The 14 Allergens
The 14 Allergens and Anaphylaxis
Symptoms of Allergies
Swelling of lips, tongue, and face
Itchy rash on the skin, usually arms, legs, and throat
Shortness of breath/coughing,
Runny nose, and inflamed eyes
Swelling of the voice box
Nausea and vomiting
Collapsing with shock (Anaphylaxis)
These symptoms are caused by the immune system responses. They can occur within minutes of the allergen being ingested. Occasionally, other symptoms can come later, like abdominal pain and increased rashes.
This is the most severe level of allergic reaction. Any food can cause anaphylaxis, but the most common are included in the main 14 allergens list. The main difference between mild allergies and anaphylaxis is the amount of chemicals that are released by the mast cells. Blood pressure drops and can cause a collapse of the circulatory system, which carries blood to vital organs of the body. There are a wide range of reactions that can occur during anaphylactic shock, but low blood pressure and shortness of breath are the characterizing features.
As well as food items, latex gloves can also induce anaphylactic shock for those allergic to latex and have the ability to contaminate products. This is something not often thought about during kitchen cross-contamination, since they are used in almost every professional kitchen.
What causes a reaction to be more severe or react faster?
Certain factors can dramatically increase sensitivity to allergic reactions such as:
The amount of allergen in the body
Adrenaline is usually carried in the form of an EpiPen, which, when injected into the thigh, contracts the blood vessels and reverses the swelling in the lungs to prevent choking and other life-threatening events in the body for long enough to obtain medical help. If you think someone is having an anaphylactic reaction you should call 999 immediately.
Allergies and Tolerances
Allergies – a reaction produced by the body’s immune system when exposed to a normally harmless substance.
Sensitivity – an increased reaction to a particular substance such as when caffeine causes palpitations and trembling.
Intolerance – when a substance causes unwanted symptoms, such as diarrhoea. This reaction doesn’t involve the immune system, and people who are affected are usually okay with small amounts. However, the symptoms worsen as the amount ingested increases.
Details on Each Allergen
A crustacean is an animal with a hard outer-shell and several pairs of legs, which usually live in water. The most common of these are crabs, lobsters, and shrimps. Being allergic to one type of crustacean doesn’t necessarily mean having an allergy to all. However, around 75% of people who are allergic to one type will have a reaction to other crustaceans.
Allergies to shellfish, crustaceans and molluscs are not necessarily related to fish allergies.
The allergen associated with crustaceans and shellfish is called tropomyosin.
This group of shellfish includes species such as clams, mussels, octopus, and scallops, though they are not exclusively seafood. Molluscs also include species of snails and other land animals.
An exception is the Kosher product carrageenan which is used for setting creams by reaction with calcium. This is produced from red marine algae however does not come under shellfish for allergen stating purposes.
On an ingredients list, milk is the allergen stated for any form of dairy product, such as cheese, yogurt, butter, and cream. All animal milk and associated products fall into this category also, as the protein casein is responsible for most reactions. Some products that contain casein need to be classified on a menu as containing the milk allergen:
Artificial butter flavours
Some butter substitutes.
Some kitchen products are safe for people with milk allergies but are sometimes confused because the names may suggest some forms of dairy products:
Calcium stearoyl lactylate
Cocoa butter, cream of tartar, sodium lactate, sodium stearoyl lactylate.
Lupin is a less well-known allergen. It is a small yellow seed which is traditionally eaten as a snack food in the Mediterranean and Latin America. It can also be used in flour production. There are similarities between Lupin and peanut allergies, so this should be a consideration when advising customers on menu choices. Pay special attention to nut mixes or pre-bought baked goods, which may contain Lupin seeds or products. Always check your flours for Lupin, even though most producers have already faded out the use of Lupin in their flours.
Sulphur dioxide, or E220/E228 is found in products that contain or have contained alcohol, such as wine or vinegars since it is a by-product of fermentation and is also used in the preservation of dried fruits. Sulphur dioxide is produced naturally during wine and beer production and is often added to wine to stop it fermenting in the bottle. For dried fruits, they stop discoloration and discourage the growth of bacteria.
Products containing Sulphur Dioxide
Pickled products and vinegars
Wine and beer
Sauces containing vinegar.
Egg allergies usually apply to hen’s eggs but can also include other species of birds. Eggs are one of the tricky allergens to keep track of since they creep into products that you don’t necessarily expect or think about. They’re used as stabilizers, thickeners, and emulsifiers, and it is vital that you check everything you use for egg traces, even if it seems unlikely.
Common Sources of Egg
Artificial and natural flavours
Meat products such as burgers and meatballs
Soybeans are part of the legume family, the same as peas and peanuts, although despite the prevalence of peanut allergies. this does not mean you’re more likely to be allergic to soy. Only an estimated 0.3% of the European population suffer an allergy to soy. Anaphylactic shock is very rare with soy allergies. Other symptoms are as per other allergens. Many people with a soy allergy can tolerate small amounts of soy protein since the typical dose to start an allergic reaction is 90 to 100 times the dosage of other allergens.
However, it can be the most difficult to avoid as it is found commonly in a wide variety of foods:
Condiments like Worcestershire sauce, mayonnaise and soy sauce
Tamari a soy sauce substitute without wheat
Natural artificial flavours
Vegetable broths and stocks
Fillers in processed meats such as chicken nuggets
Soy oil in margarine
E322 Soy oil found in sweets
Most Asian foods
Some peanut butter,
Some ice creams
Soy lecithin is one of the most common food additives on the market. It is a food stabilizer and emulsifier in many food products and also features in supplements and health foods. Oil is extracted from raw soybeans and then separated to isolate the lecithin.
A common question asked is, does it contain soy? The simple answer would be yes since it is a by-product of soy. However, it only contains trace levels of soy proteins and it is widely accepted that this trace amount is not enough to provoke an allergic reaction in most people with an allergy to soy. Since allergens are found in the proteins of a product, which are almost all removed in the manufacturing process, many nutritionists and allergists don’t advise their patients to avoid soy lecithin, even when it’s listed as a food ingredient. This depends on the severity of the allergy and always check with your doctor.
Pollen Food Syndrome
One common form of the soy allergy is pollen food syndrome, also called secondary allergy. This is common in people that are allergic to birch, hazel, or alder pollen. The proteins are similar to the soy proteins, therefore, the antibodies for those allergens can attack the soy proteins and trigger an allergic reaction. A soy allergy can be caused, not only by eating soy but also breathing in soy particles in large amounts which can cause the body to produce antibodies. This is most common in food industry workers who have to handle or process soybeans or soy flour products. Soy is one of the most common allergies in young children, but in most cases, this subsides by the age of 10.
Gluten is not technically an allergen since the reactions experienced are not usually allergic reactions but a range of different gluten/wheat triggered conditions. So it’s still included on allergen lists to make customers aware of its presence in food.
Gluten allergies and intolerances are something that cause huge problems in restaurants, although neither actually exist. Most restaurants experience gluten-free customers each day and gluten free can range from a customer avoiding gluten for their diet to a customer avoiding high levels of gluten due to coeliac disease. It is important that we make no assumptions when it comes to these customers. A lot of these special requests will be preference or diet related. However, taking insufficient care could result in symptoms such as nausea, mouth ulcers, and anaemia and coeliac.
Different types of gluten conditions:
Non-coeliac gluten sensitivity
Let’s address the only true allergy in this list first. Wheat contains gluten. However, people with a wheat allergy will be able to consume things like rye, barley, and oats which also contain gluten as long as they avoid wheat specifically. This is because the allergic reaction is caused by the wheat proteins and not the gluten. Wheat must be declared in food packaging by law. However, wheat, barley, and rye can often be labelled simply as ‘contains gluten’ so always check for which grain this refers to.
Types of Wheat and its Forms
Wheat is classified as all cereals of the tritium species, which include:
Monosodium glutamate (MSG) can also be derived from wheat. However, the production process breaks down the proteins enough to a form that is unlikely to cause reactions unless the individual has an extreme case of wheat allergy.
Products that Contain Wheat
Dried roasted nuts
Fruit pie fillings
Malt vinegar (malt is a by-product of grains which potentially contains wheat)
The following 3 varieties of gluten sensitivity are adopted terms to explain a varying degree of one of the causes of reactions to gluten or wheat (celiac disease, non-celiac disease, gluten, ataxia, gluten sensitivity or dermatitis herpetiformis or wheat allergy). Since they are so widely used it is important that it features in this list to prevent confusion with the real causes of these symptoms and categorizing people with separate conditions under the same umbrella. Whilst they may not be true allergens,from a chef’s point of view they should be treated in the same way and with the same care as allergies as they can still be harmful.
Affecting 1 in 3,300 people this is known more commonly as gluten rash. It is a red and extremely itchy skin rash. This is why people can easily adopt the term gluten allergy. Medically, an allergy to gluten is unrecognized and the term has been adopted by the use of online medical forums and word of mouth.
The rash is caused by clogs in small blood vessels of the skin where antibodies latch on to gluten proteins believing them to be a threat to the body and release a chemical called complement which causes the rash. This can also damage the parts of the intestines that allow the absorption of vitamins and minerals.
Coeliac disease is a disorder in which your immune system responds abnormally to gluten. Eating gluten as a coeliac will cause your immune system to destroy your villi, parts of the small intestine that are responsible for absorbing nutrients. Without healthy villi, coeliacs can become malnourished and unable to absorb the vitamins and minerals needed for bodily functions. This is an extremely serious condition and all steps must be taken to avoid gluten contamination.
Non-Coeliac Gluten Sensitivity (NCGS)
NCGS refers to people without coeliac disease who still experience uncomfortable symptoms when consuming gluten-containing foods. This is the most common condition and can be mislabelled as gluten intolerance. This is not particularly dangerous like coeliac disease, however, you must take steps to prevent contamination to avoid any uncomfortable side effects for NCGS customers.
Nut and Peanut Allergies
Nut allergies are possibly the most well-known allergies around the world and are the main cause of reactions in the UK. Peanuts do not come under the same allergen classification as other nuts because they are not in the same food family. Peanuts are legumes which grow in the ground, unlike other nuts which grow on trees. It is true that most people can be allergic to one and not the other. However, it’s not uncommon for customers to be allergic to both. It is not true that cooking nuts makes them any less allergenic.
Using peanut oil is a controversial topic for chefs and customers with food allergies, normally avoided completely to prevent any devastating mistakes. Highly-refined peanut oil poses little to no risk to people with a peanut allergy. In an unlikely event of reaction, it would be very mild. Without full understanding, though, this can lead people to believe that all peanut oil is fine for those with peanut allergies. On the other hand, unrefined peanut oil contains traces of peanut proteins and can cause serious reactions and anaphylaxis. Confusing these two is an easy mistake to make and the use of the wrong type could, in the worst-case scenario, be fatal. Avoiding it completely would be a good recommended course of action if a customer has a peanut allergy.
Coconut and nutmeg
Despite being called nuts, coconut and nutmeg are not related to nuts or peanuts. A reaction to either is very unlikely, however, it still may be a problem for a small number of individuals.
Most essences are safe to use since they contain none of the proteins that cause reactions, however, always check the brand you’re using.
Disaronno and Other Alcohols
Although it can’t be stated, not every liqueur is nut-free. Disaronno is specifically a brand that uses apricot kernels to impart the distinctive almond flavour, so it is nut-free.
Individuals that are allergic to sesame must avoid it completely, both cooked and uncooked. It is slightly less common than some other allergies but still remains a substantial risk to the customers that are affected. Sesame oil made from cold-pressing is one of the few oils that is not refined. This oil will contain large amounts of the protein responsible for allergic reactions. Sesame seeds are also a common cause of cross-contamination since they are so small.
Unrefined foods that contain sesame:
Raw sesame in bread, biscuits and crackers
Pre-brought marinades and sauces
This refers to any finned fish, not shellfish crustaceans or molluscs. The allergens in fish can cause extreme allergic reactions, including anaphylaxis. Even trace amounts can cause strong reactions. More than half of people who are allergic to one type of fish are allergic to others, so never assume with the customer if they have only specified an allergy to one type of fish.
Other Sources of Fish Allergens:
Some barbecue sauces
Fish allergy is sometimes confused with iodine allergy because fish is known to contain iodine, but this isn’t what triggers the reaction. Parvalbumin in the muscle tissue and bones is believed to be responsible along with collagen and gelatine in the skin of the fish.
Apart from peanuts, celery appears to be the second-most dangerous allergen for causing fatal anaphylactic shock. Cooking does not remove or destroy the allergen from either the stalk, fruit or seeds. The highest allergen content comes from the seeds which can easily become a contaminant due to their size. Celeriac (celery root) has the second-highest allergen content and is largely dangerous since the connection between celery and celeriac can sometimes be missed. The stalks have the least amount of allergen, however, it’s still highly dangerous and potentially life-threatening for a customer with celery allergy.
Celery is possibly the hardest allergen to track since it is used as a base or flavouring for thousands of products. Always check your spice mixes and bases for celery products. Be aware that even though one brand of product may be celery-free, the same product from another brand may use different ingredients.
Mustard is normally thought of as the spreadable, jarred condiment, however, we sometimes forget that it’s made from mustard seeds and it is these that contain the most allergen. Mustard seeds are used in pickles and can be found in products such as gherkins, pickled onions, and spice mixes. Mustard may also be present in some flours, crackers and various condiments. The dose of mustard needed to cause reaction is very small since the concentration of seeds in spreadable mustard is so high. This means that even a trace amount could cause severe reactions.
Grapeseed and Canola Oil
Grapeseed oil/canola is a major source of vegetable oil and is related to mustard. Although, it is worth noting the hidden allergen, canola oil, is considered safe due to the fact it is so highly refined. It is also worth noting that it is very common for someone with a mustard allergy to be allergic to other products in the Brassica family such as broccoli, cabbage, brussel sprouts, turnips, and cauliflower
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