Food Allergies: How to Cope

If allergy tests show 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.

Avoiding Allergens

The only real way to prevent a reaction is to completely avoid foods you're allergic to. Food allergies aren't like environmental allergies. There's no medicine you can take to prevent a reaction before it happens.

Avoiding a food you're allergic to means more than not eating that food. It also means not eating anything that might contain the 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 three 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
• 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 allergies can stay safe. But it still helps to know the different names of the foods you're allergic to: For example, shellfish may show up on a food label as "crevettes" or "scampi." Peanuts may show up as "arachis" or "mandelonas" or be hidden in "hydrolyzed vegetable protein."

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 can normally eat comes in contact with a food you are allergic to, like if a manufacturer uses the same equipment to grind lots of different foods.

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.

Although companies have to say if a food contains allergen ingredients, they 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, email the company and ask.

Even if you've eaten a particular food before, be cautious. Companies sometimes change how they make their products or the suppliers they use. Different size products may even have different ingredients or be made in different facilities.

3. Be Alert When You're Not at 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 eat out: Foods you're allergic to can get into foods you normally eat 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.

A Summary of What to Do

• Read food labels and be alert for cross-contamination. Sites like the Food Allergy Research and Education network (FARE) have lots of information to help you read labels and navigate different foods and ingredients.
• Learn all you can about food products. Some of the things that contain allergens may surprise you.
• Learn the different names for the food you are allergic to that may show up on food labels. Read the list of ingredients on everything you eat. Dressings, sauces, processed deli meats, soup broth, and even frosting can have surprising allergens in them.
• Talk to your parents about getting foods you're allergic to out of your home so there's no risk of cross-contamination.
• Avoid foods you didn't make yourself if you're not sure of the ingredients.
• Tell everyone who handles the food you eat, from relatives to restaurant waitstaff, about your allergies.
• Carry a personalized "chef card." This card details your allergies and helps kitchen staff understand how to prepare a safe meal for you. You can find chef cards in many different languages on food allergy websites (like the FARE site). If the manager or owner of a restaurant seems uncomfortable about your request for safe food preparation, don't eat there.
• It's best to avoid some types of restaurants. For example, if you have a peanut or tree nut allergy, don't go to places that use lots of peanuts, peanut oil, or tree nuts like Asian (Chinese, Japanese, Vietnamese, Thai, Indian, etc.), African, Mexican, or Mediterranean restaurants. If you have a fish or shellfish allergy, don't eat at seafood restaurants, Asian restaurants, and places with open stovetops or steam tables.
• When eating at restaurants, avoid fried foods. Many places cook multiple foods in the same oil.
• Don't eat at buffets or salad bars. They 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.
• Make school lunches and snacks at home where you can control the preparation.
• Be sure your school knows about your allergy and has an action plan in place for you.
• Watch out for non-food items where foods may be a hidden ingredient — such as bird food, pet food, mouse or ant traps, nutritional supplements, and cosmetics.
• If your doctor prescribes epinephrine, always carry it with you. Keep your prescription up to date.