What to eat with wheat and dairy allergy
A number of companies produce food intolerance tests, but these tests are not based on scientific evidence and are not recommended by the British Dietary Association (BDA).
The best way of diagnosing a food intolerance is to monitor your symptoms and the foods you eat. See what happens when you cut out the suspected food for a while, and then reintroduce it into your diet.
Try keeping a food diary, noting:
- what foods you eat
- any symptoms you own after eating these foods
- when these symptoms happen
Trial elimination diet
Once you own an thought of which foods may be causing your symptoms, you can attempt excluding them from your diet 1 at a time and observing the effect this has.
Try cutting out the suspected food from your diet for 2 to 6 weeks and see if your symptoms improve.
Reintroduce the food to see if symptoms return.
You may discover you can tolerate a certain level and you only get symptoms if you own more than this amount.
Consider seeing a dietitian to make certain you’re receiving every your recommended daily nutrients while you do this trial. Discover a registered dietitian.
Never restrict your child’s diet unless this has been advised by a dietitian or your doctor.
What causes a food intolerance?
It is often unclear why a person is sensitive to certain foods.
If your symptoms happen after eating dairy products, it’s possible you may have lactose intolerance. This means your body cannot digest lactose, a natural sugar found in milk, yoghurt and soft cheeses.
A GP can generally diagnose lactose intolerance by looking at your symptoms and medical history.
Some people own trouble digesting wheat and experience bloating, wind, diarrhoea, being ill and stomach pain after eating bread. Read more about wheat intolerance (also known as wheat sensitivity).
Otherwise, the culprit may be a food additive, chemical or contaminant, such as:
- monosodium glutamate (MSG)
- histamine (found in Quorn, mushrooms, pickled and cured foods, and alcoholic drinks)
- artificial sweeteners
- toxins, viruses, bacteria or parasites that own contaminated food
- artificial food colours, preservatives or flavour enhancers
Many people cut gluten from their diet thinking that they are intolerant to it, because they experience symptoms after eating wheat.
But it’s hard to know whether these symptoms are because of an intolerance to gluten, an intolerance to something else in wheat, or nothing to do with wheat at every.
It may assist to read more about cutting out bread from your diet.
Very few people need to cut out gluten from their diet, although it’s significant to do so if you have coeliac disease (which is not an intolerance, nor an allergy, but an autoimmune condition).
Could my symptoms be something else?
If you regularly own diarrhoea, bloating, tummy pain or skin rashes but you’re not certain of the cause, see a GP.
A GP may be capable to diagnose the cause from your symptoms and medical history.
If necessary, they’ll order tests, such as blood tests.
You can also do some research yourself. It may help to discover out about other conditions that cause similar symptoms. For example, discover out about:
The bowel is a sensitive organ and it’s common to own bowel symptoms when you own been ill or feel run below or stressed.
When do I need to see a specialist?
A GP may refer you to a specialist if they’re not sure what’s causing your symptoms and further tests are needed.
You may also be referred if your kid has digestive symptoms (such as tummy pain and diarrhoea) and:
- is not growing well
- has reacted suddenly or severely to a food
- has not responded to any elimination diets that your healthcare professional recommended
- has a suspected food allergy
Sheet final reviewed: 12 August 2019
Next review due: 12 August 2022
Bird JA, Jones S, Burks W.
Food allergy. In: Wealthy RR, Fleisher TA, Shearer WT, et al, eds. Clinical Immunology: Principles and Practice.
5th ed. Philadelphia, PA: Elsevier; 2019:chap 45.
Du Toit G, Sayre PH, Roberts G, et al; Immune Tolerance Network LEAP-On Study Team. Effect of avoidance on peanut allergy after early peanut consumption. N Engl J Med. 2016;374(15):1435-1443.
PMID: 26942922 www.ncbi.nlm.nih.gov/pubmed/26942922.
NIAID-sponsored expert panel, Boyce JA, Assa’ad A, et al. Guidelines for the diagnosis and management of food allergy in the United States: report of the NIAID-sponsored expert panel. J Allergy Clin Immunol. 2010;126(6 Suppl):S1-S58. PMID: 21134576 www.ncbi.nlm.nih.gov/pubmed/21134576.
Sicherer SH, Lack G, Jones SM. Food allergy management. In: Adkinson NF Jr, Bochner BS, Burks AW, et al, eds.
Middleton’s Allergy: Principles and Practice. 8th ed. Philadelphia, PA: Elsevier Saunders; 2014:chap 84.
Togias A, Cooper SF, Acebal ML, et al. Addendum guidelines for the prevention of peanut allergy in the United States: report of the National Institute of Allergy and Infectious Diseases-sponsored expert panel. J Allergy Clin Immunol. 2017;139(1):29-44. PMID: 28065278 www.ncbi.nlm.nih.gov/pubmed/28065278.
Managing a wheat allergy — your own or someone else’s — includes strict avoidance of wheat ingredients in both food and nonfood products.
Wheat is one of eight allergens with specific labeling requirements under the Food Allergen Labeling and Consumer Protection Act (FALCPA) of 2004.
Under that law, manufacturers of packaged food products sold in the U.S.
and containing wheat as an ingredient must include the presence of wheat, in clear language, on the ingredient label.
The grain is found in a myriad of foods — cereals, pastas, crackers and even some boiling dogs, sauces and ice cream. It is also found in nonfood items such as Play-Doh, as well as in cosmetic and bath products. Note that the FALCPA labeling rules do not apply to nonfood items; if you own questions about ingredients in those products, check the manufacturer’s website or contact the company.
Foods that don’t contain wheat as an ingredient can be contaminated by wheat in the manufacturing process or during food preparation.
As a result, people with a wheat allergy should also avoid products that bear precautionary statements on the label, such as “made on shared equipment with wheat,” “packaged in a plant that also processes wheat” or similar language. The use of those advisory labels is voluntary, and not every manufacturers do so.
A challenging aspect of managing a wheat allergy is baking. While there’s no simple substitution for wheat as an ingredient, baked goods such as breads, muffins and cakes may be made using a combination of non-wheat flours, such as those made from rice, corn, sorghum, soy, tapioca or potato starch.
Your allergist can provide you with guidance on which grains are safe for you.
Options for wheat-free grocery shopping include foods made from other grains such as corn, rice, quinoa, oats, rye and barley.
The recent growth in gluten-free products is making it easier to manage a wheat allergy. Gluten is a protein found in wheat, barley and rye.
A gluten-free product may be safe for those who are allergic to wheat because the product should not contain wheat ingredients.
However, because a product marketed as “gluten-free” must also be free of rye and barley in addition to wheat, those who must avoid only wheat may be limiting themselves. Anyone managing a food allergy shouldn’t rely on a “free from” label as a substitute for thoroughly reading the finish ingredient label.
People with any helpful of food allergy must make some changes in the foods they eat. Allergists are specially trained to direct you to helpful resources, such as special cookbooks, patient support groups and registered dietitians, who can assist you plan your meals.
Managing a severe food reaction with epinephrine
A wheat allergy reaction can cause symptoms that range from mild to life-threatening; the severity of each reaction is unpredictable.
People who own previously experienced only mild symptoms may suddenly experience a life-threatening reaction known as anaphylaxis. In the U.S., food allergy is the leading cause of anaphylaxis exterior the hospital setting.
Epinephrine (adrenaline) is the first-line treatment for anaphylaxis, which can happen within seconds or minutes, can worsen quickly and can be deadly. In this type of allergic reaction, exposure to the allergen causes the whole-body release of a flood of chemicals that can lead to lowered blood pressure and narrowed airways, among other serious symptoms.
Once you’re diagnosed with a food allergy, your allergist will likely prescribe an epinephrine auto-injector and teach you how to use it.
Check the expiration date of your auto-injector, note the expiration date on your calendar and enquire your pharmacy about reminder services for prescription renewals.
Be certain to own two doses available, as the severe reaction may recur. If you own had a history of severe reactions, take epinephrine as soon as you suspect you own eaten an allergy-causing food or if you feel a reaction starting. Epinephrine should be used immediately if you experience severe symptoms such as shortness of breath, repetitive coughing, feeble pulse, generalized hives, tightness in the throat, trouble breathing or swallowing, or a combination of symptoms from diverse body areas such as hives, rashes or swelling coupled with vomiting, diarrhea or abdominal pain.
Repeated doses of epinephrine may be necessary.
If you are uncertain whether a reaction warrants epinephrine, use it correct away, because the benefits of epinephrine far outweigh the risk that a dose may not own been necessary.
Common side effects of epinephrine may include anxiety, restlessness, dizziness and shakiness. Rarely, the medication can lead to abnormal heart rate or rhythm, heart attack, a sharp increase in blood pressure, and fluid buildup in the lungs.
Patients with certain pre-existing conditions, such as diabetes or heart disease, may be at higher risk for adverse effects and should speak to their allergist about using epinephrine.
Your allergist will provide you with a written emergency treatment plan that outlines which medications should be istered and when (note that between 10 and 20 percent of life-threatening severe allergic reactions own no skin symptoms). Be certain that you understand how to properly and promptly use an epinephrine auto-injector.
Once epinephrine has been istered, immediately call 911 and inform the dispatcher that epinephrine was given and that more may be needed from the emergency responders.
Other medications, such as antihistamine and corticosteroids, may be prescribed to treat symptoms of a food allergy, but it is significant to note that there is no substitute for epinephrine — this is the only medication that can reverse the life-threatening symptoms of anaphylaxis.
Symptoms caused by a food allergy can range from mild to life-threatening; the severity of each reaction is unpredictable.
People who own previously experienced only mild symptoms may suddenly experience a life-threatening reaction called anaphylaxis, which can, among other things, impair breathing and cause a sudden drop in blood pressure.
This is why allergists do not love to classify someone as “mildly” or “severely” food allergic — there is just no way to tell what may happen with the next reaction. In the U.S., food allergy is the leading cause of anaphylaxis exterior the hospital setting.
Epinephrine (adrenaline) is the first-line treatment for anaphylaxis, which results when exposure to an allergen triggers a flood of chemicals that can send your body into shock. Anaphylaxis can happen within seconds or minutes of exposure to the allergen, can worsen quickly and can be fatal.
Once you’ve been diagnosed with a food allergy, your allergist should prescribe an epinephrine auto-injector and teach you how to use it.
You should also be given a written treatment plan describing what medications you’ve been prescribed and when they should be used. Check the expiration date of your auto-injector, note the expiration date on your calendar and enquire your pharmacy about reminder services for prescription renewals.
Anyone with a food allergy should always own his or her auto-injector shut at hand. Be certain to own two doses available, as the severe reaction can recur in about 20 percent of individuals. There are no data to assist predict who may need a second dose of epinephrine, so this recommendation applies to every patients with a food allergy.
Use epinephrine immediately if you experience severe symptoms such as shortness of breath, repetitive coughing, feeble pulse, hives, tightness in your throat, trouble breathing or swallowing, or a combination of symptoms from diverse body areas, such as hives, rashes or swelling on the skin coupled with vomiting, diarrhea or abdominal pain.
Repeated doses may be necessary. You should call for an ambulance (or own someone nearby do so) and inform the dispatcher that epinephrine was istered and more may be needed. You should be taken to the emergency room; policies for monitoring patients who own been given epinephrine vary by hospital.
If you are uncertain whether a reaction warrants epinephrine, use it correct away; the benefits of epinephrine far outweigh the risk that a dose may not own been necessary.
Common side effects of epinephrine may include anxiety, restlessness, dizziness and shakiness. In extremely rare instances, the medication can lead to abnormal heart rate or rhythm, heart attack, a sharp increase in blood pressure and fluid buildup in the lungs.
If you own certain pre-existing conditions, such as heart disease or diabetes, you may be at a higher risk for adverse effects from epinephrine. Still, epinephrine is considered extremely safe and is the most effective medicine to treat severe allergic reactions.
Other medications may be prescribed to treat symptoms of a food allergy, but it is significant to note that there is no substitute for epinephrine: It is the only medication that can reverse the life-threatening symptoms of anaphylaxis.
Be additional careful when eating in restaurants. Waiters (and sometimes the kitchen staff) may not always know the ingredients of every dish on the menu.
Depending on your sensitivity, even just walking into a kitchen or a restaurant can cause an allergic reaction.
Consider using a “chef card” — available through numerous websites — that identifies your allergy and what you cannot eat. Always tell your servers about your allergies and enquire to speak to the chef, if possible. Stress the need for preparation surfaces, pans, pots and utensils that haven’t been contaminated by your allergen, and clarify with the restaurant staff what dishes on the menu are safe for you.
Managing food allergies in children
No parent wants to see their kid suffer.
Since fatal and near-fatal food allergy reactions can happen at school or other places exterior the home, parents of a kid with food allergies need to make certain that their child’s school has a written emergency action plan. The plan should provide instructions on preventing, recognizing and managing food allergies and should be available in the school and during activities such as sporting events and field trips. If your kid has been prescribed an auto-injector, be certain that you and those responsible for supervising your kid understand how to use it.
In November 2013, President Barack Obama signed into law the School Access to Emergency Epinephrine Act (PL 113-48), which encourages states to adopt laws requiring schools to own epinephrine auto-injectors on hand.
As of tardy 2014, dozens of states had passed laws that either require schools to own a supply of epinephrine auto-injectors for general use or permit school districts the option of providing a supply of epinephrine. Numerous of these laws are new, and it is uncertain how well they are being implemented. As a result, ACAAI still recommends that providers caring for food-allergic children in states with such laws maintain at least two units of epinephrine per allergic kid attending the school.
Managing food allergies in children
Because fatal and near-fatal wheat allergy reactions, love other food allergy symptoms, can develop when a kid is not with his or her family, parents need to make certain that their child’s school, day care or other program has a written emergency action plan with instructions on preventing, recognizing and managing these episodes in class and during activities such as sporting events and field trips.
A nonprofit group, Food Allergy Research & Education, has a list of resources for schools, parents and students in managing food allergies.
If your kid has been prescribed an auto-injector, be certain that you and those responsible for supervising your kid understand how to use it.
The primary way to manage a food allergy is to avoid consuming the food that causes you problems.
Carefully check ingredient labels of food products, and study whether what you need to avoid is known by other names.
The Food Allergy Labeling and Consumer Protection Act of 2004 (FALCPA) mandates that manufacturers of packaged foods produced in the United States identify, in simple, clear language, the presence of any of the eight most common food allergens — milk, egg, wheat, soy, peanut, tree nut, fish and crustacean shellfish — in their products. The presence of the allergen must be stated even if it is only an incidental ingredient, as in an additive or flavoring.
Some goods also may be labeled with precautionary statements, such as “may contain,” “might contain,” “made on shared equipment,” “made in a shared facility” or some other indication of potential allergen contamination.
There are no laws or regulations requiring those advisory warnings and no standards that define what they mean. If you own questions about what foods are safe for you to eat, talk with your allergist.
Be advised that the FALCPA labeling requirements do not apply to items regulated by the U.S. Department of Agriculture (meat, poultry and certain egg products) and those regulated by the Alcohol and Tobacco Tax and Trade Bureau (distilled spirits, wine and beer). The law also does not apply to cosmetics, shampoos and other health and beauty aids, some of which may contain tree nut extracts or wheat proteins.
Avoiding an allergen is easier said than done.
While labeling has helped make this process a bit easier, some foods are so common that avoiding them is daunting. A dietitian or a nutritionist may be capable to assist. These food experts will offer tips for avoiding the foods that trigger your allergies and will ensure that even if you exclude certain foods from your diet, you still will be getting every the nutrients you need. Special cookbooks and support groups, either in person or online, for patients with specific allergies can also provide useful information.
Many people with food allergies wonder whether their condition is permanent.
There is no definitive answer. Allergies to milk, eggs, wheat and soy may vanish over time, while allergies to peanuts, tree nuts, fish and shellfish tend to be lifelong.
Can food allergies be prevented?
In 2013, the American Academy of Pediatrics published a study which supported research suggesting that feeding solid foods to extremely young babies could promote allergies. It recommends against introducing solid foods tobabies younger than 17 weeks. It also suggests exclusively breast-feeding “for as endless as possible,” but stops short of endorsing earlier research supporting six months of exclusive breast-feeding.
Research on the benefits of feeding hypoallergenic formulas to high-risk children – those born into families with a strong history of allergic diseases – is mixed.
In the case of peanut allergy, the National Institute for Allergy and Infectious Disease (NIAID) issued new updated guidelines in 2017 in order to define high, moderate and low-risk infants for developing peanut allergy. The guidelines also address how to proceed with introduction based on risk.
The updated guidelines are a breakthrough for the prevention of peanut allergy. Peanut allergy has become much more prevalent in recent years, and there is now a roadmap to prevent numerous new cases.
According to the new guidelines, an baby at high risk of developing peanut allergy is one with severe eczema and/or egg allergy.
The guidelines recommend introduction of peanut-containing foods as early as 4-6 months for high-risk infants who own already started solid foods, after determining that it is safe to do so. Parents should know that most infants are either moderate- or low-risk for developing peanut allergies, and most can own peanut-containing foods introduced at home. Whole peanuts should never be given to infants because they are a choking hazard.
If your kid has no factors to be at high risk, the best way to introduce peanuts is to make certain first of every your kid is healthy – they don’t own a freezing, fever or anything else. Make certain it’s not the first food you’ve introduced to them.
Ruchi Gupta, MD, ACAAI member
Clinical studies are ongoing in food allergy to assist develop tolerances to specific foods.
Askyour board-certified allergistif you or your kid may be a candidate for one of these studies.
How closely do I need to watch what I eat?
Most babies own no problems with anything that mom eats. It’s generally recommended that you eat whatever you love, whenever you love, in the amounts that you love and continue to do this unless you notice an obvious reaction in your baby.
There is no list of “foods that every nursing mom should avoid” because most nursing mothers can eat anything they desire, and because the babies who are sensitive to certain foods are each unique – what bothers one may not annoy another.
Is it a food intolerance or food allergy?
A food intolerance is not the same as a food allergy.
Here’s how to tell the difference.
A food allergy:
- is a reaction by your immune system (your body’s defence against infection). Your immune system mistakenly treats proteins found in food as a threat
- is often to specific foods. Common food allergies in adults include fish and shellfish and nut allergies. Common food allergies in children include milk, eggs, fish, peanuts and other nuts
- can trigger allergy symptoms, such as a rash, wheezing and itching, after eating just a little quantity of the food (these symptoms generally happen quickly)
- can be life-threatening
A food intolerance:
- does not involve your immune system – there is no allergic reaction, and it is never life-threatening
- only results in symptoms if you eat a substantial quantity of the food (unlike an allergy, where just traces can trigger a reaction)
- causes symptoms that happen gradually, often a few hours after eating the problem food
- can be caused by numerous diverse foods
Find out more about diagnosis of food allergies.
What are the symptoms of food intolerance?
In general, people who own a food intolerance tend to experience:
These symptoms generally happen a few hours after eating the food.
It can be hard to know whether you own a food intolerance as these are general symptoms that are typical of numerous other conditions.
How do I manage it?
If you’re confident you are intolerant to a specific food, the only way to manage this is to stop eating the food for a while and then reintroduce little quantities while monitoring how much you can eat without causing symptoms.
Check food labels to see which sorts of foods to avoid.
If you ponder your kid may own a food intolerance, check with a GP or dietitian before eliminating foods from their diet, as a restricted diet could affect their growth and development. Cows’ milk, for example, is an significant source of calcium, vitamin D and protein.