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Food allergies: A minefield in the supermarket

Parents become instant experts at protecting their kids from some foods.
By Sean P. Means
The Salt Lake Tribune

When a doctor told Michelle Fogg four years ago that her daughter Emalee, then 15 months old, was allergic to peanuts, tree nuts, eggs, milk, soy and mustard, it changed the lives of both mother and daughter.
Her first reaction? "Scared, overwhelmed, kind of devastated," said Fogg, a Salt Lake City resident and founder of the Utah Food Allergy Network.
"You don't know why this happened, if it was something you did, if it was your fault," Fogg said. "You mourn the loss of something. You're upset, you're overwhelmed, then you're angry, and then you are kind of able to handle it. You have to go through that process, to get to that place where you feel like, 'OK, this is just life now.' "
For the families of approximately 3 million children in the United States -- 3.9 percent of U.S. children in 2007, according to the Centers for Disease Control and Prevention's latest figures -- the diagnosis of a food allergy changes the way they eat, shop and live.

"You've never had to think, 'OK, I'm in the grocery store, I'm getting some things off the shelf, and my two-year-old is running over to the bulk bin and reaching in to grab a bunch of nuts,' " Fogg said. "Now, when I go shopping, my child has to be in the cart --and I constantly have to be watching their environment."
Food allergies are on the increase, according to the CDC, who found that from 1997 to 2007, the prevalence of reported food allergies went up 18 percent among children under 18.

Allergy doctors have seen the increase firsthand. Evan Matheson, a Provo allergist, said that when he started out in 1982, he would only see a few peanut allergies -- which are often the most severe and life-threatening. Recently in his practice, "I saw seven in a week," he said.
No one knows why more children are suffering from food allergies, but theories abound. One says more children are diagnosed correctly than before. Another questions the impact of industrial food processing. Still another, called "the hygiene hypothesis," suggests that children are so overprotected from household bacteria that their immune systems attack what used to be ignored -- such as food products. "No one truly knows," said Edwin Bronsky, a Salt Lake City allergist.
After diagnosing a food allergy -- which, Bronsky and Matheson said, sometimes can be a long process of asking about family histories, skin and blood tests, and differentiating between a genuine allergic reaction and some simpler explanation -- "the treatment is avoidance. ... If their [food] history is something life-threatening, avoid it and carry an EpiPen," Matheson said, referring to a dose of epinephrine in a quickly administered syringe.
Parents sometimes overreact to a child's allergy by removing too many foods, "and can actually lead to starvation of the child," Matheson said.
Kelley Lindberg, who runs the Utah Food Allergy Network's Davis County chapter, has her 10-year-old son Orion carry an EpiPen because of his allergy to peanuts and tree nuts. But she didn't learn that from the doctor who first diagnosed Orion's allergy.
The first allergist Lindberg consulted told her to "keep him away from peanut butter and he'll probably outgrow it," Lindberg said. "He didn't tell me about EpiPens. He didn't tell me about Benadryl. He didn't tell me how to read a label for cross-contamination. He told me nothing."
A parent whose child has a food allergy becomes an instant expert on reading ingredient labels. The first trip can be discouraging, because many products one wouldn't think would be dangerous contain ingredients made from the most common allergens: Milk, soy, wheat, eggs, peanuts, tree nuts, fish and shellfish.
For Fogg, dealing with her daughter's allergy was a process. On her first shopping trip after Emalee's diagnosis, "I left the store crying because everything has the warning on it," she said. Gradually, she came to focus more on what her daughter could eat, not what she couldn't, and realized there were a wider variety of foods available then she initially thought.
Since 2006, thanks to a federal law, labels must state clearly if the product contains ingredients made from the major common allergens. But even with that law in place, there is still confusion -- as corporations cover their bases legally with vague warnings that their foods "may contain" or are "manufactured in a facility that processes" peanuts or other allergens.
Lindberg said she learned how to read ingredient labels closely, discovering that a long-winded name like "hydrolyzed vegetable protein" could include peanuts. Though some parents and allergy experts debate that the "may contain" labels are too broad, Lindberg doesn't take chances. "If a company puts that label on, I treat it seriously," she said.
Labels need to be standardized, said Scott Mandell, founder and CEO of Enjoy Life Foods, an Illinois-based maker of allergy-free cookies, granolas and other treats. "When you read a lot of ingredient labels in the market, there are certain ingredients being used where you would need a degree in chemistry to really know what is this -- and what allergens might this product have in it," Mandell said. "You read our ingredient labels, you understand what our ingredients are."
Parents also learn to check out their allergic child's school for dangers.
At most schools, officials work with parents to develop a food-safety plan. Some schools have eliminated peanut products from the lunch menu. A "no-nut table" is a common sight in the cafeteria, to protect allergic students from classmates who might brown-bag a peanut-butter sandwich.
In 2008, the Utah Legislature approved a law that allows students to carry their own EpiPens. Before, such medication would be held in the office or the nurse's room -- and precious time could be lost in an emergency tracking down the school secretary who had the key.
One of the biggest aids a parent can have is knowing others are going through the same thing.
Lindberg, whose son Orion is allergic, learned that Orion's best friend also had food allergies. "[His] mom and I have grown up treating both boys as if they have the same allergies when they are together, so there's no cross-contamination," she said. "We have got birthday-cake recipes, we have cookie recipes, we know packaged products that work."
Fogg founded the Utah Food Allergy Network so "moms could talk to other moms who knew exactly how it felt," she said. UFAN now has about 100 members, Fogg said, with chapters in Salt Lake County, Davis County and Tooele County -- and one launching soon in Utah County. Membership is free.
The UFAN Web site -- at utahfoodallergynetwork.googlepages.com -- links to information about food allergies, and to Lindberg's blog. The group is also an advocate on allergy-related issues, and maintains an online forum where parents can trade tips and commiserate.
"To help [your kids] with their anxiety," Fogg said, "it helps to speak to others who have gone through it."
spmeans@sltrib.com