When it comes to Thanksgiving meals, the big worry most of us have is that we
'll eat too much. But for millions of Americans with food allergies and on restrictive diets, the real threats are hidden health dangers in many traditional holiday foods.
According to the American College of Allergy, Asthma and Immunology (ACAAI), Thanksgiving can pose a minefield of health hazards to the 1 in 12 people with food allergies, as well as asthmatics. Traditional foods can also create serious problems for those on gluten-free or other special diets for health reasons.
For such individuals, soy and wheat products in self-basting turkeys, milk in mashed potatoes, nuts in side dishes, and even the ingredients in pumpkin pie can cause potentially life-threatening reactions.
"A number of holiday-related triggers can make people sneeze, wheeze or, in the case of food allergies, have a more serious reaction," notes allergist Myron Zitt, M.D., past ACAAI president. "But by planning ahead, the day can go smoothly for people with allergies or asthma."
To help holiday party hosts, and partygoers alike, the ACAAI and its allergy specialists have compiled a list of suggestions to help keep celebrations safe for people with food allergies, asthma, or those on health-related restrictive diets. Among them:
Turkey: That roasted bird is the centerpiece of the Thanksgiving meal, but many self-basting turkeys can include soy, wheat, and dairy ingredients that can cause serious problems for people with allergies. Your best bet: A so-called "natural turkey," which by law must contain nothing but water.
Stuffing: This tasty staple of the holiday dinner goes hand-in-hand with turkey, but most stuffing recipes call for bread and other ingredients that people with wheat allergies and celiac disease — who cannot tolerate the gluten in many grain-based products — should avoid. The safest option: Go for stuffing that is made from wheat-free bread or other ingredients.
Side dishes: The nut bowl is an obvious hazard for people with nut allergies; very sensitive individuals can have a reaction to even to the scent of peanuts. But a host of other side dishes — asparagus almondine, green beens with pine nuts, vegetables sautéed in peanut oil — can also present a risk. If you do prepare foods with nuts, it's a good idea to let guests know what's in them, and if you're allergic and enjoying the holiday with family or friends, be sure ask how dishes are prepared.
Potatoes: Can't imagine Thanksgiving without mashed potatoes? No worries. Just be aware that loading them up with butter, cream, milk, or gravy can make them off-limits to guests with dairy or wheat allergies and those who are lactose intolerant. But you don't have to give up flavor for safety: For allergen-free mashed potatoes, swap the milk and butter for chicken broth and margarine. You can also corn starch instead of wheat flour to thicken the gravy instead of wheat flour.
Dessert: Pumpkin allergies are rare, so that the traditional Thanksgiving pie made from the vegetable isn't usually a cause for concern. But be aware that many desserts are made with hidden ingredients that can cause allergic reactions — from nuts to wheat flour to dairy products. It's a good idea to offer alternative desserts, including fresh fruit and berries. Holiday guests with serious food allergies might want to bring their own sweet treats.
In addition to watching for these hidden food-related health traps, you might also want to discuss strategies with your allergist, who can help you prepare for the holiday season and suggest avoidance techniques for you or any children with allergies you may have or are hosting.
Your allergist also can help you and your child become "label detectives" so you both know what ingredients and common household items to watch out for when visiting friends or relatives, Dr. Zitt added.
For example, some common household triggers include fragrances that can cause wheezing, soaps that can cause allergic contact dermatitis, household pets that can make it difficult for asthmatics and people with allergies to breathe. Dusty holiday decorations, the holiday candles, and even evergreens can all cause allergic reactions. And avoid smoke — from tobacco products, as well as that cozy fireplace — to limit your risk of having an asthma attack.
If you're planning for an extended visit with friends or relatives over Thanksgiving, you will want to be sure to take medicine and emergency medications for your allergies — such as antihistamines, nasal sprays, decongestants, and asthma drugs and inhalers.
"During the holiday season you're going to be exposed to allergens," Dr. Zitt said. "Be aware of where the problems lie so you can deal with them. And then, have a good time!"
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