HOW TO READ A FOOD LABEL Avoid food and non-food items that have advisory statements on labeling such as “may contain...” or “made/manufactured on equipment” or “in a facility that processes…" How to Read a Label for a Milk-Free Diet How to Read a Label for an Egg-Free Diet All FDA-regulated manufactured food products that contain milk as an ingredient All FDA-regulated manufactured food products that are required by U.S. law to list the word “milk” on the product label. contain egg as an ingredient are required by U.S. law Avoid foods that contain milk or any of these ingredients: to list the word “egg” on the product label. • butter, butter fat, butter oil, butter • lactulose Avoid foods that contain eggs or any of acid, butter ester(s) • milk (in all forms, including these ingredients: • buttermilk condensed, derivative, dry, • albumin (also spelled • mayonnaise • casein evaporated, goat’s milk and milk from albumen) • meringue (meringue • casein hydrolysate other animals, low fat, malted, milkfat, • egg (dried, powdered, powder) • caseinates (in all forms) nonfat, powder, protein, skimmed, solids, white, yolk) • ovalbumin • cheese solids, whole) • eggnog • surimi • cottage cheese • milk protein hydrolysate • lysozyme • cream • pudding Egg is sometimes found in the following: • curds • Recaldent ® • baked goods • macaroni • custard • rennet casein • breaded foods • marzipan • diacetyl • sour cream, sour cream solids • candies • marshmallows • ghee • sour milk solids • canned soups • nougat • half-and-half • tagatose • casseroles • pasta • lactalbumin, lactalbumin phosphate • whey (in all forms) • cream fillings/custards • meatballs/meatloaf • lactoferrin • whey protein hydrolysate • lecithin • salad dressings • lactose • yogurt Keep the following in mind: Milk is sometimes found in the following: Individuals with egg allergy should also avoid eggs • artificial butter flavor • luncheon meat, hot dogs, from duck, turkey, goose, quail, etc., as these are • baked goods sausages known to be cross-reactive with chicken egg. • caramel candies • margarine • chocolate • nisin • lactic acid starter culture and other • nondairy products bacterial cultures • nougat How to Read a Label for a Soy-Free Diet How to Read a Label for a Peanut-Free Diet All FDA-regulated manufactured food products that All FDA-regulated manufactured food products that contain peanut as contain soy as an ingredient are required by U.S. law an ingredient are required by U.S. law to list the word “peanut” on the to list the word “soy” on the product label. product label. Avoid foods that contain soy or any of these ingredients: Avoid foods that contain peanuts or any of these ingredients: • edamame • soybean (curd, granules) • artificial nuts • monkey nuts • miso • soy protein (concentrate, • beer nuts • nut meat • natto hydrolyzed, isolate) • cold pressed, expeller pressed, or • nut pieces • shoyu • soy sauce extruded peanut oil • peanut butter • soy (soy albumin, soy • tamari • goobers • peanut flour cheese, soy fiber, soy flour, • tempeh • ground nuts • peanut protein hydrolysate soy grits, soy ice cream, soy • textured vegetable protein • mixed nuts milk, soy nuts, soy sprouts, (TVP) Peanut is sometimes found in the following: soy yogurt) • tofu • African, Asian (especially Chinese, • egg rolls • soya Indian, Indonesian, Thai, and • enchilada sauce Soy is sometimes found in the following: Vietnamese), and Mexican dishes • marzipan • Asian cuisine • vegetable gum • baked goods (i.e., pastries, cookies) • mole sauce • vegetable broth • vegetable starch • candy (including chocolate candy) • nougat • chili Keep the following in mind: • The FDA exempts highly refined soybean oil from being Keep the following in mind: labeled as an allergen. Studies show most allergic • The FDA exempts highly refined peanut oil from being labeled as an individuals can safely eat soy oil that has been highly allergen. Studies show that most allergic individuals can safely eat peanut refined (not cold pressed, expeller pressed, or extruded oil that has been highly refined (not cold pressed, expeller pressed, or soybean oil). extruded peanut oil). Follow your doctor’s advice. • Soy protein may be found in numerous products, such • A study showed that unlike other legumes, there is a strong possibility as breads, cookies, crackers, canned broth and soups, of cross-reaction between peanuts and lupine. canned tuna and meat, breakfast cereals, high-protein • Mandelonas are peanuts soaked in almond flavoring. energy bars and snacks, low-fat peanut butters, and • Arachis oil is peanut oil. processed meats. • Many experts advise patients allergic to peanuts to avoid tree nuts • Most individuals allergic to soy can safely eat soy lecithin. as well. • Follow your doctor’s advice regarding these ingredients. • Sunflower seeds are often produced on equipment shared with peanuts. ©2017 ST. LOUIS CHILDREN’S HOSPITAL, FOOD ALLERGY MANAGEMENT & EDUCATION PROGRAM | STLOUISCHILDRENS.ORG/FAME How to Read a Label for a Wheat-Free Diet How to Read a Label for a Shellfish-Free Diet All FDA-regulated manufactured food products that contain wheat as All FDA-regulated manufactured food products that contain a an ingredient are required by U.S. law to list the word “wheat” on the crustacean shellfish as an ingredient are required by U.S. law to product label. The law defines any species in the genus Triticum as wheat. list the specific crustacean shellfish on the product label. Avoid foods that contain wheat or any of these ingredients: Avoid foods that contain shellfish or any of these ingredients: • bread crumbs • Kamut • barnacle • lobster (langouste, • bulgur • matzoh, matzoh meal (also spelled • crab langoustine, Moreton bay • cereal extract as matzo, matzah, or matza) • crawfish (crawdad, crayfish, bugs, scampi, tomalley) • club wheat • pasta ecrevisse) • prawns • couscous • seitan • krill • shrimp (crevette, scampi) • cracker meal • semolina Mollusks are not considered major allergens under food labeling • durum • spelt laws and may not be fully disclosed on a product label. • einkorn • sprouted wheat • emmer • triticale Your doctor may advise you to avoid mollusks or these ingredients: • farina • vital wheat gluten • abalone • oysters • flour (all purpose, bread, cake, • wheat (bran, durum, germ, gluten, • clams (cherrystone, geoduck, • periwinkle durum, enriched, graham, high grass, malt, sprouts, starch) littleneck, pismo, quahog) • scallops gluten, high protein, instant, • wheat bran hydrolysate • cockle • sea cucumber sea urchin pastry, self-rising, soft wheat, • wheat germ oil • cuttlefish • snails (escargot) steel ground, stone ground, • wheat grass • limpet (lapas, opihi) • squid (calamari) whole wheat) • wheat protein isolate • mussels • whelk (Turban shell) • hydrolyzed wheat protein • whole wheat berries • octopus Wheat is sometimes found in the following: Shellfish are sometimes found in the following: • glucose syrup • starch (gelatinized starch, • bouillabaisse • seafood flavoring • soy sauce modified starch, modified • cuttlefish ink (i.e., crab or clam extract) food starch, vegetable starch) • fish stock • surimi • surimi • glucosamine Keep the following in mind: • Any food served in a seafood restaurant may contain shellfish protein due to cross-contact. • For some individuals, a reaction may occur from inhaling cooking How to Read a Label for a Tree Nut-Free Diet vapors or from handling fish or shellfish. All FDA-regulated manufactured food products that contain a tree nut as an ingredient are required by U.S. law to list the specific tree nut on the product label. How to Read a Label for a Fish-Free Diet Avoid foods that contain nuts or any of these ingredients: • almond • litchi/lichee/lychee nut • pecan All FDA-regulated manufactured food products that contain fish as • artificial nuts • macadamia nut • pesto an ingredient are required by U.S. law to list the specific type of fish • beechnut • marzipan/almond • pili nut on the product label. • Brazil nut paste • pine nut (also • More than half of all people who are allergic to one type of fish also • Butternut • Nangai nut referred to as Indian, are allergic to other fish, so allergists often advise their patients to • cashew • natural nut extract pignoli, pigñolia, • chestnut (i.e., almond, walnut) pignon, piñon, avoid all fish. • chinquapin • nut butters (i.e., and pinyon nut) • Finned fish and shellfish do not come from related families of foods, • coconut cashew butter) • pistachio so being allergic to one does not mean that you will not be able to • filbert/hazelnut • nut meal • praline tolerate the other. Be sure to talk to your doctor about which kinds • gianduja (a choco- • nut meat • shea nut of fish you can eat and which to avoid. late-nut mixture) • nut paste (i.e., • walnut • The term “fish” encompasses all species of finned fish, including • ginkgo nut almond paste) (but not limited to): • anchovies • haddock • pike • snapper • hickory nut • nut pieces • bass • hake • pollock • swordfish Tree nuts are sometimes found in the following: • catfish • herring • salmon • tilapia • black walnut hull extract (flavoring) • nut distillates/alcoholic extracts • cod • mahi mahi • scrod • trout • flounder • perch • sole • tuna • natural nut extract • nut oils (i.e., walnut oil, almond oil) • grouper • walnut hull extract (flavoring) • Fish is sometimes found in the following: Keep the following in mind: • Caesar salad/dressing • fish oil • surimi (artificial • caponata (Sicilian • fish sauce crabmeat also • Mortadella may