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Jill Castle, MS, RD

Food Allergies Blog


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Finding Soy in Common Foods

Sunday April 20, 2014

edamame & quinoa salad

In my years of private practice, I saw many kids with food allergies. Soy allergy was one of them and often combined with milk allergy.

"I stay away from edamame, tofu and soy sauce," said one mom.

"Yes, these are obvious sources of soy," I agreed.

I always want to know how a family is managing factory-made, processed food because these sources can be filled with soy. Granola bars, deli meat and peanut butter can surprise even the most savvy, label reading, food allergic person. And don't forget the Asian sauces--they're loaded with soy.

No doubt, the presence of soy in our everyday food supply can be surprising. While you probably know how to look for soy ingredients on labels, that doesn't always work for restaurants and community gatherings. You need to know these surprising foods containing soy off the top of your head! No worries, I have summed them up, along with why soy is included in many foods.

Of course, there are other hidden sources of allergens in everyday products too--not just food.

What foods containing soy do you find the most troubling?


A Lupine Allergy?

Monday April 14, 2014

Easter basket

Well, it's true.

In my research and writing about immunotherapy for food allergy, I came across a new allergy with which I wasn't familiar: lupine allergy.

Rare in this country, lupine is a pretty purple flower whose seeds are ground and used in baked goods, especially in Europe. You can read more about the connection of lupine to peanut allergy and much more in my article. Maybe you will learn something new like I did!

Speaking of peanut allergy, I had some fun writing about the surprising foods that contain peanut. I highlighted 12 foods--see if you know them! If you are not careful about reading ingredient labels, you could get blind-sided, as peanut is used in many different food products as a thickener, flavor enhancer and more. I give you the background on WHY peanut is included in some of the most unlikely foods.

How is your week going? Are you getting ready for Passover or Easter? Here are some fun Easter recipes from the website:

Easter Baskets for Children with Food Allergies

Allergy-Friendly Easter Candy

Allergy-Safe Easter Menu

Allergy-Safe Alternatives for Your Seder Plate


Do You Know About Immunotherapy for Food Allergy?

Friday March 28, 2014


Research for treating food allergies may involve oral immunotherapy.

Immunotherapy is a big word, but an area in food allergy research that is evolving and comes up in the media every now and then. You may be curious or confused about what this trending research is all about. What is it?Is it something you can do? Where can you find more information?

Immunotherapy for food allergy is under research investigation for the treatment of food allergy. In general, the individual with food allergy is enrolled in a research study and tested with small amounts of a food allergen in order to build up a tolerance to that food allergen.

While there are many treatment options being studied, oral immunotherapy for food allergy is one of the long-standing studied approaches to find a way for people with food allergies to withstand accidentally eating their food allergen. The idea being this: if there is a level of allergen tolerance, an accidental ingestion won't cause adverse allergic reaction. And that is what researchers are trying to prove.

For example, oral immunotherapy for peanut allergy is of interest for those individuals with peanut allergy, as an accidental exposure to peanuts could be life-threatening. Because allergy to peanuts tends to be persistent, oral immunotherapy is one of the most studied types of immunotherapy.

Immunotherapy for egg and milk are also being researched. These are two allergens that may be outgrown in childhood, so research in this area has shown both success and some drawbacks. I summarize the latest findings for each of these areas of immunotherapy so you have a general idea of the research that is ongoing.

The most important points for you to understand:

This is research. It is not for general use with the public yet. Those who are doing immunotherapy are generally enrolled in a research study. If this is something you are interested in, check out this website for more information about getting involved in the research.

Significant allergic reactions may occur. From skin reactions to anaphylaxis, using oral immunotherapy should be done under the guidance of medical professionals who are experienced in this line of work. It should never be done on your own.

We still have a lot to learn. Beware of any guarantees, quick fixes or other seemingly too-good-to-be-true promises for a food allergy cure. The science isn't there to back up these claims.

Have you had experience with oral immunotherapy for food allergy?

The Million Dollar Question Every Person with Food Allergy Wants Answered

Tuesday March 25, 2014

Mushroom and Farro

What can I eat? No.

Where can I eat? No.

Will I outgrow this dang food allergy?


As a pediatric dietitian, almost every person I have ever encountered with food allergy has asked me, "When will I (or he, or she) grow out of this food allergy?"

My sister had a milk allergy when she was a toddler. I remember my mother using orange juice as a substitute for milk in her cereal. By the age of two, my little sister had outgrown her milk allergy and hasn't had any problems with milk since.

Some people like my sister will outgrow their food allergy, and some won't. I cover the latest information on the rate of outgrowing a food allergy, as well as why you should be checking in with your food allergist on a regular basis in this article. I think you will appreciate the information.

I also did some experimenting with farro, a whole grain with which I had never cooked. I am in love with mushrooms, but unfortunately my family is not, so whenever I can, I cook with mushrooms (or order them at restaurants)! I came up with thisBaby Bella Mushroom and Farro recipe that I have to admit, was so good. If you're a fan of mushrooms or risotto, this is a terrific whole grain stand-in.

Last, I finished the installment of what to expect with your child's eating in this installment entitled Great Expectations: Your Food Allergic Teen (13-18 years). If you want to know what's going on with teens and their eating, and how it affects food allergy management, this is the article for you. Take a look and know what to expect! It will help you and your teen get through this stage of development.

Do you ever wonder if you (or your child) will outgrow your food allergy?

How Do You Decide Where to Eat Out?

Tuesday March 18, 2014

Allergy-friendly dining doesn't have to be hard.

I love to go out to eat. But I do it infrequently. I am picky when it comes to restaurant food. Maybe because I am a decent cook, I am not in favor of spending money on food that is less than what I can do in the kitchen.

When I go out for dinner I want to be impressed. I want to eat food that is beyond my cooking abilities. I want to eat food that I don't carry in my refrigerator at home.

And I want my needs to be met. Sometimes I want all vegetables on the side. Sometimes I want no sauce. Or extra sauce. Maybe sauce on the side.

I really like it when a restaurant is able and willing to accommodate my needs.

If you have a food allergy, I bet you feel the same way. When it comes to my food allergic son, I do. I appreciate a restaurant that is clear and transparent about the ingredients that go into their dishes. I welcome a waiter who doubles back to check on preparation methods or ingredients, just to be sure of my son's safety. I love it when a manager stops by my table to see if everything is okay.

That may sound like high maintainance, but it's just the way things have to be done when you're dealing with a food allergy.

One resource that makes dining out easier is the list for allergy-friendly restaurants published by AllergyEats, a website and mobile app that reviews over 650,000 restaurants in America for their allergy-friendliness (how clear and transparent they are about allergen content in their meals). You can find out more about AllergyEats here, and their founder, Paul Antico.

Check out the most allergy-friendly restaurants of 2014, as compiled by AllergyEats.

How do you decide where to dine out?

Ditch the Nuts on Airplanes, Please

Monday March 10, 2014

Nuts for snacktime on the plane?

I recently took a long, cross-country flight to Oregon (from NYC) and was struck by the availability of peanuts and cookies passed out as complimentary snacks. I guess each airline serves different snacks, and I hadn't been on this particular airline in a while.

It made me remember flying with my son when he was younger. I have never allowed him to have peanuts on an airplane. It just seems too risky. I feel the same way about cookies, too.

For me, I can't think of a worse place for an allergic reaction: cramped seats, narrow aisles and aloft in the air.

Once on a flight to Europe, a woman sitting next to me passed out (in her seat). She was on the aisle seat, and her husband was next to her in the center seat. He was awake and noticed her slump over. It was such a challenge for the crew to reach her (they were passing beverages at the time), get her out of the seat, and lie her down on her back. Then they had to request a physician over the intercom. It turned out she was fine, but had a negative reaction to her usual medicine mixed with alcohol and flying.

The whole experience made me realize how incredibly challenging it is for an in-air medical emergency. This experience heightened my fear of an allergic reaction with my son, but it also solidified my commitment to steer clear of the snacks that are passed around when he's flying with me.

Avoiding the snacks on airplanes doesn't cut it for many food allergic folks. What about trace allergen from crumbs left on the seat or tray table? What about residual allergen smeared on the arm rests or magazines in the seat back holder?

To me, it's risky business to serve food containing or potentially containing nuts or tree nuts. They are the food allergens most likely to produce a life-threatening reaction.

I think airlines should stick with beverages and ditch the nuts. Or if they do serve a snack, why not serve something allergen-free?

I can think of many allergen-free alternatives.

Airlines should also make it a routine practice to thoroughly clean the carpets, seats, tray tables and arm rests between flights. An additional option of disinfecting wipes for individual passengers who would like to make sure their seating area is clean would be nice too.

What do you think about airlines serving peanuts and other snacks that may contain trace allergens? Here's what one concerned citizen is doing.

How do you feel about nuts on airplanes?

More reading:

Signs and symptoms

Tree nut allergy

Peanut allergy

Anaphylaxis treatment

Air travel with a food allergy

How to tell someone about your food allergy

Photo Credit: Flickr/Superhua




Let's Stop the 'Allergy Insanity' in the Classroom

Thursday February 27, 2014

Fruit kabobs can be fun birthday food!

I read a blog post this week that had me a little irked. Yeah, annoyed is a better way to say it.

The blog appeared on the Huffington Post and was titled "Why Do Your Kid's Allergies Mean My Kid Can't Have a Birthday?"

Aside from the inflammatory nature of the title (which, as a blogger myself I recognize this as a way to grab the reader's attention), the post carried on about what a pain it is to have an allergic child in the classroom and how the accommodations required for him are an inconvenience for everyone, especially the birthday child. The author proceeds to share that she thinks her child should be able to have whatever he wants on his birthday--even if that means allergen-filled cake that another child may be deathly allergic to.


The author ended the article with this:

Let's stop the allergy insanity, and let the rest of them eat cake -- the lovely, homemade, buttery, gluten-stuffed cake.

I'm sorry but the 'allergy insanity' phrase rubs me the wrong way. It implies that those of us who have or deal with food allergies elect to do so--as if we had a choice! I myself never wished my son to have a food allergy, but he does, and it's my obligation to keep him safe--everywhere he goes.

Would the author have me home school my son so that her child could have his cake and eat it to? Would she have me remove my son from the classroom, sit him away from the class alongside the chalkboard, or have me bake a special cupcake so he won't feel left out?

I think the issue is deeper than who is leaving who out. Or who is missing out on a special day.

It gets to the messages we are teaching our children.

Unfortunately, the message an impressionable child might hear are these:Don't be sensitive to the needs of others. You can have what you want, no matter what. Don't do the right thing, just do what's right for you.

I think children need to learn just the opposite:Be sensitive to others and their needs. You can't always get what you want, but if you work hard, you might get close. Do the right thing--you'll always be proud of yourself for that.

Having a food allergy or a child with a food allergy is stressful. Studies show that the stress of food allergies takes its toll--on everyone in the family, but especially the parent who is keeping their child safe and the food allergic individual himself. I am almost certain that attitudes and articles such as this one adds to the anxiety, frustration and isolation families with food allergies can feel.

I had to chuckle at the beginning of the article because the author started with this question:

"What is gluten, nut, and egg-free AND also store-bought that I can serve at a kindergarten class party?"

Fruit. Vegetables. Pencils. Stickers. A book. Removable tattoos.

I can think of a whole long list of celebratory alternatives that have nothing to do with food allergens or birthday cake.

So why don't we just take food off the list of parties at school? Better yet, how about a crown or a sash for the birthday boy? A 'Happy Birthday' announcement over the PA system and a special book?Somenon-food items can have potential allergens in them, so plan thoughtfully.

Toning down the party scene at school (and the food influx) will keep our food allergic kids safer. And it will cut down on anyone feeling left out.

Let's take a broader and more sensitive look at how we treat those with medical challenges. We can make life harder for them, or we can make it easier and safer.

I vote easier. How about you?

February Round-Up

Tuesday February 25, 2014

Lemon-Stuffed Chicken is delicious and allergen-free.

The stress of raising a child with food allergies or dealing with them yourself can be overwhelming. Researchers have been looking atquality of life in individuals with food allergies so that they can identify ways to combat their stress and enhance the experience of daily living. I summarize the latest findings in What Tugs on the Heartstrings of Food Allergic Families? If you are feeling stressed out about your food allergy, you are not alone. The good news is there are things you can do to help melt the tension that food allergies may bring to daily life.

Getting healthy, delicious, allergen-friendly food on the table is one area that bothers parents, with or without food allergies! My family loves this Lemon Stuffed Roasted Chicken, especially on a weekend night. The best part is the leftovers (if you have any!) which can be used for school lunch box sandwiches, atop a salad, or stuffed into a quesadilla or chicken soup. I love having a recipe that has multiple applications to our weekly menu.

I recently wrote about oral immunotherapy for peanut allergy and will be looking into the patch for peanut allergy treatment soon. Have you heard of this?

Last, my Great Expectations: Food Allergy in the Child (6-12 years) will help you anticipate some of the food choices, complaints and general behaviors around food and eating with your grade-schooler, which can be frustrating. My own son went through a phase where he felt left out when parties rolled around, and when friends brought enticing foods for lunch that he couldn't have. It helped me to know that his wanting to belong to his peer group was completely normal for his age--and helped me understand him and help him with his frustration of having a food allergy.

I will have a special article like this for the toddler and teen soon, because they experience different milestones that affect their eating. You can get a glimpse of what's to come in this article called How Child Developmental Stages Affect the Food Allergic Child's Eating.

I hope everyone is doing well, and warming up a bit. Hang tight, spring is almost here!

The Latest on Oral Immunotherapy for Peanut Allergy

Thursday February 20, 2014

People who have peanut allergy have some interesting news to sort through regarding oral immunotherapy (OIT) as a way to help treat peanut allergy.

If you read the news headlines, you might think that OIT was a cure-all for peanut allergy. Yup, step right up and take a bit of peanut powder everyday and you're on your way to being peanut allergy free.

We all wish it were that easy. But it's not.

Don't be fooled by those catchy news headlines. While OIT for peanut allergy is being studied and has some promising aspects, the jury isn't out yet.

I've done a quick update on peanut allergy OIT for you with the some of the latest research findings, which you can find here.

Remember, be open to new information, but check your research and your facts thoroughly.

Have you heard of oral immunotherapy for peanut allergy?

An Added Layer of Protection: Safety-Tat

Tuesday February 11, 2014

SafetyTat Food Allergy Tattoo

I remember the first time my son's teacher called me and said, "Your son had a bite of a granola bar! I am so sorry--I was distracted and he just popped it into his mouth..."

My son has a tree nut allergy, and I had supplied the teacher with labeled snacks for him in the event of an unexpected (or planned) party.

My heart sank, and my stomach heaved. My imagined fear came to life in one phone call. This was my biggest fear about sending my son to school.

Of course, I couldn't blame my son--he was only 5 years old and still on the learning curve about his food allergy. I knew it was normal for him to want to eat what his classmates were digging into.

I couldn't blame the teacher--she was doing her best in a public school with 20 kindergartners and lots of distractions.

I'm sure many of you have experienced this scenario with an allergic child. Whether it be a birthday party, class party, family gathering, or other.

Thankfully, in our case, the teacher realized quickly what had happened and called me. Thankfully, I was at home to receive the call. Thankfully, my son took his Benadryl right away, and had no adverse reaction.


At the time, there wasn't any other way to remind caregivers that my son had a food allergy, other than to pester, leave notes, emails and other reminders.

And pray they didn't forget about my son.

Now, parents have more options. Although the SafetyTat wasn't around when my son was younger, I would have gladly given it a try.

What is SafetyTat?

SafetyTat, the inventor of children's safety tattoos, has a line of allergy tattoos to help children with food allergies.

Each tattoo offer two lines of information for special medical attention or a second phone number.  "Medical Attention" and "In Case of Emergency" tattoos include phone numbers or other basic information and are also available in the allergy line of SafetyTat tattoos.

SafetyTat's target age is for kids aged 1-7, taking into consideration this age group's need for additional help to recall important information. However parents apply SafetyTat on older kids as well for an extra layer of protection especially for those with medical and allergy related issues and for kids taking part in sports activities.

Have you heard of SafetyTat?

Disclosure: I was given this product to review. I have no financial interest or stake in this company. This review is for informational purposes only.

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