food ingredient (virtually always a protein). When a susceptible person is exposed to this protein (called the allergen), the body mistakenly interprets the protein as foreign and produces antibodies to fight it. With repeated exposures to the offending food protein, the body continues to mount its "defense," so that at some point consuming the allergenic food triggers the release of histamine and other powerful chemicals which cause common allergy symptoms (see Chart 1).
The most severe food allergy reaction is called anaphylaxis. This infrequent, yet potentially fatal, response to a food allergen involves several different body systems and results in a number of symptoms instead of the usual one or two seen with a typical food allergy. An anaphylactic reaction can progress quickly from the mild symptom stage—where the individual experiences an itchy tongue or mouth, throat tightening, and wheezing—to the life-threatening stage of cardiac arrest and shock. Immediate medical attention is necessary, and treatment usually includes an injection of epinephrine. "Although they are rare, anaphylactic reactions which are fatal most often occur when the allergic individual is eating away from home and inadvertently consumes the offending food, fails to recognize the reaction quickly, and there is a delay in epinephrine administration," explains Susan Hefle, Ph.D., co-director of the Food Allergy Research and Resource Program and assistant professor of food science at the University of Nebraska at Lincoln.
Food Sensitivities
Non-immunological food reactions, while not true allergies, can produce symptoms similar to those of a food allergy. This can be confusing to people who suffer from them and is probably one reason why people are quick to say they have a food "allergy" when in fact they may just have a food sensitivity or intolerance of some sort. Food sensitivities are rarely life threatening and the symptoms tend to be more localized. Lactose intolerance, where the body lacks the enzyme to break down the milk sugar, lactose, is one example of a non-immunological food reaction. Idiosyncratic food reactions, where the cause is unknown, also don't involve the immune system. One example of a food idiosyncrasy is sulfite-induced asthma, which is estimated to affect about 1.7 percent of all asthmatics, according to Hefle. "Some idiosyncratic reactions, such as a connection between food colors and hyperactivity have been disproved through scientific research, while still others, such as monosodium glutamate (MSG) sensitivity remain unproved," adds Hefle.
Common Causes of Food Allergy
Amazingly, over 160 food allergens have been identified—but only a handful of them account for more than 90 percent of the food allergies in the United States. Most food ingredients (such as aspartame, MSG, food colors, high fructose corn syrup and sugar) are not food allergens. Food oils, such as peanut oil or soybean oil are generally highly refined, rendering them free of allergenic proteins. In fact, research has shown that people with allergies to the oil's originating food (such as peanut or soybean) do not react to commercially refined and processed oils-the most commonly used oils. Cold-pressed oils, such as various nut oils, can still contain allergenic proteins, which may trigger an allergic reaction in a sensitive individual.
Tips for hosts: Coping with Food-Allergic Guests
Granted, most of the responsibility for avoiding food allergens rests with the person who has the allergy, and one would expect that a life-threatening food allergy would be acknowledged by the individual when he or she is invited to a dinner party. However, a little planning and preparation can eliminate the need for dealing with a food allergy situation altogether.
Here are some recommendations:
- Ask about food sensitivities when inviting guests and let your guests know what you plan to serve when inviting them. Knowing what you may be dealing with is half the battle. If a guest insists he or she is allergic to a food or ingredient which isn't a known food allergen (and may instead be just a sensitivity) don't get into a debate, simply offer to change the menu.
- Invite guests far enough ahead of time so that the menu can be revised, if necessary.
- Practice safe food handling methods during both the preparation and serving of foods.
Sometimes one can't avoid serving a common food allergen, even when an individual has alerted you to the existence of an allergy. In these cases, it's still possible to have a reaction-free event, but careful cooking and serving is necessary. According to Hefle, measures to take include:
- Avoiding cross contact by not sharing utensils, food containers, cutting boards and serving dishes. For example, simply wiping off a knife used for a child's peanut butter sandwich, and then using the same knife to spread mustard on a peanut-allergic child's cheese sandwich is not adequate for preventing a possible allergic reaction. A separate, clean knife, cutting board and plate should be used.
- Avoiding using the same cooking oil for both allergenic and non-allergenic foods. Food allergens can survive home cooking temperatures-even when deep-frying. If frying fish and chips, for example, two separate batches of hot oil should be used, as well as separate utensils and serving platters.
- Avoiding "creative" recipe formulation-"secret ingredients" can be dangerous. Many times a food-allergic individual doesn't expect a food allergen to be present in a dish, and will unwittingly consume it only to suffer later. For example, if you know a guest has an allergy to seafood, you should tell him that bottled Asian fish sauce has been used in the salad dressing.
With a few questions and some attention to planning and preparation, both you and your guests can have an enjoyable dinner.
Chart 1
Food Allergy Symptoms
- Skin symptoms
Swelling, hives, eczema/atopic dermatitis (skin rash)
- Gastrointestinal symptoms
Abdominal cramps, nausea, vomiting, diarrhea
- Respiratory symptoms
Runny nose, asthma/difficulty breathing, tightening of the throat
- Oral symptoms
Itching, swelling and hives in the mouth, palate and tongue
- Systemic symptoms
Anaphylactic shock (severe shock involving several body systems)
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Chart 2
Common Food Allergies
In Infants: Cow's milk, eggs, peanuts, tree nuts (almond, walnut, hazelnut, Brazil nut, etc.), soybeans, wheat
In Adults: Peanuts, crustacea (shrimp, crab, lobster, crawfish), tree nuts, fish
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