Allergy Shmallergy

Simplifying life for families with food allergies.

IMPORTANT: FDA Issues Temporary Policy Allowing Some Substitutions in Food May 26, 2020

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The FDA just released a temporary relaxation of its food labeling policy.  This temporary change comes into effect to prevent shortages and manage delays in the food chain supply during the COVID-19 crisis.  This policy will remain in effect through the end of the public health crisis.  Although the policy takes food allergies into consideration, it may have an affect on the safety of food particularly for those who allergies fall outside of the Top 8 (peanut, tree nut, dairy, egg, wheat, soy, fin fish, and shellfish).

 

“The food industry has requested flexibility when manufacturers need to make such minor formulation changes… that may cause the finished food label to be incorrect, but that do not pose a health or safety issue and do not cause significant changes in the finished food due to the temporary formulation modifications.”

 

The policy allows manufacturers to:

  • Make minor formula changes consistent with the product’s taste, texture and integrity; and
  • Continue labeling their original ingredient list without noting changes made.

 

[Read FDA’s statement summary here.]

 

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Image by Kevin Phillips from Pixabay

 

The specifics of the policy offer a few important details:

  1. On page 6, FDA encourages manufacturers to make label changes whenever possible noting that consumers rely on those labels to make informed choices. They are not, however, required to alter their labels during this time.  If labeling cannot be changed on the package, the FDA recommends companies use alternative means of informing consumers for transparency, such as posting information on their website or applying stickers to packaging.
  2. As always, flexibility remains in place for formulations of generically grouped ingredients, such as “spices”, “flavoring” or “color,” and can be changed without relabeling.
  3. The FDA is authorizing this flexibility for minor ingredient changes.  When considering these “minor” ingredients, the FDA highlights:
    • Safety: does the ingredient substitution cause an adverse health effect (such as food allergens)?;
    • Quantity: the substitution must generally be for ingredients that comprise 2% or less of the finished food/final product;
    • Prominence: the substitution should not conflict with a major component of the product (for example, wheat in a muffin);
    • Characterizing Ingredient: the substitution/omission should not represent the ingredient that defines the product (such as raisins in a raisin bagel); and
    • Nutritional/Other Claims: the substitution should not misrepresent nutritional or other claims made about the product.

 

Faced with supply issues of their own, manufacturers can now reduce the amount of ingredient they use or choose to omit it altogether.  Additionally, they may temporarily substitute an ingredient that is less than 2% of its finished product.  The FDA encourages manufacturers to consider allergens (the Top 8 allergens as well as many common allergens beyond) before making a change and suggest labeling should such a change be necessary [page 8].  

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The FDA policy outlines several areas where it will not object to substitutions [page 10].  One area of possible note for those with food allergies is Fats and Oils.  The FDA will not object to a swap of fats and oils as long as they do not pose an obvious allergenic risk (say using peanut oil instead of vegetable oil) and is derived from the same source (plant, animal, etc) and are highly refined.  They specifically mention a hypothetical scenario where a manufacturer might substitute canola oil for sunflower oil.  Speak to your allergist about your personal risk with refined oils and these possible substitutions.

 

As we strive to understand how this policy will impact our community, we recommend that those with food allergies:

  • Read ingredient labels carefully, looking for stickers or other notifications of ingredient substitutions;
  • Call manufacturers and/or check on their websites frequently to understand which products may be affected by substitutions; and
  • Speak with your allergist about these changes and how they may affect your specific allergies.

 

 

[Read the FDA’s full policy here:  Temporary Policy Regarding Certain Food Labeling Requirements During the COVID-19 Public Health Emergency: Minor Formulation Changes and Vending Machines]

 

The FDA has issued this guidance without public comment due to the emergency circumstances.  However, their policy notes, “This guidance document is being implemented immediately, but it remains subject to comment in accordance with FDA’s good guidance practices.

Comments may be submitted at any time for FDA consideration. Submit written comments to the Dockets Management Staff (HFA-305), Food and Drug Administration, 5630 Fishers Lane, Rm. 1061, Rockville, MD 20852. Submit electronic comments to https://www.regulations.gov. All comments should be identified with the docket number FDA-2020-D-1139 and complete title of the guidance in the request.”

 

Food Allergies at the Food Pantry – Information and Resources for Food Pantries May 18, 2020

 

According to a study conducted by Dr. Ruchi Gupta and her colleagues in 2013, having a food allergy in the house costs an additional $4,000 per year.  Among the many factors that go into that figure is the cost of food allergy-friendly food.  Safe food can cost two to five times as much as their regular counterparts.  For example, a jar of peanut butter currently costs $1.19 and a jar of peanut-free sunbutter costs $6.29. It’s the same story with dairy-free milk and gluten-free pasta. These differences are enough to blow almost any budget.

 

 

Food banks and food pantries should be aware that about 10% of all of their clients and client families have a food allergy.  This doesn’t even include those with celiac disease which also requires a restrictive diet. When one family member has a food allergy, the food is often excluded from the home out of an abundance of caution. While food allergies directly affect 10% of the population, they indirectly affect the entire family by impacting their food selection.  This leaves food allergy families with few viable options when seeking out assistance.

 

As you can imagine, the inability to afford safe food disintegrates an already delicate situation quickly making mealtimes even more dangerous or sparse.

 

Resources for Food Pantries

 

  • Ask clients directly if they or a member of their household has a food allergy.  Some patients volunteer their food allergy diagnosis, but many do not.

 

  • If you hear a client describing their experience with food with any of the following symptoms, they will likely need to avoid that food and should seek advice from a doctor.

 

  • Symptoms of food allergy vary from reaction to reaction.  They include: hives, swelling, wheezing/trouble breathing, nausea/vomiting, fainting/dizziness, and tightness in the throat among others.  [Please see Anaphylaxis 101: Familiarize Yourself With the Symptoms for a full list of symptoms and what to do if they occur.]. These symptoms usually occur soon after eating.

 

 

  • U.S. food manufacturers are required to label for certain allergens by their common name. And “Made in a facility with…” or “May contain…” statements are completely voluntary.  Read about food labeling laws here [The Ins and Outs of Reading Food Labels] and offer this information to your clients who may have a food allergy.

 

  • If food is being prepared on site, please familiarize yourself with “cross contact” also referred to as “cross contamination.”  This occurs when an allergen touches another food directly or indirectly by touching a shared surface.  For example, this can happen on counters, cutting boards, in pots, on pans, cooking and serving utensils, plates, etc.  And although you may not be able to see the allergen with the naked eye, there may be enough protein present to trigger a life-threatening reaction.  It’s important to clean work surfaces, pots/pans, and cooking/serving utensils when preparing safe food for clients with food allergies.

 

  • When trying to remove an allergen, always use soap and water.  Hand sanitizer (which is effective in killing bacteria, viruses and germs) does not remove allergens  (which are made up of proteins) from hands or surfaces.  Always wash your hands before preparing a safe meal for clients with food allergies.

 

 

Food Allergies at the Food Pantry – Need Assistance? May 12, 2020

 

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Photo by Monirb CC BY-SA 4.0

Affording safe food is on the minds of many right now.  With layoffs, furloughs and unemployment, more people are turning to food pantries than ever.  But if you have a food allergy, you may be concerned about facing challenges to obtaining safe food.

 

If you have food allergies and need food assistance, here are some things to keep in mind.

 

Tips for Those Who Need Assistance

 

  • If you’re lucky to live near one, there are a few food allergy-specific food pantries operating in the United States.  Note: some have suspended operations due to COVID-19. They may, however, still be a resource for information during the lockdown.  Check out each organization’s page for eligibility requirements.

 

  • There are many local food pantries kindly serving the public right now and some are willing or already stocking safe supplies.

 

  • If you’re looking for specific allergy-friendly (or “free-from”) staples, those goods may be harder to find.  Sometimes, food pantries will shop for/hold items for those with medically necessary diets.  Call your local food pantry and explain your family’s needs.

 

  • Rather than relying on staff, check the food choices for you/your family personally, taking time to read labels.

 

  • Many of us are relying on brands we haven’t used before.  Read the ingredient labels of all food carefully.  Remember that allergens outside of the top 8 (dairy, eggs, wheat, soy, peanuts, tree nuts, fish, and shellfish) are not required to be labeled by their common name.  And manufacturers are not required to label for possible cross-contamination.  Call the manufacturer directly for more information.

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  • If there are prepared meals on site, ask a supervisor about whether the staff receives food allergy training and/or take measures to prevent cross-contact and always have your epinephrine auto-injector with you as usual.

 

  • Many schools are offering free lunches to their students.  Some are naturally free of certain allergens (often peanuts and tree nuts).  Call your local school district and speak with the food services manager to get details on how your district handles food allergies in these packaged meals.

 

 

  • It was just announced that SNAP recipients can buy groceries through Amazon. Shoppers get free delivery when they spend over $25.  Visit amazon.com/snap-ebt for more information.

 

 

  • Make your resources go further!  Use fresh food first, followed by frozen foods and pantry items.  Planning meal ahead of time with a thought towards how to incorporate leftovers into future meals helps eliminate waste and makes the best use of your food.

 

  • Food substitutions may be more practical than expensive free-from products.  For example, using applesauce ($2.75/jar) when baking may cheaper than buying specialty egg-replacer ($6.99/box). There are many great places to find these substitutions, like this one from Kids with Food Allergies.

 

 

 

Free-From Manufacturers Who SHIP TO YOU! April 18, 2020

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Photo by Wonderland via Flickr, Attribution 2.0 Generic (CC BY 2.0)

 

It’s rough getting groceries these days!  You never know what you’ll see or miss at the supermarket.  One day it’s bread, the next it’s chicken!  And, those empty shelves can be a little disheartening.  It is even worse when you rely on a specific product to keep you safe and out of the hospital.

 

While most consumers can get by with a different brand here and there, families with food allergies can’t.  They depend heavily on specific brands and products to keep them fed and safe from experiencing a severe allergic reaction called, anaphylaxis.  “Free-from foods” are often in smaller supply than their  regular counterparts without a global pandemic. Because many consumers are buying in bulk (or sometimes panic buying) as they shelter-in-place, it often means food allergy-friendly essentials are unavailable to those whose health depends on them.

 

Let’s take a look at how to get the food you or your family needs as they STAY HOME and shelter-in-place:

Good tip:  Some companies are running a little behind on shipment (only a week) so order BEFORE you need something urgently.

 

We’ve noticed that some big box stores are selling certain free-from items online and are willing to ship things like gluten-free pastas (whereas boxes of regular pasta are often “in-store only” products). It’s worth taking a quick peek at these sites if you need a product more urgently since they tend to ship food fairly quickly.

 

Cold products (those that need to be refrigerated or frozen) are best purchased directly at the store or through a local delivery service (such as Instacart, PeaPod, etc).

 

Some items that are hard to find in person, are easy to find online.  Some free-from/allergy-friendly brands are shipping directly to their customers.  Look at all the manufacturers who are working overtime to ensure you get the products you need!

 

If you’re looking for a big or little treat, why not try a food allergy-friendly bakery?  Some are local (for pick up) and others you can order online.  Here’s Allergy Shmallergy’s list of Allergy Friendly Bakeries.

 

Allergic Living also compiled an excellent list of how manufacturers are handling the increased need for their products during the coronavirus – read here.

 

(Do you have a free-from product you’ve been purchasing directly?  Leave us a comment and we’ll add it to the list for other families!)

 

Schar  – offers gluten-free products including breads, snacks and pasta

Enjoy Life – offers products free from the Top 14 allergens!  Enjoy Life makes snack foods as well as baking supplies (chocolate chips, flour, pizza flour, etc).

Vermont Nut Free Chocolate – this feels critical to me!  I’ve already had enough chocolate to become a living, breathing chocolate Easter bunny.

Namaste – recommended by a baker, this is a great resource for gluten-free and allergy-friendly baking and waffle mixes, soups and pasta mixes.

Made Good – known for their granola bars and cookies, Made Good is currently offering 35% off plus free shipping!

Ener-G – Known widely for its egg-free egg replacer and gluten-free products.

WowButter – a tree nut and peanut-free sunflower butter now ships directly!

The Gluten and Grain-Free Gourmet – offers gluten, dairy and soy-free products.  Paleo friendly.

Safely Delicious – snacks that are free from gluten, peanuts, tree nuts, dairy, soy, and egg PLUS they are donating a portion of their proceeds to SpokinCares and Food Equality Initiative.

Eleni’s New York – the delicious, safe nut-free cookies can be delivered right to your door!!

The Gluten-Free Bar – selling gluten-free granola bars and bites!  On sale now…. stock up!

Cherrybrook Kitchen – their gluten, dairy, peanut, nut-free baking and breakfast mixes have been a staple of many pantries.

No Whey Chocolates – Chocaholics rejoice.  These are dairy, peanut, tree nut and soy-free.

ZEGO Foods – These healthy bars and mix-ins are full of the good stuff with none of the allergens.  For real – they are free of the Top 14 (check out their allergen statement!)

OWYN – selling plant-based protein drinks as well as dairy-free milk!

Kate’s Safe and Sweet – free from peanuts, tree nuts, soy, wheat, fish, shellfish, dairy and eggs (as well as pea, legume, sesame, chickpea and coconut-free!), Kate’s cake mixes, frosting, food coloring and accessories ship quickly straight to you!

Senza Gluten – This 100% gluten-free restaurant and bakery in NYC is closed through May 1st, but lucky for us they ship!

Kips – Who doesn’t love Top 8 free granola bark?!  Free from peanuts, tree nuts, dairy, eggs, wheat, soy, fish and shellfish.

Baked Cravings – Too many amazing tree nut and peanut free treats to name!  Ships nationally!

Simple Kneads – Small batch baked goods in a dedicated gluten-free facility.  I can smell the bread from here!

Partake Foods – Makers of delicious gluten-free, vegan (dairy and egg-free) cookies.

(more…)

 

Food Allergies, Eczema, Asthma and the Coronavirus (COVID-19) March 26, 2020

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What strange times we’re living through!

 

Because we’re dealing with a novel virus (that means “brand new!” – lucky us…), everyone has LOTS of questions.  Many food allergy, asthma and eczema patients are concerned how COVID-19 interacts with their condition(s).  This information is best guidance from experts given what we currently know about the coronavirus, COVID-19. As always, speak to your own doctor about your personal health and follow best guidance issued by the Center for Disease Control (CDC).

 

We will keep updating this page as questions and answers arise.

 

Are patients with food allergies more susceptible to the coronavirus?  

No, having a food allergy does not put you at increased risk for COVID-19.  Even if a patient has experienced anaphylaxis, they are not considered immunocompromised or at a higher risk of catching the coronavirus.

Sources: Allergic Living

 

What about patients with asthma?

Patients with asthma are at the same risk of acquiring the coronavirus as the general public.  However,  because COVID-19 is a respiratory virus, outcomes for patients with asthma are unknown.  In addition to best prevention practices (social distancing, washing hands, not touching your face, etc), asthma patients are urged to continue maintaining their asthma – keeping it well-controlled is key.

 

For more clarification and more detailed information, please see AAFA’s coronavirus guidance here and speak to your personal doctor.

 

If I’m experiencing a severe allergic reaction, should I avoid the emergency room?

No.  We urge patients to continue being cautious (read labels, stick with brands you trust and ALWAYS carry epinephrine).  However, if you are experiencing severe symptoms of an allergic reaction (called anaphylaxis, learn to recognize the symptoms here), use your epinephrine auto-injector immediately, call 911 and get to the emergency room for additional care and monitoring.

 

Should I be aware of any food allergens in COVID-19 treatments?

It appears that there isn’t a universal medicine that doctors can prescribe to combat the coronavirus at this time.  The current treatments are all experimental and vary from hospital to hospital and patient to patient.  Wear a medical bracelet if you have one detailing your food allergies and mention your allergies should you need to see a doctor or be prescribed medication.

 

For more on this topic, please read the detailed answers from FARE’s Chief Medical Advisor, Dr. Tom Casale.

 

I hear there are spot shortages of inhaled albuterol.  Is it still safe to use a nebulizer for my asthma?

Nebulizers are believed to spread coronavirus by aerosolizing contagious virus particles, so hospitals are turning to inhaled albuterol to help COVID-19 patients (thus the shortage). However, using your nebulizer at home as prescribed is still safe. (Albuterol itself is still being produced at a normal pace.)

 

IF YOU SUSPECT YOU HAVE COVID-19, know that virus particles can remain in the air for several hours.  Be sure to use your nebulizer in an area away from other household members so as to minimize their risk of infection.

 

For more information, please see the American College of Asthma, Allergy and Immunology (ACAAI) site.

 

Is there an epinephrine shortage?

No, epinephrine auto-injectors are not experiencing a shortage.  Check the expiration date on your auto-injectors.  Should you need a new one, contact your doctor or local pharmacy.  Many pharmacies are delivering prescriptions as well as other supplies with no minimum and Auvi-Q operates on a direct delivery system.

 

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I have eczema, is there anything I should do to prevent infection?

Eczema is a break in the skin’s natural barrier, so it’s critical to take extra care of your hands and face during the coronavirus outbreak to prevent discomfort and unnecessary touching of the face.  Currently experts do not believe having eczema poses an increased risk of contracting the coronavirus which is typically transmitted through the mouth, nose, and eyes to the respiratory system.

According to the National Eczema Association, there is no need to wash with harsh antibacterial soap.  If the skin on your hands are already cracked or prone to stinging, try soap formulated for sensitive skin, making sure to wash for 20 seconds as recommended.  Additionally, use lotions as usual to continue to heal the affected areas and use anti-inflammatory creams as needed.

 

I’m in the middle of oral immunotherapy (OIT).  How do I proceed?  Do I go to my regular visit?

This is a discussion best had with your doctor.  Many practices are delaying updosing during this time.  But food allergies vary from patient to patient as does oral immunotherapy treatment protocols.  Contact your doctor for detailed guidance.

 

Here are some additional places to reference with expert medical guidance and vetted facts:

Allergy and Asthma Network (AAN, The Network)

Asthma and Allergy Foundation of America(AAFA)

Food Allergy Research Education (FARE)

American Academy of Allergy, Asthma and Immunology (AAAAI)

American College of Allergy, Asthma and Immunology (ACAAI)

Center for Disease Control (CDC)

 

 

Be a Food Allergy Friend – Kid Edition March 3, 2020

Filed under: Uncategorized — malawer @ 9:30 am

You’ve probably heard of food allergies.  Someone in your class might have one.  Maybe your friend has one.  But what are they?

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What is a food allergy?
Food is safe for most people, but a person with a food allergy cannot eat the foods they are allergic to or they will get sick and may need to go to the hospital.  The most common food people are allergic to are peanuts, tree nuts (such as almonds, walnuts, and pecans), milk, eggs, fish, shellfish (like shrimp and lobster), soy and wheat (bread, pasta, cake, and cookies for example) – but you can be allergic to almost any food!  Food allergies are a medical condition – that means they are not a choice.  They can be serious, so it’s important to know how to be a Food Allergy Friend.

 

HOW TO BE A FOOD ALLERGY FRIEND

 

Don’t Share Food 

People with food allergies have to be very careful about what they eat.  Even though it’s nice to share and be generous with your friends in general, it’s best not to share food with someone who has a food allergy.  They know how to read ingredients to find food that is safe for them.

 

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Wash Your Hands!

Washing your hands before and after eating is a great habit!  It cleans your hands of dirt and germs before you eat so you don’t get sick.  After you eat, washing your hands wipes away food that your friends might be allergic to and keeps them safe and healthy, too!

 

Know What to Do

If your friend begins to feel sick or has trouble breathing after they eat, get an adult right away.  If no adult is around, call 9-1-1 and tell them about your friend’s food allergy and how they are feeling.

 

Speak Up!

Some times other people – even adults! – don’t understand what a food allergy is. YOU can help others understand how serious food allergies are.  And, if you see something that might not be safe for your friend with a food allergy, speak up and let someone know.

 

Have FUN Without Food

Food isn’t the special ingredient in having fun – your friends are!  So plan activities with your friends without the food.  There’s LOTS to do!  Build a fort, climb a tree, play ball, paint, jump rope…  you name it! What do you like to do with YOUR friends?

 

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Is it Safe? Chocolate vs. Food Allergies February 7, 2020

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Photo by Pixabay on Pexels.com

Chocolate might just be the key to the heart.  But if you have food allergies, proceed with caution – Chocolate can contain a number of common allergens.  Although people can be allergic to the proteins in chocolate itself (often times to cocoa), patients typically react to one of the many other common ingredients in chocolate products.  These are dairy, eggs, peanuts, tree nuts, soy, and corn among others.

 

Under the U.S. Food Allergy Labeling and Consumer Protection Act, food manufacturers must label for the top 8 allergens (milk, eggs, peanuts, tree nuts, soy, wheat, fish and shellfish).  Sometimes, however, allergens are present in a food but not named on the ingredient list.  Undeclared milk is the most frequently cited reason for FDA product recalls and chocolate is one of the most common products that causes consumer reactions.

 

What about dark chocolate? That’s safe, right?

Dark chocolate can contain milk even when it isn’t listed as an ingredient.  In fact, in 2017 the Food & Drug Administration conducted a study, testing nearly 100 different chocolate bars.  Only 6 listed dairy as an ingredient.  Of the remaining bars, 61% contained milk.  Why is this?  Dark chocolate is often produced on the same equipment as milk chocolate which cross-contaminates it making it unsafe for those with dairy allergies.

 

The FDA also found that milk was present in 3 out of every 4 dark chocolate products with advisory statements, such as “may contain” or “made on equipment with.”  These advisory statements are voluntary, so be sure to call the manufacturer if you don’t see one present.

 

What if I’m not allergic to milk? How do other food allergies fair?

Although dairy is one of the most common causes of allergic reactions when consumers eat chocolate, it’s not the only allergen to be concerned about.  Candy, treats and dessert products are often processed on shared lines with other ingredients and cross-contamination is a problem.

 

If you’re allergic to peanuts, tree nuts, soy, corn, eggs and wheat you should also be careful – as should patients with celiac disease.

 

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White Chocolate?  Please tell me I can have that…!

White chocolate is made from cocoa butter, milk, sugar and vanilla.  Manufacturers also often add soy.  Just as with milk or dark chocolate, it can contain other common allergens such as wheat, corn, peanut or tree nuts that could cause a reaction.  If you are allergic to one of those allergens, you may wish to steer clear of white chocolate as well.

 

What IS Safe?  A lot actually!

If your mouth is watering just looking at square of chocolate, don’t despair!  Here are some allergy-friendly options to satisfy that sweet tooth:

 

Disclaimer: Manufacturers change their practices often and without warning. Always check the ingredient label and call the manufacturer should you have further questions.

 

[This is not a sponsored post.]

 

Andes Candies

These refreshing chocolate and mint treats are peanut, tree nut, and gluten-free and produced in a peanut, tree nut, gluten and egg-free facility.

 

Dove

SOME of Dove’s product line (Silky Smooth) are made free of peanuts and tree nuts in a peanut/tree nut-free facility (see link).  However, be sure to read labels carefully because Dove makes other products that contain nuts or could be cross-contaminated with them.

 

Enjoy Life

Enjoy Life’s products are always free from peanuts, tree nut, dairy, eggs, soy, wheat/gluten, fish, shellfish, sesame, sulfites, mustard, lupin, and crustaceans.  And you can sometimes find it in your local grocery store!

 

Free2B Sun Cups

For those with peanut, tree nut, and/or dairy allergies, these sunbutter filled chocolate cups are just as good as their peanut butter counterparts but SAFE!  All of their products are free of the top 12 allergens (dairy, egg, peanuts, tree nuts, soy, wheat, fish, shellfish, sesame, corn, mustard, and coconut).

 

Hershey’s

Contact Hershey’s to get the latest allergen information.  They have a fair number of gluten-free products.  Milk-chocolate Hershey’s kisses were processed in a peanut and tree nut-free facility on peanut and tree nut-free lines as of summer 2019.  Plus, Hershey’s utilizes good labeling practices, offering thorough ingredient and advisory labels.

 

No Whey Chocolate

No Whey Chocolate products are always free from peanuts, tree nut, dairy, gluten, egg, soy, and artificial colors and flavors. (Plus, they’re vegan and kosher!)

 

PASCHA chocolates

PASCHA products are free from peanuts, tree nuts, dairy, eggs, wheat/gluten, soy, sesame, fish, shellfish.  Check out their website where they clearly label their (lack of – *except soy*) cross-contamination list.

 

Safe Sweets

This family owned company makes treats that are peanut, tree nut, dairy, and gluten-free in a free-from facility. Many of their products are also soy-free – be sure to check their FAQ section to identify which ones.  (They are also kosher pareve and some products are vegan!)

 

Vermont Nut Free Chocolate

It’s in the name: nut-free chocolate that’s delicious and easy to order.  They are very allergy-aware and will label if a product is processed alongside anything in the top 8 allergens.  You can find these in stores or order online.

 

 
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