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Living with Food Allergies

Q&A with Dietitian Abbey Sharp of Abbey’s Kitchen

Abbey Sharp
Abbey Sharp

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What’s the difference between food allergy and food sensitivity/intolerance?

A food allergy involves your immune system mounting a response to a specific non-threatening food protein. On first exposure to the food, your body’s immune system creates antibodies called Immunoglobulin E (IgE) that are specific to that particular allergen. With every subsequent exposure, the allergen binds to the IgE antibiotics, which triggers a more aggressive and sometimes life-threatening response. Typical symptoms of a food allergy include hives and redness, itching, swelling, canker sores, dizziness or an anaphylactic reaction. Symptoms can occur immediately or several hours later and can affect the entire body or be isolated to the exposed area of the body.

A food sensitivity or intolerance is a reaction triggered by the digestive system where your body struggles to digest or break down a particular food or food component. Usually, food sensitivity symptoms appear 30 to 60 minutes after eating, but they can also show up one or two days later. The most common symptoms of food intolerance are stomach pain, cramps, diarrhea, constipation, gas, bloating, headaches, fatigue and brain fog. While food intolerances can absolutely affect the quality of life, they’re generally not life-threatening.

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What do you recommend as alternatives to some of the top food allergens?

Eggs: Folks with egg allergies have a number of alternatives depending on how the eggs are being used. Thanks to the rise in veganism, there are lots of liquid plant-based egg alternatives that can be scrambled like real eggs. Tofu can also be crumbled and pan-fried to yield a “scrambled egg” like consistency. For baking and binding, mixing a 2.5:1 water to ground chia or flax seed can be used for its sticky egg-like consistency.

Milk: Thankfully, there’s now a wide variety of plant-based dairy alternatives for fluid milk, cheese, yogurt and ice cream. Depending on your preferences and goals, look for non-dairy “mylk” products made of oats, almonds, soy, coconut, or cashews.

Mustard: If you’re using mustard for its zippy flavour and heat, you can swap in prepared horseradish or pure wasabi (check ingredients of prepared wasabi for mustard powder). If you’re adding a small squirt to salad dressings for its emulsifying properties, you can add a beaten egg.

Peanuts and Tree nuts: Swap in soy-based or seed-based butters for spreading, or toasted pumpkin, sunflower, hemp, chia or flax seeds for crunchy breakfast or salad toppings.

Shellfish and Fish: If you’re allergic to seafood, stick to beans, legumes, tempeh, tofu, eggs, dairy, and poultry to meet your protein needs. There are also creative ways to mimic the texture of specific fish or shellfish products. For example, mushrooms can be marinated and pan-fried to yield a similar texture as shrimp; jackfruit can be used in tacos like white fish; tempeh or tofu can be breaded to taste like fish fingers; hearts of palm can be fried like fish and chips; and carrots can be “cured” to yield a smoked salmon like texture and flavour. Thanks to the popularity of veganism, there are also a number of great prepared “faux fish” products on the market.

Sesame seeds: Poppyseeds, sunflower seeds, flax seeds, hemp heads, minced roasted nuts like almonds, or pumpkin seeds are all great “toppers” for recipes that call for sesame seeds. If your recipe calls for sesame oil, use a fragrant nut oil like walnut oil.

Soy: For an easy alternative to soy sauce, coconut aminos have a similar umami salty flavour that’s perfect for sauces, dressings, or marinades. 

Wheat: In the past 10 years, we’ve seen an explosion of gluten-free, and therefore, wheat-free products on the market in all categories. Look for products specifically labelled as wheat-free or gluten-free made from ingredients like rice, coconut, corn, potato, or bean flour.

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How can parents safely introduce common food allergens to their babies or young children?

In 2019, the Canadian Paediatric Society released new recommendations on how to introduce top allergenic foods to infants. While we used to think that delaying allergenic food introduction was beneficial, we now know that we ideally want to strategically offer the top allergens early on when an infant starts on solids, ideally around six months old. 

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Here are some guidelines to get started: 

Introduce one new food allergen at a time so that you have a clearer understanding of what the offending food is if your baby does have a reaction. Start with a very small amount of one of the potential allergens, like ⅛-¼ tsp of nut butter, for example. Then, if there’s no reaction, increase the amount over the next few days to at least two teaspoons for a full dose. I usually recommend trialling an allergen for 3 to 4 days before moving on to the next allergen. It’s important that we maintain tolerance to the allergen, so even after you’ve ruled out food like peanuts as being a problem, make sure to offer it regularly, at least once or twice a week.

I also always recommend introducing new allergens in the morning breakfast meal as far away from a nap or sleep time as possible. Most allergic reactions will occur instantly or within a few hours, so offering them well before your child has to go to sleep gives you the most time to monitor for any adverse reactions and intervene if necessary. 

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What advice do you have for parents looking for healthy, allergy-friendly meals and snacks?

First of all, if you’re managing a new food allergy, I recommend meeting with a dietitian to get some guidance on how to properly read labels and ask questions to ensure a food is safe to eat. Thankfully, there are so many fantastic food blogs and cookbooks out there specifically designed for families with food allergies. And there’s a wide range of food products that are labelled as soy-free, nut-free, dairy-free, and so on to make shopping simpler. There are also online food markets like Natura Market that allow you to filter for foods without specific common allergens.

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