The holiday season is rapidly approaching, and with it the inescapable march toward excessive food consumption is poised to begin. But those affected by food allergies need not retreat. While Thanksgiving may pose some challenges for the 12 million Americans with food sensitivities, it is still possible to enjoy the holiday. For starters, experts say, let go of your worries about hurting chef grandma's feelings.
"My most important advice is to be very forthright about having a food allergy," says Dr. Robert Wood, director of pediatric allergy and immunology at Johns Hopkins Children's Center. "The more open you are about it, the more chance there is that your host can accommodate your food allergies in the preparation of the food. If you are trying to be quiet about it and not reveal that you have this restrictive diet, then the risks of a problem go much higher."
Since the Food Allergen Labeling and Consumer Protection Act took effect in 2006, foods regulated by the Food and Drug Administration must have labels that clearly establish the source of all ingredients that are -- or are derived from -- the eight most common food allergens: milk eggs, fish, crustacean shellfish, tree nuts, peanuts, wheat and soybeans. These substances account for 90 percent of food reactions.
"We always look at the holidays in general as the highest risk time for accidents to happen," says Wood, who has dealt with a lifelong peanut allergy and is author of "Food Allergies For Dummies". "It's likely that some food preparation will be outside your control and it also turns out that many of the snacks and desserts and things like that would pose a particular risk, especially for those with peanut or nut allergies."
The approach to managing food restrictions vary significantly depending on the allergy, but with public awareness about these allergies increasing, having a safe and healthy holiday has become far more realistic. For example, many national grocery stores -- including Whole Foods Market, Wegmans and Kroger -- are now offering guidance about gluten-free products both online and in the stores.
"Check out our website, our recipe section for special diets, there are special holiday options as well," says national grocery coordinator for Whole Foods Market Errol Schweizer. "We carry all of the products that are listed in our recipes so you can just print out the recipe and then go shopping at our store to find everything."
Whole Foods Market, which has a staff of "team members" versed in allergen-free foods, is also providing a cooking alternative to those with limited time this year: preordered meal options clearly labeled with allergen information.
"Many of our stores are offering Thanksgiving meals that you can preorder in advance," said Schweizer. "People can peruse the menu and order just the turkey or turkey with all the trimming and do the whole meal. Those recipes available will vary by region or store, but they'll all say may contain wheat, or soy customers can see if there's something they can order."
While purchasing premade foods provides a less-hassle option, for those looking to cut costs, Erin McKenna, founder of BabyCakes, an award-winning New York bakery specializing in gluten, wheat, dairy, egg and soy free products, offers several tips of the trade for creating allergee-free alternatives.
If you're looking to replace dairy, McKenna says, "If it's a heavy dairy, like a half and half or a whole milk, coconut milk works well because it has high fat content. If you want to more low-fat option, rice milk is great."
McKenna, who is also the author of this year's "BabyCakes: Vegan, (Mostly) Gluten-Free, and (Mostly) Sugar-Free Recipes from New York's Most Talked-About Bakery", uses several flours when composing her indulgent masterpieces, but she says garbanzo bean flour is her favorite and works best when using a pinch of xanthan gum as a binder.
"I like it, because it fluffs up really well. The same with rice flour," says McKenna, who suggests replacing regular flour cup for cup with gluten-free flour and adding a quarter teaspoon of xanthan gum per cup as a thickener.
If eggs are the culprit, "replace three tablespoons of apple sauce per egg. That works well as a binder."
While McKenna's trade secrets can be helpful, she warns trial and error is a large part of producing tasty allergen-free foods.
For those with a peanut allergy, dessert, often despite efforts to be made without allergens, will be the most difficult part of the meal.
"When you look at home accidents that happen with a peanut allergy, the most common reason is baked goods, even baked goods that were thought to be safe or didn't have peanut in the recipe. It's because the chance of having a cross-contaminated baked good is much higher than cross contamination of other food types," says Wood.
But even the turkey, which may seem innocent to many, can pose a risk for those with food restrictions. The seasonings and broth used for basting, as well as the ingredients in the stuffing, sometimes contain one of the eight major allergens. To avoid allergen-laced processing solutions used to make the turkey more tender, look for a natural turkey instead of a basted turkey. Be aware that even a hormone-free or organic turkey can still contain additives, so read the lables carefully.
Of course the preparation of the bird is also a factor for people with food limitations. While deep-fried and beer-can turkey seem to be popping up on the menu in many households, the peanut oil and beer used in the respective cooking processes can pose a risk for people with nut and gluten allergies. Sticking to basic ingredients -- olive oil and organic spices and seasonings that specify the use of any allergens -- is the safest option.
For those dealing with a milk or gluten allergy, it's quite possible that the Thanksgiving favorites: potatoes, stuffing, biscuits, could all contain a source of dairy or gluten. Numerous resources offering substitutions for these foods are available: Whole Foods Market has published a comprehensive list of both dairy free and gluten free;The Food Allergy and Anaphylaxis Network, a nonprofit organization devoted to allergen-free living, has published several recipe tips for the holidays and retail book stores, such as Amazon.com sell allergen-free cookbooks.
While there are plenty of recipes to accommodate an alternative menu on Thanksgiving, keeping an open mind may be your best solution to navigating the holiday. Try to let go of that nagging compulsion to keep everything constant from one year to the next, and this year, think outside the bun, create new holiday traditions.
Since Thanksgiving is a time to express gratitude, focus on activities that will bring the family closer together. Dust off your Boggle game or volunteer at a homeless shelter for the afternoon. If the sporty cousins are in town, initiate a game of flag football, or go for a walk. The nonprofit organization Kids With Food Allergies, which seeks to support and educate the allergy community, has several suggestions for ways to pass the holiday without sacrificing the spirit.
Symptoms of food allergies include hives, swelling, vomiting, dizziness, abdominal cramps, wheezing and loss of consciousness. While a resistance to gluten, or celiac disease, is often associated with food allergies, one who can tolerate gluten should not be mistaken as someone who is allergic to gluten. Allergies can also be life-threatening, causing anaphylaxis, often resulting in shock, suffocation and inability to breath. Each year in the United States, it is estimated that there are approximately 30,000 episodes of food-induced anaphylaxis, which result in as many as 200 deaths.