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Tips for Avoiding Your

● All FDA-regulated manufactured products that contain a “major food allergen” (, , , , nuts, , crustacean , and soy) as an are required by U.S. law to list that allergen on the product label. For tree nuts, fish and crustacean shellfish, the specific type of or fish must be ed.list ● Read all product labels carefully before purchasing and consuming any item. ● Be aware of unexpected sources of , such as the listed below. ● *Note: This list does not imply that the allergen is always present in these ; it is intended to serve as a reminder to always read the label and ask questions about ingredients. For a Milk-Free For an Egg-Free Diet Avoid foods that contain milk or any of these ingredients: Avoid foods that contain or any of these ingredients: , butter , butter oil, butter acid, lactulose (also spelled albumen) butter (s) milk (in all forms, including condensed, egg (dried, powdered, solids, white, ) (meringue powder) derivative, dry, evaporated, ’s milk surimi and milk from other animals, lowfat, globulin vitellin casein hydrolysate malted, milkfat, nonfat, powder, , livetin words starting with caseinates (in all forms) skimmed, solids, whole) “ovo” or “ova” (such as ) milk protein hydrolysate cottage cheese pudding Egg is sometimes found in the following: Recaldent® rennet casein baked goods custard sour cream, sour cream solids breaded items sour milk solids drink foam (alcoholic, specialty coffee) marshmallows ghee tagatose meatloaf or meatballs half-and-half (in all forms) fried , lactalbumin phosphate hydrolysate pasta lactoferrin Keep the following in mind: Avoid foods that contain milk or any of these ingredients: ● Individuals with egg should also avoid eggs from duck, turkey, goose, quail, etc., as these are known to be cross-reactive with chicken egg. artificial butter luncheon , hot dogs, sausages baked goods ● While the whites of an egg contain the allergenic , patients with an caramel candies nisin must avoid all eggs completely. nondairy products starter culture and other nougat bacterial cultures Keep the following in mind: For a Soy-Free Diet ● Individuals who are allergic to cow’s milk are often advised to also avoid Avoid foods that contain soy or any of these ingredients: milk from other domestic animals. For example, goat’s milk protein is (concentrate, hydrolyzed, similar to cow’s milk protein and may, therefore, cause a reaction in isolate) individuals who have a . natto shoyu soy (soy albumin, soy cheese, soy fiber, soy flour, soy grits, soy ice cream, soy tamari milk, soy nuts, soy sprouts, ) For a Wheat-Free Diet soya textured vegetable protein (TVP) (, granules) Avoid foods that contain wheat or any of these ingredients: Soy is sometimes found in the following: bread crumbs protein bulgur Kamut® Asian cuisine vegetable gum cereal extract matzoh, matzoh meal (also spelled as vegetable broth vegetable starch club wheat matzo, matzah, or matza) couscous pasta Keep the following in mind: cracker meal seitan durum semolina ● The FDA exempts highly refined from being labeled as an einkorn spelt allergen. Studies show most allergic individuals can safely eat soy oil that emmer sprouted wheat has been highly refined (not cold pressed, expeller pressed, or extruded farina triticale farro vital wheat soybean oil). flour (all purpose, bread, cake, durum, wheat (bran, durum, germ, gluten, grass, ● Most individuals allergic to soy can safely eat soy lecithin. enriched, graham, high gluten, high malt, sprouts, starch) protein, instant, pastry, self-rising, soft wheat bran hydrolysate ● Follow your doctor’s advice regarding these ingredients. wheat, steel ground, stone ground, wheat germ oil whole wheat) wheat grass freekah wheat protein isolate hydrolyzed wheat whole wheat berries Wheat is sometimes found in the following: syrup starch (gelatinized starch, modified oats starch, modified food starch, vegetable soy sauce starch) surimi

1 foodallergy.org ©2020 For a Shellfish-Free Diet For a Tree-Nut-Free Diet Avoid foods that contain shellfish or any of these Avoid foods that contain nuts or any of these ingredients: ingredients: natural nut extract (e.g., almond, ) artificial nuts nut (e.g., butter) barnacle (langouste, langoustine, Moreton beechnut nut meal crab bay bugs, scampi, tomalley) nut meat crawfish (crawdad, crayfish, ecrevisse) prawns butternut nut paste (e.g., almond paste) krill (crevette, scampi) cashew nut pieces Mollusks are not considered major allergens under food labeling laws chinquapin nut pesto and may not be fully disclosed on a product label. filbert/ pili nut (a chocolatenut mixture) (also referred to as Indian, Your doctor may advise you to avoid mollusks or these ginkgo nut pignoli, pigñolia, pignon, piñon, and hickory nut pinyon nut) ingredients: litchi/lichee/lychee nut abalone oysters nut clams (cherrystone, geoduck, littleneck, periwinkle marzipan/almond paste shea nut pismo, quahog) scallops Nangai nut walnut cockle sea cucumber cuttlefish sea urchin Tree nuts are sometimes found in the following: limpet (lapas, opihi) snails (escargot) mussels (calamari) black walnut hull extract (flavoring) nut oils (e.g., walnut oil, almond oil) octopus whelk (Turban shell) natural nut extract walnut hull extract (flavoring) nut distillates/alcoholic extracts Shellfish are sometimes found in the following: Keep the following in mind: bouillabaisse flavoring (e.g., crab or clam ● Mortadella may contain . cuttlefish ink extract) glucosamine surimi ● There is no evidence that oil and shea nut oil/butter are allergenic. fish stock ● Many experts advise patients allergic to tree nuts to avoid peanuts as well. Keep the following in mind: ● Talk to your doctor if you find other nuts not listed here. ● Any food served in a seafood restaurant may contain shellfish protein due ● Coconut, the of a drupaceous , has typically not been restricted in to cross-contact. the diets of people with . However, in October of 2006, the ● For some individuals, a reaction may occur from inhaling vapors or FDA began identifying coconut as a tree nut. Medical literature documents from handling fish or shellfish. a small number of allergic reactions to coconut; most occurred in people who were not allergic to other tree nuts. Ask your doctor if you need to For a -Free Diet avoid coconut. Avoid foods that contain peanuts or any of these ingredients: For a Fish-Free Diet artificial nuts monkey nuts Fish is sometimes found in the following: nuts nut pieces barbecue sauce fish stock cold pressed, expeller pressed, or nut meat bouillabaisse fishmeal extruded peanut oil peanut butter Caesar salad nuoc mam (Vietnamese name for fish goobers peanut flour caviar sauce; beware of other ethnic names) ground nuts peanut protein hydrolysate deep fried items pizza (anchovy topping) fish flavoring fish flour salad dressing Peanut is sometimes found in the following: fish fume seafood flavoring fish (kosher gelatin, marine shark cartilage African, Asian (especially Chinese, Indian, egg rolls gelatin) shark fin Indonesian, Thai, and Vietnamese), and enchilada sauce surimi Mexican dishes marzipan fish sauce imitation fish or shellfish sushi, sashimi baked goods (e.g., pastries, cookies) mole sauce isinglass lutefisk maw, maws (fish maw) candy (including chocolate candy) nougat chili Keep the following in mind: Keep the following in mind: ● If you have , avoid seafood restaurants. Even if you order a non- ● Mandelonas are peanuts soaked in almond flavoring. fish item off of the menu, cross-contact of fish protein is possible. ● The FDA exempts highly refined peanut oil from being labeled as an ● Asian cookery often uses fish sauce as a flavoring base. Exercise caution allergen. Studies show that most allergic individuals can safely eat peanut when eating this type of cuisine. oil that has been highly refined (not cold pressed, expeller pressed, or ● Fish protein can become airborne in the steam released during cooking and extruded peanut oil). Follow your doctor’s advice. may cause an allergic reaction. Stay away from cooking areas when fish is ● A study showed that unlike other , there is a strong possibility of being prepared. cross-reaction between peanuts and lupine (or lupin). Flour derived from lupine is becoming a common substitute for gluten-containing flours. The law requires that a food product’s ingredients must be listed on the label, such as “lupin” or “lupine”. ● Arachis oil is peanut oil. ● Many experts advise patients allergic to peanuts to avoid tree nuts as well. ● Sunflower are often produced on equipment shared with peanuts. ● Some alternative nut butters, such as soy nut butter or sunflower seed Updated November 2020 butter, are produced on equipment shared with other tree nuts and, in some cases, peanuts. Contact the manufacturer before eating these products. For more information, visit: foodallergy.org/foodlabels

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