Hidden Allergens in Christmas meals

This Christmas season, when families gather together and consume tasty holiday foods, it is essential to be aware that allergic reactions, which usually increase during this period.

Food allergies are estimated to affect 1% to 10% of adults and children in developed countries[1]. Notably, young children, especially toddlers, are at a higher risk of the potential for an anaphylactic shock due to food allergy, at a rate 5x that seen in adults[2]. Despite paying attention to ingredients used for cooking delicious traditional holiday meals, your loved ones with multiple food allergies will remain at high risk for allergic reactions due to hidden allergens.

Tips to prevent food allergy issues include;

1. Tell the host about food allergies in advance.

2. Offer to bring an allergen-safe dish.

3. Offer to show recipes to guests with food allergies.

4. Keep food packaging for guests to review.

5. Avoid cross-contamination during food preparation and serving.

6. Always have epinephrine with you at meals.

When it comes to food, common hidden allergens can be tree nuts (Almonds, Walnuts, Cashews), dairy, eggs, wheat/gluten, soy, shellfish, and fish. Drinks are another component of the Christmas season to consider. Wines, for instance, if they are not ecologically sourced, might contain sulfites, a preservative that grape growers dust over grapes in the weeks leading up to harvest. Sulfites can trigger allergy-like reactions to sensitized people, such as wheezing in those suffering from asthma, allergic rhinitis, and urticaria[3].

Additionally, we can find other hidden allergens in beverages, such as pine nuts in craft beer, almonds in some gins, milk in cream liquors, or wheat in beers and spirits.

Patients and clinicians must be educated about allergens' relevant sources and cross-reactive allergens to prevent accidental reactions. It is important and recommended to visit your allergist if you experience any allergic symptoms this holiday season and get tested for specific allergens to pinpoint your true allergy triggers.

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[1] 2018 Hidden allergens in food allergy Mary Grace Baker, MD*; Sarah Saf, MD* ,y ; Angela Tsuang, MD*; Anna Nowak-Wegrzyn, MD, PhD DOI: https://doi.org/10.1016/j.anai.2018.05.011 [2] 2013 Prescott, S.L., Pawankar, R., Allen, K.J. et al. A global survey of changing patterns of food allergy burden in children. World Allergy Organ J 6, 1–12 (2013). https://doi.org/10.1186/1939-4551-6-21 [3] 2019, ASCIA. Sulfite Sensitivity. Online: https://www.allergy.org.au/patients/other-allergy/sulfite-allergy

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