Allergy Shmallergy

Simplifying life for families with food allergies.

Food Allergies on a Budget September 9, 2022

It is no shock for those of us who live with this condition to learn that food allergies are expensive. The cost of medical care on top of prescription auto-injectors, grocery bills, time away from work to manage our condition, special child care (and sometimes schooling) can add up quickly. According to a 2013 study out of Northwestern University by Dr. Ruchi Gupta and others, food allergies cost over $4,100 per child in the U.S. That’s a total of over $20 billion dollars a year carried by patients and their families; $25 billion when other costs are factored in. To reduce the expense of food allergies on an individual or families budget, we need to look at a few key areas:

Prevention

From the Northwestern study, it is clear that prevention saves money. Hospitalizations accounted for the largest direct medical cost with emergency department visits coming in third. One way to manage your medical costs is to check in with your healthcare provider annually. Be sure to discuss any changes in your allergy, realistic risk and lifestyle management as well as treatment options available to you. Treatment can help protect you from accidental exposure by potentially lessening the symptoms of a reaction and keep you from needing emergency services.

Epinephrine Auto-Injectors

At that same yearly appointment, ask your healthcare provider which epinephrine auto-injector would be best for your lifestyle. Carrying a set of epinephrine auto-injectors is key to food allergy management and using it at the first signs of anaphylaxis can keep you out of the hospital and on the road to a quick recovery. There are many auto-injectors on the market to choose from, so finding one that fits your life should be easy. To make these more affordable:

  • Call your insurance company to see which auto-injectors they cover and at what rate. Ask questions about how often you can renew prescriptions so that you can plan accordingly when you need a second (or third) set for work, school, or child care locations.

Food

Finding and buying allergy-friendly food can be a challenge. Dairy, egg, soy and wheat allergies – especially in combination – make purchasing safe food difficult and expensive. People with food allergies often need to shop at multiple supermarkets to find costly allergy-friendly products they can use. To save money on groceries, consider a few things:

  1. Sign up for coupons on your favorite allergy-friendly manufacturers’ websites. While many stores don’t offer discounts on these “free-from” products directly, companies often offer. For example, if you scroll to the bottom of their homepages, Enjoy Life foods, Sunbutter, and others, offer coupons for both American and Canadian customers.
  2. Use simple substitutions. Sure, you can bake with a speciality egg replacer at $6.50 a box. OR, you could use applesauce ($3.25 per jar).
  3. Buy in bulk. We all know that bulk pricing is often lower per unit (ounce, pound, etc) than their smaller counterparts. Consider buying food that you use often in larger quantities. Also consider splitting the cost and contents of a bulk item (especially if it will spoil, like fruit, vegetables or meat) with a friend or member of your family – that way, you both get the best price!
  4. Create a meal plan that utilizes leftovers from one meal to create another later in the week. You might have hamburgers one night and use the leftover ground meat to make tacos, meatballs, or chili another night.
  5. Create a shopping list and stick with it. If you plan your meals, this is all you should need for the week or month.
  6. Once you have your list, visit the website of the supermarkets near you to find the best prices. One store may be having a sale on just the item you need! And while you’re there, sign up for and take advantage of store loyalty cards. You can load coupons and discounts onto the card itself, so that all you need to do is enter your phone number at checkout to receive all the savings.
  7. Save yourself a trip to a second or third store for those few allergy-friendly products they stock. Each stop means more time, more gas, and more temptation for impulse purchases. See if your item can be shipped to you via Amazon, Peapod, Walmart, Target, Costco, etc.

Food Assistance

Food assistance programs are a great way to get the food you need. Both the Supplemental Nutrition Assistance Program (SNAP) and Women, Infant, Children programs (WIC) are run by each state and offer a monthly stipend to be used on qualified products. Hint: your SNAP dollars go further at farmer’s markets!

Contact your local school to discuss availability of free breakfast and lunch programs. Some programs extend into the summer months, so be sure to inquire about how to access that benefit after school ends. These programs are available through the USDA and other non-profit organizations. While you’re there, also ask about weekend backpack programs run through food pantries and other non-profits.

If you need further assistance, contact a local food bank or food pantry. There are many tips for safely navigating the food pantry, so be sure to read through these suggestions. If possible, sign up to choose the items you need yourself (rather than having a box preprepared for you) – that way, you can pick food you like and read ingredient lists to make sure they are free from your allergen.

Medical Care

Contact your state to see if you qualify for Medicaid, an insurance program that provides medical coverage for individuals and families. If you do not, consider the Children’s Health Insurance Program (CHIP), also offered by each state. CHIP provides low-cost medical coverage to children (and sometimes to pregnant women) who earn too much to qualify for Medicaid. Like Medicaid, CHIP covers routine check ups, vaccinations, dental and vision care, emergency services and more.


There’s no doubt that food allergies are expensive. But taking care of yourself, planning ahead, and reaching out for help when needed can go a long way in reducing cost AND stress.

 

Taking Care of Your Food Allergies AND Your Health May 10, 2022

There are a few simple things that everyone should be doing to protect their health. And while they benefit all, they are particularly important for people with food allergies. These activities aren’t just good for your well-being, they are also important to help prevent serious allergic reactions.

GET CONSISTENTLY GOOD SLEEP.

Yes, the elusive sleep recommendation… But studies show that sleep deprivation can lower a person’s threshold – meaning, the amount of allergen it takes to trigger a reaction. The lower a person’s threshold, the less allergen it takes to set off a reaction. Experts recommend getting a consistent amount of sleep every night by turning off devices an hour before bed; sleeping in a dark, cool room; and waking up at the same time every day ((sigh) yes, even on weekends…).

REDUCE EMOTIONAL STRESS.

Easier said than done, we know. Excess stress (and who doesn’t have that these days?!) also lowers your threshold and escalates potential reactions. Take care of your mental health by connecting with friends; getting out in nature; paying attention to your physical health (exercise, eat well, etc); engaging in yoga, meditation, or other relaxation techniques (like art, breathing and imagery exercises); taking breaks from social media and news when needed; and learning to say “no” to reduce feeling overwhelmed.

HYDRATE.

Water is critically important to the functioning of our bodies – and when they aren’t hydrated, it can wreak havoc. For someone with food allergies, dehydration can affect lung function, heart rate and core temperature – all of which are known factors in more serious reactions, known as anaphylaxis. You may be familiar with the “8×8 Rule”: every adult should drink eight cups of eight ounces of water a day. That amount might vary a bit based on where you live, your health, diet and what activities you do. One thing experts recommend is sipping on water even when you’re not thirsty to replenish all that you lose throughout the day.

LIMIT ALCOHOL USE.

Moderation is best. Alcohol dehydrates the drinker and can reduce threshold, triggering serious reactions faster. Alcohol can also decrease a person’s ability to make good decisions. People with food allergies have to be careful about what they eat and drink and they need to be able to evaluate their health in case of accidental exposure.

GET BETTER CONTROL OF YOUR ASTHMA.

It’s probably been on your to-do list anyway. Not being able to breathe clearly is no fun. It’s not only uncomfortable, it also dangerous for your health. Uncontrolled asthma can make allergic reactions worse by speeding up dangerous swelling in the lungs, making it difficult to breathe. Now is a great time to speak with your healthcare provider about lifestyle changes and other ways you can improve your asthma treatment.

ALWAYS CARRY TWO.

You can’t plan for accidental exposures, but you can be prepared for a reaction by always carrying two epinephrine auto-injectors. It is critical to carry a set with you (rather than leaving them in the car, a locker or at home) because occasionally a reaction may be persistent and require two doses of epinephrine before the patient reaches medical care. And rarely, devices are misused or misfire – so having a back-up is always a good idea.


There’s no day like today to begin making positive lifestyle changes. Experts say it takes about three weeks to turn change into a new habit – so be patient and positive with yourself, making one good decision at a time. Talk to your doctor about these and other ways to improve both your health and your food allergy outcomes at your next visit.

 

Food Allergy Awareness Week May 9, 2022

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AllergyStrong Food Allergy Awareness Month

Food Allergy Awareness Week (FAAW) brings attention to food allergies, a growing epidemic worldwide that affects up to 250 million people. But for those of us already living with this condition, FAAW is an excellent time to review important food allergy information, make changes to your food allergy routine and educate yourself on new information to improve your quality of life.

As the melodious Julie Andrews sings in The Sounds of Music, let’s start at the very beginning:

Food allergies are an immune system response to food. The immune system mistakes food for foreign substance and begins mounting an internal attack on it. For someone with a food allergy this results in a variety of symptoms that can range from mild to severe, to life-threatening.

To review symptoms of a reaction and anaphylaxis as well as how a young child might describe those symptoms, please see below.

The Language of a Food Allergic Reaction

There is no cure for food allergies. The most recommended treatment is food avoidance – that is strictly avoiding your allergens. While this sounds simple, food avoidance can be difficult to manage, time consuming, and costly.

For more information on US labeling laws and how to read food labels for allergies, please see below.

The Ins and Outs of Reading Food Labels

Some people with food allergies are pursuing a treatment called oral immunotherapy (or OIT). This is one of several treatments that offer “bite protection” for those with food allergies. This means, it would lessen or eliminate a reaction if someone with food allergies accidentally ingested their allergen. OIT and other similar therapies (like sublingual immunotherapy (SLIT), epicutaneous immunotherapy (EPIT), etc) offer protection but not a cure.

To learn all about OIT, please read the article below.

Food Allergy Treatment: OIT 101
Photo by cottonbro on Pexels.com

Food allergies are more common among adults than children. Studies show that 1 in 12 children have a food allergy whereas 1 in 10 adults do. Not only do food allergic kids grow to be adults, but adults are acquiring new food allergies in adulthood. These adults suddenly find themselves allergic to food they may have safely eaten their whole lives and navigating that change can be difficult.

To learn more about the impact of adults with food allergies, please see below.

The Impact of Adult On-Set Food Allergies

As we move through this week, we’ll explore several ways to make life a little better for you and the 32 million other Americans living with this chronic condition.

 

Can I Safely Get a Flu Vaccine with an Egg Allergy? October 15, 2021

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Flu season is upon us and it’s poised to spread like wildfire once again. Patients who are allergic to eggs want to be protected from the affects of the flu, but worry about the risk of anaphylaxis from the ingredients in the vaccine. Those of us with an egg allergy face the same challenge each fall: Can we safely get a flu vaccine?

Myth Busting

Concern about egg allergy and the flu vaccine is one of the many myths that surround vaccines that we can easily dispel. YES, you can get your flu shot even if you have an egg allergy. The amount of egg protein that might be in the shot is too little to trigger a severe reaction according to allergists and the CDC. If you also have asthma, it becomes even more important to get vaccinated as asthma can lead to more discomfort and serious complications.

Another myth worth dispelling: You cannot get the flu from the flu vaccine. The vaccine does not contain a live virus; the live virus used to produce the vaccine is killed, broken up, and purified to make the vaccine. This means, the flu shot does not have any ingredient in it that can make you sick or spread the virus as was previously thought. The components of the vaccine allow your immune system to form antibodies that will be ready to attack should you be exposed to the real thing.

A Little History

Vaccines have been produced using egg for more than 70 years.

When the flu vaccine was first introduced in the early 2000s, it contained a small amount of egg protein. At that time, doctors were concerned that those with an egg allergy might have a reaction. They were particularly worried that the nasal spray delivery method might overwhelm the immune system and trigger a response. For that reason, they used to recommend the injectable flu vaccine followed by a 15-30 minute observation period for anyone with an egg allergy.

…the scientific community has noted that only 1.31 people in 1 million will react [to the flu shot]. That’s 0.000131% for perspective. You have better odds of being hit by lightning.

Where We Are Today

Things are different today. Although the flu vaccine still contains a very small amount of egg protein (ovalbumin), studies have examined the use of both nasal and injectable flu vaccine in allergic and non-allergic patients and have recorded almost no reaction for those with an egg allergy. In fact, the scientific community has noted that only 1.31 people in 1 million will react. That’s 0.000131% for perspective. You have better odds of being hit by lightning. That’s great news!

There are some who react to vaccines. In the last 10 years, there have been several studies that have shown that most of these reactions are caused by another component in the shots, not the trace amount of egg.

As such, the CDC encourages those with an egg allergy to get the flu vaccine and no longer recommends an observation period. Now, you can get your flu shot and be on your merry way!

Severe Reaction to Eggs in the Past?

No worries! The CDC still recommends patients with a history of severe reaction get a flu shot, but they suggest doing so in a medically supervised environment. That could be at a clinic, doctor’s office, hospital, outpatient facility or anywhere else where healthcare professionals can respond to an allergic reaction in the unlikely event one should occur.

The CDC defines a severe reaction as any symptom other than hives, particularly cardiovascular (fainting, lightheadedness, etc), respiratory (wheezing, coughing, etc) as well as any reaction requiring epinephrine.

In Short/Recommendations

  • Doctors recommend that patients with an egg allergy get their flu shot.
  • If you have an egg allergy, the chances of having a reaction to the flu vaccine are incredibly low.
  • Both the flu shot and the nasal spray vaccine are safe for those with egg allergy.
  • Most patients with egg allergy no longer need to be monitored following their vaccine unless instructed by their doctor.
  • **If you have had a severe reaction to egg, be sure to get your flu shot in an inpatient or outpatient facility.**
  • The flu vaccine protects patients from serious illness.
  • If you have asthma, the flu shot is important to keep you from experiencing complications from the flu.
  • **If you have reacted to the flu vaccine in the past, talk to your healthcare provider before getting your next shot.**

Questions?

For more information, please see the CDC’s page Flu Vaccine and People with Egg Allergies.

Symptoms of the Flu

Should you experience any of the following symptoms, please stay home and call your doctor.

Symptoms of the flu – which range from uncomfortable to dangerous – can vary:

  • Fever/chills
  • Cough
  • Sore throat
  • Runny or stuffy nose
  • Muscle or body aches
  • Headaches
  • Tiredness
  • Vomiting and diarrhea, *this is more common in children than adults

 

The Myth of the “Mild” Food Allergy March 1, 2021

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Patients and caregivers describe their food allergies in all sorts of ways, but there’s only one term that worries healthcare providers: mild.

Patients often list off their food allergies, distinguishing one from the other by stating, “I’m allergic to peanuts and have a MILD allergy to sesame.” or “I’m allergic to egg and have a life-threatening allergy to dairy.”

Statements like these are very concerning to healthcare professionals. They know something they wish EVERYONE did: there is no such thing as a “mild food allergy.” ALL food allergies have the potential to be life-threatening.

“Mild” and “severe” are words to describe allergic reactions. Reactions come in all forms and they CAN be mild. But it is impossible to know when a mild reaction will snowball into a severe, life-threatening one, called anaphylaxis.

When patients experience some of the less severe reactions to food – such as hives, swelling, itching or an upset stomach, for example – they believe that this will always be their reaction to that particular food. People often confuse their mild reaction for a mild food allergy. This mistake is certainly understandable, but it leaves patients, caregivers, teachers, chefs and waitstaff underprepared when a life-threatening reaction does occur.

Unfortunately, severity differs from one reaction to the next. And even doctors cannot predict how a patient will react to an allergen. Not only do reactions vary between different patients with the same food allergy, but reactions can differ from day to day in the same patient to the same allergen from one reaction to the next. This is why doctors recommend that patients strictly avoid their allergens and ALWAYS CARRY two epinephrine auto-injectors with them at all times.

There’s a saying in the food allergy world that sums it up:

“Past reactions do not predict future reactions.”

In short: each food allergy is as serious as the next – and every one can turn dangerous with the next bite. This is not to stoke fear, but rather a call to be vigilant about reading labels, take proper precautions, carry your epinephrine and follow your individualized emergency action plan should you have a reaction.


As a reminder, here are the symptoms of an allergic reaction.

Mild SYMPTOMS include:

  • Sneezing
  • Runny nose
  • Itching (often in the mouth, nose, and skin)
  • A FEW hives
  • Localized rash/redness
  • Mild nausea/stomach discomfort

More severe symptoms include:

  • Trouble swallowing/Throat tightening or closing
  • Trouble breathing
  • Wheezing/coughing/hoarse
  • Feeling dizzy/faint
  • Skin turning blue/low pulse rate
  • Significant swelling of the mouth, tongue or lips
  • Repetitive vomiting/diarrhea
  • Widespread hives or rash
  • Sudden anxiety/sense of danger

If you experience any severe symptoms or are in doubt, administer the epinephrine auto-injector and call 911 immediately.

 

Another Pitch for Food Allergy Education October 28, 2020

Following my fascinating time teaching a senior writing seminar at a local high school (see What Does Food Mean to You?), I was struck by two things:

  1. These high school seniors were impressively thoughtful, creative and bravely willing to share their rich and rewarding stories (and souls) with their peers. And,
  2. They wanted to talk about food allergies more than any of that.

It’s FUN to talk about food – who doesn’t love to tell stories about their food adventures, a favorite meal, a holiday celebration, their dream dessert…?! As robust as our conversation was about writing and food, the conversation that followed was absolutely enlightening.

When I mentioned to the class that, in addition to my other writing, I often write about food allergies, hands went up immediately.

“How is a food allergy different than a food intolerance?”
“Can you outgrow a food allergy?”
“Do adults acquire new food allergies?”
“Are there treatments available?”
“What that medication people carry? How does it work?”
“How can I support my friend who has a food allergy?”

We spent 45 minutes – half of their class time – talking about food allergies that day. Forty-five minutes before we needed to cut them off and return to writing.

I spend a lot of time talking to school administrators about the value of food allergy education – especially for young children through early adolescence. This experience not only underscores the importance of food allergy education, but it highlights the continuing need to discuss it.

Two kids in every classroom have at least one food allergy. But as teenagers grow into young adults, they’ll soon find that EVEN MORE adults have food allergies than children. According to a study by Dr. Ruchi Gupta and her colleagues at Northwestern, 1 in 10 adults live with food allergies – 25% of whom acquired a new allergy AS an adult.

Administrators often see the value of a short unit about food allergies to health education, but don’t often add it to their curriculum. Why? Because, they say, these days kids grow up around food allergies. They know all they need to know from being around their peers.

But, based on my time in the classroom, it is clear this theory that students are absorbing food allergy lessons by osmosis doesn’t cover it. Young children don’t understand what a food allergy is and why some people have them. Pre-teens may lack understanding of the frequent obstacles and dangers their peers with food allergies face day-to-day. Teenagers are expected to help keep their friends safe but don’t know what it’s really like to have food allergies and don’t know how to help. And young adults may need to know how to recognize symptoms of food allergies and use an epinephrine auto-injector to save someone’s life.

Students hear the words “food allergy” and only have a vague sense of what it means. Even by age 18, students hadn’t learned what they felt they needed to know about the food allergies that they encounter. They were left with so many questions, I could have filled several sessions answering their questions.

If we expect our children and young adults to be empathetic to their peers who are physically, socially and emotionally affected by food allergies (and other medical conditions), we need to give them a proper introduction and equip them with the age-appropriate skills to become supportive friends and classmates.

At this time, most schools STILL don’t formally teach their students about food allergies despite the fact that there are nut-free classroom, peanut-free tables, and gluten-free options in the cafeteria. A short lesson would go a long way in fostering community, building empathy, empowering helpers and protecting students.


 

COVID Life: Food (Allergies) in the Classroom this Fall? July 2, 2020

 

The American Academy of Pediatrics (AAP) came out with a statement in favor of in-person schooling for children wherever schools can do so safely.  In it, they cite the importance of school on child and adolescent mental health and academic engagement as well as the lower rate of transmission and contraction of the coronavirus. [Read the AAP’s full statement here.]. The AAP’s statement also offers guidance to schools about how they might resume in-person education while protecting students as much as possible.

 

In May 2020, the Center for Disease Control (CDC) also published guidance about schooling during the COVID-19 pandemic.  At that time, AllergyStrong co-signed a letter urging the CDC to balance their guidance with the concerns of life-threatening health conditions facing students including food allergies – which they did.  [Read the CDC’s updated guidance here.}

 

Both the AAP and CDC recommended that students eat meals in the classroom rather than the cafeteria in order to promote social distancing and limit contact between classes (cohorts) and grades.  And, both AAP and CDC mention the need to be cognizant of food allergies in that scenario.

 

 

How do you bring food into the classroom safely?

The AAP and CDC guidance leaves many parents wondering how can teachers, staff and administrators help protect their students from food allergic reactions while following this guidance?

1. Enforce a “No Sharing” food policy.  

This must be strict and plainly stated to protect classmates from food allergic reaction which can be serious.

2.  Wash hands.  

This is doubly important in the age of COVID.  But unlike a virus, food allergens are not eliminated by hand sanitizer.  Hand washing with good-old soap and water is what is recommended to prevent cross-contamination and cross-contact with food protein that can cause a severe reaction.

3.  Cleaning shared surfaces.

It is critical to clean common surfaces (again doubly so with the coronavirus at play) to prevent accidental cross-contact and protect students with food allergies.  Cleaning with soap and water is best.

4.  Review symptoms of an allergic reaction.

It is imperative for teachers and classroom staff to re-familiarize themselves with the signs and symptoms of an allergic reaction as well as how a child might describe those symptoms [Read, The Language of a Food Allergic Reaction for more information.].

5.  Know how to respond to an emergency.

Minutes matter during a food allergic reaction.  Severe reactions, called anaphylaxis send patients to the hospital and can be fatal.  Review a student’s 504 plan and any Emergency Action Plans available.  Know where epinephrine auto-injectors are stored, how to use them and WHEN to use them.

6.  Take advantage of the stock epinephrine program.

Under the School Access to Epinephrine Emergency Act, also referred to as the Stock or Unassigned Epinephrine Act, schools are allowed to keep on-hand epinephrine auto-injectors that are not prescribed to a particular patient for use in emergencies.  This program is available in 49 states and is used to save the life of any student, teacher or staff member having an allergic reaction regardless of whether they have epinephrine on file.  Up to 25% of stock epinephrine use in schools is with people who have no history of diagnosed food allergies.

 

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What can parents do to protect their children?

1. Establish/Review the student’s 504 plan.

Section 504 of the Americans with Disabilities Act protects a student’s access to equal education and academic success while preserving safety.  Provisions in a 504 plan for a student with food allergies might include class-wide hand washing, a voluntary refrain from bringing allergens into the classroom, communication with parents about allergens, or approval for a student to carry his/her own epinephrine auto-injectors. Now is the perfect time to work with your school to establish a written 504 plan for your food allergic child should you feel they need it.  [Read Kids With Food Allergies Sample Section 504 Plans for Managing Food Allergies for more information.]

2. Practice how to respond to situations with food with your child.

Because eating may be done in the classroom, a child’s peers may have questions or comments about his/her food allergy.  Practice answering these questions with your child so they feel comfortable and confident to handle anything that comes their way. [Read Armed with Words:  Teens and Food Allergies to get your conversation started.]

3. Review symptoms of an allergic reactions with your child.

It is critical that everyone with food allergies know the signs and symptoms of an allergic reaction.  Teach these symptoms in an age-appropriate way so as not to scare younger children.  Let kids know that these symptoms typically appear soon after eating and tell them to speak up (even interrupting a teacher) if they are concerned they are having an allergic response.  [Read: React? Act! to help teach this important lesson.]

4. When age-appropriate, demonstrate how to carry/use epinephrine auto-injector.

Carrying an auto-injector is a big responsibility and a big relief to some children.  Teaching kids how to carry their epinephrine auto-injector (always have it with you, don’t let your friends play with it, etc) and how to use it is key.  In fact, invite one or two close friends over and demonstrate how to use the auto-injector with the trainer or firing off an old one on an orange or grapefruit will also help protect your child should an emergency arise.  We’ve adapted an old medical school mantra from my father-in-law for food allergies, “If you think you need to use the auto-injector, you DO need to use it!” Remember, administer epinephrine and go to the hospital immediately for further treatment and monitoring.

 

Important Update: FDA Temporary Labeling Policy June 22, 2020

 

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AllergyStrong has participated in several discussions with the US Food & Drug Administration in partnership with several passionate food allergy advocacy organizations to ensure protections for food allergy consumers.

 

Our most recent meeting offered an opportunity for the food allergy community to voice its concerns based on our daily challenges with food purchasing.  Additionally, we were able to learn more about the policy itself as well as manufacturers initial reactions.

 

The food allergy community should feel reassured that the FDA understands our concerns and is working with advocates to keep patients safe.  They underscored their commitment to transparency in our meeting and demonstrated their willingness to respond to our concerns.

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Background:  The FDA relaxed it requirements for food labeling on May 22, 2020 in order to preserve the food supply chain during the COVID-19 pandemic.  In short, this temporary policy allows manufacturers to substitute minor ingredients without issuing a label change. [Read FDA Issues Temporary Policy Allowing Some Substitutions in Food for details of this policy.]

 

The FDA is trying to balance food safety with food security during the COVID-19 pandemic.  They believe this guidance provides the flexibility needed by manufacturers with guardrails to ward against adverse health effects.

 

 

 

 

FDA’s Stance on Food Allergies in Relation to this Policy:

  • Although the FDA gives limited flexibility to manufacturers to substitute minor ingredients, it does not compromise on food allergens because they represent a health and safety risk.
  • The Top 8 allergens (peanut, tree nuts, milk, egg, soy, wheat, fish and shellfish) cannot be substituted in for another ingredient without an appropriate label change.
  • Additionally, gluten, sulfites, glutamates and other ingredients known to cause sensitivity in people cannot be substituted in for another ingredient.
  • Finally, manufacturers are warned against substituting in priority allergens (such as sesame, celery, lupin, buckwheat, molluscan shellfish, and mustard) that are common in other parts of the world without a label change.

 

 

Latest Information and Clarification:

  • We urged the FDA to require more transparency from manufacturers when they need to substitute an ingredient.  Advocates and the FDA agreed that a sticker that sits on top of the ingredient label on packaging to indicate the most current ingredients would be best.
  • The FDA is also recommending that substitution information to be listed on manufacturers websites and signage be placed at the point of sale.
  • Following conversations with the food industry, the FDA stated that manufacturers do not want to make changes to their products unless forced to by circumstance.  They expect to see this policy employed rarely and to see omissions rather than substitutions.

 

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In response to our conversation, the FDA issues an FAQ page on this policy with further clarifications.

 

AllergyStrong will continue to track this policy and keep you informed.  We will continue our conversations with the FDA to best support food allergic consumers and ensure food safety and transparency for all.

 

 

 

 

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.

 

But wait, there’s more!

Should you need an epinephrine auto-injector refill and wish to avoid the pharmacy, remember that many pharmacies are delivering prescriptions free of charge.  And, Auvi-Q continues to serve patients through its excellent home delivery program that ships straight to your door!

(more…)

 

Food Allergy Treatment: OIT 101 January 21, 2020

[DISCLAIMER: Oral Immunotherapy is always conducted under the direction and supervision of a medical doctor.  It is an individualized plan.  Please talk to your doctor if you’re interested in learning more about OIT.  This is not an endorsement of OIT and is for informational purposes only.]

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UPDATE:  Palforzia was approved by the FDA in late January 2020 and is use today.  If you choose to pursue OIT, discuss whether Palforzia or other OIT programs are best for you with your healthcare provider.

While the U.S. Food and Drug Administration considers whether to approve Aimmune’s  Palforzia – possibly the first drug to be approved for peanut allergy, let’s get an overview of OIT.

Oral immunotherapy isn’t a new concept.  In fact, it has been discussed in medical journals for over a century and used for decades to help patients desensitize to environmental and drug allergies as well as build a tolerance to venom.  OIT has been studied in food allergy (mostly for peanut allergy) for the last 20 years and been in medical trials for just over 10 years.

Following a successful presentation to the U.S. FDA in September 2019, we stand on the cusp of seeing the first oral immunotherapy drug (Palforzia) approved.  Until now, food allergic patients have had no other option but to avoid their allergen for the life of their allergy.  FDA-approved drugs, like Palforzia, and other therapies would offer some patients progress, giving them much-needed treatment options to increase tolerance and protect them from life-threatening reactions for the very first time.

What is OIT?

Oral immunotherapy – or OIT – is a treatment option for some with food allergies that is managed and is strictly monitored by a patient’s allergist.  [NOTE: OIT and desensitization should ONLY be done under medical supervision and with guidance from your personal doctor.]

Oral immunotherapy is a safeguard.  It is a therapy intended to protect patients should they accidentally be exposed to their allergen.  It can also bolster a patient and caregiver’s mental health by reducing anxiety and stress caused by the heavy burden of food allergy management and unexpected, potentially life-threatening reactions.

Immunotherapy (whether oral, epicutaneous, sublingual or otherwise) is a treatment option to help patients tolerate a higher level of allergenic protein and is NOT a cure for food allergies.

boy and girl eating cookies

Photo by cottonbro on Pexels.com

How does it work?

OIT is a form of desensitization – that is, the process of retraining a patient’s body to tolerate a larger amount of the allergen to which they are allergic without causing a reaction.

For example, if a patient is allergic to peanuts, a doctor would give a patient an amount of peanut protein (beginning with a tiny dose of 1/100th of a peanut or three milligrams). That dose is gradually increased until that patient can safely eat a level of protein that would otherwise cause a reaction.  The goal of many OIT programs is to get the patient to tolerate at least 600 mg of peanut protein (or the equivalent of 2 peanuts), although these goals vary from practice to practice and patient to patient.

milk OIT

Dairy OIT solution – photo by OakleyOriginals via Flickr (CC BY 2.0)

Is OIT only for those with a peanut allergy?

Although the FDA is currently only reviewing a drug aimed at peanut allergy, oral immunotherapy trials are available for those who suffer from other food allergies as well.

How effective is oral immunotherapy?  Does it work?

Peanut, egg and milk OIT has been studied most closely and shown to desensitize 60-80% of participants.  Studies related to peanut oral immunotherapy specifically have between 85-90% success rates.  Other food allergens have not been studied as thoroughly and initial results show they may not be as effective at increasing a patient’s tolerance.  These  numbers are the result of oral challenges and not real-world accidental exposure.

Can anyone pursue oral immunotherapy?

If you’re interested in OIT, it’s best to speak with your doctor.  The process of going through OIT can be demanding and does not fit every lifestyle.  And, there are certain food allergy-related conditions (such as eosinophilic esophagitis – EOE – and others) that might make immunotherapy more difficult.

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Photo by Negative Space on Pexels.com

Consider this…

There are a few side effects that are possible while undergoing OIT.  The most common issue patient’s experience is gastrointestinal (reflux, cramping and vomiting), followed by oral itching, hives, and wheezing.  The risk for anaphylaxis is higher for those going through immunotherapy due to a patient’s regular exposure to their allergen.   Patients also risk  developing/inciting EOE – which often goes away when therapy discontinues.

The process of oral immunotherapy can be rigorous.  It requires an oral challenge, frequent doctor’s visits, and a comfort with using an epinephrine auto-injector.  Therapy also puts some restrictions on the life of patients as a precaution. For example, after dosing patients are required to rest to keep their body temperatures steady for 2 to 4 hours. And, daily monitoring is required.

Patients often need to take a daily or weekly maintenance dose indefinitely to keep up their tolerance.

Finally…

Oral immunotherapy is a much-needed treatment options for those seeking some protection and relief from the demands of living with food allergies.  Safeguarding patients against cross-contamination and accidental exposure is important for a patient’s physical as well as mental well-being.  But OIT is not for everyone.  If you’re interested, talk to your doctor about OIT and see if it’s a good fit for your lifestyle.

For more information, please read:

The Current State of Oral Immunotherapy from AAAAI

 

Food Allergy Resolutions January 7, 2020

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Photo by Anna-Louise on Pexels.com

Happy New Year!

 

Each new year brings the hope of getting things right, of bettering ourselves.  When we set new year’s resolutions, we often seek self-improvement, time for personal passions, valuable social interaction, travel and adventure.

 

For those with food allergies, a key component to all of those resolutions is sticking to good food allergy management practices.  There’s nothing you can’t do with food allergies, but you need to make sure you’re safe and prepared when you do it!

 

Setting small achievable goals will help reset your habits and keep you safe as you pursue your dreams.  Here are some food allergy resolutions we ALL should keep this year:

 

Auvi-q and Epipen

1. Always carry 2 epinephrine auto-injectors.  There are many varieties on the market today in all shapes and sizes.  Find one that fits your lifestyle and carry it with you everywhere (yes, everywhere).  This may take some creativity, but it’s critical because early use of epinephrine is shown to save lives and reduce complication at the hospital.

 

Symptoms of Severe reaction

2. Know the signs and symptoms of an allergic reaction.  A severe allergic reaction, called anaphylaxis (ANA-FIL-AXIS) can be VERY SERIOUS and even fatal.  That’s why it’s key to know the signs of a reaction and to know what to do in the first few minutes.  The Language of a Food Allergic Reaction outlines both the symptoms as well as how a young child might describe them.

 

 

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photo credit: mia! via Flickr, creative commons (CC BY-SA 2.0)

3. Know the labeling laws. Food manufacturers are required to label for the Top 8 allergens – these are responsible for 90% of all allergic reactions.  But they are not required to label for cross-contamination or any allergen outside of the Top 8.  Are your allergens in that list?  What else should you know?  The Ins and Outs of Reading Food Labels is critical to help you make safe decisions for yourself and your family.

 

 

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Photo by Luis Quintero on Pexels.com

4. Teach ONE person how (and when!) to use an epinephrine auto-injector.  Food allergies are a growing problem.  Statistically, 2 kids in every classroom have them. So do 1 in 10 adults.  We either know someone with a food allergy or we are allergic ourselves.  To protect patients and create food allergy allies, let’s teach one friend or family member (who doesn’t yet know) how to use an auto-injector.  Let them use a trainer if you have one – this will empower them should they need to use the real thing in an emergency.  Even elementary school kids can recognize symptoms of an allergic reaction and be taught to get an adult or nurse and call 911.  It’s easy!

 

 

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Photo by Joshua Woroniecki on Pexels.com

Send us your new year’s resolutions!  We love to hear what kinds of wonderful and exciting things you have your sights set on!

 

 

 

 
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