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Navigating the holidays with your loved ones can be complicated—even in the best of circumstances. What’s your COVID-19 risk? Can you avoid politics (or other uncomfortable topics)? With a food allergy, the big family dinner just gets more complicated. Your friends and family want to celebrate with you, but they might not fully grasp how serious of a reaction you could have.
Certain foods can cause anaphylaxis, which is a life-threatening allergic condition. Every year, 200,000 people require emergency care for allergic reactions to food.
“Some patients with a severe food allergy can experience a reaction after touching the food allergen or even inhaling small airborne particles of the food,” says Sanjeev Jain, MD, allergist and immunologist at Columbia Asthma and Allergy Clinic.
It’s important for everyone to take food allergies seriously—and that includes at the holidays.
What are the most common food allergies?
One thing that you should do if you have a food allergy is get an accurate diagnosis of your particular allergy or sensitivity, says Stanley Fineman, MD, a spokesperson for the American College of Allergy, Asthma, and Immunology.
“Go to an allergist and find out exactly how sensitive you are,” he recommends.
According to the U.S. Food and Drug Administration, the most common food allergens that cause dangerous allergic reactions include:
- Peanuts
- Tree nuts
- Milk
- Egg
- Soy
- Wheat
- Fish
- Shellfish
- Sesame seeds
While peanuts may get a lot of attention for the dangers that they can pose to people with peanut allergies, all of these allergens should be taken seriously.
“All food allergies should be approached with an equal amount of caution,” explains Dr. Jain.
And these allergens can lurk in foods that you might not realize. Those fluffy mashed potatoes may contain a lot of milk, or the squash may have pecans or walnuts mixed in.
How to safely navigate a holiday gathering
As the winter holidays near, you’ll want to be proactive and not make any assumptions. Here are some holiday tips for people with food allergies.
1. Notify your host about your food allergy in advance.
“It is always best to inform the host and guests at a communal holiday event if anyone attending has a food allergy,” Dr. Jain says. That is, it’s important not to assume that your host knows or remembers that you (or your spouse or your child) has a food allergy. They might not think to ask you about it or to make any accommodations.
2. Ask questions.
If you’re going to a restaurant, you should ask the server about the ingredients or preparation methods for certain foods before you order them and emphasize that you have an allergy or sensitivity. If you’re gathering at a friend’s house, you can ask the host about the food or the serving process. Your host may not realize that you shouldn’t use the same spoon to serve dishes, since that introduces the possibility of cross-contamination.
3. Bring your own food.
One way to avoid accidentally triggering an allergic reaction is to avoid eating the food provided at a holiday gathering. You may have to bring your own food that is safe to eat. Yes, you may have to forego your aunt’s casserole or your cousin’s pie if you can’t verify that it’s nut-free (or egg-free, or whatever your allergen happens to be).
4. Don’t eat something if you’re uncertain.
If you don’t know exactly what’s in a dish, it’s better to skip it. It’s just not worth the risk to give someone else the benefit of the doubt unless you know for sure that they understand your food allergy and took steps to address it. If you receive a food gift, it might be time to re-gift it to someone without an allergy. Also, consider wearing medical alert identification, such as jewelry, with information about your allergy.
5. Have an allergy action plan.
If something does happen, it’s important to know what to do. Food Allergy Research Education (FARE) is a not-for-profit organization that provides education, sends alerts, and helps you develop an allergy action plan. You can download an allergy action plan here. You should keep a copy of the plan with you in case you are exposed and make sure your family members and close friends know of the plan as well.
6. Bring your medicine.
If you don’t bring anything else with you to a festive holiday gathering, bring your epinephrine autoinjector. “[People with food allergies] should have their EpiPen with them all the time, especially when they’re eating,” Dr. Fineman says. “That’s a given.”
Keeping an allergy medication, like antihistamines, on hand is a good idea in general to address a variety of allergy issues, suggests Dr. Fineman. Second-generation antihistamines tend to have fewer side effects than older versions. A few you could keep on hand can include:
But these kinds of allergy meds usually aren’t fast acting enough to be useful in a food allergy reaction situation. In other words, if you think you’ve been exposed to your allergen, don’t wait for an antihistamine to kick in—use your EpiPen. You can list all of your medications in your allergy action plan.
RELATED: Everything you need to know about using an EpiPen
7. Give your regrets.
It’s okay to decline an invitation to a holiday dinner or party if you don’t feel safe. Perhaps you can arrange to visit with your loved ones at your home or in a setting that doesn’t involve food.
8. Host your own get together.
When you’re the one in charge of the event, you can ensure that the food will be safe. Volunteer to host your own Thanksgiving dinner or New Year’s Eve shindig and provide all the eats yourself. Then, you can relax and enjoy the celebration.
