Food Allergies
Food is often at the center of holiday celebrations, making food allergy awareness especially important this time of year.
By Abby Strickland, MS, RDN, LD
More than 170 foods have been reported to cause allergic reactions in individuals, according to the Academy of Nutrition and Dietetics. However, there are nine allergens that are seen most, often referred to as the “Top Nine Allergens.” Those allergens are: milk, eggs, peanuts, tree nuts, wheat, soy, fish, shellfish, and sesame. Sesame is the latest addition, added in 2021.
According to Food Allergy Research and Education, approximately 33 million people in the United States have at least one food allergy; that is about 1 in 10 adults and 1 in 13 children. Therefore, the chances of knowing someone with a food allergy is quite high, and it’s important to know how those allergies could impact those around you.
Food Intolerance vs. Food Allergy
While many people use the terms “intolerance” and “allergy” interchangeably, they are quite different. The American Academy of Allergy Asthma & Immunology (AAAAI) compares the two in a 2026 article.
Food intolerance happens in the digestive system when the body struggles to break down the food, causing discomfort. Most individuals can eat small amounts of these foods without issue but choose to limit or restrict them to improve quality of life.
Alternatively, an allergic reaction involves the immune system. Our immune system identifies a certain food as an invader (allergen) and produces antibodies called Immunoglobulin E (IgE), which causes an allergic reaction.
These reactions are serious medical conditions that can be life-threatening and may cause severe gastrointestinal and/or respiratory symptoms. With the holidays approaching, it is important to know how to safely prepare foods for friends and family members with food allergies.
Food Allergy Best Practices
A 2024 research study focused on the mental health burden of food allergies. The study’s authors found 62% of those with food allergies reported mental health concerns related to food allergies such as anxiety and panic.
Caregivers also experience a similar burden, worrying for the safety of their children or loved ones.
If you are hosting a holiday gathering or bringing a side dish to share where extended family members or friends with allergies are coming, there is one important task that needs to be done ahead of time. And that is simply to ask. Ask those attending if there are any allergies or food intolerances and share that with anyone else who is bringing food.
And remember to be flexible. It can be very stressful for someone with a food allergy to ask for accommodations. They want to enjoy the gathering just as much as you do.
When shopping for food, careful label reading is one of the most important habits to be in when you have a food allergy or are preparing food for someone who does.
Always avoid products if the allergen is in the ingredient list but also be aware of wording such as “this product may contain trace amounts of __” or “made in a facility that also produces __.” There is a high risk of cross contact with these products; therefore, they cannot be verified as safe.
Another variable that makes shopping difficult is that some allergies have alternative names. For example, those with a gluten (wheat) allergy should look for keywords such as wheat, barley, rye, malt, yeast, semolina, and durum.
The cook’s job is extremely important when it comes to safely preparing food. The goal is to prevent cross contact, which occurs when an allergen is transferred from a food containing an allergen to a food that does not contain that allergen.
Always use separate cooking equipment for allergy-containing and allergy-free foods to ensure there is no cross contact. This includes cutting boards, pots, pans, serving dishes, knives, and other utensils.
Risky equipment includes toasters, strainers, wooden spoons, and any porous surface, as they are difficult to clean. Thoroughly clean equipment with soap and water before and in-between use to minimize the risk of cross-contact.
Before serving the person with the allergy, explaining how you read food labels carefully to avoid allergens and how you helped prevent cross contamination can go a long way in making them feel welcome.
If you routinely cook for someone with an allergy, a good practice is to have dedicated equipment for allergy-friendly foods. A color-coding system often works well. Another safe practice is to always wash hands thoroughly if touching gluten-containing foods before handling safe foods.
When it comes time to serve the food, be aware of extra steps you can take to have a safe event; clearly label each item on the serving line or table and separate allergy-friendly dishes from other dishes to reduce the risk of cross contact, allow the person with the allergy to get their food first, and don’t share serving utensils between dishes.
Taking steps to understand and accommodate food allergies can help ensure that every guest enjoys the season safely and confidently.