Sunday, April 01, 2007

the allergy list (Imperfectly relevant only!)

Welcome to Imperfect Allergy 101.

I find this title to be appropriate in a number of ways, aside from the obvious. Mostly, it suits because this post will always be imperfect. Consider it a starting point, a beginning education. The suitability (and ingredients/processing) of any product mentioned here can change, so please do check in with me when you go shopping. Above all, thank you for reading this, and for undertaking to feed my family, and welcome us into your home.

We can only imperfectly express how cognizant we are of the challenge you take on, and how delighted we are that you chose to do so. Truly, if we had a choice, we wouldn't. But here we all are, so let's get to work.

The Upside
I find that when people see our list, they blanch and stop thinking. All they can manage is something along the lines of, but what do you eat? Well, let's start there. We eat:

  • cheese! lots and lots of cheese - but check for lysozyme, which can be extracted from eggs...
  • dairy of all kinds (brand specific, o' course, but did I mention DAIRY? yes? okay, then, did I mention ICE CREAM? am I grinning like an overfed idjit? I am? right we are, then.)
  • pasta (rice pasta!)
  • fish (if your fishmonger sells prepared fishes, always ask for fish from the back room to avoid cross-contamination.)
  • chicken
  • turkey
  • beef
  • lamb
  • salads. Lots and lots of salads. And homemade salsas. And fresh veggies. And fresh fruit. And - okay, stopping now.
  • root veggies
  • soups
  • rice and wild rice (gluten free)
  • spring rolls (rice wrappers, thanks!)
  • any number of tofu products (but not Tofutti because, well. yeah.)
  • homemade sushi (check your soy products for wheat!!)
  • curry (as of 2/08, with soy!)
  • bread (you might want to talk to us about specific bread-like options)
  • pizza (think lots of deeply roasted veggies, sizzled lox, AND cheese - did I mention the cheese?) 
  • fresh fruit (excepting kiwi)
  • homemade sorbet (but avoid 'tropical' flavors, since some of those flavors could be kiwi)
  • coffee, chocolate - no, wait, that might just be me.
  • peanut butter! Yes, the clever lad that is our Eldest has decided to reexamine his peanut allergy, and lo! Peanuts and other legumes have rejoined our life. But watch out for nut allergy warnings on that PB, and hunt yourself up a fresh jar of J.
  • dips (tahini-free hummus, tapenade, safe eggplant dips - and did I mention salsas?)



Specific recipes can be found by typing their name, or a main recipe ingredient into Blogger's search feature.

Allergy Rules to (literally) Live By

* don't eat anything if you don't know exactly what's in it.
* always consider cross-contamination. For example, innocent rice cakes are usually made with sesame flavored rice cakes on the same machinery. Cross-contamination ensues. Ever brush sesame seeds off the bottom of a plain bagel? Pull grains of barley out of a bag of lentils? Don't risk it.
* avoid vague labels. If the label says anything like 'spices,' 'flavors,' 'natural flavor,' or "colors' put it back on the shelf. Just because something is 'natural strawberry flavor,' doesn't mean it's ever been near a strawberry. Go buy a real strawberry, instead of the cackling mad scientist production that is a Ding-Dong. Your body, the eco-system and our boys' immune systems will thank you for it.
Note: artificial flavors and colors are okay, our allergists tell us, because they are so far removed from actual food that they don't have a risk of an allergen. Disturbing, but hey.
* read every single label, every time. Buying two cans of beans? Check each can to make sure the ingredients are safe. Manufacturers can change their ingredients without changing their packaging, so always read the label. Every label, every time.
* watch out for dried beans! We've found wheat in Goya's dried beans, and barley in many other brands...sigh.
* consider the crumble factor. A slice of bread will leave any number of traces - on the tablecloth, the carpet, a child's clothes. Crumbly food is more dangerous than non-crumbly food, so....
* If you eat it and it's got allergens, clean up after. Clean: hands, face, eating surface, countertops where food was prepared. Life happens, and when done right (according to the Man) it includes a PB&J for lunch every day at work. So, before coming home, he washes his hands and face, and tidies up. It works.
* children change everything. The ability of small children to race away from the table, hands and face unwashed, is an alarming thought when you have allergens at the table. Try a box of baby wipes by a parental chair, and wipe small hands and faces before they escape. Do a quick clothes check for residue. Got a kid who throws food? Don't serve allergens at the table. Got a polite, tidy eater? consider a non-crumble, non-smearing allergen, like beans - and have the wipes handy.
* wipes or wash - not Purell! Despite what you may hear, studies have shown that antiseptic hand-cleansers do not- do not - do not remove allergens. A wet wipe will do that, but the best cleaning method is soap and water (with a supervising adult for the small people).
The Allergy List
Anaphylactic:
  • sesame
  • kiwi
  • tree nuts (including pine nuts)
  • wheat
  • eggs
  • dairy
  • pumpkin seeds

Moderate:
  • poppy seeds
  • rye
  • barley
  • spelt
key: anaphylactic means life-threatening allergy, the item should not be on the table, and cross-contamination should be strictly avoided.
Moderate means a systemic allergy, which has the capacity (as does any allergy) to become life-threatening. We recommend not serving foods with moderate level allergens during a meal we attend, as it's too easy for cross-contamination to happen. One of the Eldest's moderate allergens, in one dish can be fine, but the Giggles is still learning how to coexist with human food. Whichever you choose, please warn us! There's a psychological benefit to having an allergen-free meal, but there's also a developmental aspect: the Eldest can - and should - handle some degree of risk responsibly, the Gig? Russian roulette. Fun, eh?
Contact allergies are when the person will react just from touching the food/a dish containing the food. Obviously, we don't recommend this as a form of entertainment.

Suggested Alternatives
grains: rice, wild rice, quinoa, potatoes, sweet potatoes
protein: chicken, turkey, beef, lamb, fish (especially popular, Chez Imperfect), soy, dairy
beans: lentil, green beans, black beans, great northern beans, small white beans, chickpeas or, heck, any bean.
dairy: dairy offers creaminess and richness to many recipes. We're dairy friendly these days, but if you are cooking a pareve/fleishigs meal (kosher), here's what we've found. For dairy substitutes, it depends on context.  Try substituting a mixture of coconut milk and rice/soy milk for cream, rice/soy milk for skim milk (rice and soy milks are sweeter and thinner than dairy milk - be warned!), deeply sauteed onions and wine for richness in savory recipes. See warning regarding rice milk and soy milks.
broth: unless homemade, broths contain 'spices,' or other vague ingredients - and many contain the Toddles' grains. We've only found one company who would really talk to us about their products (as opposed to form letter reply). In general, broth isn't worth the risk. Make some with the ends of your carrots and onions and potato peels, stripped herb stems or whatever you have, simmered for a ruthless 2-3 hrs in lots of water. Or try sauteed onions (browned), peppercorns, bay leaves, salt, fresh pepper and a splash of cooking wine to deglaze the pan.

menus! To prove it can be done...

* try this: brown rice pilaf, apple spinach salad, lasagne. Add a veg and you have a rather starchy but yummy meal. (Note: the job of the pilaf is to act as backup in case of children digging in their heels at the sign of the lasagne.)
* the Thanksgiving menu
* this quick, if highly vegetarian dinner
* this also quick (but nonvegetarian) dinner
* this Eldest-pleasing meal
* this Shavuot menu
* the Pesach menu
* semi-scones! a quick yummy baked treat
*a one-pot vegetarian meal
*fried fish or chicken fingers - kids' delight, and quick cooking!
Note the First: not all recipes are updated as to the relevant allergies. If you leave a query in the comments section, I'll respond with a recipe tweak.

Note the Second: the above are posts that include menus, specifically. There are also lots of individual recipes. Try a search for 'recipe' in blogger.com's 'search this blog' box at the top of this page. Or click on any recipe tag to get a list of recipes that we've tried. Still not hooked? Try epicurious.com's recipe search, using the 'exclude' feature to find safe recipes for our crowd. Also, look around for other allergy/celiac/gluten-free blogs. You may need to avoid/adapt some recipes, but they are a wealth of information. For example, take a peek at Gluten-Free by the Bay's Pesach (Passover) roundup Pesach (Passover) roundup. Wow.

products that work - today, anyway!
* Tinkyada pasta
* Soy Dream soymilk ( many soy milks have barley/wheat in them, Rice Dream has barley cross-contamination issues, other rice milks have nut cross-contamination issues)
* Trader Joe's lox/smoked salmon
* Ducktrap smoked trout, smoked roasted salmon (and hello? YUM!)
* Wildwood soy yogurt (it really is dairy free, and I'm mystified by the hechsher)
* Enjoy Life cookies (the snickerdoodles and chocolate chip cookies are especially popular)
* Trader Joe's wheat free vanilla extract
* Real Foods organic original flavor corn thins
* Trader Joes dried fruit - TJ's is good about labelling for nuts, peanuts and cross-contamination
* Trader Joe's kettle corn, some tortilla chips (check labels)
* Trader Joe's gluten free pancake/waffle mix, Van's frozen gluten-free, dairy-free waffles.
* Allergygrocer.com, use their advanced search to list things you want to avoid, plus 'kosher' as a thing you want, and see what turns up!
* Cherrybrook Kitchen's gluten free mixes, most Gluten Free Pantry mixes, 1,2,3 Gluten Free! mixes
* Luigi's Italian Ices, Trader Joe's Ice Floes
* Sharon's Sorbet
* Hood's - see their website for gluten-free, and allergy friendly lists of products.
*General Mills: Kix and Rice/Corn Chex are both fine, and GM has a good history of working to track allergy safety.


Companies to avoid:

  • Hain Celestial - lousy customer service
  • Earth's Best (are they owned by Hain's? The voices sound familiar when I call with questions)
  • Gerber (cross-contamination plus lousy customer service)
  • Tofutti - unapologetically not labelling for the nuts in their ice creams, last I checked. What else are they not telling us?
  • Glutino, a gluten-free endeavor, who has sesame on site - excepting Gluten-Free Pantry, which is owned by Glutino, but seems to have a different facility.
  • 365, who has a bad cross-contamination track record.
  • Unilever, for an impressively dense form letter response. 

Products to check carefully:
- oats - most oats have wheat cross contamination. Quaker Oats are fine (but check the label), and Bob's Red Mill makes a gluten-free oat (but many non GF oats, so check). Arrowmill oat flour has also been fine in the past.
- vanilla extract (wheat/wheat derived alcohol) Trader Joe's often has a wheat/alcohol free variety, as do many other stores.
- rice. Some companies rotate their rice crops with wheat and may have wheat inadvertently mixed in. Check the labels carefully. If a bag of rice says it's "gluten-free," then you are fine.
- anything that says 'textured protein,' 'vegetable protein'
- anything that says 'fruit,' 'fruit juice,' or unspecified fruit product. Alas.
- rice, soy milk (can contain barley or other grains, or be made on the same machinery as nut milks)
- rice cakes and crackers (even if you get a plain kind, the company usually has a dairy or sesame variant, big risk for cross-contamination)
- potato chips (wheat is often used as an agent to hold on flavors)
- gluten-free baked goods (often contain nuts or egg)
- dried fruits (often processed in the same factories as nuts)
- ice creams/sorbets/juice (when they have nonspecific naturally derived flavors or vaguely described, like 'tropical fruit juices.' Most ice creams have nut variants, also, so as lovely as they seem, I'd avoid all ice creams but the 365 brand - especially Tofutti)
- olives - olives packed in oil can be packed in vegetable oils. Which begs the question: what kind of vegetable? Check!

Bottom line: go simple. Buy fresh produce, whole foods, simple foods. Roast that chicken, broil that fish, toss that salad. And then call up your doctor and boast about the healthy stuff you ate...shortly before you fled our company in search of a good doughnut.

**********************
This post was last updated on: 8/4/2011.

10 comments:

Lois Grebowski said...

OY VEY! How do you keep up with all that? My head is spinning. Kudos to you... I couldn't manage that...

dykewife said...

just as i was saving my comment blogger decided to take a maintenance break. sucks.

anyway, what i wrote to you about was wondering if wild rice is on the list of things the boys can eat. it's a grass seed and has a nice nutty flaour. it makes a very nice mix with brown rice and the texture is nice. it also is good in chicken soup, but needs to be cooked up separately and then added to the soup when it's done cooking. it tends to add a flavour to the soup that reminds me of something musty. i don't know why.

also, i use pickling spice in my chicke soup stocks. it's the mix of mustard seeds, all spice and bay leaf bits that is used in sweet pickles. with a some whole black pepper corns and an additional bay leaf or two that's my spicing for soup stocks.

mama o' the matrices said...

Lois, I hate to say it - but you could if you absolutely had no choice. It's a rather awful thought, isn't it?

Dw, yes, they do eat wild rice. In fact, wild rice with dried cherries and a bit of red wine is one of our favorites! Mmm.

Never thought of trying pickling spices - thanks. Must try that for tomorrow's crockpot.

Celiac Mom of 3 said...

Questioning the "Quaker oats are fine" portion of your list.
I have Celiac disease (among other things) and Quaker will not say that their oats are safe or free of wheat, rye and barley. The label says 100% oats, but their website only says the USDA allows a certain percentage of other grains to be in the oats.
I wanted you to be aware just in case.
Becca
http://celiacstockings.blogspot.com

Miryam (mama o' the matrices) said...

Becca, you are absolutely right! And, of course, there's the whole debate as to whether folks with celiac should eat oats at all. Or, if they do, in what quantities. Etc.

I have asked our allergy team about celiac standards, and whether we should apply them. Setting aside that GF foods don't help us with nut allergy (the opposite, given how many GF foods contain nuts/eggs/etc), it seems that GF foods are held to a standard that may be higher than we need it to be. One reason, I was told, is because the damage done by gluten may be initially undetectable, yet cumulative. And folks with celiac may experience damage from minute amounts - amounts which might not trigger a reaction in some.

But it's hard to say which food allergic folks will react, which what degrees of sensitivity.

Yet another reason to have a very good allergist, working in a good allergy clinic. Our clinic suggested the Quaker Oats Old Fashioned variety, cautioned us against the other varieties - and yes, Quaker did decline to confirm this. (I heard a legal department echoing behind their reply to my questions, btw...)

But this is exactly why one blogger should never prescribe for another!

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