The best way to handle a food allergy is to avoid the problem food. However, as the current massive recall of products containing ground cumin spice shows, this is often easier said than done. Cumin isn’t the allergen. It’s peanuts, traces of which got into the popular seasoning during processing. Cross-contamination is not unusual as food manufacturers often process a variety of foods using the same equipment.

When known food allergens like peanuts are used as ingredients, the Food and Drug Administration (FDA) requires that they be listed on the product label. However, when an allergen is inadvertently added to a food during manufacturing, preparation, storage or when it is served, this regulation does not apply. Undeclared allergens in foods can be deadly for some people. They are also the leading cause of food recalls in the United States.

“You might do all of the things you are supposed to do and read the label, but there could still be undeclared allergens,” says Dr. Michael Pistiner, a pediatric allergist in Boston. “It’s challenging to know that and still feel comfortable.”

The cumin recall

Since December, miniscule amounts of peanut dust have been found in a growing number of food products where cumin is an ingredient. Hundreds of items are being recalled. These include spice mixes, cooking kits for Tex-Mex and Indian dishes and over 500,000 pounds of seasoned beef, poultry and pork products. The widening scope has led to a warning from the FDA that people with a peanut allergy avoid all foods containing cumin. (Cumin-seasoned products manufactured before 2014 are not affected.)

An undertaking of this magnitude may seem like an over-the-top response to a problem that affects just a little over one percent of the U.S. population. However, for these three million Americans, it is a very serious problem. According to the Asthma and Allergy Foundation of America (AAFA), peanut allergy is the most common cause of food-related death. Reports of peanut allergy are also on the upswing, as are food allergies in general. An estimated 15 million Americans are allergic to some type of food.

Food allergies

A food allergy occurs when the body’s immune system reacts to a particular food as if it were dangerous. Eating, touching or simply being near the item can cause minor itching and hives or at worst, life-threatening anaphylaxis. Reactions can develop within minutes. Other times, it can take hours.

Anyone can develop a food allergy. Sometimes it happens with a food the person has been eating for years. Shellfish allergies, for example, often don’t appear until adulthood.

Common food allergy signs and symptoms include:

  • Tingling or itching in the mouth
  • Hives, itching or eczema
  • Swelling of the lips, face, tongue and throat or other parts of the body
  • Wheezing, nasal congestion
  • Abdominal pain, diarrhea, nausea

Food Allergy vs Food Intolerance

Food allergy is an immune system reaction that affects the entire body. Food intolerance, which is more common than food allergy, is a digestive system response to an ingredient that either irritates the digestive system or cannot be broken down because the digestive system lacks the necessary enzyme.

Intolerance to lactose, a sugar found in milk and other dairy products, is a common food intolerance.

Food intolerance can sometimes be treated with medication. Lactase enzyme pills, for example, may make it possible to eat dairy products without suffering ill effects. You can also buy lactose-free milk and enjoy lactose-free cottage cheese and ice cream.

Signs of anaphylaxis include:

  • Constriction of airways
  • Difficulty breathing
  • Shock with a severe drop in blood pressure
  • Rapid pulse
  • Dizziness, lightheadedness or loss of consciousness

Anaphylaxis can kill. Emergency treatment is essential.

Reading ingredient labels and calling the manufacturer if you have questions is crucial when you or someone in your family has a food allergy. It is also important to speak up when dining in a restaurant, school or in the home of a friend. Ask what ingredients were used in making the various dishes and whether utensils and cutting boards used in preparing were thoroughly washed between food items. If you have doubts, don’t eat it.

If you have a food allergy, be prepared for an unintentional exposure:

  • Develop a plan with your health care provider
  • Alert your place of business or your child’s school or day care
  • Wear a medical alert bracelet or necklace
  • Keep on hand an accessible auto-injector device containing epinephrine (adrenaline)
  • Seek medical help immediately if you are exposed

Food allergies cannot be cured, but they can be managed. Pay attention to what you eat and how it was prepared and you can lead a healthy life.

[Janet Lubman Rathner]