food allergy secrets

Food Immune Triggers

October 6, 2023

In our September article, we covered what a food allergy is as well as provided more information on the first four of the nine food allergies we will be covering. Let us recap what a food allergy is. A food allergy occurs when the body’s immune system wrongly identifies a food as a threat. A food allergy is a hypersensitivity reaction that involves the immune system. These reactions are basically exaggerated or inappropriate immunologic responses occurring in response to an antigen or allergen.

The body releases chemicals, such as histamine, in response. It is the release of these chemicals that causes the symptoms. A food allergy can range from mild reactions to severe, life-threatening (anaphylactic) reactions and can occur even with tiny doses or cross-contamination.


In South Africa, the food industry is regulated by several regulations, including the Regulation Relating to the Labelling and Advertising of Foodstuffs. According to this regulation:

  • The presence of common allergens in the product or its packaging material must be indicated on the food label. If the food producer cannot prevent allergen cross-contamination in the manufacturing environment, they are required to place precautionary allergen labeling statements (may contain) on their products.
  • For uncommon allergens, their presence or risk of allergen cross-contamination doesn’t need to be stated on the packaging. However, this information must be disclosed by manufacturers upon request by a consumer.

Food at Empact Group allergen signs states the following ingredients that are classed as allergens which we will be covering in further detail: eggs, fish, shellfish (crustaceans and molluscs), soya, wheat, gluten, cow’s milk, nuts, seeds and celery. This article will cover the last five allergens in this list. Please see the article released last month for the first four allergens in this list.


5. Wheat Allergy

Many people complain of reactions to wheat, but most of these are not actually wheat-allergic – they are either wheat intolerant or may have coeliac disease. Wheat allergy occurs when a protein in wheat (albumin, globulin, gliadin or glutenin /gluten) causes allergic reactions. The immune system treats one or more of these proteins as a danger to the body and starts an allergic reaction when the proteins are eaten, touched or in some cases inhaled (baker’s asthma).

Wheat intolerance is not triggered by the immune system and cannot be diagnosed with standard allergy tests (such as blood or skin tests). It affects digestion with common symptoms including stomach pain, diarrhoea and bloating after eating too much wheat. Coeliac disease is a response by the immune system but is not an allergic response. It is a condition where gluten proteins found in wheat and some other cereals damage the small bowel lining and the gut.

How to avoid wheat?

If you are allergic to wheat, you must avoid eating bread and all wheat products. Wheat-allergic patients should look out for the label “wheat-free” and not just “gluten-free”. Gluten is only one of many wheat proteins. Because wheat is a staple food product, wheat elimination diets are particularly difficult to maintain. Wheat-allergic patients who have sensitivity to gluten (or gliadin) should avoid other gluten-containing cereals such as oats, rye and barley.

Items that often contain wheat to look out for on labels:

  • Wheat is a main ingredient of many foods such as: Breads, chapattis and naan breads, breakfast cereals, biscuits, crackers, crumpets, scones, pancakes, wafers, cakes, pizza, pasta, pastries and yorkshire puddings.
  • It is also found in many convenience foods such as soups, sauces, spices, malted drinks, processed meats and ready- made meals.
  • Bread crumbs; rusks, bran or wheat bran; semolina wheat; cereal extract; couscous; bulgar wheat; cracker meal; enriched flour; high-gluten flour; high protein flour; unbleached flour; potato flour; hydrolyzed vegetable protein; rice grains/flakes/flour; sago; gluten; spelt; kamut; triticale; modified food starch; modified starch; starch; vegetable gum; vegetable starch; natural flavouring; buckwheat flakes or flour; corn; corn flour; maize; polenta; vital gluten; wheat bran; wheat germ; wheat gluten; wheat malt; wheat starch; durum wheat; whole wheat flour; soy sauce; soy flakes or flour; millet grains/flakes/flour; quinoa;

It is important to read the ingredient list carefully. Products like breaded cheese, sausages, beef burgers, Quorn (used as a meat substitute), gravy granules, stock cubes and beverages (malted milk, Ovaltine) can contain wheat. Sometimes a label may not specify wheat but another form of wheat like bran, semolina, couscous, rusk, or flour.

Oil that has also been used to fry food containing wheat-like fish fingers can lead to a reaction. People allergic to wheat need to be aware of the risk of cross-contamination in restaurants, bakeries and loosely sold products.

What are the symptoms of wheat allergy:

  • The most common type of wheat allergy is “immediate” type (IgE-mediated) food allergy. Immediate reactions occur within minutes of exposure and include an itchy rash (hives), swelling, vomiting, diarrhoea, runny nose, and itchy eyes. Severe reactions are much less common but can include difficulty in breathing (with wheeze or swelling in the throat), feeling faint or dizzy. Some people develop symptoms with wheat only after vigorous exercise (exercise-induced wheat-associated allergy).
  • Most allergic reactions to wheat are mild, causing hives (urticaria), swelling or vomiting. Some allergic reactions can be severe, causing difficulty in breathing due to throat swelling or asthma, or a drop in blood pressure. This is known as anaphylaxis.
  • Delayed reactions occur several hours after eating the food and include tummy pain, vomiting, diarrhoea and worsening of eczema.
  • Coeliac disease or gluten intolerance is a delayed reaction to wheat. People with Coeliac disease do not get hives or breathing difficulties but can have belly aches, diarrhoea or generally feeling run down.


6. Dairy Allergy

Milk contains many different proteins that can cause allergic reactions. The main proteins are casein and whey. Casein is the curd on top of milk that forms when milk is left to go sour. About 80% of protein in milk is casein. Casein protein is not broken down by heating.

Whey is the watery part that makes up the other 20% and can be broken down by heating (whey-allergic patients may be able to tolerate boiled milk or food cooked with milk).

Lactose Intolerance

Lactose intolerance is not an allergy but an inability of the gut to breakdown lactose, the sugar found in milk. Lactase is an enzyme that breaks down lactose so that it can be absorbed by the gut. If lactase levels are low, milk sugar can’t be broken down and builds up in the gut causing bloating, gas, diarrhoea, nausea and stomach pain. Lactose intolerance never causes allergy symptoms or anaphylaxis. Some dairy products have lower lactose levels than milk, so some people with lactose intolerance can eat yoghurt and cheese.

There are also low-lactose and lactose-free milk available as well as lactase enzyme replacements that can be added to milk products or eaten before consuming a milk product. A person with a true milk (protein) allergy will have allergic symptoms if they eat lactose-free dairy products.

How to avoid dairy products?

If you have a dairy allergy, you must avoid drinking whole milk and eating all dairy products. People should read food labels and recognize terms that may indicate the presence of cow’s milk protein. These include terms such as whey, lactose, casein, caseinate, lactalbumin and lactoglobulin. 

Milk proteins are changed when they are cooked to become much less likely to cause an allergic reaction. This is why many people with milk allergy can still eat biscuits or cupcakes that have been cooked with milk as a minor ingredient.

Foods that should be avoided include:

  • Full fat, semi-skimmed, skimmed, sterilised, evaporated and condensed cow’s milk; Milk powder, milk solids, non-fat milk solids; Butter, buttermilk, butter oil; Cheese, cheese powder, cottage cheese, cream, ice cream, yogurt, fromage frais, crème fraiche; Casein/caseinates – hydrolysed casein, calcium caseinate, sodium caseinate; Margarine, ghee, whey/whey hydrolysate, whey powder, whey syrup sweetener; lactalbumin and lactoglobulin

Remember to read the ingredient lists on food packets carefully every time you shop. Read the ingredient list every time you buy a product as manufacturers change their recipes often. Ask staff directly if the food you’d like to buy contains dairy and if there is a risk of cross-contamination. Let them know that even small quantities can cause a reaction.

What are the symptoms of dairy allergy?

Reactions may be mild or life-threatening and include hives, flushing, swelling, itching, nausea, vomiting, wheezing, difficulty breathing and collapse (anaphylaxis).

  • Immediate reactions – Fifty percent of infants have symptoms that begin straight away. These include hives / “nettle” rash and swelling of the lips. Some children feel sick, vomit or have diarrhoea. Severe reactions (anaphylaxis) are much less common, but include difficulty breathing (wheeze or throat swelling), feeling faint or dizzy.
  • Delayed reactions – These occur hours or up to a day or two after eating the food. They include flares of eczema, vomiting after feeds, colic and diarrhoea (sometimes with blood in the stools) even small quantities can cause an allergic reaction.


7. Tree nuts and peanut allergies

Peanut and tree nut allergies are types of food allergy. The peanut is a legume and is in the same plant family as peas, beans and lentils. Tree nuts are in different plant families and include almonds, hazelnuts, walnuts, cashew nuts, pecans, Brazil nuts, pistachios and macadamia nuts. As the plant families are different, many people only react to peanuts but not to any tree nuts, and vice versa.

Many people who are allergic to tree nuts are only allergic to one type of tree nut, but some are allergic to more. For example, it’s quite common for people with cashew nut allergy to be allergic to pistachios, and for people with walnut allergy to be allergic to pecans.

Peanut and tree nut allergies are common – they are the most commonly known foods to cause anaphylaxis. Peanuts and tree nuts can both cause serious allergic reactions which can be treated in the same way. Peanut allergy is an allergy to peanut protein and not the oil.

How to avoid tree nuts and peanuts?

Once you have been diagnosed with a peanut or tree nut allergy, you will need to avoid the nut or nuts you’re allergic to. Read the ingredient list every time you buy a product as manufacturers change their recipes often. Ask staff directly if the food you’d like to buy contains nuts or peanuts and if there is a risk of cross-contamination. Let them know that even small quantities can cause a reaction.

Foods that often contain tree nuts and peanuts:

Satay sauce, pesto sauce; marzipan and praline; salads and dressings; multicultural cuisines (especially Thai, Indian and Chinese); vegetarian dishes such as nut loaf and nut roast; vegetarian and vegan products; gluten-free alternatives, cakes, breads, biscuits and pastries; muesli and granola, cereal bars; chocolates and other confectionery; ice cream and desserts, snack foods; peanut shoots – these look similar to bean sprouts

If you are allergic to tree nuts, avoid oils made from the nuts as well. Nut oils can be used for frying, baking and making salad dressings. Research has shown that refined peanut oil will not cause allergic reactions in most people with peanut allergy. This is because it contains no or very little peanut protein, which is the part that causes allergy.

Symptoms of a tree nut and peanut allergy:

The symptoms of peanut and tree nut allergy usually come on quickly, within minutes of eating the food. Mild to moderate symptoms may include a red raised rash (known as hives or urticaria) anywhere on the body, a tingling or itchy feeling in the mouth, swelling of lips, face or eyes and stomach pain or vomiting. More serious symptoms include anaphylaxis.


8. Sesame seed allergy

Sesame seed allergy is an allergy to sesame protein after eating the seed. Sesame seeds are difficult to control in food production. They often become ‘electrostatic’, causing them to cling to charged surfaces such as other foods and clothing, which makes it difficult to prevent cross-contamination. If a food product carries a warning such as “may contain sesame”, it’s best to avoid that food. Heating does not destroy the part of sesame that cause allergies which means they can still cause allergic reactions when they’re cooked.

How to avoid sesame seeds?

Once you have been diagnosed with a sesame allergy, you will need to avoid it and the foods that contain it. Avoid sesame oil as well as seeds. It’s usually unrefined and contains the proteins that trigger allergic reactions. Sesame seeds can be black, white, brown or red.

Breads baked in in-store bakeries can also become contaminated with sesame seeds. Take extra care when buying foods that are sold loose, such as bread and baked products at delicatessen counters and in-store bakeries. The seeds may not be obvious. They could be hidden in the dough for example, and products can be contaminated with seeds from other products at the counter. When eating out, always check the ingredients.

Read the ingredient list every time you buy a product as manufacturers change their recipes often. Ask staff directly if the food you’d like to buy contains sesame seeds or oil and if there is a risk of cross-contamination and let them know that even small quantities can cause a reaction.

What are the symptoms of sesame seed allergy?

Most people present with urticaria (hives) with or without angioedema (swelling), and to a lesser extent with gastrointestinal symptoms such as abdominal pain. People with sesame allergy are at risk of severe reactions (anaphylaxis).

Symptoms usually occur straight after eating food containing sesame seed but can occur up to one hour later. The reaction tends to be mild and may include a rash (hives or “nettle” rash) or swelling, especially around the face. Some people have an itchy throat while others may vomit or have diarrhea.

Severe reactions (anaphylaxis) are less common and include difficulty breathing (with wheeze or swelling in the throat), feeling faint or dizzy. People can also develop delayed skin reactions to using creams and toiletries containing sesame seed oil.


9. Celery Allergy

Celery allergy is an allergy to celery, including celery sticks, leaves, spice, seeds and celeriac. People with celery allergy also need to be aware a potential allergy to celeriac. Celeriac is a type of celery but the root is the main edible part rather than the stalk. Celery and celeriac are likely to contain very similar allergens and should also be avoided.

How to avoid celery?

The first line of defence is to avoid foods that contain celery or celeriac. It is vital to read food labels carefully every time you shop. Remember that ingredients are sometimes changed. Watch out for “may contain” warnings, which indicate the possibility of cross-contamination during the food production process. You should question staff very directly, asking whether celery is an ingredient of the food you have chosen or whether there is a risk of cross-contamination.

Foods that often contain celery:

Celery salt; Salads; Some meat products; Canned soups; Stock cubes; Pre-prepared sandwiches; Crisps; Spice mixes; Marmite; Batter for frozen foods; Some cured bacon (celery juice can be used); For some people, allergic reactions to cooked celery will take place even after high temperatures are used.

What are the symptoms of celery allergy?

The symptoms of a food allergy, including celery allergy, may come on rapidly (usually within minutes). The most common symptoms of celery allergy are a tingling or itchy mouth or throat, but can also include nettle rash (otherwise known as hives or urticaria) anywhere on the body. More serious symptoms include anaphylaxis.

In conclusion, educating oneself about allergens reinforces the value of continuous learning and self-empowerment. It reminds us that, in the vast world of information, there is always something new and important to learn. Ultimately, the more we understand about allergens and how they affect our bodies, the more equipped we are to make informed decisions about our health and lifestyle. Allergy education is not just a matter of personal interest—it’s a public health priority that deserves our collective attention and action.

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