Tag Archives: anaphylaxis

The Big 8 Food Allergens (Part 2)


About 15 million Americans have food allergies. Over 90% of all food reactions (nearly 30,000 anaphylactic reactions annually) are caused by 8 specific allergens. This group of highly allergic foods has been dubbed “The Big 8” (if you haven’t caught our post on the first 4, check it out). The Big 8 include: peanuts, tree nuts, dairy, eggs and:

  • Fish – People with fish allergies may be sensitive to all or only a couple types of fish. They are often advised to avoid all fish as a preventative measure. Fish allergies can occur at any age and can be life-threatening. Unfortunately, a fish allergy can be extra dangerous because unlike many foods that only cause a reaction upon contact, if fish is cooking and the allergic person breathes in the fumes, they can have a serious or life-threatening reaction. So not only do people with fish allergies have to avoid eating or touching fish, but sometimes must avoid even being around cooking fish or others who are eating it. Fish ingredients are often hidden in strange foods such as worcestershire sauce, caesar salad and dressing or Clamato drink.
  • Crustacean Shellfish – largely consist of shelled seafood such as shrimp, crab, lobster, prawns and crayfish. Mollusks can cause allergic reactions too but aren’t as common as crustaceans. Similarly to fish, crustacean allergies can be caused by inhalation of the cooking shellfish or cross contamination as well as direct contact or ingestion. They are often caused by a protein called tropomyosin that is found in many shellfish. These reactions could be mild, moderate or deadly and may require the person to carry an EpiPen. While food companies must disclose shellfish ingredients, they don’t have to list a warning about mollusk ingredients like oysters, so read the label carefully for keywords. Shellfish ingredients may be present in such foods as surimi, glucosamine and bouillabaisse, to name a few. It is a good idea to let establishments or planes know in advance about your allergy so they can refrain from serving dishes that contain seafood.
  • Wheat – A wheat allergy is different from celiac disease. Celiac is an autoimmune condition in which the small intestine overreacts to gluten proteins causing many unpleasant gastrointestinal and systemic symptoms. A wheat allergy is an IgE response to wheat causing a range of symptoms from hives, itchy eyes, headaches to anaphylactic symptoms. If you have a wheat allergy it is important to know your labels. There are often hidden wheat ingredients to look for include: “flour,” “wheat germ,” “wheat starch,” “bran,” “modified food starch,” “graham flour,” “farina,” “spelt” and “semolina.”
  • Soy – soy allergies afflict people of all ages and are usually caused by an intolerance to certain proteins in soy. It can be mild to life-threatening, often including such symptoms as gastrointestinal, respiratory, topical or anaphylaxis. Soy is found in a wide range of food products and can be difficult to avoid.

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The “Big 8” Food Allergens (Part 1)

Nearly 15 million Americans have food allergies. People can be allergic to nearly any type of food substance however, 8 foods in particular comprise 90% of all food allergies, earning them the moniker “The Big 8”. These allergens are responsible for up to 30,000 anaphylactic reactions annually. Due to the prevalence of the Big 8, companies are required to list these ingredients on labels. Unfortunately not all other allergy foods contain such warnings. The Big 8 include:

  1. Peanuts – peanuts are one of the most notorious and prevalent food allergies. They are also the most common cause of food induced anaphylaxis because those who are highly reactive to peanuts can have life-threatening reactions not only through ingestion, but also through cross contamination or inhalation. Many parents give their babies their first taste of peanut butter early under supervised circumstances, as some studies suggest early exposure may lower risks of developing the allergy, or in the least will catch it right away before a potentially deadly chance encounter can occur.
  2. Tree nuts – Unlike most of the others listed here, a tree nut allergy is one of the Big 8 that is rarely outgrown. Some of the most well known tree nuts are almonds, cashews, brazil nuts, hazelnuts, chestnuts and pine nuts. Tree nuts allergies range from mild to severe, but are often serious enough for the sufferer to carry an EpiPen. Many people hear “nut allergies” and assume those allergic to tree nuts definitely share an allergy peanuts, but that isn’t necessarily true. Peanuts are actually legumes not nuts, so just because you are allergic to tree nuts doesn’t mean you are automatically allergic to peanuts and vice versa.
  1. Milk – Cow’s milk is the most common food allergy in young children. Approximately 5% of children under 3 years of age are allergic to milk. Milk allergies should not be confused with lactose intolerance. People with milk allergies have an immune overreaction to milk, causing hives or rashes to life-threatening anaphylactic reactions, whereas people with lactose intolerance are missing the enzyme that breaks down lactose, so their system cannot process dairy regularly, resulting in gastrointestinal symptoms. Children allergic to milk most often carry EpiPens in case their symptoms advance. Many children grow out of dairy allergies.
  2. Eggs – Are caused by an intolerance to a specific protein found in hen’s eggs. It is most common in children under 5 and is commonly outgrown. It usually causes digestive symptoms such as swelling, bloating, nausea and vomiting but can also cause hives, nasal symptoms or in rare cases more severe symptoms. If you have an egg allergy, look out for: “egg white”, “dried egg” or “albumin” listed in ingredients.

Thanks for reading, please keep an eye out for #’s 5-8 of The Big 8 in our next post! Thanks for visiting DocChat!