Allergy Shmallergy

Simplifying life for families with food allergies.

What is Lupin Allergy and Why You Should Care June 26, 2017

Lupin allergy is on the rise.  But most people haven’t even heard of lupin in the first place.    Travelers to Europe, Australia, Canada, the Mediterranean and even the U.S. should become familiar with it.  So should those who are gluten-free as well as those who have a peanut or soy allergy.

 

Read the article I recently wrote for the Allergy & Asthma Network, entitled “Why Is Lupin Allergy Becoming More Common?” to find out what lupin is, where it is found and who is most at risk for a reaction.

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Why Is Lupin Allergy Becoming More Common?
from the Allergy & Asthma Network dated June 14, 2017

 

Have you heard of lupin? Don’t feel bad; most Americans haven’t heard of it either. But that’s likely to change.

 

What is lupin?

Lupin (or lupine) beans are legumes – putting them in the same plant family as the peanut. Lupin beans are high in antioxidants, dietary fiber and protein and low in starch. And like all legumes, they are gluten-free.

Lupin beans are commonly used in Mediterranean cuisine. Sometimes ground into flour and blended into regular wheat flour, lupin is also widely used in Europe and Australia. There, lupin is frequently found in baked goods and pastas as well as breads, sauces, beverages (such as beer) and meat-based products like sausage and hamburgers.

Lupin is showing up in the United States as well. It appears most often as a substitute for gluten or soy in free-from products as well as replacement for genetically modified ingredients and animal proteins (primarily dairy and egg).

 

Can you be allergic to lupin?

Although not one of the “Top 8” allergens, lupin is beginning to make headlines in the food allergy world. For many, eating products containing lupin is completely safe. However, for a few, lupin can trigger an allergic reaction. The odds of having a reaction are higher if you already have a peanut allergy. This is called cross-sensitivity.

There is no evidence that lupin allergy is more severe than other allergens. Like all allergic reactions, symptoms vary. Those who are allergic to lupin have reported reactions ranging from hives, swelling of the lips and face, to gastrointestinal and respiratory distress, and cardiovascular issues.

 

Do manufacturers label for lupin?

Due to the frequent use of lupin in European and Australian packaged goods, coupled with reports of allergic reaction, manufacturers in the European Union are required to label for lupin. But this requirement is voluntary in places like the United States, Canada, Australia and other parts of the world where you may find lupin listed among other ingredients without special emphasis. U.S. laws and regulations only require labeling to highlight the Top 8 allergens.

Those allergic to lupin or unsure should be careful of unlabeled, over-the-counter baked goods like pastries sold at a bakery, bread rolls served at a restaurant or beer at a local pub.

 

Other names for lupin are:

  • Lupin Bean/Flour
  • Lupine Bean/Flour
  • Lupin Seed
  • Lupini
  • Termes
  • Altramuz
  • Tarwi
  • Termos

While lupin is currently popular in Europe, its presence is increasing in the United States and elsewhere. As the demand for gluten-free and other free-from goods grows, so may the use of lupin.

If you are concerned you may be allergic to lupin, speak to your board-certified allergist to discuss level of risk, testing and prevention strategies. Avoiding the allergen is the only way to prevent an allergic reaction.

 

 

 

 

‘Tis the Season: 504 Plans April 15, 2016

 

Fall and the start of school seem far away – I mean, who can think about going back to school when summer is just around the corner?!  That said, many of you are now sitting in front of a pile of forms thinking about 504 Plans for your children for next fall.

 

504 refer to Section 504 of the Rehabilitation Act and the Americans with Disabilities Act.  These plans are set in place to provide accommodations to school age children with disabilities (food allergies are listed among the qualifiers) to ensure that they are afforded equal access to learning and academic success as their peers.

 

These plans are created in collaboration with your child’s school and spell out food allergy management.  In addition to a Food Allergy Action Plan, 504 Plans can cover a broad range of topics such as snacks and meals, storage of emergency medication, addresses classroom issues related to food allergies such as science projects and other manipulatives, as well as hand washing policies.

 

Many people, including school administrators, get 504 Plans confused with IEPs.  An IEP is an Individual Education Plan which allows students with disabilities (often learning or cognitive disabilities) to receive specialized instruction and/or related services.  IEP qualification is determined both at meetings and in conjunction with standardized assessments, as well as other data collection.  504 Plans are determined by looking at medical records. Both are federally funded programs: 504 Plans guarantee access to education while IEPs provide supplemental academic services.

 

I recently came across an incredibly thorough and helpful article written by Vivian Stock-Hendel on fellow blogger, Sharon Wong’s blog “Nut Free Wok.”  Entitled, Food Allergy 101: 1, 2, 3…504 , you will learn everything you need to know about completing a 504 Plan and what to do if you need both a 504 and IEP.

 

Keep in mind, both plans can be used at schools which receive federal funding.  If your child attends private school, ask someone in administration if the school makes food allergy accommodations through 504 Plans or by another means.

 

Best of luck!

 

Additional Resources:

FARE: Advocacy – Section 504 and Written Management Plans

Food Allergy Action Plan Template

 

Milk Alternatives -Best of the Best January 8, 2016

Getting the proper amount of calcium is a tough job for those with a dairy allergy.  There are many ways to incorporate dairy into your diet (see How to Get Enough Calcium When You’re Dairy-Free), but a nutritionist recently told me that the best way to get calcium is to drink it.  And, sometimes you just want something cold and delicious to pour on cereal.

I recently stumbled upon an article from Real Simple (April 2015) where their food contributors reviewed a variety of milk alternatives to come up with the best tasting among them.

Here’s the original link to the article:  The Best Milk Alternatives.  And, below are they’re declared winners.

Best Original Soy:  Silk Soymilk Original

Best Vanilla Soy:  Silk Soymilk Vanilla

Best Unsweetened Soy:  365 Everyday Value Organic Soymilk Unsweetened

Best Vanilla Almond: 365 Everyday Value Organic Almondmilk Vanilla

Best Unsweetened Almond: Almond Breeze Almondmilk Unsweetened Original

Best Rice: Pacific Foods Rice Non-Dairy Beverage Original

Best Oat:  Pacific Foods Organic Oat Non-Dairy Beverage Original

 

Now I can’t speak about the almondmilks since my son has a tree nut allergy.  I can, however, vouch for both the Silk soymilks and the Pacific rice milk.  He enjoyed them both.  But if he were to put in a vote for best milk alternative, he’d put two thumbs (and maybe a foot) up for Silk Very Vanilla Soymilk.  Tastes great and works fabulously well as an ingredient in baked good.

We’ve also tried Costco’s Kirkland Signature Organic Soymilk Vanilla which came in as his close 2nd favorite.

 

What kinds of milk alternatives do you use?  Any input on creamers, cream cheese, sour cream?  Bring ’em on!  The more votes the better!

 

A Look Ahead: A Summary of Teens and Food Allergies December 3, 2015

I have a food allergic 10 year old.  I’m starting to see all those signs of tweeny-ness that my friends have been talking about.  And, although I could use a lot less eye rolling and smart alecky retorts, but I understand this is a (questionably) necessary right of passage into his more independent teen years.

Do you all remember being a teenager?  How many ill thought out decisions did you make?  My oldest child will be a teen before I know it and he’ll be faced with choices of his own.  The only way he’ll grow is to make mistakes, I know.  But when food allergies are a part of your life, small mistakes could be costly.

So, even if you don’t have a teen YET, please read on so as your kid ages you know what to look out for:

According to an article posted on Radio Canada International [Severe Allergy Risk Worse Among Teens, Young Adults], there are several issues at play during the teenage years that put them at greater risk for a severe food allergy reaction:

  1. They believe they are invincible.  Having had the minutia of their lives cushioned by their parents, teachers, etc up until these years, they feel they are unstoppable.
  2. They typically feel a strong need to conform to their peer group.  Admitting to a food allergy, needing to ask multiple and sometimes persistent questions at meals, not to mention carrying often bulky epinephrine doesn’t make them invisible.  If anything, it highlights their “differentness.”
  3. Teens are independent creatures.  They may balk against whatever makes them feel limited.

According to Dr. Scott Sicherer of Mt. Sinai in practical terms this means:

  • They fail to tell their peers about their condition.
  • They don’t want to/don’t know how to speak up to authority figures (such as teachers, waiters, etc) and alert them of their food allergies and dietary limitations.
  • Teens often leave their emergency medication at home – particularly when active and/or wearing something fashionable that leaves little room for autoinjectors.
  • They taste foods to see if it might contain an allergen, rather than reading labels.  My guess is that it may be harder for teens to reject an invitation to taste something “amazing” or even terrible, particularly if it means that behavior allows them to better fit in with their social circle.

The Radio Canada article goes on to quote Dr. Adella Atkinson, who offers a few helpful suggestions:

  • Start the conversation about food allergies early.  Without scaring them, very young children should be aware that some foods can make them sick.  Empowering young children will enable them to more confidently handle their food allergies as they age.
  • Provide choices.  [I thought this was the best suggestion I’ve heard in a while.  I can’t wait to implement it this weekend!]  Decisions about who and which kind of epinephrine autoinjector to carry, what kind of cuisine they’d like to eat, what their food plan is for outings without you will again empower them and force them to think through their food allergy roadblocks before they hit them.
  • In the WebMD article, Teens With Food Allergies Take Risks, Dr. Sicherer goes on to suggest educating friends as a secondary safety net.  This has already served us well [See That’s What Friends Are For] as my son’s friends help look out for him, are careful to make eating a more INCLUSIVE rather than exclusive experience, avoid eating my son’s allergen around him, and have been taught how to use epinephrine autoinjectors.
  • Teach your child’s friends how to use an autoinjector.  This is a great use of old EpiPens and Auvi-Qs and tweens and teens find it interesting.  By now, they’ve usually seen autoinjectors before and have loads of excellent questions.  Practice using autoinjectors by injecting them into an orange or grapefruit.
  • Buy/create several different accessories to help your tween or teen wear her epinephrine in all circumstances.  A dress with no pockets?  No problem!  Going skiing? We’ve got your covered.  School dance?  Don’t worry: there’s a way to wear it there too!  [See Your Growing Child: How to Carry Epinephrine]

But the most important thing you can do is keep up the conversation.  Not only are food allergies dangerous, they are stressful.  Keep talking to your tween and teen about them.  Make sure they know the door is wide open to discuss anything that comes up surrounding them.  And, present them with the big picture:  that you might want to fit in during your teens but you want to stand out in your twenties.  Encourage them to get a head start by being careful and responsible with their health!

 

Now What? What To Do After Receiving a Food Allergy Diagnosis April 25, 2014

 

The child of a friend of mine was just diagnosed with a peanut allergy.  Until I began to discuss what this meant with her, I had forgotten just how overwhelming the initial part of this process can be.

 

So, what DO you do upon learning you or your child has a food allergy?  Where to begin!?  Don’t panic, take a deep breath and follow these few steps to get started:

 

1.  Find a recommended allergist; preferably one who specializes in food allergies.  Often times, food allergy diagnoses emerge from a pediatric/internist visit or a trip to the emergency room.  And while these professionals are knowledgeable, it’s important to touch base with an allergist who is on top of ever-changing information and treatment.  Our fabulous pediatrician not only has a child with food allergies but is food allergic herself.  And despite that, even SHE defers to our allergist!

 

2.  Fill your prescriptions and learn how to use your auto-injector.   There’s no wrong answer when it comes to choosing which auto-injector to use (see: Auvi-Q vs. EpiPen: Which Is Best for You?) .  And you can learn how to use them here:  Familiarize or Refamiliarize Yourself With How to Use an EpiPen and Auvi-Q: Watch and Learn.  While you’re at the pharmacy, I would pick up a couple of boxes of Benadryl (for kids, at least two liquid packages) to keep in your house and at school.

  

3.  Review your pantry and devise a labeling system.  It’s important to make your home a safe space to eat.  Begin by reading ingredient lists and separate safe and unsafe foods.  Put that dining room table to good use!  And, don’t forget: manufacturing being what it is, many products are made on equipment that contains your allergen and should be put aside until you speak to your allergist.  An example of a labeling system can be found here.

  

4.  Create an Emergency Action Plan and an Emergency On-the-Go Pack.  An Emergency Action Plan eliminates questions and increases your confidence about what to do when certain symptoms arise.  You can have your pediatrician/internist or your allergist fill one out for you. Make a few copies to keep at home, school, in the car, on the fridge, in your On-the-Go Kit, etc.  The more, the better!

 

An Emergency On-the-Go Pack corrals all your emergency medication, including your auto-injector, plus your Emergency Action Plan and a copy of your insurance card into one pouch.  You’ll always know that you have all of your necessary supplies when you leave the house.  Plus, it will make it super-simple to pass your pack between bags or to another caregiver and know that everything your child needs to stay safe is at hand.

 

A few notes:  Jot down questions as they arise in this early part of the process.  Use your questions as discussion points and get clear answers from your allergist.  Please refer to Allergy Shmallergy’s SCHOOL category to get ideas of how to handle allergy issues at your child’s school, starting with Back to School Food Allergy Checklist.

 

Most of all, remain calm!  Managing with a food allergy certainly requires a different perspective on life.  But, it doesn’t need to be stress inducing.  Staying informed and answering each challenge with simple solutions will allow your family to thrive.

 

 

 

Sonny’s BBQ and the Problem with Menu Allergen Lists February 27, 2014

We recently ate at my father-in-law’s favorite restaurant chain:  Sonny’s BBQ.  It’s a southeastern BBQ chain that reminds my father-in-law of the time he spent at the University of Florida.  So whenever we’re in Florida, we “dine” there.

 

As usual, before we went, I reviewed their allergen menu and identified a few items my FA son could choose from.  And, as usual,  I verified all my information with the manager.

 

Now, let me say, Sonny’s manager couldn’t have been nicer or more responsive.  He researched the ingredients for the hamburger bun and the cornbread from his suppliers and was willing to bend over backwards to accommodate my son as best as he could.  And, as a result, we enjoyed a safe and yummy meal.

 

But I noticed something that was distressing in asking all our usual questions.  While the manager knew his ingredients and was willing to investigate further when he wasn’t sure, Sonny’s BBQ corporate may not understand how food allergies actually work.  For example, Sonny’s Corporate allergen menu shows that their fries are milk, egg, tree nut, peanut, shellfish, and SOY free.  But that’s only if you eat them UNFRIED because their manager confirmed they were fried in vegetable oil.

 

While soy is no longer a concern for my son, I can imagine this mistake would pose a danger.  If I had read their allergen menu and decided to just take it at face value, my son could have wound up with some serious problems.

 

Corporations need to take into broader considerations when publishing food allergen menus.  Their menus must reflect fry oil and cooking methods as well as supplier-driven “manufactured on equipment” issues.  More information of this kind allows diners to make better, clearer choices.  Whenever I can make more sure-footed decisions about meals for my son and other food allergic family members, I feel grateful and relaxed.  And, that’s something that will keep me coming back.

 

 

How Allergy-Friendly is Your College or University? August 12, 2013

As many college kids prepare to head back to school in the next couple of weeks, it’s also a good time to know how food allergy-friendly your campus is.

Udi’s, the makers of gluten-free breads, compiled a list of the Top 10 Gluten-Free Accomodating Universities. You can read about what each school is doing to offer their students the best and safest selection of on-campus food here, but in the meantime, these ten universities deserve some praise:

1. University of Notre Dame

2. Georgetown University

3. Iowa State University

4. University of Arizona

5. Emory University

6. University of Connecticut

7. Ithaca College

8. Carleton College

9. University of New Hampshire

10. Clark University

It appears that many other colleges and universities are also beginning to tune into the needs of their food allergic students. And, while there’s no single method that appears to be used as a “best practices” model, there are a number of different variations of making dining food allergy friendly that schools are adapting. Be sure to check your school’s Dining Services information page for their specific guidance and policies regarding food allergies.

Schools have begun food labeling, placing “free from” icons at each meal station. The University of New Hampshire has set aside gluten-free pans for students to use at food preparation stations. Some universities (such as Franklin and Marshall), but not many, are making their dining halls nut-free. Colleges are stocking their shelves with gluten-free, dairy-free and soy-free, and vegan groceries (as an example, see Cal Poly’s list here), a few offer pre-ordered allergy-free meals and others post dining hall ingredient lists online. In addition to the accommodations made by dining services, many universities offer access to staff dieticians who will work one-on-one with students to evaluate a student’s dietary needs, set up meeting with school chefs, and help navigate menu options.

Many schools are taking necessary and thoughtful steps towards protecting their food allergic populations and some have a ways to go. The best way to stay safe at school is to:

  • always keep your emergency meds with you and teach your friends how to use them and when;
  • learn about your school’s policy towards on-campus dining with food allergies;
  • put yourself in contact with the dining hall director, head chef and/or school’s dietician; and
  • ask lots of questions to ensure your food’s safety.

Here’s a great Washington Post article by Sloane Miller, who went through college with food allergies herself. In it, she offers a few more excellent suggestions to keep you on the right track at school: Managing Your Food Allergies in Dining Halls and Dorm Rooms.

There’s no reason you’ll need to miss a meal with friends in the dining hall if you’re informed and prepared!