Lezli R. Stone is a Registered Dietician specializing in nutrition counseling for people with food allergies and other medical conditions. She works closely with AAAI physicians to ensure our patients have access to nutritional counseling that will complement their medical treatment.

Tips for living with a dairy allergy

THE “NUTS” AND BOLTS of FOOD ALLERGIES, Part  4

TIPS FOR LIVING WITH A DAIRY ALLERGY

Dairy Allergy vs. Lactose Intolerance

An allergy to cow’s milk is the most common food allergy in the United States.  Approximately 3% of American children are allergic to milk.  Also referred to as a “dairy allergy,” it is different than the condition known as “lactose intolerance.”  It is important to understand the two terms:

Dairy allergy – an allergic reaction to any food product that contains milk.

Lactose intolerance – this is not an allergy; it is a “common sensitivity” to the natural sugar found in milk. The intolerance occurs due to a lower amount of the enzyme lactase in the digestive system.  This enzyme is necessary to digest milk.

Living Without Milk

Milk is found so frequently in processed food that reading food labels to identify which foods include milk is very important.  Milk can crop up in the strangest places.  For example, restaurants often add a pat of butter to grilled steaks before serving.  Milk is also added to some brands of canned tuna.

The most common sources of milk include cheese, butter, cream, and yogurt.  If you are allergic to cow’s milk you should also avoid goat and sheep milk.

Remember that “lactose free” milk is safe for individuals with lactose intolerance, but it still contains milk protein so it is not safe for persons with a milk allergy.

Milk Substitutes to Try

With so many people allergic to milk, grocery stores now offer many healthy alternatives.

Soy Milk, Rice Milk, Coconut Milk and Hemp Milk are all readily-available alternatives.  These milk substitutes come in many varieties, including chocolate, unsweetened, or vanilla flavored. They can be found “non-refrigerated” in most stores.  However, they must be refrigerated after opening, and are best served cold.

Substituting for Yogurt, Sour Cream and Cheese

Substituting for other products with milk can be very easy. For example, you can try soy based yogurts which taste very similar to traditional yogurt.  Try the WholeSoy Yogurt products, they are not only dairy free but have no chemical additives. They come in many delicious flavors from cherry to apricot mango.

On your milk free diet you do not have to give up sour cream. Tofutti’s Sour Supreme is an excellent non-dairy sour cream.  The texture is a bit different, but the taste is very similar and delicious. Toffutti’s sour cream can substitute for traditional sour cream in your favorite recipes.

To substitute for cheese in your diet try the brand Daiya. They offer Cheddar, Mozzarella and Jack Cheese varieties. This dairy free cheese comes shredded, all ready to put on top of your pizza.

On-Line and In-Store Products to Try:

  • Vance’s Dari-Free Milk is delicious and is made from potatoes.
  • Divvies is an on-line bakery for all dairy free products.
  • For a great book to help children understand milk allergies, read “Cody the Allergic Cow” by Nicole Smith.

Snacks for the Kids:

Even without milk kids can still have fun snacks.  They will enjoy the following snacks and remain dairy free:

  • Oatmeal with bananas
  • Dried fruit
  • Corn tortillas with soy cheese
  • Raw carrots dipped in honey or hummus

Bon Appetite!

Lezli Stone is a Registered Dietician and a consulting clinical staff member of the Arizona Asthma & Allergy Institute.  She counsels AAAI patients about food allergies and nutrition.  She is authoring a four-part series of articles about living with food allergies, which will be posted on this website over the next few months.

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Tips for grocery shopping for people with food allergies

THE “NUTS” AND BOLTS of FOOD ALLERGIES, PART 3

TIPS FOR GROCERY SHOPPING FOR PEOPLE WITH FOOD ALLERGIES

Purchasing food for a member of the family with a food allergy may seem like a daunting task, but with some practice you can make that trip to the grocery store as “easy as pie”.  Try these suggestions:

Become an Expert Label Reader

  • Food labeling laws require that common allergens be listed on food labels.  This means food products will always list the following ingredients: milk, eggs, peanuts, tree nuts, wheat, soy, fish or crustacean shellfish.  These common allergens are listed separately in a “contains” statement located directly below the “ingredients” list.
  • Check for cross-contamination warnings. If there is a possibility for cross-contamination with allergens, there will be a warning that the product is “manufactured in a facility that processes a common allergen” such as wheat or nuts.  When applicable, avoid these products to be 100% safe.

CAUTION – Certain Foods Have a High Risk of Cross-Contamination

The risk of cross-contamination with allergens is higher in certain areas of the grocery store. Be cautious when purchasing the foods listed below, and always read the label carefully for warnings:

  • Imported foods
  • Foods from deli counters
  • Foods from salad bars

Be Cautious when Purchasing Non – Food Items

  • Pet food: Food labeling laws do not apply to pet food. Dog food can contain ingredients such as eggs and peanuts. Family pets love to lick faces, so teach your children about this potential exposure to allergens.
  • Medications: Always check medications for allergy warnings and content, whether they are prescription or “over the counter.”  Ingredients can be found on the package insert which you can obtain from the grocery store pharmacist.
  • Cleaning Products: Personal care products such as soap, make-up and cleaning products may be labeled “hypoallergenic” but can contain food products.  Be sure to check the label.

Try “Allergy Friendly” Stores

  • Shopping at stores that are sensitive to living with food allergies and intolerances can help.  Stores such as “Trader Joes,” “Sprouts,” and “Whole Foods” advertise their commitment to serving people with food allergies.
  • Also try online grocery stores that are allergy friendly.  The website kidswithfoodallergies.org/marketplace offers great selections.

Be “Label Free”- Try Non-Processed Foods

Grocery stores may carry over 50,000 items, and reading labels with fine print can be stressful.  To alleviate some this worry, start becoming “label free.”

This can be done by limiting consumption of processed foods with labels; this will reduce the stress of wondering if you missed an allergen listed as an ingredient on a food product.

Not will you significantly decrease your potential exposure to allergens, you will get the added benefit of a reduced intake of fat, sugar and sodium, which are often added to processed foods.

To start this process, go slowly and start buying products that have less than 5 ingredients listed on the label.  This will also substantially reduce the time you spent looking for ingredients on a label that could cause an allergic reaction.

Make a conscious effort to expand your diet and try different types of fresh fruits and vegetables or whole grains you’ve never tasted. You might find a new food that your family really enjoys!

Lezli Stone is a Registered Dietician and a consulting clinical staff member of the Arizona Asthma & Allergy Institute.  She counsels AAAI patients about food allergies and nutrition.  She is authoring a four-part series of articles about living with food allergies, which will be posted on this website over the next few months.

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Tips for Living Wheat Free

THE” NUTS” AND BOLTS of FOOD ALLERGIES, PART 1
TIPS FOR LIVING “WHEAT FREE”
by Lezli R. Stone

You just finished your food allergy testing at the Arizona Asthma & Allergy Institute and have been informed that you have an allergy or intolerance to WHEAT.
A “wheat allergy” is clinically different from another condition you may be aware of, called “Celiac Disease,” which is a complex autoimmune disorder, not an allergy. With either Celiac Disease or a wheat allergy you may think “I’ll never eat pasta again!”

Do not despair – you can live a wheat-free lifestyle and still have a diet full of flavor.
Sensitivity to wheat is linked to the four different proteins in wheat – Albumin, Gliadin, Globulin and the one you are probably most familiar with, Gluten.

To alleviate your symptoms, the most important step is to totally eliminate wheat from your diet.
Since wheat is found in many processed foods, you must be very diligent about reading food labels. It is a legal requirement that food labels state if wheat is in their products. You may be surprised to find that common processed foods like hot dogs and candy can contain wheat.

Fortunately, you have many foods available that can substitute for wheat including: Rice, Amaranth, Millet, Kasha, Gluten-free Oats, Teff, and Quinoa.

A few of these you may not recognize; let’s discuss two of them.

Amaranth
Amaranth is an 8,000 year-old grain utilized by the Aztecs, who thought it had supernatural powers. Amaranth should be soaked overnight in water before cooking. It can be cooked as hot cereal by adding 2 ½ cups of water and 1 cup Amaranth to a pot, bringing it to a boil, then reducing heat to low. Cover and cook for 20 minutes. Serve with honey and raisins for a hot breakfast.
Amaranth can also be popped (somewhat) like popcorn. Add to a hot pan, no oil needed, and it pops in about 30 seconds. Don’t add it slowly to the hot pan, or it will burn. The popped Amaranth may be added to salads for a nice crunch.

Rice
One of the best grains to substitute for wheat is rice, of any variety. Of all the grains, rice is considered the least allergenic. Rice is also very nutritious, low in calories (about 100 calories for a ½ cup), loaded with B vitamins, and high in fiber (if you chose the brown rice).
For something different, try Black Rice, which is a specialty rice that is as high in antioxidants as blueberries. The dark color will fade to purple when it is cooked, which is fun for children to watch. When eating rice, always use low sodium soy sauce and watch the portion sizes.

Gluten-Free Products
Another great alternative for wheat-free foods is gluten-free products. The market for gluten-free products has grown considerably in the past five years, and they have improved in quality and taste. Please remember that “gluten-free” does not mean “sugar-free,” “fat-free” or “low calorie.” Here are some products to try:

  • Dr. Praegers – Frozen foods
  • Rustic Crust – Pizza products
  • JK Gourmet – Grain free products

Many gluten-free products are available at Sprouts or Whole Foods. Wheat free living can be delicious, so try new foods and Bon Appetit!
Lezli Stone is a Registered Dietician and a consulting clinical staff member of the Arizona Asthma & Allergy Institute. She counsels AAAI patients about food allergies and nutrition. She is authoring a four-part series of articles about living with food allergies, which will be posted on this website over the next few months.

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Tips for Living “PEANUT AND TREE NUT FREE”

THE” NUTS” AND BOLTS of FOOD ALLERGIES, PART 2
TIPS FOR LIVING “PEANUT AND TREE NUT FREE”
by Lezli R. Stone

You just finished your food allergy testing at the Arizona Asthma & Allergy Institute to discover you have an allergy to nuts, specifically peanuts or tree nuts.
So let’s start with some specific definitions so this doesn’t “drive you nuts”.

What is a peanut?

The name “peanut” is somewhat misleading because peanuts are actually part of the legume family, which includes foods such as beans, peas, lentils, and chickpeas. Fortunately, the majority of people with a peanut allergy are not allergic to other members of the legume family.

What is a tree nut?

Tree nuts are actually dried fruit and include over 20 different types of nuts. Tree nuts you might be familiar with are walnuts, pecans, almonds, pine nuts, cashews, and coconuts. Walnuts and cashews usually cause the most allergic reactions. There is a strong possibility of cross–reactivity among various families of tree nuts so people who are allergic to one type of tree nut usually are advised to avoid all tree nuts.
Peanut and tree nut allergies have a tendency to be strongly associated with severe reactions so identifying processed foods that contain any nuts is extremely important. If diagnosed with a nut allergy you must become a very diligent LABEL READER! Any food sold in the USA must state on the label if it contains peanuts or tree nuts.
A potentially tricky area of managing an allergy to peanuts or tree nuts can be eating away from home. Here are some helpful tips:

  1. Always let your meal server know of your allergy and remember any type of cuisine can contain nuts.
  2. Keep food choices simple, for example avoid sauces and stir-fried dishes.
  3. Try Japanese Food, this cuisine tends to use nuts less frequently.

Peanuts and tree nuts are high in calories, (one cup of macadamia nuts is about 900 calories) so even though you are now avoiding the extra calories, you may miss the nutty flavor. Fortunately, there are some viable safe substitutes.

Butter spreads to try:

  1. IM Healthy Soy Nut Butter – Nice substitute for peanut butter and is great on a celery stick or with apple slices.
  2. Sunflower Butter – Has a taste very similar to peanut butter and can be used in baking.

Eat more seeds:

Always check with your physician first, but often (not always) people with nut allergies can safely eat seeds. Sunflower, pumpkin, flax and sesame seeds are acceptable substitutes for tree nuts or peanuts and provide similar nutritional value and taste.
Sunflower and pumpkins seeds are rare allergens so these are your best options. Sesame seeds cause the most allergic reactions in the seed family.
Seeds can be eaten as a snack, added to cooked vegetables or to hot cereal in the morning for a delicious flavor.

Cooking with nut free products:

  1. Enjoy Life’s Semi-Sweet Chocolate Chips are great for chocolate chip cookies.
  2. I.M. Healthy Southern Home Style Corn Flake and Tortilla Crumbs can be used as breading when cooking chicken or fish.
  3. Try substituting “pumpkin seeds” for “almonds” in bread or muffin recipes.

Living without peanuts or tree nuts can take some work but remember there are now many safe alternatives to enjoy!
Please keep a look-out for our next article on grocery shopping with food allergies.

Lezli Stone is a Registered Dietician and a consulting clinical staff member of the Arizona Asthma & Allergy Institute. She counsels AAAI patients about food allergies and nutrition. She is authoring a four-part series of articles about living with food allergies, which will be posted on this website over the next few months.