Ask ten people whether they know someone with a food allergy. You’ll hear at least one “yes,” and probably more. Research published last May in the Journal of the American Medical Association (JAMA) concurs, indicating that as many as one in ten people may have a food allergy. The Food Allergy and Anaphylaxis Association (FAAN) estimates that more than 12 million Americans currently suffer from food allergies, and the number is increasing.

The “Top 8” most common food allergies in the United States today are wheat/gluten, eggs, dairy, peanuts, tree nuts, fish, shellfish, and soy. Parents inevitably encounter food allergies, as schools send home warnings about classmates allergic to peanuts/tree nuts, or gluten-allergic birthday guests refuse a slice of cake. Food allergies are also on the rise among adults, as demonstrated by the marked increase in availability of gluten-free, nut-free, dairy-free, and soy-free products. Some restaurants now offer gluten-free or allergy-free menu items.

However, for many families, food allergies go beyond the Top 8, and dealing with less common food allergies—which can be just as deadly—is an ongoing challenge. My family is one that struggles daily, because my daughter, Abby, is allergic not only to wheat but also to sunflower oil. Until we eliminated both wheat and sunflower oil from her diet, she was experiencing frequent flatulence, extreme bad breath, and significant hair loss. Unlike wheat-free foods, sunflower-free foods are harder to come by (many items are taboo because their ingredients list includes sunflower oil, or worse yet, says “may contain sunflower or safflower oil”). I’m not willing to take the chance.

Fortunately, dealing with less common food allergies is not new to my family. We’re already very careful about which foods go near my mother (who lives with us), as Grandma can go into anaphylactic shock if exposed to peppers, potatoes, cantaloupe, or ginger. In fact, Grandma is allergic to so many foods that it’s easier to list what she CAN eat rather than what she can’t; there are only 26 foods on her “safe” list. Like other families who must deal with less common food allergies, we have found ways to cope and even thrive. Furthermore, addressing this life challenge has strengthened our family’s understanding of and compassion for other people’s difficulties.

Among the effective strategies we use are:

•   Forewarning visitors about bringing unsafe foods into the house (you may have to list the foods). For my son Nick’s weekly youth group meetings at our house, his friends kindly bring safe alternatives to potato chips or salsa, so that Grandma won’t be affected.

•   When cooking a meal, double the batch and use two pots, following the recipe but substituting or leaving out unsafe ingredients from one of the pots. Both pots will be ready to serve at the same time, so the whole family can still sit down to eat together.

•   Keeping an extra freezer for stocking up on safe foods, especially portion-size containers of “ready to heat” meals from doubled recipes (see sidebar for recipe sources).

•   Taking a pre-made meal to restaurants; servers are usually happy to heat it in the microwave for you, or you can keep the food warm/cold in a thermos/mini cooler. Be aware that just being near food ordered by others can still cause allergic reactions, even if the food isn’t actually eaten by the food-allergic person.

•   When traveling, dedicate a portion of your suitcase to well-wrapped pre-made foods or ready-to-use ingredients, adding freezer packs to keep items cold until you arrive at your destination. Remember to bring something safe to eat on the way. Aim to stay near a supermarket that sells allergy-free foods e.g. Whole Foods Market.

•   Looking for alternative foods. My pantry contains such items as coconut flour, date sugar, cassava root, and carob molasses, which are healthy and tasty substitutes for numerous ingredients.

•   Varying your foods. Foods eaten too frequently can cause food sensitivity and ultimately induce allergic reactions. For example, periodically replace beef with lamb or venison; replace chicken with turkey or duck. Try more exotic meats such as ostrich or alligator.

•   Unless eaten too often, foods that come from a small food family may be less likely to cause allergic reactions. For example, macadamia nuts (the sole member of the Proteaceae food family) can replace other nuts in most recipes.

•   Many world cuisines use ingredients that can be safe substitutes or pleasing new foods. Iranian sour grape juice (verjuice) can replace citrus juice and Peruvian yacon syrup can replace honey. Explore your local Indian, Chinese, Middle Eastern, and Latin American grocery stores.

•   Sometimes the allergen is an additive or preservative, not the food itself. When possible, use organic foods. Find a local company to deliver organic meats and produce; we receive a quarterly bulk order and store it in our extra freezer.

•   Grow your own organic produce, even if just in a container garden on your deck, and experiment with substitutions (swap swiss chard and other greens in recipes, substitute spaghetti squash or shredded zucchini for pasta). My kids love to help plant and harvest our garden each summer, and they learn a lot from it too.

Having multiple food allergies that extend beyond the eight most common allergens is a fast-spreading global phenomenon. Dealing with food allergies can be overwhelming and frustrating. Thankfully, though the “Top 8” food allergens may currently get top billing, multiple food allergy sufferers and their families can be assured that with vigilance, creativity, and loving support, this serious life challenge is not insurmountable.


Local resources for allergy-free products, tips, and support:

Online resources (also check out their many links):

www.food-allergy.org – How to Survive with Multiple Food Allergies
www.foodallergy.org – Food Allergy and Anaphylaxis Network (FAAN)
www.allerjenn.com – Allergen-free recipes and virtual cookbook
www.cookingallergyfree.com – Allergy Diet Resources
www.foodallergykitchen.com – Recipes and allergy-free news
www.livingwithout.com – U.S. food allergy magazine and website
www.kidswithfoodallergies.org – Kids with Food Allergies (KFA)
www.allergicchild.com – Support for families and communities dealing with severe food allergies
www.allergyfreeshop.com – Allergy-free products from food to household cleaners to baby items
www.goldminenaturalfoods.com – Large variety of harder-to-find foods and ingredients
www.fossilfarms.com – Delivers organic alternative/"exotic" meats

Possible food substitutions (but make sure the substitutions aren't also allergens for you):

Wheat flour** – Other flours: oat, rice, amaranth, spelt, teff, sorghum, barley, chestnut, carob, chestnut, water chestnut, flax, rye, buckwheat, chickpea, lupin, millet, quinoa, kamut, mung bean, coconut, potato, mesquite, and chebe (commercial name, primarily manioc flour).
Wheat pasta – Pasta made from any of the above flours. Steamed spaghetti squash or shredded zucchini is somewhat crunchier than wheat spaghetti but can be topped with sauces in the same way.
Cow's milk – Animal milks: goat, sheep, or buffalo. Non-animal milks: soy, rice, nuts, hemp, or coconut. Try fruit juice or puree.
Cane sugar – Other sweeteners in powder and/or syrup form: honey, maple, rice, date, coconut, beet, agave, carob, corn, barley malt, sorghum, yacon, and stevia. Try fruit juice or puree.
Cacao/Chocolate – Carob (powder, chips, or molasses).
Eggs – 1 egg = 2 T. potato starch or arrowroot powder (if more moisture is needed, add up to 3 T. water) OR ½-1 c. mashed ripe banana. In most baked goods, 1 egg = 2 T. water + 1 T. oil + 2 tsp. baking powder OR 1 T. water + 1 T. vinegar + 1 tsp. baking powder. Try gel made from salba (ground chia seeds) or ground flaxseed mixed well with hot water (1 T. ground flaxseed to 3 T. water, let sit a few minutes). In muffins, try mashed banana, shredded zucchini, or applesauce to replace moisture provided by eggs.
Citrus (juice) – Unsweetened pomegranate juice, cranberry juice, sour grape juice (verjuice), vinegar, white wine, cream of tartar.
Potatoes – Mash cooked cauliflower or celeriac with butter and cream. It's almost indistinguishable from mashed potatoes. Prepare cassava the same way, but remove any tough fibers before mashing. Substitute cornstarch or arrowroot for potato starch (but not for potato flour).
Nuts – Substitute toasted rolled oats or toasted rice cereal, or macadamia nuts for other nuts. Instead of peanut butter, try "butter" or sandwich spread made from macadamias, almonds, cashews, sesame, hemp seeds, or apricot kernels.
Poultry – Chicken, turkey, duck, squab, and quail/pheasant are from different food families, so an allergy to one might not preclude eating the others. Other substitutes for chicken: rabbit, frog legs, alligator.
Meat – Recipes calling for ground meat can exchange turkey, chicken, lamb, pork, beef, or buffalo. Substitute cubed lamb or beef in stews. Try more unusual meats: antelope, ostrich, quail, or turtle.
Greens – Substitute spinach, swiss chard, kale, collard, mustard, or parsley; though some are from the same food family, an allergy to one might not preclude eating the others. Interchange cooked spinach or chard leaves in recipes.

** Most baked goods benefit from an extra 10–20 minutes in the oven if you're replacing wheat flour with another flour.

Bethany Niazian is the mother of two pre-teen children and divides her time among chauffeuring them, creating and adapting recipes, gardening, and trying to figure out which of her recipes to include in the allergen-free cookbook she’s currently developing.